Monday, March 8, 2010

up next: IUI #3

I should have known when I stepped in dog shit this morning that today was not going to be a good day. While cleaning off my nice, new, beige satin heels in the waiting room of the RE's office, I thought, "The results of the SA aren't going to be good."

And they weren't.

The overall count was up to 98 million, but there were still none moving rapidly and only 6% were normal morphology.

So it's official. My mild endo is an obstacle, but MFI is our definitive diagnosis. In a way, it's good to have a firm answer about why things aren't working.

Where do we go from here? Well, we're dumping the male fertility vitamins. His counts were lower without them, but his morphology and motility weren't nearly this bad. I'd rather have less sperm to work with and have them be higher quality.

We need to go back in for another consult after my lumpectomy, and then we'll do IUI #3 next cycle, which will probably fall on the week of my 25th birthday. I have a choice of using Femara or injectables. Thoughts? Has anyone used both and preferred one over the other?

He's giving us the option on the number of IUIs we do before moving on to IVF, but we'll probably stick with 3. This will make 5 IUIs total: 2 with Clomid and 3 with some other form of medication.

I know what most of you will say. "Don't focus on IVF." But part of me has to. If we have any hope of doing IVF, we will need to look into financial options so that we aren't completely blindsided with the cost if that's what has to end up happening.

How does the average person afford IVF? And still have money left over to HAVE a baby?

We CANNOT afford IVF right now. As much as I would love to jump straight to IVF and increase our odds, it can't happen. Our insurance covers no part of it and we do not live in a state that requires mandatory coverage.

This is never how I saw my life. My heels stained in dog shit. My eyes puffy from wanting to cry but not having the energy (and thinking "Why the hell should I cry over this? It's nothing new"). My mind adding numbers in my head to see when we'll have an extra $10,000 laying around.

Bring on the baby. This IUI has to work.


IF Crossroads said...

Ugh, dog shit to top off your morning? Lovely. So sorry about that!!! Doubly sorry to read about the repeat S/A #'s. If it were me, I'd probably skip the femera and move on to injects. But that's just me. The LAP should have hopefully cleared out a path but I think you'd likely have better success with injects. GL with your upcoming lumpectomy. Thinking of you always.

Jessica said...

Sorry you are having such a "shitty" day! My DH has low morph too and to be honest I wished we wouldn't have spent the money on the injectable IUI's. My new RE has made it sound like it was a waste of our money. If I were you I would way the costs and see what makes most sense for your situation. I know IVF is really expensive but it gives you your best shot and can get around MFI.

We are doing a Low-Stim IVF cycle which means not as many drugs, plus we qualified for a program that donates free we are spending about $7400 for this cycle and that includes everything. We spent about $1500 per injectable IUI adds up. It is just something to think about, I know its a hard decision.

Good Luck!

pandadiaries said...

I'm sorry you're having such a bad day. You'll be in my thoughts and prayers, hoping that this round works out for you both.

Nixy said...

Ug. Sorry about such a bad day. Dog poop on nice shoes is the worst.

I think Jessica makes a really good point. When you have to make decisions like this and money is such a huge factor, then you are right to think about skipping steps. It only seems natural.

Did your RE tell you what your chances of pregnancy are with the IUIs? maybe that would help your decision. If it's only 5% or so, it might make sense to just skip to IVF.

Jin said...

I'm not sure what to say. Sure the costs of IVF is much higher, but so is the success rates. But then again most folks need to go through more than 1 round of it. And I have no idea how regular folks get the money for it - loans? Because there aren't many folks that come out and say they're saving for the next 12 months to afford IVF. What does your doc think about the IUI?

Whatever y'all decide, I'm here rooting for you.

Kandid Kelli said...

All I am going to say is I love you, b.c thats all there is to say. We talk a lot during the day via twitter, so you know my feelings- You do what you gotta do.

But I couldn't let this go uncommented.

xo & Praying for you!

Jen said...

Not sure if you have any coverage for the Femara, but I did 2 months of that without coverage. It made me feel a whole lot crappier (headaches, some nausea) than the Clomid did, and although it doesn't have the thinning effects on the lining, it didn't help my follies enough. I felt like it wasn't worth the $. We ended up canceling the IUI one cycle, as they weren't big enough to spend the $ on it.
I would honestly jump right into injects, for what it's worth. Obviously I am a little biased since it worked for me, but after having little to no success on both Clomid and Femara, the Follistim created a near perfect cycle on the 1st try. My RE said I had a 25-30% success rate that month.
Good luck with your biopsy, and I'm sorry to hear about the crappy swimmers.

Bean stalk ballads said...

Yuck. I can relate to this post all too well. IVF is everything that you say it is, and the truth is, many of us cant afford the cycles. But.. it is what we do unfortunately. I wish it was easier for you. Rest assured there are a lot of us out here caring for you.

Did the clinic tell you to consider ICSI with IVF? Given we have so little sperm to work with that is what we did. The other good thing about IVF is diagnostically it is very helpful because they can really see whats happening with your eggs and swimmers. They just leave out the part of the emotional fallout though...

Kelly said...

Blech. Dog shit in the morning. Your shoes sound adorable, though.

Katie, I'm sorry you're going through this. I truly, truly am.

If you are thinking forward to IVF, start doing some research into different clinics. Do they do shared risk? This would be the way that I would go if I were faced with IVF (and I were accepted). Just my two cents. You have to do what feels right.


Crossed Fingers said...

*giant hugs* I don't have advice on which to choose but I'm so sorry you're faced with that choice. I can hear the heaviness in your post. I will hope with all that I have that IUI works for you guys. Fingers crossed, lucky rabbit foot ready, and wishing on stars.

erika said...

Oh, dear Katie, I am so sorry about the shitty start to the day. I am sorry you guys have to make all these hard decisions.
We are in similar shoes, we were just told we were more likely dealing with MFI and got on our last cycle with injects IUI.
Femara got me some nice follicles and it's definitely much cheaper than the injects. However, the inject cycle has a greater chance than just the pills so we decided to go with injects for our last shot at IUI.
It seems with our dx it's gonna be ICSI for us next (sad face inserted here).
These are all such hard decisions. They are crippling both emotionally and financially. Not to mention all the hormones going on while in this hamster wheel.
I hope you guys won't need to think about it for long, because #3 will be your charm!
In my culture, we think stepping into poop (accidentally) brings good luck. Hope it's a great sign for you (((wink, wink)))
How long do you have to decide about the IUI protocol?

Astrid said...

Gross, as I read about the dog shit I thought "that is the WORST!" but then when I read the words "new beige satin heels" my jaw completely dropped. It really blows to have the universe turned so decidedly against you.

But I totally get the bright side of having a diagnosis, that is good. And you're moving on and taking a serious step towards the goal which is awesome. Hang in there.

Arlyne said...

I've never tried femara, but don't respond too well to injects ( my dr. says they're synthetic & some people just don't do well with them) which is why we are combining them with Clomid this time around. ( I got my short-lived BFP with Clomid) At your age, you have a good chance of responding better than I did to the injects though. Like everyone said, it's a tough choice, but I'd probably go all in with the injects.

Sending (((HUGS))) & positive thoughts your way!!!

Suzanne said...

I read your blog from time to time and happened to see today's post - I'm sorry it's been such a tough day!

Having done both Femara and injectibles, I'd recommend going straight to injects - although I responded well to the pills, the injectibles provide much tighter control of your cycle and (usually) a better follicle response. My husband and I have MFI (low motility) and were successful on our second IUI cycle with Menopur and a total motile count of 4.9 million, believe it or not.

Good luck, you'll be in my prayers!

Rebecca said...

I'm so sorry about this. Whatever you decide to do, I really hope that it works for you soon.

We're sticking with femara at this point because of cost, mostly. We are saving for IVF. I know I have to keep some sort of faith that an IUI might work at some point (or why am I doing them) but I feel like I'm just going through the motions because my doctor says I have to. I feel like we're more likely to skip injects and go to IVF after we try two more femara IUIs.

Erin said...

I loved doing the injectables. Seriously. It was such a nice change from Clomid, and I got great results. Plus, the injectables give you a higher quality of egg.

There are grants and other monies out there to help couples who can't afford IVF. Maybe that might be something to look into?

Carrie said...

Oh your shoes!!! That is devastating enough! I never did injects, but it would definitely be a stronger drug to give you more/better quality eggs. I have to say that I would set your number of IUIs and stop. If it is an option that doesn't work, you should know within three cycles or so. I continue to think of you daily!

JC said...

Oh Katie, I'm so sorry! What a shitty morning. I'm sorry about your hubby's SA, and the new heels. I know what you mean about looking to the future. Like my "talk" with F the other night, he just wants to focus on the now, but I can't help but think about adoption. I mean part of me feels happy thinking that at least I could have a baby at the end of that. Who knows though, IVF could be in our future too if F decides he's not sure if he wants to. Ugh, I hate thinking about it, and the cost of it. I'm in the same boat with 0 coverage. We should move ;). I hope you and Joey agree on a plan and on the meds you want to use. My RE gave me a choice of Clomid or injections, and we chose injections mainly b/c the chances are better. It's more $ but I didn't want to waste my time, I wanted something with the highest chance of success. Thinking of you. =)

Dawn said...

I'm so sorry about your crappy day. The dog crap was enough. I'm sorry about repeat S/A numbers. I hope that you can get the other numbers back up!

I hope that a birthday IUI brings you lots of luck though.

Ashley said...

Ugh. I'm so sorry about your crappy day!:( unfortunately I have no advice for you. I never had a choice when it came to meds. Fingers crossed for a lucky birthday iui!!!:)

Nicole said...

It's totally normal to look down the road to the next steps and the what ifs; especially since having a plan can be of some comfort when bad news sets it.
I used femara (not on an IUI, just BDing) and it did about the same for me as 50mg of Clomid. I would do injectables if I were you. You'll want to be monitored carefully so you don't hyperstim or end up with quintuplets (isn't that so ironic to have to consider the risk of high order multiples in IF when you are worrying about getting anything?), but I think you will respond better with both more and more mature eggs. I would also use trigger meds if they'll let you.
There's my advice!

Nicole said...

more as in quantity and more as in better quality. Sorry that was unclear

The Baby Race said...

So sorry to hear about your horrible day. Doing my first IUI this month and am terrified. Geting an u/s tomorrow and am freaked at what horible things may be lurking there - cysts, growths. who knows.