The dr’s visit at the clinic was interesting. Certainly has given us a lot of things to think about, some that we were already considering and some that we hadn’t really thought were on the radar yet (or at all).
As usual, the organisation of the clinic left much to be desired (such as the dr telling us one thing then the nurse telling us another, and not being able to get the info we need most for a couple of weeks). We had a meeting first with the dr, then after with a nurse who talked some more about the same stuff but also more detail with costs etc.
The dr has basically given/suggested four options, and told us his recommendation. He was nice an sympathetic and said that all of K’s testing levels have been normal and that there is nothing he can see to worry about or point towards why it hasn’t worked yet. He did mention ‘unexplained fertility’ as she has clearly been ovulating, hsg was clear etc but also that he doesn’t like to diagnose that until 8 failed IUI’s.
So, the options are:
- Continue as we are, doing natural cycle, unmedicated IUIs until we have reached the ‘quota’ of 8. He mentioned stats that showed from attempts 4-8 another 30% of women would get pregnant. He also mentioned that if there is an underlying condition that he can’t see at this point, then obviously there would not be success.
- Moved to stimulated cycles/IUI for the next 3 attempts. This would involve clomid days 2-6, then Gonal-F injections (2-4) of these prior to ovulation, followed by a trigger shot before the IUI.
- Third option is IVF (which we weren’t expecting to be mentioned at all at this stage!)
- Fourth option is laproscopic surgery to make sure there isn’t anything else happening that we were unaware of. He mentioned this because K has had appendicitis in the past, and suspected PID (pelvic inflammatory disease – this was mentioned by a dr once years ago and no evidence found on ultrasounds etc nor any symptoms since).
The dr’s recommendation is that we move to stim cycles for 3 months, then consider IVF if no success by then.
So, our initial reaction to these options is:
- Surgery pretty much ruled out – for one thing it is incredibly invasive, would cost $6-7000 which wouldn’t be covered by our insurance, would involve 2 weeks off work recovering.
- IVF is hideously expensive – somewhere in the region of $10,000. This would mean we would probably need to get a loan. We don’t want to get ourselves into debt over this but this is a decision for further down the track.
- Stim cycle. Injections. Hmmm. K is very worried/nervous/stressed about the idea of injecting herself (and it would make it worse if I was to do it for her). At this point in the nurse’s office things got a bit teary. See, when the dr said that she probably wouldn’t need to inject she was very relieved, so as a result as soon as the nurse said yes you will definitely need to, she just started crying.
We don’t know yet what we’ll do, we have another appointment with a nurse in 2 weeks where she’ll show us the needles and exactly whats involved. We have a prescription for Clomid now, but we’re not going to use it this cycle – we need some time for K to get her head around it all before deciding. This is where we are a bit pissed off at their organisation as well – it sucks that they couldn’t do the needle thing while we were there – they knew we were coming and they knew that was the course they would be recommending, instead we have to take more time off work to come back etc.
We are also considering just doing 3 more unmedicated cycles and seeing what happens – the stim cycles will cost us at least twice – possibly nearly three times as much so we can get more tries that way, but with lower odds.
Really though, it all comes down to how K feels about the needles. It’s easy to sit here and say well the odds are better, we should do it this way, but it’s not worth it if she’s going to be that uncomfortable and stressed – she has enough stresses in her workplace that probably aren’t helping as it is.
We talked last night about what we want to do, and whether we fit in another unmedicated cycle this month while we decide.
This morning K said she would rather have a break this month and try to make this decision with as little pressure as possible so that’s what we’re doing. There is always that little corner of my mind that thinks – what if this was supposed to be the month, but I agree that that’s probably the sensible option.
We also asked the dr about excercise during the tww, as we’ve been told K should take it easy which has been really hard for her both with weight management and her job (high school PE teacher who always plays every game with the kids). However he said that aside from taking it easy for a couple of hours after the IUI, she should just do what she normally does. Basically that there is no evidence to suggest it harms the conception or implantation if she continues the same level of exercise – yay.
Today, K has gone up to Auckland to help her parents clear out some stuff from their house in preparation for K’s sister, husband and 5 kids moving in for a few months while they build their own house. I am home doing our mountain of housework, then this afternoon we’re battening down the hatches in preparation for what is supposed to be ‘the most intense sub-tropical storm of the decade’.
It’s already pretty yucky out there and it’s not supposed to hit our area til late this afternoon.