TTC: Fertility Treatments

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TTC: Fertility Treatments

Postby MapleSyrup » Tue Jul 02, 2013 8:55 am

So my "TTC Saga" thread is getting really drawn out and truly is becoming a "saga". :(

This new thread is still about TTC, but I wanted to discuss the fertility interventions specifically, because it looks like I'm going to be taking another step up the "intervention ladder".

I've been taking Clomid for the past 3 cycles...

Month 1: 50 mg per day x 5d--- progesterone @ 3.2 (should be over 15---FAILED)
Month 2: 100mg per day x 5d--- progesterone @ 5.2 (FAILED)
Month 3: 150mg per day x 5d---progesterone @ 3.3 (What?! ---FAILED)

So here I am... nearing the beginning of cycle four and my OBGYN has basically said Clomid has failed and I need to come in for an appointment to discuss the next step. So my question to you all is--- what are my options?? Anyone else have fertility interventions beyond Clomid? What steps did you take?

I am so frustrated and upset. I can't believe my stupid body won't cooperate at ALL!!! :x :(
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Re: TTC: Fertility Treatments

Postby Princess_Bear » Tue Jul 02, 2013 1:46 pm

I'm sorry I can't remember all the details of your journey up to this point. I think I remember that you did a semen analysis and everything there came back okay?

I suggested trying Femara on your other thread, but I didn't see where you ever responded to that suggestion. I know some women who don't respond on Clomid do respond to Femara. Not sure if that would be an option for you.

I think I remember that you had an HSG to check that your tubes were clear, correct? (Just trying to recap...)
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Re: TTC: Fertility Treatments

Postby MapleSyrup » Tue Jul 02, 2013 2:15 pm

Princess_Bear wrote:I'm sorry I can't remember all the details of your journey up to this point. I think I remember that you did a semen analysis and everything there came back okay?

I suggested trying Femara on your other thread, but I didn't see where you ever responded to that suggestion. I know some women who don't respond on Clomid do respond to Femara. Not sure if that would be an option for you.

I think I remember that you had an HSG to check that your tubes were clear, correct? (Just trying to recap...)


Yes, to recap...

DH has a semen analysis... all normal
HSG done... normal
Blood test for hormone levels...normal


Also, it's not that I'm NOT ovulating... I have typically been ovulating LATE in the month (around CD22) and get my period around day 36... so I don't really understand the point of an ovulation stimulating drug like Clomid... it did not succeed in moving up my ovulation a week. I really don't understand WHY we haven't gotten pregnant! Everything seems "A-Okay", biologically speaking. :(

Femara... I don't recall the suggestion, but perhaps it got lost in other replies/ideas... so my apologies! What is it? is it an injectable or oral medication? Have you had experience with it?
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Re: TTC: Fertility Treatments

Postby Princess_Bear » Tue Jul 02, 2013 3:07 pm

I believe it's a pill, just like Clomid. It's used the same way, early in the cycle, for about five days.

I've never taken it personally, but I know of a few women who took it after not responding on Clomid, and they conceived using Femara. Since you didn't respond on Clomid, it makes me wonder if maybe you would actually respond on Femara, since I've heard of it happening. :) Using it to conceive is an off-label use though, and I'm not sure how you or your doctor feel about that.

I'll be curious to see what your OBGYN suggests as the next step. If I remember correctly, you're several hours away from "better" fertility specialists, like reproductive endocrinologists, right?

Did the hormone levels that you checked include a full thyroid panel?
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TTC: Fertility Treatments

Postby Maneo » Tue Jul 02, 2013 5:13 pm

My DW used clomid. We have moved to the next step where they take my semen and "clean it" and the doctor places the cleaned semen in my DW when ultrasound has shown her body is at the peak of readiness. Just did the first round of this procedure this last week so we will know the results in a couple weeks. We also continue to get the semen in her the old fashioned way. She also is wearing an estrogen patch, well two actually, on her belly as well as some shots she self administered just before and up to her most fertile time but I will have to ask her exactly what was in the shots.


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Re: TTC: Fertility Treatments

Postby angellove » Tue Jul 02, 2013 6:18 pm

Are you doing anything to increase your progesterone levels? If you are ovulating, those are pretty low numbers for prog.

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Re: TTC: Fertility Treatments

Postby MapleSyrup » Tue Jul 02, 2013 6:43 pm

Princess_Bear wrote:If I remember correctly, you're several hours away from "better" fertility specialists, like reproductive endocrinologists, right?

Did the hormone levels that you checked include a full thyroid panel?


Yes, I'm 5 hours away from the "Big City" that offers REs, IUI, IVF, etc. All my doc can do from here is prescribe meds. (Not to mention I require a referral to get in... otherwise I'd just drive down there now! I'm currently 3 months in on their 6 month waiting list.... )

I had a rather in-depth blood work-up done before he prescribed Clomid... I believe thyroid was part of that, and if it was, it's normal.

angellove wrote:Are you doing anything to increase your progesterone levels? If you are ovulating, those are pretty low numbers for prog.


Those numbers are for a CD21... which WOULD have been 7DPO, if the Clomid had worked (and put me on a day 14 ovulation, 28 day cycle). But because I was actually ovulating around that time, the progesterone levels would read as low as they hadn't had a chance to spike. That would have happened around CD28 instead (true 7DPO). So I actually haven't had a blood test done at 7DPO.
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Re: TTC: Fertility Treatments

Postby MapleSyrup » Tue Jul 02, 2013 6:46 pm

Maneo wrote:My DW used clomid. We have moved to the next step where they take my semen and "clean it" and the doctor places the cleaned semen in my DW when ultrasound has shown her body is at the peak of readiness. Just did the first round of this procedure this last week so we will know the results in a couple weeks. We also continue to get the semen in her the old fashioned way. She also is wearing an estrogen patch, well two actually, on her belly as well as some shots she self administered just before and up to her most fertile time but I will have to ask her exactly what was in the shots.


This sounds like IUI... wish I could get this done where I live!!! I currently don't have that choice. I'm on a waiting list though. :(
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Re: TTC: Fertility Treatments

Postby Princess_Bear » Tue Jul 02, 2013 8:02 pm

MapleSyrup wrote:
angellove wrote:Are you doing anything to increase your progesterone levels? If you are ovulating, those are pretty low numbers for prog.


Those numbers are for a CD21...
Just curious why you would have gotten your progesterone drawn on CD21 if you knew you hadn't ovulated? (I assume you were charting your basal body temperature?)
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TTC: Fertility Treatments

Postby Maneo » Tue Jul 02, 2013 11:36 pm

MapleSyrup wrote:
Maneo wrote:My DW used clomid. We have moved to the next step where they take my semen and "clean it" and the doctor places the cleaned semen in my DW when ultrasound has shown her body is at the peak of readiness. Just did the first round of this procedure this last week so we will know the results in a couple weeks. We also continue to get the semen in her the old fashioned way. She also is wearing an estrogen patch, well two actually, on her belly as well as some shots she self administered just before and up to her most fertile time but I will have to ask her exactly what was in the shots.


This sounds like IUI... wish I could get this done where I live!!! I currently don't have that choice. I'm on a waiting list though. :(

Yeah, I think you are right -IUI. I'm just the dumb husband who does as the doctor and wife instruct. The doc also gave my wife a shot of something when we began the IUI to improve her chances.

And we do live in a city where my wife's ob/gyn did refer her to a fertility specialist who counseled us and is leading the treatment regimen. And it is not cheap. Most health insurance doesn't cover fertility treatment. We've spent close to $1,500 so far. But the eventual baby will be priceless.


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Re: TTC: Fertility Treatments

Postby MapleSyrup » Wed Jul 03, 2013 6:38 am

Princess_Bear wrote:
MapleSyrup wrote:
angellove wrote:Are you doing anything to increase your progesterone levels? If you are ovulating, those are pretty low numbers for prog.


Those numbers are for a CD21...
Just curious why you would have gotten your progesterone drawn on CD21 if you knew you hadn't ovulated? (I assume you were charting your basal body temperature?)



I was just following Doctor's instructions. ;) I had a standing order to go in on Day 21. Not 7DPO.

The Clomid was supposed to make me ovulate early, so I wasn't tracking anymore. But I know from previous experience I typically ovulated around day 21... which my period date would still make that the day during Clomid.
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Re: TTC: Fertility Treatments

Postby Princess_Bear » Wed Jul 03, 2013 7:32 am

MapleSyrup wrote:
Princess_Bear wrote:
MapleSyrup wrote:Those numbers are for a CD21...
Just curious why you would have gotten your progesterone drawn on CD21 if you knew you hadn't ovulated? (I assume you were charting your basal body temperature?)

I was just following Doctor's instructions. ;) I had a standing order to go in on Day 21. Not 7DPO.
Then I would find a new doctor, and keep charting, especially if you either do another round of Clomid, or start Femara, or do something else to induce ovulation. Do NOT do another progestrone test on CD21 unless you know for certain (via charting or ultrasound) that you ovulated on CD14. It sounds like, if you ovulated ON CD21, that you should have waited until CD28 to do your progesterone draw. That's why your numbers were so low. They were inaccurate.
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Re: TTC: Fertility Treatments

Postby MapleSyrup » Wed Jul 03, 2013 12:49 pm

The test was to see if the Clomid worked and I ovulated at the right time. Not to see if I ovulated in general. So a day 21 test was the way to do that. :)

We'll see what the next step is. I just want something to work. I don't care what it is. If he told me IVF was the next step, I'd do it. I just want this to work.
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Re: TTC: Fertility Treatments

Postby angellove » Wed Jul 03, 2013 4:28 pm

I would want to know what your progesterone levels are post-ovulation, then. Without good levels, forcing ovulation could be unhelpful in achieving a pregnancy (regardless of the method used).

However, I'm guessing your options are going to be limited without access to more specialized medical care (probably to prescription drug interventions). Would a referral to a specialist make it possible to not be on a waiting list? -- not sure how it works there.

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Re: TTC: Fertility Treatments

Postby MapleSyrup » Wed Jul 03, 2013 5:15 pm

I have a referral. The referral is what put me on the six month waiting list to begin with. ;)

I might call the clinic directly to see if there's anything else I can do.
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Re: TTC: Fertility Treatments

Postby Princess_Bear » Wed Jul 03, 2013 5:45 pm

angellove wrote:I would want to know what your progesterone levels are post-ovulation, then. Without good levels, forcing ovulation could be unhelpful in achieving a pregnancy (regardless of the method used).
I'll second this.
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Re: TTC: Fertility Treatments

Postby MapleSyrup » Sat Jul 06, 2013 9:40 pm

Well, I'm armed to the teeth this month! I just spent an arm and a leg purchasing 100 OPK strips, Pre-Seed lube, FertiliTea, and an "OvaCue" fertility monitor.... I am going to do my part this month and pinpoint my fertile window and have baby-making sex like a madwoman! I got a little lazy with my tracking (and sex) the past few months because I was trusting that the Clomid would work (so we only had sex every second day, CD10-18 and that was about it... we're getting stinkin' TIRED of passionless sex!! TTC KILLS lovemaking and demotes it to exchange of bodily fluids... yay.) . Well, no more, I say!!! A BFN will NOT be the result of poor timing/planning! A BFN will only be, conclusively, my stupid body's fault! ARG. THIS BETTER HAPPEN!!!! I'll even pull out the ol' Diva Cup and use that to aid in the "marinating" process, if I have to!!!!

I'm currently at CD37 and my period is MIA (it has shown up CD36 for the past 3 months). Took a preg test yesterday and it was negative. OBGYN appointment on Monday. Game face is on. Let's do this. :evil: :x
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Re: TTC: Fertility Treatments

Postby Princess_Bear » Sat Jul 06, 2013 10:38 pm

Just remember that the OPK's can't confirm ovulation DID occur.

I'm not familiar with the Ovacue fertility monitor, so I just pulled up the website. It sounds interesting, but it also sounds like without the vaginal sensor, all it does is the same thing as the OPK's. (So, I hope you invested in the vaginal sensor too!) I'd encourage you to keep taking your temperature, even with all these other things you're doing, since temperature really is the best way to pinpoint ovulation, and that will show you how accurate the monitor and the OPK's really are. :)
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Re: TTC: Fertility Treatments

Postby MapleSyrup » Sat Jul 06, 2013 11:04 pm

Princess_Bear wrote:Just remember that the OPK's can't confirm ovulation DID occur.

I'm not familiar with the Ovacue fertility monitor, so I just pulled up the website. It sounds interesting, but it also sounds like without the vaginal sensor, all it does is the same thing as the OPK's. (So, I hope you invested in the vaginal sensor too!) I'd encourage you to keep taking your temperature, even with all these other things you're doing, since temperature really is the best way to pinpoint ovulation, and that will show you how accurate the monitor and the OPK's really are. :)


I did get the vaginal sensor. :D

I may try the BBT as well, but I heard it's quite tricky and can be inaccurate... but I guess it can't hurt as an addition to the "Fertility Tracking Team". :roll: :P
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Re: TTC: Fertility Treatments

Postby Princess_Bear » Sun Jul 07, 2013 8:03 am

Glad you got the vaginal sensor! I'm still concerned that the Ovacue is just a glorified OPK, because I don't know if electrolytes can do the same thing as luetenizinng hormone (LH, what OPK's test for), and surge without actually ovulating.

Judging by your reaction to my suggestion, re: temperature taking... have you ever temped through your cycle and charted the results? Who told you it was tricky and inaccurate? Have you read "Taking Charge of Your Fertility" by Toni Weschler?

Your BBT should remain fairly constant and low during the first part of your cycle, and then rises only AFTER LH surges and progesterone takes over. Various things can have an affect on your temperature, such as mouth breathing at night, alcohol, working the night shift, not getting enough sleep before temping (recommended at least 3 hours), extreme ambient temperatures. But usually, it's pretty easy to see a true, sustained ovulation rise. Your BBT can also give clues as to what might be going on hormonally. A chart with a lot of peaks and valleys pre-ovulation can point to PCOS, and a BBT that hugs the coverline post-ovulation can point to a progesterone deficiency.
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