Two Years and Counting

Follow Up Appt With Dr. H
January 23, 2008, 4:49 pm
Filed under: Uncategorized

We met with Dr. H. today. I felt so much better after our discussion. Each time I’ve talked with her, I’ve left feeling calm and encouraged. She just has a very pleasant, calm demeanor, but knows her stuff very well and is firm and confident as well.

We discussed the past cycle and how everything looked. She went over all my levels and things that were tested throughout the cycle and said everything looked very good. She looked at M’s numbers and talked us through those saying they were good as well. (I’ll get into that more later.) She said everything looked perfect for the first IUI, which as you all know doesn’t mean much since perfect cycles can lead to a period instead of a pregnancy, but it’s good that my body is doing what it’s supposed to be doing. She said so far we’re in the unexplained infertility category since nothing has come back as having a red flag on it. After we left her office, we agreed that even though unexplained infertility can be frustrating since there’s nothing glaring to fix, we’re still glad everything on both of us has come back normal.

As for the next cycle, she said she’d suggest unmedicated again since my body is doing naturally what it’s supposed to do, and there’s really no need to go on a drug to help me ovulate, since I’m already doing that. I told her I agreed, that I don’t want to get on the meds unless there’s a good reason to. She said she thought she might have to talk me into not going on the meds since a lot of women want to go on them immediately, but that in my case it’s not necessary. She did, however, mention something called either hyperovulation or superovulation where they cause you to produce several more eggs to increase your chances of conceiving. With this, it’s risky because there’s a 20% chance of twins, a 5% chance of triplets, and some other percentage of quads. She said she didn’t suggest this, but that it’s possible. I quickly said no. Later, M said, Yea right, M and Lauren plus 8! (We watch John and Kate Plus 8 on TLC.)

We also talked about the trigger shot. I told her what happened this cycle with me probably ovulating late, and she agreed that stress can cause a delayed ovulation, but that whatever the reason for my late ovulation this time, the shot will help us time it better.

So, our plan is another natural, unmedicated cycle with a trigger shot. She actually recommends us doing 4 of these cycles (3 more after this current one.) She said the chances of conceiving with an IUI are about 10-12% (I can’t remember right now if those are stats for an unmedicated IUI.) 10-12% seems really low to me, but I have to remember that I’m not trusting in stats or in IUIs to get me pregnant. God can work despite statistics or post-wash counts or whatever. Anyway, she said with these statistics, if after 4 attempts, we’d move on to the next thing, whatever that is. She said she felt confident in this course of action, as I’m only 28 and not in a situation where I need to be super aggressive in treatment, especially, again, as everything in my body is as it should be as of now.

As for M, we talked about his levels and his exercise. First thing, she asked how many hours he’s exercising per week now and how many he’ll be doing in training. He said 10 hours, and she basically said that was too much. When there’s a lot of rigorous exercise, the amounts of endorphins that are released affect can sperm production. Also, specifically with the bike, there can be some nerve damage in people who ride for hours at a time, along with overheating due to the spandex shorts they wear. So all in all, she said exercising 3-5 hours a week is fine, and that if he wants to take an hour and a half or so bike ride once a week (which is what he wants to do) that’s fine. Any more than that makes her uncomfortable. I really wanted M to hear what Dr H said about it. Last night I told him I’d probably be uncomfortable with the rigorous training involved in competing in the triathlons regardless of what Dr. H said today. He said his family (ie, me) and trying to have a baby is his first priority, and if his training gets in the way of that, then he’ll gladly stop. His thing was that he wanted a good reason to stop, not just unfounded nervousness coming from me. Or to be more specific, if she came back and said I’m 100% comfortable with you continuing with your training schedule this summer, then he wanted me to hear that and be ok with it too, and to not continue worrying about it and resenting it. Which makes since—medical facts are one thing, and the nervousness of a wife who sometimes worries too much is another, even though I had a gut instinct that she was going to come down agreeing with me at least a little. Not that there are sides in this. I just wanted her honest opinion. And her honest opinion was that 3-5 hours a week is ok, any more than that may not be ok.

She said the good thing is that we’ll be able to tell what the 3-5 hours are doing to his sperm because of the IUIs each month. We’ll know what his percentage of motile sperm are each month, and if the counts start going down, we’ll know the exercise regimen needs to be altered. And I’m comfortable with that, and M is too.

So my plan for this cycle is to come in on CD3 for an antral count (what does this mean? I forgot) and a check of my ovarian reserve, which I think will involve an u/s and bloodwork. Then I’ll start with the dreaded OPKs at day 13 or so, calling when I see any color line on the stick. I asked her about having to come in when I see even a faint line, and she said that’s just so they can see me before the surge starts, especially this time since I’ll be having the trigger shot. If we do the u/s and it’s too early, they’ll have me come back. Then, at the right time, they’ll give me the shot, and we’ll do the IUI I think 36 hours later. We’re supposed to abstain for at least 2 days before collection. When M gave his sample for the SPA test, we’d abstained for I think 5 days, and he had a really big number, 146 million, I think. Then for the IUI collection, the number was much smaller, we think because we hadn’t abstained at all. We actually had had sex the previous morning (a Friday) for the post coital test, then he had to give his sample the next day, Saturday, for the IUI. His number was much lower for that. We’re thinking having a few days of abstention before the collection will make the numbers go up. Then it’ll be back to waiting!

And here I sit. No more thoughts right now, but I’m sure I’ll be back for more later.

6 Comments so far
Leave a comment

Lauren – I’m so glad to hear that you had a great appt. with your doctor, AND that your husband was there with you, hearing all of the info. A couple of questions – how long are your cycles? More than 30 days? The reason that I ask is that starting the OPKs on day 13 seems a little late to me. What day do you normally ovulate on? I normally ovulate between day 12-14, usually on Day 14, but once in a while I get a day 12 (like this month), and once I got a day 16. However maybe you have longer cycles so starting on day 13 is normal for you. Then a comment on abstaining – don’t abstain for more than 3-4 days because if you abstain too long then the sperm can get sluggish. There may be a lot in volume when you abstain for 5 days, but the motility won’t be as good. Definitely don’t abstain for like 7 days or anything. Glad that the doctor mentioned the bike thing too. Oh and do you know you shouldn’t take really hot baths? Maybe you already know that, but just checking. Okay I’m not trying to be a doctor, because I’m not, but just some other things for you to think about.

Comment by Soapchick

My cycle is usually around 30 days or so, and I usually ovulate around day 16 or 17. You’re probably right though–13 is probably a tad too late. I’ll probably start on day 12. The nurses at the office have a general rule of starting on day 9 and I’ve made it clear that day 9 is way too early for me. Thankfully, they understand that we women (especially those who chart temps and things) tend to know our bodies well enough to know around when we ovulate.

And the doctor did tell us not to abstain for anywhere close to 7 days. We’re thinking 2-3 should do it.

And no, I don’t take hot baths, or baths at all, even though on cold nights, I usually wish I could!

Thanks for reading!

Comment by Lauren

That all sounds really good.

The antral count is to see how many small follicles there are at the very beginning of your cycle; I think if there are too few it indicates a hormonal problem or an impending ovulation problem. I just had an antral count done, and I think there were about a dozen small follicles in each ovary, which my u/s tech said was good. (I’m not sure exactly what “normal” is, whether I was above average or at standard counts…)

Yes, IUI stats do seem low, but not when you think that a perfectly fertile couple only have a 20% chance of conceiving each month. IUI success rates are a bit lower than that, but still a lot better than our chances of conceiving spontaneously when we’re dealing with infertility! And like you said, God is bigger than any of those statistics.

Comment by andrea_jennine

The IUI stats are probably about right. I’ve actually heard lower for unmedicated IUIs but that might not take into account that you’re young and healthy.

Comment by Jennifer

Lauren – I tagged you. Go to my blog to see what I mean.

Comment by soapchick

Thanks for the comment & tag! Your plan of action sounds good. D.’s best samples for SA and IUI have always been at 72 hours of abstinence — our RE and urologist said that is often a good number to try for. Good luck!

Comment by southcitysadie

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