Just to quickly update, I called my GP yesterday to double check that the referral had actually been sent and found out that he’s leaving the practice (this Saturday - thanks for letting me know…) and I’d have to talk to him to see if he sent it. So luckily there is another doctor there taking new patients and I was able to make a meet and greet appointment for mid-February. Kind of disheartening since this will just add more time.
Oh well.
Hello - IANADoctor, but I am an executive at a company that manages Fertility MD practices.
A few points -
see a Fertility Specialist - a Reproductive Endocrinologist (RE) - as soon as you can. OB’s and GP’s often want to cycle through a number of treatments that can take years while your clock is ticking. Some of those approaches make GOOD sense, but if your causal factors will NOT allow those treatments to work, why waste time on them? Seeing an RE is more likely to help you understand which factors you and your partner are dealing with - they can put you on a more likely treatment path more quickly.
14 states in the US have “mandated” coverage in some form or fashion - make sure you understand if you qualify for reimbursement and if so, for which specific treatments.
Research is showing that IVF - normally thought of as the end of the treatment chain - is so successful vs. other approaches that it may (remember IANADoctor) make sense to really scale-down pre-IVF treatments (e.g., only do 1 - 3 IUI’s before moving on, not 20!!) before jumping to IVF.
Check into Multi-cycle IVF Treatment plans - some RE’s offer them on their own; others offer some packages from ARC and others offer the Shared Risk (recently renamed “Attain IVF”) Program from IntegraMed. Basically, you pay roughly the amount of 2 cycles of IVF and qualify for up to 6 cycles of treatment. This can be a BIG deal for a couple of reasons: 1) research shows that when a woman knows she has a lot of attempts lined up, over 95% claim that this helps them de-stress, which they feel increases their likelihood of getting pregnant - they know they can try again; and 2) Current IVF success rates for a single cycle of IVF average to about 40% (for women under 35 with standard fertility problems - this is according to SART, the national Society for Advanced Reproductive Technologies, which most U.S. RE’s are members of). If, however, you commit to 3 cycles of IVF, your chances of success ALMOST DOUBLE - to ~78%. Because IVF cycles can be so expensive, patients mentally calculate on a per-cycle basis. This is NOT optimal as the data I cite suggests. Instead, for a bit more money (on what is already, granted, a big $$ amount) you can increase your chances a LOT, obviously…
There are a LOT of options - you might consider books like **Conceptions & Misconceptions **by Wisot (one of the MD’s my company works with) or the **Infertility Survival Handbook **by Elizabeth Swire Falker (whom I have met but don’t work with…).
Best of luck - hope this helps,
WordMan
Boy, ain’t that the truth.
Lady Chance and I ditched any form of protection in our late 20s and for years nothing. It was tense but we didn’t do anything about it…
You see where this is going, right?
In mid 1999 we headed down to New Orleans for a week and a half or so. Spent the days touring swamps and feeding alligators and such and the night plastered out of our minds and doing midnight ghost tours drunk and such (I recommend the ‘Highway to Hell’ bar, myself. If I could remember where it is I’d go back but it’s very blurry.).
Nine months later along comes our first.
I’m not trying to minimize the efficacy of fertility doctors but sometimes relaxation can help quite a bit. Nobody benefits from stress.
We have a copy of this New Yorker cartoonup in the office… (the pic I found is small - sorry…)
My wife had a history of endometriosis, and had a couple of surgeries to deal with it. Pregnancy via the usual way wasn’t happening, so we did IVF several times. On the first attempt, they retrieved 3 eggs, but none of them fertilized. On the 2nd attempt they modified the fertility medications (producing more eggs) and we also had them do ICSI (which injects the sperm directly into the egg). At one point she became “over stimulated” and needed to go in for a full day of intravenous medication. Some fertilized OK, and we got positive pregnancy results for awhile, but then we found out it was ecotopic. The doctor said (wildly paraphrasing here) that it is normal for a fertilized egg to sometimes drift in and out of a tube before implantation. So they went in to deal with the ectopic (and ended up removing that tube), and also put a clip on the other tube to prevent a fertilized egg from drifting into a tube again. We attempted IVF with ICSI a couple more times, transferring about 4 reasonable embryos each time, but none of them took. At our last meeting, the doctor recommended that we not try again.
We pursued adoption, and two years later we brought home a boy and a girl from Russia.
EmAnJ, you say that you are monitoring using charts and temperature readings but are you also using ovulation tests?
When my wife and I were trying to get pregnant, we first relied on guess work to determine what time she thought was best for conception.
When that didn’t work, upon the recommendation of our sis-in-law, we purchased an OTC Ovulation Predictor Kit like this one
and within the second month, BINGO it worked like a charm.
Well you could always try NOT to get pregnant. Seemed to work fine for me and many many others 
Either way, relax, don’t stress and have fun. Good luck!
Thanks. I know it sometimes isn’t successful, and am fully open to adoption. We’ve already started looking into the process just in case.
minlokwat, I do have OPT’s at home but I haven’t used them much, so perhaps I should start. When did your wife start testing…I mean, did she guestimate when she was ovulating and start testing for it a few days in advace? Was it trial and error for the first few months?
Really my wife would have to handle the specific questions as I was merely the willing participant.
Let’s see, we went about six months with trial and error and guesstimation on her part. Our sister-in-law told us that she and my brother pursued the same path for about the same length of time and that when she got the ovulation tester it would pinpoint the best / most fertile window of opportunity, so to speak. After about two months using that, they got pregnant. If I recall correctly, my wife got the OPT kit in May and we evidently conceived our child in August. I have no idea as to the specific steps she followed other than complying with the directions that came with the kit. Hope this helps and I wish you the best of luck.
If you know the length of your cycle, the OPK you’re using comes with instructions to determine the day you should start using them. For a regular 28 day cycle this may be around day 10, in order to catch the surge a day or so before you actually ovulate (i.e. the OPK pick up the hormone surge that makes the ovulation happen, not the actual ovulation itself, acting as an early warning system).
Test every day leading up to ovulation, ideally late morning or early afternoon (not from first morning urine), but they recommend not drinking too much water, and avoiding the toilet for a couple of hours in advance - basically you want your urine nice and concentrated. Once you start seeing a line (even if it’s not as dark as the test line), start testing more than once a day. The surge can be over and done in less than 24 hours, and if you’re testing only once a day, you can miss it. Once you start seeing a darker line, start getting busy! And continue once every two days until your temp shift and CM indicate ovulation has happened.
You might want to read about the Sperm Meets Egg Plan - has some useful OPK timing advice. Also, I found the book Taking charge of your fertility a great resource when temping and checking CM - lots of info about timing things correctly, as well as other factors to fertility.
Good luck with your new GP, and remember that time is precious when it comes to this - having has much time on your side for tests and treatments as possible is important. Chase up your doctor, request a referral, demand the treatment and test protocols that you want. At the end of the day this only matters to you and your partner, and you need to take charge to get the outcome you want.
For what it’s worth, I heard about The Fertility Diet book on NPR - Walter Willett seems to know what he’s about, and use actual research to base his books on.
A lot more couples have fertility problems then you hear about. My husband and I tried for almost 4 years, including 3 IUIs and 4 IVFs, before conceiving our son on the last IVF. I was lucky enough to find an infertility support group; we helped keep each other sane.
I would recommend seeing a Reproductive Endocrinologist (RE). Also try the OPKs or another ovulation kit such as ClearPlan Blue Easy. I would stay away from the saliva kits, though. Also consider finding a support group, either local or online. My support group leader said that one study showed that women going through infertility treatment had the same rate of depression as someone with metastasized cancer. I believe it.
My support group had about 20 women in it; after about 2 years everyone had a child. Most biological, but also a few adopted.
A year and a half after my son was born, we went back to a RE to see about conceiving #2 without IVF. RE said we had about a 5% chance of conceiving naturally without IVF. Next month I became pregnant naturally and had a daughter. So go figure.
A human can be the father of a hamster, but curiously, a human cannot be its mother. Only a biological hamster can do so. Technically a hamster’s mother is called its dam.
When a hamster egg is fertilized by sperm, the hamster embryo is usually implanted into a different hamster’s uterus, who then gives birth to it. The new mother treats the baby exactly as she would her own.
This is called the New Hamster-dam.
And finally…your life’s dream of finding a thread where you could legitimately post that joke has come true.
We’ve been trying for over two years at this point (over 30 cycles), and been through all the tests (apart from the hamster one! I want the hamster test!). Although my husband’s semen analysis indicated that he had motility issues, neither of the fertility doctors we have seen seemed too concerned. I also had a large ovarian cyst removed last year, and lost an ovary, but again, the doctors didn’t seem to think that this was an issue either. I guess we are currently sitting on a dignosis of unexplained, which is very frustrating.
We have also been through the whole predicting ovulation bit (I am using a Clearblue Fertility Monitor - you can get them cheapish second hand and they give a good indication of not just when you ovulate, but also the run up to ovulation), but this hasn’t helped me get pregnant. Just because you know exactly when to have sex doesn’t necessarily mean that you will get pregnant, unfortunately.
Like you, I started by going down the route of getting a referral from my GP, but soon realised that the waiting times on the NHS were just too long (we’re in the UK)- about 2 years from referral to treatment. We decided that we couldn’t wait this long, and are going to pay privately for IVF in the next few months. We are not trying any intermediate steps (IUI) as, frankly, the stats don’t really indicate they are very useful, and with one ovary, I have been advised not to do a medicated IUI.
Do you have the option of speeding things along by paying privately. I don’t know how the Canadian system works. Depending upon your age, you might want to hurry things along a bit.
I think the worst aspect about all this is the emotional side of things, and if you can find support from somewhere all the better. I think the best thing I did was give permission for myself to be angry about the whole situation. I don’t express this side to many people, but it is normal to feel like this sometimes. There’s lots of information online, and some great blogs. These have really been a help to me when the people around me have not understood why this is making me so crazy.
Good luck!
I think I know what the problem is.
