Advice on my next course of action

[CarolineSinclair]

My unmonitored, unmedicated IUI last month was a bust, but I am not ready to close the door on ever having a child. I'll be 40 at the end of September.

I am planning to get a new doctor and nurse team from Shady Grove, I wish I could use a different clinic but they are probably closest to me while also having an egg freezing program.

I want to do egg freezing in case more IUIs would fail or I would miscarry, I do have thyroid disease, and I wouldn't want more months down the drain.

But do you think that a monitored, medicated IUI with 2 vials of sperm instead of one like the 1st IUI, might be a better chance of a child actually being born?

Just looking for advice because I know many of you have been through these sorts of things, meaning IUIs and IVF.

At this point I still want to try for a child with my own eggs before donor eggs.

[atomic sagebrush]

Medicated and monitored absolutely would be better chances of conception than what they had you do the last time.

I feel like freezing your eggs at this point would be months wasted for probably quite low odds (because you could not TTC while the egg retrieval process was happening and then you may end up finding that you only got one or two eggs at most) BUT you have to do what YOU feel comfortable with. Better now than later!!

I feel like you are perhaps putting too much emphasis on your 40th birthday as a cutoff date for getting "good eggs" but the unfortunate truth is that our fertility is in gradual decline form the moment we are born and your body doesn't know it's having a birthday - there is very little difference in getting eggs now as there would be in a month's time.

Let me lay out the way this would have to go down and you can maybe see why egg freezing to me is not going to be a great bet:

Egg freezing option - For this to work, they would have to do the egg retrieval process AND you actually respond to the meds (some don't) AND get any good eggs (some don't) AND survive the freezing process (some don't) they are fertilized (some don't) and make normal embryos (some don't) and implant successfully (some don't) and the pregnancy continues without issues (some don't) and then to top that all off, you want a girl which cuts your odds by half right from the get go - you can see that it's not entirely unlike winning the lottery which is why younger women have so much better odds - they can usually get like 20 or 30 eggs from one ER, while a 39 year old may only get ONE egg per round.

IUI option - you'll get an egg or two on medication (hopefully injectibles this month) most likely and if you DON'T, then you'll at least KNOW because they are monitoring you. Odds of conception with IUI are not sky high but at least if you're monitored they'll be doing the IUI at the right time, which I personally do not think was the case for you the last time. It's still like winning the lottery but it's more like a scratch ticket LOL - you at least have a chance IMO.

But all this having been said, remember how torn you were when you thought you could possibly be pregnant?? I just want to make sure this is really what you want, instead of what you think you should do or what your family wants. :) Wishing you the very best.

[CarolineSinclair]

Thanks for the reply, sorry I couldn't reply sooner, I was on vacation and the Wi Fi sucked, lol.

Well that's sort of what I wasthinking about the egg freezing thing, too many steps I guess you could say, that might not work.

I've realized that I really do want a child and for the right reasons now, at first it was sort of famiky pressure but now I've got that out of my system. I also became frightened by my situation not being the classic, but I don't feel that I'll ever have that, but I still feel I don't want to give up my potential baby because it can't be the traditional family.

I had never had a potential to be pregnant before, so I think I was a bit shell shocked, and I wasn't satisfied with my donor because I felt rushed when choosing, but I feel I've gotten my perspective back. Much of my fears came in because of the fear of a heart condition, but I don't want to let that stop me either.

Monday I will call the clinic's office and request a consultation with another doctor/nurse team. I feel like the previous team just had a very poor att

[CarolineSinclair]

*Editted to add, I just felt like my other team took a sort of "oh well" attitude about me. My tablet was giving me trouble, so I couldn't edit the post.

I'm also not concerned about the gender anymore, a girl may be easier for me, but who knows, maybe it wouldn't.

I was kind of feeling like I didn't deserve a child if I couldn't give it the perfect scenario, but I feel like that was being too harsh and demanding of perfection.

I thought of closing that door, but when I thought thst, I realized if I didn't try more, I'd regret it. If I try and it all fails, at least I won't be mad at myself for not trying.

Thanks again, and hopefully soon I'll have some good news to share!

[atomic sagebrush]

I totally understand and as long as you are ready to proceed. Let us know how we can help.

I can promise that palpitations on occasion are not indicative of a serious heart problem. :)

There is no perfect scenario. Even those of us who are married for decades and from the outside everything seems very stable and settled have ups and downs and things that are not perfect for our kids. :)

[CarolineSinclair]

Thanks again, sage, I'll keep all that in mind.

I notice my period cycles are getting later than they used to be, I hope that's not a sign that something is wrong or I'm going into menopause...I can't proceed any further until my period comes and they do the tests. I also hate the ultrasound test, it hurts me so much, I imagine it's because I'm not sexually active. Is there anything one can do to make those less painful?

[atomic sagebrush]

It's normal to see changes over time as we get older, many of us experience that and still get pregnant that way.

Are they using enough lubricant??

Sounds crazy but a muscle relaxer prior to going in can help. :agree:

[CarolineSinclair]

It's normal to see changes over time as we get older, many of us experience that and still get pregnant that way.

Are they using enough lubricant??

Sounds crazy but a muscle relaxer prior to going in can help. :agree:

Okay, thanks. Well, it's day 33 and I still haven't goten a period. I'm terrified I went into early menopause suddenly because of the thyroid disease and because my paternal grandmother went into it at 38.

I called the clinic on Saturday and the nurse said based on my bloodwork that she doesn't think it would be that, but I don't know.

I have cramps like I'm going to get it, but nothing.....and I worry the palps are a symptom of menopause.

I will call the clinic tomorrow to see what they want to do.

I'll tell them to use more lubricant, I don't think they used enough before, and thanks for the advice about the muscle relaxer!

[atomic sagebrush]

Menopause takes years and it is not something you wake up with one day (boy it would be GREAT if it worked like that! :p)

Some gals do get more palpitations around menopause but again it is something that would develop over time and not suddenly out of the blue going right smack dab into menopause. :) Number one cause of palpitations - anxiety.

THere is always some story about someone in the family who went into menopause freakishly early. Take all these stories with a grain of salt. Most of the women who lived even only a generation or two ago had pretty hard lives and may have experienced malnutrition as a child, smoked, had illnesses tht could have contributed to an earlier onset of menopause. My mom had menopause young and I'm still having regular cycles at 45, and had a baby at 42.

[CarolineSinclair]

Menopause takes years and it is not something you wake up with one day (boy it would be GREAT if it worked like that! :p)

Some gals do get more palpitations around menopause but again it is something that would develop over time and not suddenly out of the blue going right smack dab into menopause. :) Number one cause of palpitations - anxiety.

THere is always some story about someone in the family who went into menopause freakishly early. Take all these stories with a grain of salt. Most of the women who lived even only a generation or two ago had pretty hard lives and may have experienced malnutrition as a child, smoked, had illnesses tht could have contributed to an earlier onset of menopause. My mom had menopause young and I'm still having regular cycles at 45, and had a baby at 42.

Okay, I'll try not to worry but I am really freaking out. I have a no menses test workup scheduled for Thursday morning but in the meanwhile I'm going crazy.

I was researching something called premature ovarian failure and it said that people who Hashimoto's Disease often get this, and it is basically failure of your ovaries before age 40.

My clinic knew since they did the first tests on me in 2012 that I had Hashimoto's Disease, something I didn't know until they tested me. It took a while to get under control, and it got screwed up again in 2014, right before I was going to try an IUI, which was what delayed me in getting it done, it took a few months to get under control again.

My endocrinologist was well aware that I wanted a baby, and she never told me I could suddenly develop this POF.

I feel like both her and the doctors at Shady Grove really messed up here, if I had known the antibodies that attack my thyroid could suddenly attack my ovaries (that is what it said happens to people who get POF this way), I'd have had my eggs frozen immediately, without trying the IUI first.

[atomic sagebrush]

We have tons of girls on here with Hashimotos' having their 3,4 or 5th kids!! Itwill be ok.

I am not a believer in "fine one day, disaster the next". 999 times out of 1000 there is a lot of warning about things going south and even when things are going south you generally have years to get pregnant before it's impossible. May not be as easy as when we all were 21 but it CAN AND WILL happen. :)

[CarolineSinclair]

I got my period and had an ultrasound today, but I didn't like the results. I have 9 follicles and they like at least 10. I had bloodwork too so I'll see what that says. The sonographer said 9 isn't atypical for my age, but that doesn't make me feel any better seeing as how it's not the minimum of what they want.

[CarolineSinclair]

Just got the FSH result and it was good. Wednesday I see the new doctor and she will order the AMH and we'll go from there.

[atomic sagebrush]

9 is practically 10! HOnestly that's not too bad at all - there are many ladies on this site who would do a dance of joy to see 9! :)

What was FSH just out of curiosity??

[CarolineSinclair]

Well that's good to know! I was really disappointed about the 9 number.

I can't remember the FSH exactly but I do remember the lady said it was good. That they want it to be under 12 I believe? And under 10 is even better, and I think mine might have been 7. The thing that made me feel good was she said all my blood test numbers were really good, although I'm not sure why they didn't test the AMH and I'm still worried about that.

And I just have to hope my thyroid doesn't go off again in the meanwhile. That was what held me up with the first IUI, I had been going to get it much earlier but my thyroid got all messed up again and it took months to get it back to normal.

[atomic sagebrush]

The good news is that if FSH is good, AMH is PROBABLY good too. They work in concert with each other. FSH is a signal to your ovaries to develop eggs, and then the eggs themselves signal back when they're developing so your body stops making FSH. Over time your body gets "deaf" to the FSH and has to make more and more FSH to get the eggs to develop, and then additionally, if there are very few eggs, the reverse signal is too quiet to shut the FSH down. your body has to make a lot of FSH if your AMH is low.

[CarolineSinclair]

The good news is that if FSH is good, AMH is PROBABLY good too. They work in concert with each other. FSH is a signal to your ovaries to develop eggs, and then the eggs themselves signal back when they're developing so your body stops making FSH. Over time your body gets "deaf" to the FSH and has to make more and more FSH to get the eggs to develop, and then additionally, if there are very few eggs, the reverse signal is too quiet to shut the FSH down. your body has to make a lot of FSH if your AMH is low.


Oh that's good to know! They still haven't tested it yet, they are going to test it closer to when I will do the IUI.

I had a meeting with the doctor last week. So I'll be trying a monitored and medicated IUI next cycle. It's going to be a lot more costly than it was with the natural cycle, but more chance of it actually working. Unfortunately my insurance doesn't cover any of it. But I want try this first before going to IVF. The IVF is much more costly and sounds a lot more complicated as far as they said I'd have to undergo anesthesia which I am scared of.

The egg freezing/fertility preservation just sounds too costly. It's about $10,000 a pop and they would need to do 3 cycles to get the number of eggs they want, and that's not even counting the cost of sperm and the IVF.

So, fingers crossed that one IUI will work. I also have to get the DSH test which I'm not happy about, it's very costly and I've heard very painful. It was waived for me last time due to the cost, but this doctor wants me to do it, and it makes sense, if my tubes aren't open I need to know.

[atomic sagebrush]

FX and TX too!

Yes I agree about the test - it makes no sense to proceed if your tubes are blocked altho given what you mentioned about your history you are probably ok unless you have endometriosis.

[CarolineSinclair]

FX and TX too!

Yes I agree about the test - it makes no sense to proceed if your tubes are blocked altho given what you mentioned about your history you are probably ok unless you have endometriosis.

No, I don't have endemetriosis.

I've been worrying a lot that maybe this IUI is a waste of money because they told me it only has a 13% chance of working. That's like nothing, to me. I have a cat that's sick and needs surgery and if they told me he only had a 13% survival chance, I wouldn't put him through it. (The other IUI they told me only had a 7% chance of working. If they had told me that, I wouldn't even have bothered with it.)

Any opinions on whether I should just go directly to IVF if I can afford it?

[The Anchor]

Just my 2 cents...I would NEVER EVER do unmonitored IUI. EVER. It is a waste of time and you will not get pregnant, even if you think you have perfect cycles. Washed sperm will die within 24 hours, the timing has to be PERFECT. You're throwing your money away.

[atomic sagebrush]

No, I don't have endemetriosis.

I've been worrying a lot that maybe this IUI is a waste of money because they told me it only has a 13% chance of working. That's like nothing, to me. I have a cat that's sick and needs surgery and if they told me he only had a 13% survival chance, I wouldn't put him through it. (The other IUI they told me only had a 7% chance of working. If they had told me that, I wouldn't even have bothered with it.)

Any opinions on whether I should just go directly to IVF if I can afford it?

I answered in more detail in your other thread but you need to compare the odds of success one vs the other with the expense involved, because you'll be able to have a lot more IUI rounds for the same price as one IVF.

FWIW I think them doing an unmonitored IUI on you without informing you of the odds of success is malpractice.

[atomic sagebrush]

Also please consider that IUI success rates are not necessarily YOUR chances. Many people who do IUI have male factor infertility or unexplained fertility. YOu will be using a donor with good sperm health and for all you know you are totally very fertile. You may have better than 13% (because that represents the success rates of those purusing IUI and not people in your specific situation, if htat makes sense.)

[CarolineSinclair]

Well he told me it had 20% chance to work, the former doctor I mean, but my current nurse told me it only had 7% chance.

It's possible I should be going to another clinic but I'm not sure all of them accept single mothers.

[atomic sagebrush]

There are so many factors that go into calculating how well an IUI might work it's all very sketchy about how accurate any of it is. In a 30 year old with a good sperm donor it can be up to 20%. 38-40 it drops to about average of 7%

There is a nice breakdown of hte numbers in this link IUI Success Rate (http://www.advancedfertility.com/iui-success-rates.htm)

[atomic sagebrush]

If you scroll down on that link you can see how having a proven donor can help up your odds of success vs a couple with male factor infertility

[atomic sagebrush]

PS - just so you're aware, the success rate with IVF they are quoting numbers that seem artificially high to me and it looks to me like they are including people who had frozen eggs or embryos at younger ages and also those who used donor eggs or embryos in their numbers. Did not have time to go over it with fine tooth comb