Planning session Part 1

Today was a short day at work, but it felt like a long day. It started with a baseline appointment bright an early at 7:45am. I think I was one of the very first patients to get in there. Everything is quiet so we are ready to start tomorrow night with 50iu of Follistim again. I start tomorrow night and keep going through sunday night and then go back Monday morning for my first monitoring visit.

While I was there the nurse tells me that the way I heard the information from my patient coordinator is a little bit different. She says the RE wants to meet with me either in the middle of this cycle or after this one instead of it being my choice if I want to meet with him or not. That made me nervous. I know what is coming. He wants to put a cap on how many injectable cycles I’m going to do, to talk about doing the diagnostic tests/lap, and to talk about our next steps. That scared me this morning because I don’t think that the hubby and I are ready for IVF. It’s a lot of money and I don’t think I’m emotionally ready. I’m also scared of it. In addition, I will not be doing IVF until I can conquer those two tests – the sono and the hsg because I don’t see the point in spending boku bucks and not knowing if something is up. Some of you might say they don’t see the point in cycling now without those tests, but that was my choice.

I got out of my appointment with time to spare before work so I started googling on my ipod touch. I started reading about sono’s and they seem very similar to an iui. The only difference seems that one is injecting saline and the other one is injecting sperm. I’m sure there are small other differences, but you see my point. The first time when I was thinking about doing a sono was before I had ever had an internal ultrasound. I was scared and really nervous. However, now that I have completed five cycles I’ve become very good with internal ultrasounds and having people down there so I’m thinking I might do a little better. I can hope at least. So I started thinking. In googling I found that your supposed to have them after your period and before ovulation. So I called my RE and asked if I should have one of these this cycle to get it out of the way. Another reason I wanted to see if I could do it this cycle was because if I could tolerate it that means I could probably do the iui as well. I know it’s an easy procedure and you guys have had dozens, but for me it makes me nervy. Anyways – they called back and said to wait till I talk to my RE and see what our next steps were and that she didn’t want to interrupt this cycle. So no go on that right now.

I did however, have a conversation with the hubby when he got home. I was feeling down and like having kids was not in our future since we just finished one injectable cycle with a bfn, the RE is wanting to talk next steps already, and that we will not be doing ivf at least not now. I wanted to see what he wanted our next steps to be before we ever go talk to the RE. I did schedule our appointment for next friday so we will see how that goes. That will bring the entry planning session part 2.

Anyways – he said we have only done one cycle of injectables and it seemed to work well. He said I shouldn’t give up hope on that yet and asked if the odds go up each time you do an injectable cycle. I think so, but I don’t know what the numbers are. He asked me what the odds are on getting pregnant with injectables and I wasn’t sure. He said maybe I should focus on trying the easiest diagnostic test – the sono – and see if I can do it and how I do. If I do well then I can try the hsg with my extra courage. If I can’t do it he said that is ok too. He said he thinks we should at least do three to four injectable cycles, but I’m not sure what the norm is. I’ll have to ask my RE. We didn’t really come to an ultimatum. He basically said we will try this cycle, possibly do a diagnostic test, and then see where we are and plan again. It’s hard to leave it just at that because I am a planner and want to know how we are going to get to our goal if injectables don’t work, but I guess we aren’t there yet so I don’t need to freak out as much just yet. I’m sure that won’t stop me though.

Also, thank you all for your great comments on my last entry. You all gave me a lot of things to think about and ponder. Question though – a lot of you mentioned your cervical mucus and how that prevented you from getting pregnant. How did you know your not getting pregnant because of your cervical mucus? I know very little about my cervical mucus. I haven’t really checked, but I don’t think I have that much. I googled one page on checking it, but it sounded kinda gross and I clicked off. Are there ways of figuring this out without having to examine it?

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13 Comments

  1. hollytraveling

    I don’t know much about anything so I can’t offer any wisdom on the cervical mucus question. Sorry. I think your hubby is right though, don’t give up hope. I totally get the fear about conceiving and I totally get the IUI/IVF fear. Hang in there. There’s no reason to jump to the conclusion that injects won’t work until you get there. Remember it’s still your game until then. It’s good to plan but you still have time.

  2. Lol about the googling. I have successfully stayed away from that, I have been doing well with asking any and all questions of the doctors. I am surprised you get to wait so long before you have a monitoring apt. I have my first on Saturday and then another in Monday after my basline today. 🙂

  3. Yay for starting a new cycle! Fingers crossed this is the one and you won’t need to even think about IVF. Sorry, I don’t know much about CM, except that I never really had any before going on Clomid.

  4. So glad to hear about the next cycle, very exciting. No advice on CM but I know these smart ladies will have something good to tell you about it. Thinking of you and crossing it all. xoxo

  5. I know the mucus is supposed to aid the process by helping the sperm get to their destination. My OBGYN suggested that I use an Expectorant (Make sure it ONLY says expectorant and is not a combo type) Cough Syrup around my ovulation dates and to use it 2-3 hours before the BD during ovulation. I was able to find the expectorant syrup at WM for like $3 so it’s a cheap option. He said although it’s meant for the sinus area it will make all the mucus in your body thinner, which is a good thing when it comes to cervical mucus and the sperm journey. I started using this option in November which also happened to be the month we finally got pregnant, not sure if that was the key to progress or not?!?! But I have continued to use it since the miscarriage and I can tell a difference in my CM.

  6. My RE swabbed a sample of my CM when I got a positive OPK (or they detected an LH surge). Basically they told me to BD that night and the next morning they took a sample and put it on a microscope slide. Then they examine it and let me see it, too. We did this several times (with me taking expectorant and without, medicated and unmedicated cycles). It should have been stretchy and thinnish (like egg white) but mine was ALWAYS too thick. You could easily see DH’s poor guys trying so hard to swim in my CM but they were pretty much stuck or barely moving. I kinda knew this from charting since I almost never got EWCM at peak time. Some women have the opposite issue with hardly any CM — that is bad for sperm, too, because they need receptive CM to swim up to the egg. I had to have IUI for any chance at all. My RE gave us a 10-20% chance with injectibles + IUI (vs. 8% on Clomid). I did 4 rounds Clomid+IUI and 1 round injectibles+IUI but unfortunately got all BFNs. I now know I have egg quality issues so I guess it makes sense.

    (sorry if this is TMI, but I wanted to be clear since you asked!!)

  7. Yah, I wouldn’t give up hope on the injects yet, either!! I definitely don’t think you have to jump to IVF right now, especially if you’re feeling like you’re not prepared (emotionally, financially, whatever-lly). Will be praying that God has your baby blessing coming to you this time!

  8. Definitely only do what you’re comfortable with at the time – IF is hard enough without adding more worry to it. I feel like there are so many more things to try before IVF. As for the IUIs, I literally never felt them, I did feel the saline sono a little, but still barely nothing. The catheter they use is so so so thin, a little thicker than thread. Again, I’m not trying to convince you, only telling you my experience. As for the CM, I’ve never had it tested, but I did read about it. Sometimes it can be “hostile”. You may want to have it checked out like sonja described. If you don’t have enough CM, Preseed is suppossed to mimic it pretty well. I hope this cycle works and you don’t have to think about anymore planning 🙂

    • what other things are there besides ivf?

  9. Well, yay for kicking off this cycle. And I agree with some of the comments above, you totally don’t have to give up on injects yet! And you certainly don’t have to rush into IVF if you’re not ready, hoping you can avoid making that decision at all when you get your BFP this cycle!!

  10. EC

    I agree with the other comments. I would think your RE would be willing to let you do 3-4 cycles of injections, unless he is willing to let you do something like 3 cycles with follistim and then 3 cycles with some other kind of medication (like another injectable). You seem to be responding well on follistim, so I would think he would let you do another 2-3 cycles of that. I think the chances are somewhere around 15-20% per cycle, but unfortunately, I don’t think that necessarily increases each time. I think it’s 15-20% no matter how many times you try it, but it seems like some people do use more of a cumulative percentage (ex: 15% chance from cycle 1 + 15% chance from cycle 2 = 30%). I always think that sounds low, but that’s really close to what the chances of getting pregnant are for any average person not dealing with infertility.

    As far as CM, I think some doctors emphasize it more than others. They used to do a post-coital test where they tried to determine if CM was hostile, but most doctors have since found that the test is not reliable. Some still do it, so I guess it’s a matter of opinion. I think a lot of doctors prefer to do IUI than to bother to figure out if CM is an issue or not, but I think part of it has to do with the fact that the tests for it are just not conclusive enough. It sounds like some of your commenters have had different experiences, so maybe it depends on the RE.

    • EC

      I almost forgot – Good luck, and I hope you get your BFP this cycle – so you don’t even have to worry about it!

  11. I’m glad you aren’t giving up yet! It does seem like your body is responding and maybe it just needs another try at it…I’m praying for a BFP this cycle! LOL, I just googled for you and it looks like EC gave you all the percentages you needed and she is right on, so GOOD LUCK!

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