MM and fertility

hoffse

@AprilZ81 my luteal phase is 8 days long with spotting on days 7 and 8.  So I have 6 (and at most 7) "good" days. It's happened for three cycles in a row now, so I think that's just my cycle.

I have an appointment with my doctor after we get back from Spain, and in the meantime I'm trying the B6 trick to see if I can lengthen it... but my uncle says that it's so short I'm not likely to get anything to stick, and it might also indicate poor egg quality.

I'm trying to be optimistic that I'll be able to lengthen it without medical intervention, but my uncle said to go ahead and start the process since it can take time to get the appointments set up and the testing done.  I'm going to insist on the full battery of tests, because you are right that it's pointless to do medicated cycles if H's SA comes back poor or if I have blocked tubes.

Thanks for your feedback on costs.  That's super helpful, and it sounds like something we can definitely manage out of our cash flow for now.  I'm still waiting to hear on exact costs, but the estimates I received over the phone ("oh that's about X dollars") are inline with what you just quoted.  I think we are in similar cities from a COL standpoint.

LillibetteV

short+sassy said:

I'm so sorry to hear there might be fertility issues.  Sending my best wishes and good vibes.

It bothers me that most insurance companies don't cover fertility treatments.  It may not affect me personally, but having a child is an important need for a lot of people and it IS medically related, if a couple needs the help of science.  There are a lot of things medical insurance should cover, but doesn't (or it's difficult). 

My friend and I were discussing this the other day but not in the context of cost. A woman asked our local community group about fertility clinics in the area and someone said "just adopt" which made me livid. It may not kill you to never bear children but it's certainly a mental health and quality of life issue. Telling someone their medical issue isn't worth trying to fix is so hurtful and insensitive. A deaf person can survive with various aids and accomodations but does that mean they shouldn't also pursue surgical options to restore their hearing? Of course it doesn't. Medical care isn't  (and shouldn't be) limited to strictly life saving measures. 

vlagrl35

@hoffse - it does sound like you can benefit with a longer LP.  I'm not sure what can help that.  My LP use to be a bit shorter before my loss - probably about 12 days with 5 days of spotting prior.  Since the loss though my LP has gotten longer, it's now 16 days with only 1 day spotting prior.

Xstatic3333

@hoffse I know everyone is different, and certainly trust your uncle since he's a doctor, but my LP was 8-9 days for my first 6 months or so off BCP, despite 30 day cycles that otherwise appeared quite regular. We weren't trying right away, but I was temping to learn my cycles and to avoid. I don't know how long you've been off BC, but if you came off pretty recently things could still improve on their own. My LP was up to 11/12 days when I did get pregnant after six months of trying. 

In any case, I'm sorry you're in this position and hope a solution appears quickly for you to start your family!

AprilZ81

Obviously your uncle (and other doctors) are more knowledgeable than I am, but your short LP could be helped by taking progesterone supplements after ovulation.  There is an oral, vaginal and needle based option if it gets to that point.

Clomid and Femara will help with that as well because you tend to produce more than one follicle and each follicle creates progesterone after ovulation.  

Some women don't respond well to Clomid, I did three cycles.  The first we got pregnant but miscarried at 6 weeks (mostly likely due to low progesterone not being able to sustain the uterine lining), the second just didn't work and the third I never ovulated.  Don't be shy about telling your doctor when you are ready to move on to another treatment and also don't let him/her railroad you into a different/more expensive treatment if you aren't ready.

hoffse

Xstatic3333 said:

@hoffse I know everyone is different, and certainly trust your uncle since he's a doctor, but my LP was 8-9 days for my first 6 months or so off BCP, despite 30 day cycles that otherwise appeared quite regular. We weren't trying right away, but I was temping to learn my cycles and to avoid. I don't know how long you've been off BC, but if you came off pretty recently things could still improve on their own. My LP was up to 11/12 days when I did get pregnant after six months of trying. 

In any case, I'm sorry you're in this position and hope a solution appears quickly for you to start your family!

Thanks, that's good to hear!  I went off BC in August, so it's been about 7 months now.  Based on the timing of my doctor's appointment and the tests I will need to have done I will probably have at least two more cycles under my belt before starting any medication.  Hopefully my cycles will improve by then!

@April my uncle suggested the Clomid/Femara+progesterone regime is the thing I will most likely need.  Obviously we need to do all of the testing to confirm his suspicions.

vlagrl35

I personally suggest the suppositories when it comes to progesterone.  Don't take the pill.  I got dizzy, very tired, nauseous, heartburn, and puked with the progesterone pill.  I'll be trying out the suppositories next week.  I'm nervous about it because of all the side effects I had with that pill.

AprilZ81

You may not need the progesterone supplements (pending test results of course).  Other than my first cycle on Clomid my progesterone numbers were great on the ovulation inducing meds alone.

I hope the solution is an "easy" one though, infertility sucks!

LillibetteV

The TTC boards on Weddingbee are also really great to get more info/support on infertility issues - they helped me a lot. I have found that experiences vary wildly between women. I did progesterone in oil shots for 10 weeks and they were fine, but I know other women hated them (my clinic doesn't allow suppositories because they don't find them to be as precise and effective). Clomid is always seen as an "easy" fix but my side effects were personally so bad that I refused to take it again and found IVF side effects to be less severe. Bodies are weird.

als1982

LillibetteV said:

The TTC boards on Weddingbee are also really great to get more info/support on infertility issues - they helped me a lot. I have found that experiences vary wildly between women. I did progesterone in oil shots for 10 weeks and they were fine, but I know other women hated them (my clinic doesn't allow suppositories because they don't find them to be as precise and effective). Clomid is always seen as an "easy" fix but my side effects were personally so bad that I refused to take it again and found IVF side effects to be less severe. Bodies are weird.

Amen to this.  I've had several docs and others question and doubt my symptoms.  It is beyond frustrating when people and caregivers think they know it all.

vlagrl35

LillibetteV said:

The TTC boards on Weddingbee are also really great to get more info/support on infertility issues - they helped me a lot. I have found that experiences vary wildly between women. I did progesterone in oil shots for 10 weeks and they were fine, but I know other women hated them (my clinic doesn't allow suppositories because they don't find them to be as precise and effective). Clomid is always seen as an "easy" fix but my side effects were personally so bad that I refused to take it again and found IVF side effects to be less severe. Bodies are weird.

for real! the body is weird.  If we ever had to do clomid I would ask for femera instead.  I've heard its less side effects, but then again a friend of mine tried it and it busted a cyst on her ovary and she ended up in the ER.

AprilZ81

I had little/no side effects on Clomid or Femera.  I had a few hot flashes on Clomid, but nothing else that people complain about.

The key to both drugs and infertility treatments is proper monitoring and dosage.  Without the proper monitoring you can end up permanently damaging your fertility or high order multiples.  Most OB/GYNs will give out Clomid like candy but without any monitoring or proper testing.

vlagrl35

that's what I've heard @AprilZ81 - which is why I'm hesitant to take it although it hasn't been recommended for me.  I would hate to have more damage done to my body.  I was given progesterone pill at 200mg and I think that's too much of a dosage for someone my size.  I'm basically at the point of just going with the flow regarding TTC right now.  I've let go of the control and now it's time to just sit back and enjoy the flow.

brij2006

AprilZ81 said:

I had little/no side effects on Clomid or Femera.  I had a few hot flashes on Clomid, but nothing else that people complain about.

The key to both drugs and infertility treatments is proper monitoring and dosage.  Without the proper monitoring you can end up permanently damaging your fertility or high order multiples.  Most OB/GYNs will give out Clomid like candy but without any monitoring or proper testing.

This statement is 100% true and very common.  Our OB gave Clomid like it was candy.  When I went for my annual last April I told him we had been TTC#2 for almost a year now and my cycles were long like last time.  He wrote me a script for Clomid and gave me the papers to get a blood draw on CD21 to confirm ovulation and test progesterone.  That was it.  But I knew better and didn't fill it.  That's what we did the first time I took clomid and that pregnancy ended in miscarriage, which during the ultrasound they confirmed there was evidence of a twin.  The first time we did clomid with him, he chatted with us about selective reduction at the CD21 visit.  At that point I had already ovulated so it was too late to do anything.  We're very anti-selective reduction (just our beliefs) so it was a smack in the face for us that he was discussing it so calmly and that it was something he encounters occasionally.  That was when I knew we'd never do another round of Clomid with an OB again.  We had no clue how I responded to the medication because it wasn't properly monitored, and we didn't want to put ourselves in a situation of even needing to discuss selective reduction.

*TW/LW*
A girl from my IF mom's group did clomid with her OB not knowing the difference in monitoring between an OB and RE.  Her 8 week ultrasound showed 4 babies.  At 12 weeks they went in and reduced 2 of them.  She has twins and has discussed how much it has hurts her and her husband knowing they looked at an ultrasound and choose which 2 babies to keep and which 2 to reduce because it was harmful to her body to carry 4 to term.  She is very vocal now about informing women the difference in monitoring between the 2 so other couples don't have to go through the same thing they did.

LillibetteV

@brij2006 OMG that's so horrible for your friend! The one time I did Clomid I was on a low dose (50mg) and had regular monitoring. My RE was on the fence about canceling the IUI because I had 3 follicles at the time, but eventually decided that the risk of triplets was very low given my husband's sperm issues. Normally he cancels if there are 3 follicles and no male factor issues and then instructs the couple not to have sex. His gamble was right and we didn't get pregnant that cycle because we needed IVF. 

vlagrl35

woah! holy crap @brij2006 - well that confirms it to me that I would only do clomid with an RE if it came to that.  Proves too that the risk of multiples is high with clomid.  eek!

Xstatic3333

What a sad story @brij2006! It seems insane to me that OBs would use selective reduction instead of early cycle monitoring. 

brij2006

You and me both @Xstatic3333 When the OB recommended clomid this last time I flat out asked him if there was any way I could get monitoring prior to CD21 so we could see how my body is responding to the medication.  He said he didn't see a reason to since I responded well to it the first time we were TTC and it resulted in a pregnancy (not a viable one).  I was surprised that he was so "no" about it even when someone asked.  When I moved my stuff to the RE they asked if there was anything they could do that would have kept me there.  I said properly monitor their fertility treatments.
What's worse, this OB and facility does all the way up to IVF.  They even advertise on him being one of the OB's in office that specializes in IF.

hoffse

I called the clinic in Mobile yesterday, and they were great.  They recommended that since I'm long-distance I start with my OB for the first round of testing, etc. I need done.  They also said I could do clomid or femara with my OB if the OB agrees to monitor.  They said that if my OB does not agree to monitoring to call them and they will take me over as a patient.

I actually really appreciated their willingness to work with me, but also keep me as local as reasonably possible.  She said that she would love to have me as a patient, but that she thinks most of the OB's in B'ham will do monitoring if the patient asks for it, so I should start there if my tests indicate that this is all I will need.  She did say that if testing reveals further issues I should call them again, and they will look deeper.

I'm very happy to have a plan of action.  I am headed to Spain the last week of March, and I am meeting with my OB the week I get back.  That appointment will pretty much determine whether we proceed with the OB or not.

In the meantime I will hope that my body is just taking its sweet time adjusting to being off of BC like @Xstatic.

julieanne912

@hoffse this may not solve your problems, but have you tried out any ovulation predictor kits?  I was getting frustrated with temping by itself because I felt like I was missing the race, so to speak, since the temp doesn't go up until after ovulation has happened.  This cycle was my first attempt with OPKs and I really liked knowing a bit sooner about when the best time was.  I'm sort of regular, but not entirely, so it was hard to nail it down to the day every month.  My OB recommended the ClearBlue ones... bit pricier, but very easy to use and read.  Anyway just a thought.  I start testing this weekend so we'll see if they actually really did help!

vlagrl35

I also use to use the digital OPKs when I did - they are a bit pricier but there is no guess work because it gives you an instant smile face if you get the LG Surge.

Glad you feel good about your plan of action @hoffse - it does sound very promising.  Good to know you need extra monitoring with clomid.  Something I will ask other OBs about considering I'm about to interview a few more.  I know my OB only does the progesterone test with clomid.  I'm hoping I just need the extra Prog. to increase my lining for a seed to nestle into.

Xstatic3333

That sounds like a great clinic and plan of action @hoffse! I'm rooting for you!