Saturday, June 20, 2009

Evaluating "The Plan"

I've been doing some googleing and feeling like I have had some time to more fully process the last month of our TTC journey and the start of working with an RE. And it is starting to gel for me.

The more I read online, the more I am finding congruences with what I read online and what our RE told us, which is reassuring. I am also better understanding some of what she told us. And all indications are that the plan we have laid out is the best plan for us.

- It makes sense to boost my ovulation with clomid, to do an hcg injection, leading to a timed iui to get DH's swimmers just that much closer to my eggs. Increasing the chances. I feel like the timing is the right mix for us of having been patient enough trying it on our our, and yet still be assertive in pushing ahead with some medical intervention. (Most of our doctors still encouraged us to just be patient and keep trying. We are done being patient). So all in all, I feel like this is the right plan for us, at the right time.

I still have some lingering questions though, some of which I can find answers, some of which I don't know if there will be answers:
- I still don't have a very clear picture what this will cost. I have the fee schedule, but its hard to know what it all will cost when all is said and done. I need to call the clinic and ask some more questions.
- I am worried about what clomid and HCG will do to my body. And wondering if maybe we could do iuis with out medication? I can handle a month of side effects, but I worry about it altering my cycle, or my body having other longer term reactions to the meds. I feel like my body is sensitive to meds like these and I worry about messing with my body when we don't know for sure that I NEED these.
- To be very honest- I don't want multiples. (This is where a blog can get you in trouble, cuz once you write it is there for all of history to read). The doctor said that the increase rate of multiples is not that much greater with clomid. I don't fully believe her. And the whole theory of clomid is to mature more eggs to give the sperm more targets to aim for. Ummmm....? That sounds like a risk of multiples to me? I'm not certain how many kids I want. Two is usually what we have talked about- one biological and one through adoption. That was when we THOUGHT we had it all planned out. And if we had twins? I don't know if I could/would still adopt? But i don't want to give up my adoption dream. Sigh. This is a silly conversation I am having with myself, I know. But its hard- cuz I feel like I am playing the odds in Vegas: i can either take a gamble and see if DH and I can get pregnant on our own, and not miscarry. OR we can boost our efforts with clomid and iui and risk getting more than we bargained for. Sigh. I need to just remind my self that it all works out in the end. I am not the author of the story...

Which brings me to my other unanswered question? Miscarriage. Will I miscarry again? The theory behind our plan is that a) by boosting my cycle with clomid and an hcg injection, i am increasing my follicle quality and supporting healthy hormone levels AND b) by doing an iui with sperm wash, the healthier boys will be inserted, and more of the low morphology/motility boys will be left out. As I understand it- in theory, this addresses two possible causes of the miscarriages- poor quality sperm and/or poor egg/follicle/hormone response. (But there are still plenty of reasons for the miscarriage that we are not addressing)

Its as best of a plan that I can come up with. I need to be diligent in find out actual costs and in asking a lot of questions about clomid and hcg with my doctor. And I need to come to terms with the fact that we will be out of town during my ovulation for the next THREE CYCLES, so this has to wait until September (Which reminds me- i also need to ask about how much time husband needs for his portion of the iui- his work schedule isn't very flexible). I am trying to tell myself that this is a good time for me to care for me- to ride my bike, lose these last 6 pounds, and enjoy our summer travel plans. I need to remind myself that this will all work out, and even though I feel like I am running out of time, I am not.


  1. I just read this and talked to my husband about doing the same thing because I really think it is a GREAT plan that your RE has in place, and I DO think it is your best chance and in reading this I also believe that it would be the best chance for me and my husband to have a successful pregnancy.

    My husband had his sperm analysis done and it was considered normal but teetered on the edge of abnormal morphology. So, it makes me wonder. I also wonder about the quality of my eggs.

    I go next week to my OB/GYN and I think I am going to request going the IUI route with Clomid.

    I also am concerned about clomid and the s/e. But, I figure it is covering my basis to have a healthy pregnany than I am willing to deal with it.

    Thanks for posting this. I have been wondering what to do with our next step of treatment.

  2. All good questions. I really don't know the exact statistic on clomid and multiples but I don't think it is that high. Your doctor should be able to give you the exact statistic. I haven't met a doctor yet who aims to get their patients pregnant with multiples. Singleton pregnancies carry the least amount of risk to mother and child. So, again, talk to your doc. But, unfortunately, no matter how many precautions, medications, techniques, or procedures you try no doctor can guarantee you will not miscarry. Its horribly unfair. But we hope and we pray and sometimes (many times) things go just right.