Curious about Assisted Conception?

[{sarah}]

Ever wondered what OI, IUI, ICSI mean?

Think it's odd when the IVF ladies talk about being on the pill but to scared to ask why?

Who has ever been curious about AC (assisted conception) but never been game enough to venture into the LT TTC forum to ask a question? I was before I started!! So here's the place to do it! Feel free to ask any questions you like, whether you are new to AC, considering it or even if you're just curious about the process. There's no big secret here, I'm more thn happy to answer questions, as most of the others would be too.

Who's going to be first?!

[briggsy's girl]

just subscribing to this one Sarah - i've been asked a number of questions in live chat - happy to answer whatever questions anyone might have!

[butterfly_warrior]

Same here. Those of us going through AC get so immersed in it that we forget that others don't speak the language or understand what we're talking about. Sometimes it seems that they are a bit intimidated by the strangeness to actually ask... Whether it's here or elsewhere, please ask! We're only too happy to answer.

BW

[Indadhanu]

Well... I'll start...
I am actually really curious (but have never asked ) to know why some people have to go on the pill during IVF... And when...

And actually another one (geeeez, being a member so long you'd think I'd know something, but embarassingly I don't) is what is all the different terms... like is IVF different to ICSI... what does that mean for the people doing IVF, does it mean different medications or transferring at different times or does it have to do with what the lab people do...?

Hopefully this will help someone starting out with AC too.... but I am curious... I don't know a lot about IVF...

[slyder]

Hey Leasha,

Here's my answers quickly, but others may wish to elaborate:

- The pill is to regulate the menstrual cycle so that an AC cycle can commence at a certain time. At least in our case this is what happens.

- IVF is where the best sperm and eggs are placed in the same dish and left to do their thing. ICSI is where the sperm is injected directly into the egg. This is done either because of the quality of the sperm (ie, limited motility, other defects) or where the egg is difficult to penetrate. Basically, IVF and ICSI run exactly the same except the meeting of the sperm and egg is different.

Hope this helps

[butterfly_warrior]

Yep, the pill is basically used to control the cycle so that things can begin at the whim of the clinic. For those of us who don't ovulate, it's to ensure that we actually DO have a cycle so we aren't waiting forever to be able to start things. The other option is to use a drug to force ovulation and create a natural cycle that way. I switch between the two depending on whether I need to manipulate timing or not.

BW

[briggsy's girl]

Leasha - i'm the same as Slyders wife - i was only put on the pill for the purpose of forcing a visit from AF when the FS was good and ready for her (pity my body is more stubborn than the doctor and she was STILL late)

it basically means they can get your body to fit in with the time frame that they need for introducing the drugs and things. for me, being a country bumpkin, there is only a one week window every 2 to 3 months when they can do any of the procedures, so it's key to bring everyone's cycles together

just for anyone's reference, thought i'd add here what i've been through

3 cycles of clomid for OI (ovulation induction) - all failed
2 cycles of down reg and OI for IUI (insemination) - cancelled as my body didn't respond to the OI
3 cycles of IUI (intrauterine insemination) - 2 BFN's, 1 Chemical Pregnancy
1 full stimulated cycle of IVF - failed - BFN
1 FET (frozen Embryo transfer) - BFN


Bec - there are a couple of Luteal Phase support drugs that are sometimes used after a stim cycle or transfer - they are basically progesterone supplements that help stop AF arriving too soon. i've used both crinone gel and the pessaries. crinone is a white gel that is delivered in a tube, while the pessaries are a waxy pellet. both are inserted into the vagina as the progesterone take up from the meds is best through the walls of the vagina. some people have injections for LP support - have to go out and help DH in the garden - will come back, and if no one has answered, will answer after that!

[paradise lost]

ME! I'm learning slowly, thanks to the kind patience of BG and BW, but i always have more questions... Shall i see what i know already...?

OI - ovulation induction? Like with Clomid?
IUI - inutero insemination? Where sperm is washed and then put straight into the uterus when ovulation (induced or natural? DO they do IUI with natural O?) is imminent to maximise chance of fertilisation?
ICSI - don't know what the letters mean, but i think this is where the sperm is physically injected into the egg, rather than having to find its own way, a way to fertilise when the conditions in the uterus aren't brilliant or when the sperm count is low or the sperm quality means the little guys struggle to get into the egg?
Varicocele - a varicose vein in the scrotum which can cause problems with sperm count/quality, i think because it can make the area too warm? Is that right?

um...the Pill, is that so the FS can "get control" of a woman's cycle, so they can start with a hormonal flatline before the injections for an IVF cycle start?

OH!

IVF - invitro fertilisation - where the egg is taken out, fertilised and put back.
Stim cycle - stimulation cycle? Where the woman goes through multiple injections to stimulate the ripening of hopefully lots of follicles rather than one or two, so they can be collected in...
Egg collection - sounds dreadful from what has been mentioned (mentally hugs and applauds all the AC women who have been through this - you are incredible!) vaginal ultrasound and long needle used to collect eggs.
OHSS - ovarian hyperstimulation syndrome, where the woman's body produces too many follicles and eggs which might or might not mature to the point they can be collected, the ovaries get very inflamed and the pelviv cavity fills with fluid - very painful and dagerous - potentially fatal? I get the impression diet and exercise can play a role for some but ultimately some women's bodies do this in response to the drugs no matter HOW careful they are?
FET - frozen embryo transfer - where an embryo created in a stim cycle which was frozen is thawed and transferred into mummy?

You can mark me on that - i probably need to do more homework!

Things i'd LOVE to know more about:

Some of the tests for infertility - there is one has been mentioned where dye was put through the tubes to see if they're clear/healthy? What is it called and how does it work?

Also, BW and BG you have both mentioned a drug (possibly a pessary?) which is a nasty colour and put in after transfer or at least during a stim cycle? What is it for?

What are the drugs used in a stim cycle? What are they called and what does each one do?

Phew! Thanks so much for this thread guys, i am excited to know more!

Bx

[Indadhanu]

Bec... I think on rare occassions they do an IUI procedure without OI... sometimes ovulation induction is done for convieniance... you know roundabouts when you're going to ovulate. Though for me, I didn't ovulate without it, so it was necessary. Plus you have that extra boost for egg and endometrium lining quality.
If there were issues of hostile CM, but no ovulation issues, IUI might be done on an unmedicated cycle.

Some of the tests for infertility - there is one has been mentioned where dye was put through the tubes to see if they're clear/healthy? What is it called and how does it work?
This is a HSG... or (geez I'll have to google the long name!!!) hysterosalpingogram.
You go into an xray clinic, and they insert a small catheter through your cervix and then squirt dye through the catheter and take xrays of the dye to see if it flows freely through both the tubes, and if there are any blackages. (A seemingly simple procedure, as long as you don't have a cervix that prefers to be closed constantly..... they used a screw to open my cervix... OUCHY!).
They can also do a basic dye study while doing a lap, they don't use xrays they just look and see if the dye flows through.

[~bonnie~]

Some of the tests for infertility - there is one has been mentioned where dye was put through the tubes to see if they're clear/healthy? What is it called and how does it work?


I'm having a Hy-Co-So on Monday ( Hysterosalpingo contrast sonography ) which is similar to what Leasha mentioned, but uses ultrasound instead of x-rays. This is what I found out about it after googling it:

"Hysterosalpingo contrast sonography (HyCoSy) has been compared favorably with HSG in the literature, and has received growing attention as a minimally invasive screening test. Many clinical trials report it to be as accurate as HSG in evaluating tubal function, while maintaining the advantages of ultrasonography as a safe and well-tolerated imaging modality. Others emphasize its superiority in demonstrating ovarian morphology, which is also pertinent to infertility investigation. This review of the literature will summarise the existing data on hysterosalpingo contrast sonography and compare it to existing modalities in terms of accuracy, tolerability, and cost-effectiveness in order to determine whether it can practically replace HSG as a primary screening tool."

Looking forward to reading more in this thread as IVF is starting to look like a possibility for us.

[sushee]

I have a known, very definite fertility issue (completely blocked tubes) and even knowing that, I still (even now) get disappointed and upset by the arrival of AF. I don't think you ever completely give up on a miracle. Nor should you. Hope should spring eternal.