What the Doctor Said

We decided to have a consult with our Doctor before moving forward with any further treatment. Initially, Dr. D wanted us to do 4 IUI's (one "normal" and 3 on clomid). But after two failed IUI's we didn't feel like this was a very effective treatment and wanted to talk with the doctor.

Before meeting with Dr. D, I had to have an ultrasound to check for any residual cysts... and that was all normal. Here's a summary of what he said.

"To be blunt, the first IUI had very little chance for success because the sperm count was much lower than we anticipated. That doesn't mean it couldn't have worked, just that the chances weren't very high. That being said, you've really only had one good IUI. You responded VERY well to the clomid, we almost never see that many follicles on such a low dose. If you were my daughter, I would say you should do one more IUI, maybe two... but if you feel emotionally drained from all of this, we can take a break and start up again in a couple months."

We don't want to stop completely, not yet anyways... but just don't want to continue with something that's ineffective.

"Because you respond so strongly to clomid, you aren't a candidate for Follistim (which is a much more potent medication to produce follicles). You would likely produce more than 8 eggs, and IF successful, would almost certainly end up with at least triplets if not more. But because of the complications and heartaches in pregnancies with high volume multiples, I don't believe this would be a good/safe idea for you. Also, there are more side effects and you run the risk of getting OHSS. I think we should do one more Clomid IUI cycle. If that isn't successful, we have three options.

1. Take a break.
2. Laproscopy to check for endometriosis
3. IVF

"I recommend moving right to the IVF. Even though you have some family history of endometriosis, you don't have any signs or symptoms. The biggest indicators for endometriosis are if your periods are getting progressively more painful or heavy (which mine haven't... they've actually gotten better over the last 5 years.) Also, laproscopy is more invasive, and it costs as much as IVF. In looking at it from a cost basis, you have 0% chance of coming out of laproscopy pregnant, but you have 55% chance coming out of IVF pregnant. If an IVF is unsuccessful, we could then decide if we want to try a second one, or do laproscopy."

Dr. D was incredible kind through this conversation... the way I've written it probably comes across as him being stiff and insensitive.. but he was the complete opposite! He kept saying, "it's up to you, but I really believe this would be your best option.... this is what I would tell my daughter to do."

I asked about the possibility of doing ZIFT, but he said the success rates are much higher for IVF than for ZIFT. The only reason he does ZIFT anymore is if he can't implant into the uterus for some reason. After a little more discussion with Dr. D, we decided to do one more IUI and once that's finished, we'll make the next decision. He did switch me from Clomid to Femara. I was having hot flashes, constipation, and bloating on the clomid.... I gained 7 pounds from the clomid alone, add that to the 4-5 I gained from the progesterone the cycle before... and my clothes definitely don't fit!

Dr. D said that I wouldn't have any side effects from the Femara, and probably wouldn't produce quite as many follicles as on the Clomid, but it would still be effective.

Femara is terrible! I only have to be on it for 5 days, today is day 4 and I've had terrible hot flashes, headaches, mood swings, and I haven't been able to sleep at all. Thank goodness I only have to take it tonight and tomorrow night and then I'll be done!

We don't have a date set for our IUI, it all depends on what my ultrasound shows next week.

Thank you all for your encouragement and prayers... they're needed and much appreciated.