My doctor is definitely a researcher. Any question I asked was answered with a “well, as a matter of fact, there is research out there that shows…”. But this was a good meeting in my mind. My doctor is much more personable and easy to talk to in person. He actually gave me opinions which was good. This meeting was about what the next steps would be if this IUI fails.
Should we do injectables with IUI next?
He brought up a brand new research paper that was just released and copied it for me. This study shows that doing injectables after 3 failed cycles of clomid is of no value. The paper recommends that you go straight to IVF to get a baby faster and more reliably than injectables. Doc seems to think that we should probably just go straight to IVF. See the study here.
Should I have a laparoscopy?
His opinion on this was if I wanted to keep going with the IUI’s or wanted to bear children naturally, he said I could have a laparoscopy. But he said if I was to consider the IVF track, he would try to deter me from doing a lap because he said there’s no proof that a lap can improve your chances of conceiving via IVF. He did make a point to remind me that no matter how minor, a lap is a surgery and to not take that lightly.
Other interesting information
The other bit of information he downloaded on me yesterday was that Asian women have a reduced success rate of pregnancy after receiving fertility treatment. This goes for Japanese, Korean, Chinese and Indian women. They don’t know why, but he said there is a significant difference in the time it takes an average Caucasian women to conceive via treatment as compared to an average Asian woman. He believes that the medication affects Asians differently than they do Caucasian women and that somehow it affects the endometrium. I’m Japanese and therefore I am even more fucked than I was before. See the study here.
No huge decisions have been made yet. Meanwhile I’ve signed up for the IVF information session. Will keep you posted.
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First I want to say a big congrats to Katery from Infertile Myrtle because she got her BFP! I love hearing that someone has been successful…and on her third IUI! It’s so awesome and I am so incredibly happy for her.
Secondly I want to talk AGAIN about laparoscopy. OK Katery is the THIRD person that I know who has gotten pregnant within months of having a lap, people. I think there is a correlation there somewhere. I want a motherfucking laparoscopy! Give it to me!!! Clean my shit up!
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Posted in Uncategorized, tagged clomid, femara, fertilization, implantation, infertility, IUI, IVF, laparoscopy, TTC on June 5, 2009|
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I am going to think out aloud here because I want to have this conversation with my RE at our consultation. I’m going to ask him about laparoscopy and he’s going to tell me it’s “elective” and that it’s up to me if I want to have the procedure done. So I want to think this through knowing where I am at right now.
So the whole fertility treatment process for “unexplained” infertility is a basic elimination process. As follows:
Clomid/Femara combined with IUI
The IUI procedure effectively eliminates any issues with sperm not getting through the cervix and allows a larger amount of higher quality sperm to get closer to the egg(s). Multiple eggs obviously increases the chances of conception. But it doesn’t eliminate egg quality problems, sperm/egg interaction problems or implantation problems. This is where I am in the process now and it hasn’t worked out so far.
Injectables combine with IUI
This is plan B for superovulation and IUI. Injectables are more stimulating and I suppose that’s supposed to further increase your chances of conception. But the issues listed above are not eliminated.
Because the egg and the sperm are brought together on a cute little petri dish, IVF eliminates the need for the sperm to find it’s way to the egg at all. Also visible now and possibly prevented are any sperm/egg interaction issues, i.e. any issues with the sperm not being able to penetrate the egg, too many sperm penetrating the egg etc because the technician makes that magic happen in the lab. It also has the added benefit of giving you some idea of the quality of your eggs. But IVF doesn’t eliminate implantation problems because after transfer, the blastocyte still needs to be able to “hatch” and embed itself in the uterine lining and many other steps for it to become a viable pregnancy.
The thing is…none of these procedures address implantation issues. If you’ve got that, it appears that you are totally fucked. And while Laparoscopy can help diagnose endometriosis and it’s an opportunity to clean up cysts, scar tissue and address inflammation which could interfere with follicle development and a fertilized egg traveling through the fallopian tube, apart from removing fibroids, does it do anything to help with implantation? My thoughts from all this is that, if you’ve made the decision to proceed with IVF, the only thing that I can see a lap helping with is improving follicle/egg development IF you have issues around that. (Of course if you’ve had an ectopic pregnancy then there is a medical need to get in there and do a lap so that’s a separate issue). And when you weigh the benefits of having a lap and then having to do a 2-3 month “break” afterwards, with what issues you can eliminate with the IVF procedure, the pros are not that great for someone who doesn’t feel like they have a whole lot of time on their hands. And I’m thinking that’s why my doctor and so many other doctors don’t require patients to do a laparoscopy, unless there is a visible cyst or a medical reason to do so.
Please someone correct me if there is a flaw in my thinking or if there is something that is missing but based on this, I feel like maybe the right time for me to do a lap is if the first IVF fails to give the IVF elimination plan a chance to eliminate some of the obstacles. But then again IVF is expensive and physically intense and I would love to give the first IVF it’s best shot at working with a cleaned out inside. Maybe even a clean slate for when I get to injectables/IUI! See now I’m faltering again…I wish there were ANSWERS!
I’m not even at IVF yet and I’m jumping the gun but sometimes the act of planning my shit out helps me relax and take back control. Would love to hear others thoughts on this and please point out the flaws in my thinking. I am just pulling this out of my ass and trying to distract myself from the latest failure.
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I have the next month off. So of course, me, being unable to “relax”, I start thinking about the possibility of fitting in a lap this cycle.
The thing is…I think I have endometriosis. I have no proof of that except my gut instinct and because I have some of those symptoms that are listed in the websites…severe cramping at times as well as the fact that my mother has it and has had a lap in the past. And the more you read on the web, the relationship between endometriosis and infertility are too close to deny. I’d brought it up with my doctor during our first consultation. He did not recommed at that point that I have a lap. He wanted us to do a few cycles of IUI and then revisit the issue if those failed since he said he’s seen many women with endometriosis get pregnant. So here I am, jumping the gun again only after 1 failed IUI. But fate has it that there are no surgery availability dates during April/May and so I have decided to wait out having a lap until after the 2nd IUI. If that fails, then I’ll have a consultation with the RE to talk about next steps and at that point, as he’d said originally, we’d talk about endometriosis and the possibility of a laparoscopy again. At least that’s what I proposed to my RE and his response…”Sounds like a good plan”. Sometimes I feel like I am writing my own protocol.
Would love to hear from others on their experience with laparoscopy and whether you think it’s worth doing or not.
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