Let's Be Honest...

[Anonymous]

Please be honest here. I am considering doing this and I'm sure I'm not alone.

Have you ever tried fertility meds without monitoring, on your own, in the hopes of getting pregnant and saving some money?

For example... have you had a failed IUI and had refills available on prescriptions? Have you refilled your Clomid and taken it on your own and use timed intercourse? Assuming you're charting your cycles and using OPK's. If so, what was the outcome? If you got pregnant, did you just tell your RE you did it on your own? Did you tell your RE that you took the meds without being monitored? I'm interested in what others have done.

I don't know how many times I can throw out $1600 to keep trying IUI's.

[Anonymous]

what 'level' of fertility meds are you talking and what has been your response thus far?

I have certainly taken clomid without being monitored. After several cycles of monitored clomid + ovidrel I did some that were unmonitored. But those were after we had a pretty good idea how I was responding, and with my doctors full knowledge.

I never got pregnant on any of those cycles. My one and only pregnancy occurred totally randomly without any meds or charting, etc (and it ended in miscarriage).

If you are talking about injectibles- I wouldn't do those without monitoring. The risk of higher order multiples is really high.

Will your RE let you do a monitored drug cycle without the IUI??? That is what I have done several of (of course since our success has been zero I am probably not a model to follow).

[Anonymous]

Why don't you ask your RE about a monitored TI cycle if you don't want to try IUIs but do want to use the meds?

Here was a recent discussion:
http://www.dcurbanmom.com/jforum/posts/list/290931.page

To be honest, I'd be less concerned about Clomid than other drugs but personally would still not do it. My Clomid cycles were all over the place in terms of when we triggered and we did have a cyst here and there ... I would doubt getting it right and might worry about getting it wrong.

[Anonymous]

OP Here - I am considering just taking Clomid.

My first IUI was Clomid + Ovidrel. If I do a monitored drug cycle without the IUI I will have to pay $490 for each monitoring appointment. By the time I get my 3 monitors I might as well pay for the IUI.

I've only had one IUI, so I don't have a lot of history to look at. I honestly don't think I can afford too many more.

[Anonymous]

I would not hesitate to take clomid alone without monitoring. What dosage are we talking? How many follicles did you have on your first cycle? Have you previously had a successful pregnancy? Did you get good results from your semen analysis? (obviously- feel free to not answer any of these questions if you don't want to-- but the answers could inform the chances of the IUI being successful.)

I think some RE's push to treatment before diagnosis-- which can get expensive.

Also- what is your insurance like? It sounds like you are paying out of pocket for the IUI plus monitoring. If you are just doing monitoring could it be coded as a 'gynecological ultrasound" instead of a fertility treatment- and would that make a difference for insurance coverage? (I'm pretty sure it makes a big difference for me).

The jury is still out on this one-- but if you don't have a male factor issue there is a good chance that the IUI is not putting you in any better shape than TI.

[Anonymous]

I know I probably shouldn't tell you this and I know flames will probably rise from this post staying how dangerous and terrible this is...But I did exactly what you are asking about.

I had several failed clomid/femara iui's (around 5) and 2 failed inj iui cycles. I really believed that the inj cycles failed because the doc did not take in account my weight (I'm overweight) when calculating the gonal f doses and then miss timed my ovulation as well on both. I was furious because those two cycles cost about $2500 each (with meds). So I decided to do my own cycle. I researched extensively using Google (I know...)I found a doc's infertility website that focused on patients that were overweight. I researched this doc and he has a great reputation. I called the office and had a brief consult with him regarding gonal f dosing with specific regards to weight. As it happens, this doc had posted several of his iui protocols online. So along with my brief consult with him, reviewing his protocols along with other protocols I found, I sent started my own cycle. I had refills on my clomid, gonal-f and ovidrel--got them all refilled. Now as a side note, I was deceiving my infertility office as well, I told them I wanted to do a natural cycle iui. They only charged $250 for that and my insurance would cover the monitoring and labs. So I went in on day 3 for baseline numbers and sono. Then started clomid day 3-7, went into office again on day 8 for labs and sono. Started gonal f doses based on my research (day 8-11). Went into office again on day 11, I had 3 follicles 13, 15, and 17 (also did labs). Continued gonal f two more days (day 12-13). Office again on day 13, follicles now 15, 17 and 19. I figured a gonal boost (higher dose) was needed on this day (day 14). Day 15 went into office, follicles now 17 19 and 21, did ovidrel dose at 11am, did iui about 39 hours later. Now 20 weeks pregnant.

I know I had success, but I would not suggest this. I did tell my husband what I was doing just in case something crazy happened. I was scared the whole time. I didn't know if my labs would indicate that I was taking the meds and then my doc would call me on it. I researched extensively, like over 20-30 hours before I started. I definitely realize that is not a replacement for medical training, but I was just so mad about those two failed cycles. I did those two cycles based on a strong recommendation from the doc. I felt like I could have done and IVF cycle for just a little more. But they thought I should give inj iui a couple of tries.

So I am being honest with you about what I did. I definitely understand how the finances can be a decision maker. I know a lot of folks on this board won't understand and will bury me for posting what I did, but such is life.

Good luck, and as they say "I'm not a doctor, but I did stay at a Holiday Inn last night"

[Anonymous]

PP from above, please excuse typo's. I was typing on my phone.

[Anonymous]

Anonymous wrote:I know I probably shouldn't tell you this and I know flames will probably rise from this post staying how dangerous and terrible this is...But I did exactly what you are asking about.

I had several failed clomid/femara iui's (around 5) and 2 failed inj iui cycles. I really believed that the inj cycles failed because the doc did not take in account my weight (I'm overweight) when calculating the gonal f doses and then miss timed my ovulation as well on both. I was furious because those two cycles cost about $2500 each (with meds). So I decided to do my own cycle. I researched extensively using Google (I know...)I found a doc's infertility website that focused on patients that were overweight. I researched this doc and he has a great reputation. I called the office and had a brief consult with him regarding gonal f dosing with specific regards to weight. As it happens, this doc had posted several of his iui protocols online. So along with my brief consult with him, reviewing his protocols along with other protocols I found, I sent started my own cycle. I had refills on my clomid, gonal-f and ovidrel--got them all refilled. Now as a side note, I was deceiving my infertility office as well, I told them I wanted to do a natural cycle iui. They only charged $250 for that and my insurance would cover the monitoring and labs. So I went in on day 3 for baseline numbers and sono. Then started clomid day 3-7, went into office again on day 8 for labs and sono. Started gonal f doses based on my research (day 8-11). Went into office again on day 11, I had 3 follicles 13, 15, and 17 (also did labs). Continued gonal f two more days (day 12-13). Office again on day 13, follicles now 15, 17 and 19. I figured a gonal boost (higher dose) was needed on this day (day 14). Day 15 went into office, follicles now 17 19 and 21, did ovidrel dose at 11am, did iui about 39 hours later. Now 20 weeks pregnant.

I know I had success, but I would not suggest this. I did tell my husband what I was doing just in case something crazy happened. I was scared the whole time. I didn't know if my labs would indicate that I was taking the meds and then my doc would call me on it. I researched extensively, like over 20-30 hours before I started. I definitely realize that is not a replacement for medical training, but I was just so mad about those two failed cycles. I did those two cycles based on a strong recommendation from the doc. I felt like I could have done and IVF cycle for just a little more. But they thought I should give inj iui a couple of tries.

So I am being honest with you about what I did. I definitely understand how the finances can be a decision maker. I know a lot of folks on this board won't understand and will bury me for posting what I did, but such is life.

Good luck, and as they say "I'm not a doctor, but I did stay at a Holiday Inn last night"

No flames here. Congrats and good for you on figuring out how to work the system!

[Anonymous]

Anonymous wrote:I know I probably shouldn't tell you this and I know flames will probably rise from this post staying how dangerous and terrible this is...But I did exactly what you are asking about.

I had several failed clomid/femara iui's (around 5) and 2 failed inj iui cycles. I really believed that the inj cycles failed because the doc did not take in account my weight (I'm overweight) when calculating the gonal f doses and then miss timed my ovulation as well on both. I was furious because those two cycles cost about $2500 each (with meds). So I decided to do my own cycle. I researched extensively using Google (I know...)I found a doc's infertility website that focused on patients that were overweight. I researched this doc and he has a great reputation. I called the office and had a brief consult with him regarding gonal f dosing with specific regards to weight. As it happens, this doc had posted several of his iui protocols online. So along with my brief consult with him, reviewing his protocols along with other protocols I found, I sent started my own cycle. I had refills on my clomid, gonal-f and ovidrel--got them all refilled. Now as a side note, I was deceiving my infertility office as well, I told them I wanted to do a natural cycle iui. They only charged $250 for that and my insurance would cover the monitoring and labs. So I went in on day 3 for baseline numbers and sono. Then started clomid day 3-7, went into office again on day 8 for labs and sono. Started gonal f doses based on my research (day 8-11). Went into office again on day 11, I had 3 follicles 13, 15, and 17 (also did labs). Continued gonal f two more days (day 12-13). Office again on day 13, follicles now 15, 17 and 19. I figured a gonal boost (higher dose) was needed on this day (day 14). Day 15 went into office, follicles now 17 19 and 21, did ovidrel dose at 11am, did iui about 39 hours later. Now 20 weeks pregnant.

I know I had success, but I would not suggest this. I did tell my husband what I was doing just in case something crazy happened. I was scared the whole time. I didn't know if my labs would indicate that I was taking the meds and then my doc would call me on it. I researched extensively, like over 20-30 hours before I started. I definitely realize that is not a replacement for medical training, but I was just so mad about those two failed cycles. I did those two cycles based on a strong recommendation from the doc. I felt like I could have done and IVF cycle for just a little more. But they thought I should give inj iui a couple of tries.

So I am being honest with you about what I did. I definitely understand how the finances can be a decision maker. I know a lot of folks on this board won't understand and will bury me for posting what I did, but such is life.

Good luck, and as they say "I'm not a doctor, but I did stay at a Holiday Inn last night"

Congratulations on your pregnancy- that's great!!

I am assuming since you thought you needed to up your dosage that you were having a low response in your two failed cycles? I am completely horrified that your RE office did not think it odd that after having two low response cycles on inj's you had 3 mature follicles allegedly on no drugs.

I would also note, OP, that what this poster did is not really what you are proposing. This poster was being monitored.

[Anonymous]

Anonymous wrote:I would not hesitate to take clomid alone without monitoring. What dosage are we talking? How many follicles did you have on your first cycle? Have you previously had a successful pregnancy? Did you get good results from your semen analysis? (obviously- feel free to not answer any of these questions if you don't want to-- but the answers could inform the chances of the IUI being successful.)

I think some RE's push to treatment before diagnosis-- which can get expensive.

Also- what is your insurance like? It sounds like you are paying out of pocket for the IUI plus monitoring. If you are just doing monitoring could it be coded as a 'gynecological ultrasound" instead of a fertility treatment- and would that make a difference for insurance coverage? (I'm pretty sure it makes a big difference for me).

The jury is still out on this one-- but if you don't have a male factor issue there is a good chance that the IUI is not putting you in any better shape than TI.

We have secondary unexplained infertility. We have successfully conceived a child (who is 3). It took us almost a year to conceive him with a miscarriage along the way.
This past (first) IUI I had one lead follicle at 22 and 2 followers at 16 on the day of my trigger. I took Clomid 50mg for cd 3-7 with Ovidrel on cd 14.
There is no male factor. 12 million sperm survived the wash, I think that's a good number.

My insurance covers nothing. I asked SG how they billed the insurance and it seems to be this big secret. They can't tell me how much, if anything, that insurance will pay until they submit a claim. I can't commit to the procedure until I know how much I will have to pay.

[Anonymous]

I would take clomid with no hesitation. I feel like OB's hand it out like candy. My OB gave me three cycles worth of clomid with no instructions. At this time in my ttc journey I still thought everybody ovulated on day 14, had never heard of a luteal phase, etc. Needless to say the clomid didn't work for me.

I would probably do timed intercourse with injectibles if I had done a few cycles before. The best case would be to do what PP did and get monitored but tell the RE you wanted to natural IUI. Good for you PP!! I would've been so scared that they would've seen something from the bloodwork.

[Anonymous]

My insurance covers nothing. I asked SG how they billed the insurance and it seems to be this big secret. They can't tell me how much, if anything, that insurance will pay until they submit a claim. I can't commit to the procedure until I know how much I will have to pay.

Have you met with the financial people in Rockville? They gave me a list of everything that was covered by insurance and the approximate cost of what wasn't covered and they went over it with me, item by item. The only real unknown was the medication (at the time, none had been prescribed). Once you know the medication, I believe Freedom has its rates online and can tell you what your cost will be (that was actually the harder part for me- they wanted my credit card information BEFORE they told me what the total charge would be).

[Anonymous]

20:47 Wow. Do you mind sharing your clinic name? I can't believe that after a meeting with your RE he/she wasn't willing to let you try the protocol you had researched OR that the clinic didn't find it strange when you had 3 follicles on a natural cycle.

What you did is essentially call the shots on your medication doses using the office for monitoring and appropriate timing of your trigger. This is very different than what the OP is suggesting. If you had developed 6 follicles you would have been able to make an informed decision about cancelling the IUI.

[Anonymous]

OP I would not hesitate to take 50 mg of clomid without monitoring.
If you want to do the ovidrel trigger- I would use OPK's- b/c you don't want to trigger early and rupture follicles before they are ready.

In your situation- 1) no male factor 2) have successfully naturally conceived 3) finances are an issue 4) no insurance-- I would think carefully about next steps before doing another IUI. You made decide for example that it is more cost effective to go straight to IVF due to its greater chance of success. Alternatively, I would carefully examine your insurance coverage. I think my coverage distinguished between what it considered assisted reproduction (IUI/IVF) and meds/ monitoring. I know my meds/ monitoring not associated with an IUI/IVF cycle were completely covered.

[Anonymous]

Anonymous wrote:20:47 Wow. Do you mind sharing your clinic name? I can't believe that after a meeting with your RE he/she wasn't willing to let you try the protocol you had researched OR that the clinic didn't find it strange when you had 3 follicles on a natural cycle.

What you did is essentially call the shots on your medication doses using the office for monitoring and appropriate timing of your trigger. This is very different than what the OP is suggesting. If you had developed 6 follicles you would have been able to make an informed decision about cancelling the IUI.

20:47 here, I didn't see that part in OP original post about the no monitoring. So what I did was different. I don't want to list the clinic's name, let's just say that their may be considered the 2nd best clinic in the area.

They probably would have used the protocol I researched, they just wanted to charge me another $2500 to do so, and I wasn't down for that--not after I had done all the research. Not sure why they didn't find it strange regarding the 3 follicles--I'm a cynic, I think it was about the money. I think because I was doing a little old $250 natural cycle, they just weren't fully engaged. I know that's sad to say, but that's just how I feel. I think for the patients who are not spending the big bucks (for IVF) you don' get as much attention.

But back to OP's original topic, I definitely would use Clomid or Femara un-monitored. Especially if you have been on it before. In my above scenario I upped my dose to 150mg day 3-7 (instead of 5-9) because that's what the RE who specialized in infertility for big mama's recommended.

Good luck to all.

P.S. Although Google is not a replacement for being under supervised medical care, there is a wealth of information out there regarding infertility (some good, some bad). Do yourselves and your bank account a favor and research. I knew/know that I needed to loose weight before getting pregnant. I knew that weight could be a factor in not getting pregnant, but I don't think my RE put in the time to research what protocol changes needed to be made based on my weight, which cost me money. Which circles back to OP's reason for wanting to try something without supervision--wanting to save money.