Some Q's & A's

Friday, August 07, 2009

I got to talk to my RE's nurse Wednesday morning, and I got all of my questions (at that point) answered. I am all for this third clomid cycle, and I'm prayin my heart out that I don't need to indulge my type-A wonderings of this week. Game day #2 is today! Go team clomid!

In the very unfortunate (from my perspective, not God's omniscient one) situation that He does not use clomid to bless us with our first baby/ies, we needed to start preparing ourselves for what are our next options.

Just to review, because I think at least a few of you will ask, Mr. A and I have both been checked out, and everything looks a-okay except I had low progesterone (no/weak ovulation?) prior to clomid (my RE found this upon review of my records sent from my Gyn). I don't have any crazy pain associated with my cycle, don't have energy issues, have at least a 13-day LP (even before clomid), don't have spotting mid-LP through the end, normally have good CM (although clomid did decrease it a little), and don't really have any symptoms of any other assorted conditions that can interfere with babymaking. This doesn't mean there might not be one, I guess, but at this point, my RE's diagnosis is low progesterone, and it seems like clomid is just what I need, because it did do a great job increasing my p+7 progesterone from 6.4 to 16.8.

Let's just reiterate that I pray that God uses this clomid cycle to bless us with our first child/ren.

In the event that He does not, though, we have at least three options/permutations ahead of us. We aren't opposed to any of them- just trying at this point to figure out where God is leading us at the point when we need to make a decision.

Option 1: Clomid IUI (take clomid, have u/s monitoring, HCG shot, IUI)- This would bypass any CM disaster that I'm not picking up on- approximate cost $850 (I guess we could also just take 3 more cycles of clomid alone, but my RE normally adds IUI after three unsuccessful cycles to up the anty a few percentage points.)

Option 2: Follistim without IUI- This is an injectible suped-up version of clomid from what I can tell. The completely awesome blessing is that my insurance covers this drug, as far as I and the insurance lady at my RE's office can tell (I still want to call my insurance and confirm this with an actual person). This is huge because one follistim cycle is about $800-900 otherwise.

Option 3: Follistim with IUI: Pretty self-explanatory (see Option 1 plus Option 2), except the IUI cost would be the same as in Option 1, so this cycle would be about $850.

We are not considering IVF right now for a variety of reasons, nor was it even brought up by my RE because I don't think he thinks we'll be unsuccessful after clomid and/or these things he's already suggested.

I think we are leaning towards either Option 2 or Option 3 initially (way before we need to decide, see below), because we aren't dealing with any MFI, so I don't think Option 1 is going to be much more successful than us on our own. Plus I think we are interested in being as proactive as we feel appropriate at this point. We are planning on making a list of boundaries before any further treated cycles- financially, emotionally, spiritually, and procedure-wise, so we are not sucked into more cycles, etc. by force of momentum than we rationally feel we can traverse. If God does not use these options to give us biological children, I assume at that point that we will revisit adoption.

The thing is that, if I'm not pregnant this time, and since my cycles are so predictable, September's ovulation time window is when I'll be watching my younger cousins while their parents go to parents' weekend at their oldest son's college. As in, I'll be a little over an hour from my RE's office and playing soccer mom. So I can't exactly scadoodle for monitoring or IUI whenever the eggies decide it's time to go. ("Oh, instead of going to your soccer game this morning, we are going to the doctor office to look at a tv screen! Doesn't that sound exciting? ooOOOooo!") Mr. A will be with me, though, so all will not be lost.

That means we have until the October cycle to figure out where God is pulling us. No doubt we will spend much time in prayer between now and then, both praying that He'll bless us before we need to make this decision, and praying that He will lead us in all circumstances with a hand that is undeniable. I am actually thankful that we have this time to take our time and decide and really give God the opportunity to direct us.

I am excited and continue to feel like our baby is not that far away. I pray we'll be a family of at least three this Christmas.

Show us Your face, Jesus!!


Sew said...

This is so frustrating. I am so sorry that these options are options you have to face. It's a hard struggle and I battled IUIs.

But why don't you try amoxicillian to increase possible mucus issues, You start taking it post period through to your peak day. You can do either an HCG trigger or HCG luteal phase support and by pass all of the IUI stuff for now. There are still a few things if not a lot of things you can do before you get busy with an IUI.

Just my very humble opinion. Something is going on that is stopping you from getting pregnant naturally. In most cases, IUI isn't healthy for you or the baby and isn't really needed.

Do you chart Creighton? I don't mean to shove it down your throat, but it really gives you a mircoscope lense to what is really going on. I know it did for me and apparently we do have MFI issues.

So what I am trying to say my dear is this: I had no clue I had Stage IV endo until I received the napro book. I had NO CLUE my periods were the least bit painful or that my bleeding wasn't normal. All my doctors told me is that "I" was okay. You can have things going on in your pelvis and really have no clue as well. If you find a good surgeon, hopefully you don't need it, that is in network, surgery is $250!

Your progesterone is okay, but is it falling off too quickly on 13DPO? Or even before that? One does not know. And most doctors don't believe in LPD, some do dont' get me wrong. But really the only way to find out what is going on is to test 3,5,7,9,11 estrogen and progesterone. Did they check your estrogen when they did your progesterone? I am assuming that your progesterone was taken on CD 21. Well that is great if you truly ovualted on CD14. So sometimes that isn't always the case.

Sorry, am I preaching? I really am just "talking". And if I were face to face I might not come off as harsh, I am not trying to come off as I am trying to tell you what to do I promise! :)

Just trying to help. :)

My gut tells me that we all want to be able to conceive naturally, or as naturally as we can. So with the support of drugs and not an IUI is probably our first guess.

I know it feels like the clock is ticking but once you learn to chart and it doesn't take long, you will be in more control over this very uncontrollable situation. :)

Even if you don't have a doctor near you. This charting is something you are able to pick up on your own. I mean it is something you can monitor and you can intuitively tell if something is wrong or not. You and your practitioner can work it out. If it weren't for my Practioner's knowledge and great patience I would have been lost. :) You can start charting now and have a ton of answers to your questions by September. :)

the misfit said...

I think you're approaching this exactly right - it's so easy to get dragged down a path by gravity without having a long-term plan; it's always the next thing, then the next thing after that. And what a blessing to have nice clear options from your RE! But it sounds to me like you have as good a chance as anyone of having an addition to the fam by Christmas. Also, I had to note - my word verification word is "heart." :)

Andrea said...

Thanks for visiting my blog and for your prayers! :-) I'll definitely be praying for you this cycle, I really hope this is it! I haven't read any more than this one post, so I don't know how long you've been TTC, but it sounds like it's been too long.

Hillary said...

It sounds like a great plan! I trust the Lord will guide you as you think about each step. We have tried to "make our line" in the sand in regards to how much and how far with treatments, but for my DH it is too difficult to talk about the "what ifs." It feels too far removed for him, so we are taking each step at a time and will seek to prayerfully decide before each new step. But I hear you about getting nervous about being "sucked into treatments"! Plus, that may just be my DH :)