I am on CD26 and just waiting for my period to show up so I can FINALLY begin another treatment cycle! I have an appointment on Tuesday morning (which will hopefully be CD1) with my regular OB/GYN to discuss the possibility of doing an IUI with her. I am pretty torn on this and I'll have about 24 hours to decide whether to go with her or go back to our fertility clinic.
I was really hoping that going with my regular doc would be cheaper because (1) this will be the first time they have ever offered IF services and (2) they are not specialists in the area. This is just a small town clinic so it seems logical to have thought that but it turns out that it is about the same cost. So, I think I'll make a pros/cons list.
Pros
I LOVE my doctor and trust her completely
If there is a way to cut costs, she'll find it
I'd be treated by a doctor that I know and trust - not a nurse that I have never met before
It is a 10 minute drive to our local clinic vs. a hour drive (without traffic, so sometimes longer)
I would get a lot of time and attention since this is their first ever IUI
Cons
They aren't specialists in the area of IF or Male Factor
The cost isn't any cheaper
DH is nervous about providing his "sample" at our local clinic where you know everybody talks and will know exactly what he is there for
There is no anonymity and everybody is not there for the same reason that you are
The lab capabilities make me a little leary
Questions for Tuesday:
Who will be doing the lab work (the doctors? I hope)
Would it be possible for DH to do his thing at home and have me bring it in right away?
What are her thoughts on injectables vs. clomid?
What is there experience with follicle monitoring and do they feel comfortable with the equipment available?
Do they recommend back to back IUIs? Would that be included in the price?
Hmmm...I'm sure I'll think of more before then. I am nervous about moving away from the clinic that specialized in IF but then again, I haven't found success with them either. So, why not give it a shot with an awesome doctor who has a vested interest in my positive outcome??
Anyone have any advice on this subject??
Also, anyone have any advice on moving away from Clomid to injectables? Remember, I ovulate on my own.
5 comments:
Hey there...just got your message in my journal. As far as injectables, I used Bravelle. I had none of the side effects that I had with Clomid (less CM and hot flashes - and this on the lowest Clomid dose!). It took a couple days to get used to injecting myself, but once you get into it, it's no big deal. The plus side of injectables, especially in your case, is more eggs = more targets for your husband's sperm. The downside is more targets = increased risk of multiples. And every doctor has their own way of dealing with this increased risk. My RE is VERY conservative. He never wanted me to have more than two lead follicles because of my age and general health. And I did ovulate two eggs the month I conceived Jacob. Since I also ovulate on my own, though, I felt it was necessary to have two eggs at a time (and when we were TTC Jacob we had no children, so twins wasn't as scary of a thought as it is now). Anyway, you will need to be monitored more frequently on injectables, both by bloodwork and by ultrasound. I think I averaged three ultrasounds per cycle (baseline and then two more prior to ovulation) and bloodwork each time. Without insurance coverage you could easily be looking at $1500-3000 in out of pocket costs per cycle.
It sounds like you have a lot of pros and cons to weigh before you make your decision. I wish you much luck...I wish this whole thing was easier for us both. We don't deserve this.
-Leighann
Such a decision! I know my regular doctor's office also does IUI's, but I had them done with my RE. This was not because they didn't want to do them but because I had already done clomid for 5 cycles. I also ovulate on my own. For the IUI's my RE had doing injectibles (Bravelle). I was nervous about it, just because it was more shots, but I had already done the ovidrel injections before. Otherwise, it was no big deal. Good luck making your decision!
I have no advice for this, just lots of good wishes for success.
I did two months of Clomid with IUI and then last month we did Follistim injectables with IUI. None worked, but my response to the lowest dose of Follistim was almost TOO good. It was more trying to go to the doctor so much - I think I had no less then 6 or 7 bloodraws and then maybe 4 ultrasounds. I also ovulate on my own and we are at a loss on why it hasn't worked for us thus far. Wishing you lots of luck!
Gah-decisions like this stink. I tend to be in the same boat as the first comment; if you are responding to Clomid OK, I don't know what benefits injectibles would really give you. The cost is quite a bit more for the drugs themselves, and, as someone else pointed out, there should be more intensive monitoring (blood draws and US). For someone that ovulates on their own, it would seem that the risk of hyperstimulation and OHSS would be too high. There is also the multiples issue. As my RE pointed out, we managed to dodge that particular bullet twice-each time we conceived we had two very good follicles, and a couple of stragglers that were on the borderline. If it were me, I would stick with the Clomid for as long as you keep getting good results (it does tend to start diminishing), and put the money towards back to back IUIs to increase your chance at catching ovulation. Good luck!
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