Tuesday, April 03, 2007

We have a plan.

The plan:

Cycle 1 - one last kick at the Femara and IUI can.

Cycle 2 - Femara + injectables. IUI. BUT if I get too many follicles, we may convert to IVF.

Cycle 3 - Assuming we didn't convert to IVF last time, one more try for IUI with injectables.

Cycle 4 - IVF

The rationale:

Due to my young age, Dr. C is hesitant to go to full-on injectables. She feels that if I produce more than 3 follicles in an IUI cycle, we'll have a very high chance of multiples. She is willing to try a tiny dose of puregon along with the femara, as long as we are aware that we might need to convert to IUI.

Other questions:

Should I be put on Metformin? In short, Dr. C. feels that it's not worth it with the side effects. My fasting insulin was 95, and the normal range is up to 200. My fasting glucose was 4.6, and normal range is from 3 to 7. So I'm not even borderline... I'm full-on "normal". So Dr. C is of the opinion that since there's no insulin or glucose problem, there's no need for the Met.

Should I have an HSG? We know that I have at least one open tube since I got pregnant naturally about 9 months ago. Nothin has happened since then that would cause a blockage. We're only doing 2 or 3 cycles of IUI before we try IVF, and with IVF my tubes don't matter at all. Dr. C feels that it's not worth the discomfort and the risk of complications (she has a patient who got a huge infection from having her HSG - although it wasn't done at our clinic) just to get two open tubes instead of one for the next three months. I can live with that. I truly anticipate needing to do IVF anyway.

What happened last cycle, anyway? Well, it could have been a fluke. We're going to try one more cycle of the same and see what happens. We could start the femara a bit later, but not this month since I'm going to Israel on CD15 and doing a later start might run us into timing problems.

I think that's it. I'm honestly not expecting much from the April cycle, either... what with my trip and all... but we're getting closer to IVF, which in my age bracket has a 50% success rate. Sounds better than the 20% we're getting with IUI.


megan said...

it must be at least moderately comforting to have a plan, no? sounds like a good one at that! i think my doc may be planning on skipping the IUI and jumping right into IVF. scary.

Anonymous said...

I think it sounds like a good plan.

I hope you never have to get to the injectibles.

I hope dinner goes well tonight and your lamb is a success. Is there a right way to say Happy Passover?

Aurelia said...

Dr. C. is a good woman. She's probably right about this.

Tiny little but, you could do a sonohysterogram instead of an HSG and check for fibroids and adhesions and closed tubes without risking infection. HSG is really only good for OHIP coverage of IVF.

Maybe ask her?

ms. c said...

Sara, sounds like a good plan to me. (I'm all over the making of plans, even if it provided just temporary sanity!)
Your Dr is a smart woman- stay as far away from Met as you possibly can, girl!!!
As for the Femara+Inj- that's currently what I'm doing (at a miniscule dose of Pur.egon), so should you come to that (which I'm hoping that you don't), I'm available for any questions.

Suzy said...

That sounds like a great plan December. Break out the big guns..IVF soon...and really boost your chances...at least that's what I keep telling myself. ( :

This plan seems to really increase you chances of pregnancy over the next 4 months...very exciting!!

Barb said...

Sounds Like a GREAT plan Sara!

Wouldn't it be nice if they could just say "Ok, on this DATE you'll get BFP and then on THIS DATE, you'll have a baby". (sigh)Only in a perfect world I guess!!

Wishing you Lots and Lots of Luck and baby dust!

Anonymous said...

well a plan is good!
i'm with reality, i hope you never have to venture into injectible land...but if you do, i've got lots of pointers...
i hope spending the 2ww in Israel is just what you need next cycle!

tipsymarie said...

It sounds like a great plan. Does it feel better to have a plan in place?

And I like it that your doc wants to do IUI first - mine wanted to go straight to IVF. Which I'm still not ready to do, almost 2 years later. Hmph.

And how lucky you are not to take Met! Count your lucky stars for that break. I guess good things happen where you'd least expect them, right?