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To IUI or Not To IUI
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Anonymous
| OP here. I got a positive opk on day 24 of my cycle this month, which is super late for me. Normally, I get one on day 14-16. So at this point for me to have a sufficient luteal phase my cycle would have to be a lot longer than it has ever been. As a precautionary measure -- to extend my luteal phase -- they put me on the prometrium. 200 mg twice a day. |
Anonymous
| Thanks for the information, OP. It makes sense then to put you on prometrium although if you don't have a luteal phase defect, you should still produce enough natural progesterone if you become pregnant this cycle. In my case, even if my ovulation is late, my period starts exactly 14 days after it. |
Anonymous
| 17:26 -- really? So how often is your ovulation late? I am just worried b/c this is the first time my ovulation has been this late. I mean my cycles are never over 32 days. So I figure I'll take the prometrium just in case. Any arguments as to why that's not a good idea? I am open to suggestions. |
Anonymous
|
Cycle length varies - that's normal. That is because the length of the follicular phase can fluctuate. The luteal phase generally does not vary by more than a day. So assume you normally ovulate around day 16, with a 14 day LP, so you normally have a 30-day cycle. Ovulating late will not shorten the luteal phase, it will lengthen the cycle. So if you ovulate on day 24 instead of 16, that doesn't mean you'll still stick to your typical 30 day cycle but your LP will be only 6 days; it means you can expect a longer cycle.
Just like 17:26 said, regardless of when she ovulated, her LP is 14 days long so her period always starts 14 days after ovulation. I personally don't see the point of going on prometrium if your progesterone is normal and your LP is normally more 10 days. A late ovulation should have no effect on your LP length. |
Anonymous
| 17:26 here again. My ovulation is late once-twice a year (usually as a result of stress or sickness) and is early (day 11 instead of 13) every 3-4 months or so. PP perfectly summarized why there is no need to go on additional progesterone medication if you have no LP defect. |
Anonymous
| Op, just a suggestion, but I'd stick with your dr's advice on the prometrium. |
Anonymous
| Thanks everyone. As usual great advice. I did stick with the prometrium just because I think I would regret it if I didn't -- you know those coulda, shoulda, woulda's that plague this process. Like when I opted not to take the third dose of Clomid. Everytime I look at the pack of pills, I think, if I'd taken those pills maybe I would have gotten pregnant that month. |
Anonymous
|
IUI and IVF veteran here. Skip the IUI, if it is unmedicated. No different that well-timed intercourse. Continue to monitor your cycle with the tester and physical symptoms of ovulation. I am very leery of the unexplained infertility diagnosis, since that is what we were given after the whole battery of tests. We got pg on our first medicated IUI and then conceived our second child via IVF, round two, during which we learned we had a male factor issue that normal testing doesn't pick up. Turns out first IUI baby was pretty miraculous....Depending on your age, you can keep tring on your own, or if you are over 37, perhaps consider IVF in 6 months. The bonus to IVF over IUI, in my opinion, is that even if you don't conceive the first time, you learn more from it because the MD can see what happened or didn't happen and adjust. IUI is blind, so to speak. Having done both, I did not find IVF to be much more intense than IUI. Same meds, monitoring. The only difference is that they put you under briefly for the transfer, which was nothing.
Good luck. |
Anonymous
| 21:25 -- thanks so much for the info. For some reason my doctor is stuck on the unmedicated IUI and would NOT let me do a medicated cycle yet. I may push harder or change docs if necessary. We cannot do IVF until November 2011 at the earliest - and that is if I switch my insurance in the upcoming open season. If not, then I will switch next open season and IVF will be available to us in January 2012. So for now I am stuck with trying on our own or IUI. I am leery of the unexplained fertility diagnosis as well. Especially because my RE didn't even do the 21 day progesterone test until I requested it. I've never felt so lost with a doctor before. Like I am my own advocate. |
Anonymous
| OP, are you by any chance with Columbia Fertility? I encountered similar experience there. I had to tell Dr. Abbasi what tests to run, what my concerns were, etc. We switched practices twice and now with Dominion Fertility. |
Anonymous
| No I was with Dr. Abassi but then switched to Dr. Stillman at SG. Perhaps you'll find me soon at Dominion! No, I will try not to be a dr. switcher. I think you just really do have to be your own advocate with infertility issues. It's stupid. But apparently true? |
Anonymous
Why? Get a new RE. |
Anonymous
| Says I am ovulating on my own and he doesn't want to run the risk of too many follicles? something like that. My ob/gyn already put me on clomid so I am not sure why SG is so against it. I think maybe he's holding out hope that we'll either get pregnant on our own or that the IUI will just help things along? I am 35, DH is 40 and our tests all came back normal. So unexplained IF. Whatever the F that means. But I mean I outright asked him to let us do a medicated cycle and he said not yet. |
Anonymous
Clomid, unlike injectables, raises your cancer risk if used too often. Also, many women experience a thinning of their lining while on Clomid. There is good reason to use it with caution. |
Anonymous
Interesting b/c SG basically crammed clomid down my throat. I wanted to do injectibles and my RE at SG insisted on clomid. |