Ok, I'm getting close to my first appointment at a fertility clinic. I don't think it's technically an RE I'm seeing, as there aren't any within about 3 hours of us. This is the one clinic in the area that specializes in fertility, so I thought it would be a good place to start. I'm in my 8th cycle TTC now, with no luck at all. I'm 33, our donor is also 33, and we are both in good health. I have regular cycles and have no reason to think anything is wrong, but because of our situation using a donor, I want to find out sooner rather than later if anything is! My main question is what questions would you ask in this first appointment? I definitely want to talk about IUI since we are using a donor and need to do AI of some sort anyway. I'm concerned that our at home methods aren't working. I'm worried they won't let me do an IUI without full monitoring, which seems silly given that I have regular cycles with positive OPKs and a consistent temp rise every month. Are there other things I should bring up? Other questions to ask? Anything you did or didn't ask that was really important? Thanks!
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@2farmmoms: how long have you been trying? All of my questions were really geared towards our test results and the plan of action from there. Did your donor have a SA? Did you have any testing done? My husband and I ultimately were diagnosed with unexplained infertility, and even though I ovulate on my own and have regular cycles my Dr still put me on mess (Femara) and monitored me. He said unmedicated iuis have a 4% (I think) success rate, while medicated iuis bring you up to 8%+
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Yeah, I would definitely suggest getting your donor an SA if you haven't already. You'll probably have to go through the whole diagnostic cycle of bloodwork and maybe an HSG or SHG before they even discuss intervention options. I've heard that unmediated IUIs have a pretty low success rate, but they might let you try if you really want to. Good luck!
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I would ask them to run the day 3 labs, a day 3 antral follicle count (ultrasound on day 3 to look at how many eggs you have maturing), and to check your progesterone levels on I think day 21 ( to make sure your luteal cycle is doing its work to potentially sustain a pregnancy). I would also suggest asking for your donor to have an SA with IUI wash (to see how many "good" sperm you'd have if you went the IUI route).
I would also expect to give them details about how you're doing your AI - maybe there's a better / different technique / timing? This is definitely not something I know much about.
Based on your test results and his, there are many options they may have you pursue - medicated cycle, triggering O to have "better" timing, IUI, etc.
You may want your donor to come with you because the fertility clinic we went to had a lot of questions for my DH about his family history and his own medical history that I didn't know all the answers to. Or, you might explain ahead of time and ask if there are forms they can send you for him to complete and you to bring with you. His medical & family medical history are as important as yours, according to our clinic.
I really hope they can help you!
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@MrsKRB: this is my 8th cycle. I know it hasn't been that long but I don't know how long we will be able to use this donor before he doesn't think this is fun anymore so I want to start the process. He's had a SA and I've had basic bloodwork done. How is it possible that IUIs have a lower success rate than the old fashioned way? I thought they were good because they bypassed a few steps.
@ballerinabee: thanks. This is going to get expensive really quickly! I wish my insurance would cover some of it. Good idea about asking for forms for him to fill out about his history. There were a few questions on my paperwork but not many. I'll give them a call at lunch today. I'm really hoping they'll be helpful too!
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Hugs- if you want I can put you in touch with my cousin. She and her wife took a while to conceive and ended up using a home IUI method (but she's a nurse midwife).
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@2farmmoms: I think using medication during an IUI can potentially help in two ways: "controlling" your ovulation to give your doctor a more precise idea of when you will ovulate, and also potentially stimulating the release of more than one egg, which obviously ups your odds of pregnancy.
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@ms.line: oh yes I understand why medication helps, just not why the success rates of IUI (medicated or not) would be so much lower than without intervention. I'd imagine it has something to do with those who use IUIs generally have fertility problems already.
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@2farmmoms: Well, typically you have ~20% chance of conceiving each cycle. Once you have been trying a year/have been diagnosed with infertility, your chances go down to 2% naturally - so technically an unmedicated iui doubles your chances.
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@2farmmoms: Derp, sorry, I misunderstood. Agreed, I think it has to do with the fact that most people undergoing IUIs have fertility issues already.
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@Mrs. Jacks: that would be awesome. I have no friends who have done this so I'm relying on the internet for ideas and connections. Would be great to talk to someone else. You can wall me her email if she doesn't mind?
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@Mrs. Jacks: I've been curious about at home IUI. I know there's no one around here who does it, but there are a couple midwives in the bay area. Sometimes I wish I lived in the city, just for this process. My resources are very limited!
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@MrsKRB: yes that totally makes sense. Thanks!
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Well, I had the appointment yesterday afternoon and I'm pretty happy with how it went. I didn't get as organized as I wanted to and I didn't bring a list of questions, but I felt comfortable with the doctor and I think she felt comfortable with our situation.
We talked about various possibilities, but she agrees that there aren't really any signs that anything is seriously wrong with either of us, so she thinks I should go ahead and try an IUI next cycle with clomid, assuming that maybe our AI method just isn't working well. She isn't going to require a bunch of testing ahead of time, but I think I will have her do the FSH and AMH bloodwork on day 3 just so we have that info. She will do an ultrasound to monitor before the IUI, but will be able to bill it to insurance because she can call it a diagnostic ultrasound because I have pretty painful cramps. I think I will wait one cycle to do the HSG, as that will be completely out of pocket and is $800.
So all in all I'm happy with how it went. She is very young but I also think that helps in that she's more comfortable with our situation, our known donor, etc. We will go ahead and try as usual this cycle (first insemination tomorrow) but plan for the clomid + IUI next cycle if it doesn't work. I'm happy to have a plan!!
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@2farmmoms: I'm so glad your appointment went well. I think that the feeling you get from your doctor is a really important part of feeling good about the plan. Fingers crossed for you!
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So glad you have a plan!
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