It is time to move on from the medicated cycles with timed intercourse. It has been 20 months. Five of those months we tried without any help and I just wasn’t ovulating regularly. Then we tried for eigth months with the aid of Metformin, which regulated my cycles. Then we tried for seven months with Clomid and timed intercourse. It definitely is time to move on.
I’ve never talked to my new doctor about IUIs. I don’t know his philosophy, his procedures, his techniques, nor have I have really stopped to give it much thought, until two days ago with my latest negative. So, in consideration of IUI, I’ve begun brainstorming questions I want to cover with my RE next week at my day 3 ultrasound.
- I want to avoid throwing money at IUIs if my right tube has mucked up again. Do you recommend a repeat HSG or a saline sonogram to determine if the tubes are still open?
- Prior to leaving my last RE, she recommended a hysteroscopy or saline ultrasound to get a better look at my uterus prior to moving on to more expensive and intrusive procedures. Do you think either of these would be an important procedure? Can you check the tubes with either procedure?
- Clomid makes me feel like death would be a happier place than my reality. And it really messes with my vision. Can we do an IUI with Femara?
- What are the strengths and weaknesses of using Femara versus injectables? Given my history, which would you recommend?
- I am concerned about the use of injectables and multiples. Do you convert IUI cycles to IVF cycles if I am overstimulating?
- Do you use a trigger shot, and, if so, do you trigger based upon the LH surge or based upon the size of the lead follicle?
- Research regarding the timing of IUIs produces conflicting results. How do you time IUIs?
- I’m concerned about timing. The last time I used a trigger shot I ovulated the same day. When I get positive OPKs I typically ovulate that same day. If we trigger and then do an IUI 36 hours later, I am confident we will miss ovulation. By miss I mean extend beyond the window of the life of an unfertilized egg. In light of research that demonstrates that doing an IUI prior to triggering is more successful than after the trigger, are you flexible on the timing of the IUI? Will you check before doing an IUI to ensure I haven’t ovulated yet? Will you consider an IUI both before and after the trigger?
- It seems as if the research regarding single or double IUIs produces mixed results. What do you recommend and why?
- I’m concerned about low estrogen levels and my uterine lining. Do you monitor and supplement estradiol during IUI cycles?
What do you guys think? Too much? Obnoxious? Does anyone have any other suggestions?