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Trying-to-Conceive Blog

jeskla's blog

IVF consult

Today, we met with Dr. Silber at the Infertility Clinic of St. Louis. We spent an hour in the waiting room and about 15 minutes speaking directly to him about what our best option would be. He thinks that mini IVF would be the best, and sugested that I do more than 1 ER because my antral follicle count is so low. I was very suprised that he gave me a 60% chance to get pregnant with his protocol. Dr. Pineda said I probably had a 42% chance. I know those numbers arent set in stone and it might not happen at all, but they have given me a bit of hope. 

So here's the plan:

1. Begin birth control pills on cycle day 1 (around 7/25) of my next period to suppress any cysts that may develop

2. 8/20 stop birth control pills

3. 8/26/13 start stim monitoring and Clomid 50mg

4. 8/28/13 Follistim 150iu every other day begins

5. 8/30/13 Monitoring daily or every other day

6. 9/6/13 Target day for egg retrieval !!!

Now if only they would negotiate on the price 9,200 plus the cost of meds, ouch!

2nd RE appt

Those clear blue digital advanced tests never gave me a peak symbol showing that I was ovulating this month. They read as low fertility from CD 13-17 (6-10 to 6/14) then that dang flashing smiley face showed high fertility on CD 18-CD23. So I wasnt able to tell when or if I even ovulated until I had my progesterone drawn on CD24 (6-21). I was suprised when the nurse told me that I ovulated a week earlier on CD 17 (6-14). I called clear blue and gave them the what for, because their tests should not have showed that I had high fertility for 6 days after i ovulated. They are giving me a refund as soon as i mail in the UPC and reciept.  One interesting thing, though, is that the lady from clear blue told me that the tests pick up ovulation when it is at a level of >40 and if i only ovulated at a level less than 40,  then it wont show it....but it definately should not show high fertility up to 6dpo.  She suggested i use a different brand in the future.

So I started AF a couple days ago and I went to my second RE appt today (CD3). I had what seemed like tons of bloodwork done. They took 4 tubes and did like 7 different lab tests. I also had an ultrasound done which showed only 4 antral follicles on the right side and 6 on the left side. The MD explained that was low, he usually likes to see 10 on each side. He said that he thought my best option was to go directly to IVF because anything else might just be a drain on my resources. He said that the spotting I have been having this past year could be due to my low egg quality/diminished ovarian reserve. He told me that at my age, I have a 42% chance of becoming pregnant using the mini ivf procedure and the cost is about 9k.

I felt devastated. I called my husband on the way home from the hospital and cried. After thinking about the situation for a bit, he told me that he would be willing for us to try IVF. I am now scared of failing that also.

1st RE appt 6/10/13

Yesterday was my first appointment with an advanced reproductive specialist. He was an elderly middle eastern gentleman with 30 years of experience and a kindly face and demeanor. At the very start of the meeting, he asked me if I had any questions. I replied by saying that I wanted to know why I was spotting brown gunk before my period and why havent I been able to stay pregnant these past 2 years?

In his gentle  accent he responded, "The spotting is one of two things. It is either caused by low progesterone or it is cause by an early ectopic pregnancy that my body is ridding itself of."

We both hope it is a progesterone issue, which is easily treated with medication. However, it could likely be the other because I have had a tubal ligation in 1999 then reversal in 2011. A HSG was done at that time and my tubes were clear but who knows what could happen in 2 years. He went on to explain the plan of action and I was excited by all he was saying because I was so afraid he wasnt going to put forth much of an effort in my case.

Here is the plan:

1. Go buy some Clear Blue ovulation tests. I told him that I was using a brand I found online and he asked me to try the CB ones because he has found they are more accurate. I completed this step last night. I splurged and bought the digital ones with the smiley faces just because I didnt want to deal with the "is this darker, well it kinda looks darker, should i hold it up to the light or photoshop it" scenarios.

2. Use the CB tests once a day from 12-4 pm (do not use morning urine even though the directions say to- per the nurse) She doesnt want the LH to build up overnight.

3. If I get a positive that day, do two things. One- call their office to schedule a post coital exam the next day and Two- BD with the hubby that night. I asked how this worked, "why would they want to see all the lazy sperm left who didnt get up and go where they were supposed to," the nurse told me that they check this to make sure they dont find dead sperm. If they do, then DH will need to have a full sperm analysis and they will address the issue further to make sure there is nothing wrong with my CM.

4. BD for 4 days or nights in a row (once per day) when I get a positive OPK.

5. Instead of waiting to find out if the progesterone is low, he is going to treat me as though he knows it is low due to my spotting issue that has been going on for over a year now. Sometimes I see brown discharge and tissue anywhere from 3-7 days before my period actually begins. He is going to use 100 mg Prometrium Capsules starting 4 days after the positive OPK.

6. 7 days after the positive OPK, go into the lab for bloodwork to test my progesterone level. While I am at the lab. I am also to get other tests done. (prolactin, thyroid, prenatal ABO/RH/ASBC, Rubella, and HCG)

7. If my period does begin after all that, then on CD3 I am to go in for more bloodwork and then schedule a HSG to see if my tubes are open.

Im so excited to have a plan instead of just the monotony of BD, test, fail ...month after month. I really like this doctor, but there is something about his staff. The ladies in the front office just seemed to have a negative vibe or something. One of the things I am not looking forward to is having to pay for all this. Well hubby will, as I am not working and am staying at home with the 2 homeschooled teens,  TTC,  and housework. Fun Fun !