RE Consult

Greg and I went had our consultation with the RE on Tuesday. The visit went great, and we really like our RE. He has a wonderful bedside manner and really wants us to have input on each decision. He started the appointment by listening to our concerns (my CM), and agreed that it is likely an issue.

He also stressed that we are very young and have plenty of time (I am 32 and Greg is 31). While this is probably true, I still feel that clock ticking because: 1) I am healthy now, and who knows what the future will hold; and 2) We would like to have two children, so, if it takes us a while to get pregnant, I may be approaching 40 by the time we are ready to have number two.

With that said, he is ready for us to jump right into testing, and, if everything looks good, into IUI. We could do our first IUI as soon as next week! However, we decided to wait until the next cycle because we are feeling a little overwhelmed by how fast everything is moving, and because we would like a few more weeks to save up money.

The plan is to do the following tests:

• CD 3 bloodwork. This will test for various hormones that indicate if my ovaries are in good working order. This website seems to do a good job explaining what they test for and why they test for it. My RE said I could actually do the bloodwork anytime between CDs 2 & 4. (I had it done yesterday, which was CD3.)

• Bloodwork to test my thyroid. Apparently, thyroid problems can cause early miscarriage, so the RE just wants to rule it out. (This was included with the bloodwork I did yesterday.)

• A sperm analysis, which Greg is planning to do this week.

• A Hysterosalpinogram (HSG) between CDs 6 & 10. This is an x-ray of the uterus and fallopian tubes to looks for abnormalities. Because there is some anecdotal evidence that fertility increases for the few cycles after the HSG is performed, we are going to wait until next cycle to do this so we can have it done right before our first IUI.

Our RE also spent a good amount of time explaining the various options for IUI. He said we could do unmedicated IUI, which means I would not take any medications to help my body release eggs. Or, I could take fertility drugs to induce ovulation (Clomid, or more aggressive injectibles).

Going into the consult, Greg and I already knew we wanted to try unmedicated IUI because I am ovulating on my own and we would like to minimize the risk of multiples. I had heard that some REs do not like to perform unmedicated IUI, so I was thrilled when our RE agreed right away that unmedicated IUI would be our first step.

Normally, for an unmedicated IUI, a person would just come in the day after the first positive OPK. However, I sometimes do not get a positive OPK until the day of, (or the day after), ovulation. When I explained this to the RE, he suggested we do an ultrasound on CD 14 to see if an egg is about to be released, and, if it is, perform an HCG trigger to make it happen the next day (and do the IUI the next day). This way, we will definitely know when I am ovulating, and we won't be performing an IUI for nothing.

So that's the plan! Although we are not doing our IUI this cycle, and I am excited and can't wait to see the first round of test results come in!

And here's some more info that people may find useful:

Cost - My insurance covers testing to diagnose infertility, but not the actual treatment. Luckily, this means my insurance will pay for the CD 14 ultrasounds because it is a test.

• Doctor appointments: $35 copays
  

• HSG: $300 deductible plus 15% of the remaining cost, for a total cost of about $425

• HCG shot: $44

• IUI: $565

And here are some statistics on multiples (provided to us by our RE).

• Clomid - risk of twins = 10%, risk of 3 = less than 1%, risk of 4 or more = way less than 1% (and grrrr, for some reason blogger won't let me use the "less than" symbol!)
  

• Injectibles - risk of twins = 25%, risk of 3 = 5%, risk of 4 or more =1% (YIKES!!!)

Oh, and one last thing - the doctor said I don't have to modify my caffeine intake (because I already drink less than 300 mg/day), wine drinking, or exercise - WOOOHOOO!!