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Need advice before Thursdays appointment!

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Old 07-19-05, 08:06 AM
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Question Need advice before Thursdays appointment!

Hi Guys,

I was just looking for some advice and questions for the Doctors appointment I have on Thursday. It is to decided if we do 2 more DIUI or go straight to IVF.

I have been tested for PCOS, had an HSG and various blood work and u/s there appears to be nothing wrong with me reproductively. The only thing of note is my P4 progesterone has on some cycles been on the low side. My treatments so far have been using home ovulation kits.

DIUI 1 Natural cycle P4 14 think we missed ovulation
DIUI 2 Natural Cycle P4 19
DIUI 3 Natural cycle P4 24
DIUI 4 50mg Clomid P4 44
DIUI 5 50mg Clomid P4 42
DIUI 6 50mg Clomid P4 41
DIUI 7 Full injectable cycle u/s and b/w monitoring, trigger shot and progesterone support in 2ww.

Break here had weight loss surgery lost 100lbs and back to treatment.

DIUI 8 Natural Cycle P4 37
DIUI 9 Natural cycle P4 25
DIUI 50mg Clomid P4 40

All these of course BFN...

So the question is do we 2 aggressive injectable DIUI cycles then go to IVF or is enough enough already on the DIUIs and should we just skip to IVF? I have to mention here also that the donor sperm counts here in the UK vary very much from USA my best count ever on a cycle was 1.5 million of motile sperm the worst was half a million so IVF kind of helps in this department.

I dont want to move to IVF then it doesnt work and regret not having the 2 DIUI cycles in case one of those may have worked. But then I figure if the IVF doesnt work then the DIUIs probably never would have anyway.

Also any other questions you would ask your doctor at this stage?

Thanks guys as always!

Ruthx
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Old 07-19-05, 10:29 AM
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I would do the injectibles cycles - you are young enough that two months will not compromise your egg quality. See if you can pump up the dosage a bit to crank out 4+ follies. IMHO the sperm quality is VERY important. I finally got pg on sperm that had a post-thaw motility of 55%, so now I will not go with specimins with less than 50% motility. It's not the numbers that count, but how well they swim - that is what my RE told me.

My current RE says that she washes the IUI-ready sperm and she says that improves the motility. Since I haven't cycled with her yet (other than cancelled ones) I can't attest to that, but maybe someone else can.

Good luck, Ruth. You've been through a lot and are definitely due for a BFP!
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Old 07-19-05, 02:01 PM
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Ruth, I really feel like you should move on to IVF. Your body is working well with the weight loss, as your P4 has come up nicely on natural cycles. IVF protocol will certainly give you additional P4 support. Sperm quality is a big issue and although I acknowledge that it truly only takes one sperm to achieve pregnancy, I wonder if the sperm's motility isn't good.
 
Between that and timing, I think lies your answer as to why IUIs just haven't worked. Some REs don't seem to understand that not all women O at the same time in their cycle and not all women O at the same post-trigger point either. IVF bypasses all of the issues that seem to be your obstacles and I feel like that is your best option! I wish you TONS of luck.
 
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Old 07-19-05, 03:02 PM
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Thanks for your advice ladies, one thought to move me to IVF is unfortunately I am in the UK and the sperm numbers and motility is all you get there are no alternatives clinics or labs there is no other way. It is also illegal to grow more than 2 follies on any medicated cycle so there is no way of upping the follie counts they cancel any cycle with more than 2 follies.

Guess these are all things I need to talk to the doc about but wanted to see what you guys thought as you have all been with me through all of this.

Ruthx
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Old 07-19-05, 07:22 PM
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Here's another vote to move onto IVF. As Tracy said, you only need 1 sperm. Well, I'd rather have 1 sperm injected into an egg or have the drs watch 1 sperm penetrate the egg in a petri dish then take my chance with 1 sperm swimming into an egg in my tube. You must laugh at us when we say but we only had 12 million motile sperm. That's a low count for some of us. However, I remember reading that 5 million sperm is sufficient in a sample to get pg. You don't even get 5 million in your samples. Truly unfair!

Also with IVF, you date of ovulation will be controlled. No guess work. They'll have you on lupron or antagon etc. so the clinic can manipulate your cycle.

I wasn't aware that it was illegal to grow more than 2 follicles on a medicated cycle. I know Europe has rules about not putting back more than 3 embryos with IVF. However, if you produce more embryos you can freeze them for a FET.

Also with IVF, since the eggs are seen by the drs, if you do have any other issues i.e. egg quality they can be seen.
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