Hi girls,
Well, after 4 failed IUIs (3 on clomid, 1 on clomid & pergonal) and this month "au natural", it looks like AF is on her way again. I will most likely see my RE early Monday morning and I have been compiling a list of questions to ask him, to help give me a better handle on what's going on. I'd love your input on this list of questions and perhaps your suggestions for questions I might want to include:

1) Could I have mature follicles and a trigger shot and still not be releasing the eggs? Is there anyway to verify if an egg is released from the follicle before the IUI procedure?

2) In your professional opinion, why do you think the past IUIs were unsuccessful? How likely is it that we would get a different (positive) result with more injectibles/IUI cycles?

3) What are the real benefits of doing 2 IUIs over two days (my DH sc is 10 mil post wash (less, I believe if only 24 hours pass in between).

4) Is it possible to collect and freeze his swimmers over a course of a month, save them up til they are a greater number (like KJinky's dh's supersperm http://www.healthboards.com/ubb/biggrin.gif), and then IUI?

5) Why do the OPK tests NEVER show that I have had a surge - even when I test the mornings of my IUIs?

6) If we had all the money or the best insurance coverage in the world, what protocol or procedure would you recommend for us to achieve optimum positive results? (And since we have little money and crappy insurance, how does our affordable protocol compare)?

7) Don't you think REs should give patients those Coffee Bean-type punch cards -- like, pay for 5 cycles of meds/IUIs and get the 6th one free?!

What would you ask?

Thanks for your input!

Laura

TTC (aggressively) since Nov 2002
33 yrs old, pcos (outer symptoms, RE says no)
married DH in 1995; he's 38 now.

Have you had the full battery of diagnostic tests? If not, you should see what other ones your doc recommends. Do you have a diagnosis or is it unexplained?

I think I know the answer to a couple of your questions. #1, an ultrasound the morning of your IUI will show whether you've ovulated (follicles will have ruptured), as will a blood test. #2, I've heard a number of RE's say that there's not much point in doing any given protocol more than 3 times (e.g. 3 tries with Clomid/IUI, 3 tries of injectibles/IUI, etc.). If it hasn't worked in 3 tries, it's unlikely it will work. (Of course there's always a chance). And #6, I've been told that the typical chance of success of Clomid/IUI is 12% in any given cycle; injectibles/IUI is 20%; and IVF is 50%. All of that of course depends on your age, diagnosis, clinic, etc. But those might be some guidelines.

It sounds like you're thinking well about all of this and should get some good answers from your RE. Good luck!

rachellara,
Thanks for your input. I have had all the tests and supposedly the only obstacles in getting pg are 1) I don't seem to ovulate on my own (despite pretty regular periods) and 2) DH sc is 10 mil after wash.

Our RE was very confident in the beginning, and maybe he still is. But sometimes I feel like he has a method to his madness, and I'm not sure what it is. Plus, if IVF is $10K, and each injectible/IUI cycle is at least $1K, I'd rather cut my losses and start saving for the IVF (if he's not still confident that the IUI could get the job done).

It's sad how desperate I feel to take some control over or at least understand this infertility business. But there are no guarantees...

L

I think it's great that you're taking control over your situation. It's true, there are no guarantees, but you're going about it the right way -- asking questions and expecting answers. You need to understand your RE's plan for you and the reasoning behind his recommendations. As a patient, you're entitled to that. Some RE's are better than others at communicating, and you definitely need to have one who is good at keeping you informed so you can make the right decisions along with him.

It's so hard when you have to pay so much for these treatments. It sounds like you'd be a prime candidate for IVF, especially with the low SC. See what your RE says. Mine was totally understanding when I wanted to skip injectibles/IUI because of our insurance situation. He said there was nothing wrong with moving to IVF after having tried Clomid. In an ideal world, you'd try all the least invasive treatments first, but in the real world, we're not getting any younger and money/insurance doesn't grow on trees. My attitude improved immensely when I started IVF because after the frustration with IUI, I suddenly felt like we were doing the thing that gave us the best chance. (Still don't know whether it worked, but mentally it was easier for me to handle than IUI.) It might be worth taking a break and saving up for an IVF cycle if your doctor thinks that's right for you.

Good luck, and be insistent that you get answers to all your good questions!

laura - i love your number 7!! that is sooo cute!:-) your questions all seem very well-thought out. if i think of any others, i will let you know... hugs, jen

Hi Laura!

I will be trying OPK next cycle as I have a feeling that I ovulate 2-3 days after my IUIs (judge that from the mucus)so I'm interested what he says to number 5. It crossed my mind to have u/s done to see if that egg(s) have actually released too. Sometimes I wonder if you could buy or borrow u/s somewhere I do your checking at home any time! I don't think we can afford it so...

You could also ask if your follies have thick or thin outer layer if the sperm can get in... My RE told me that my last egg had a very thick layer (after it was unsuccesful of course!!!!)

I like number 7 http://www.healthboards.com/ubb/smile.gif It might be like that one day...

The best of luck, Sarka

Jen, Sarka & Rach -- thanks so much for your input... seriously, if you think of any other questions (even smartazz, sarcastic ones!) let me know.

Sammy, on another posting said something about ordering her meds from a pharmacy in Italy! Her stuff costs $12 a vial + $40 shipping total! Can you imagine? 20 vials of pergonal for $280?!! I was paying close to $50 for one vial -- that's like, buy 6, get 14 free!!!!!

http://www.healthboards.com/ubb/dance.gif

I'll have to ask my RE about that for sure!!!

xoxoL




[This message has been edited by laura1 (edited 08-02-2003).]