Curious about Assisted Conception?

[paradise lost]

Ah DP has friends who had ICSI and they told him their FS said she had a "hostile environment" which was killing the sperm before they got to the egg, and so they had to have the sperm injected into the egg instead, but maybe there was a male factor to it too, or maybe they just meant straight IVF as no-one actually SAID ICSI, iykwim.

Thanks for the drugs info BG, that was great!

Bx

[slyder]

Yep, IVF certainly overcomes the hostile environment factor. As for the ICSI component, like you say, there could've been MF issues, or in some cases I've read that some clinics just do ICSI routinely regardless of whether it is technically needed or not. I don't agree with this personally, but that's a whole 'nother story

[DrGirl72]

Thanks for this thread. I am about to take my first clomid tablet tomorrow! After seven months of known donor self insemination and 1 year of tracking my cycle, it appears that i may have a luteal phase defect (lp 9-11 days). Have just done a cycle of serial progesterone levels and was told yesterday that the peak was only about half what it should be. My ob seems fairly convinced i am ovulating as regular cycles, af pain, biphasic bbt and regular monthly positive opks. So he says i am ovulating but it needs to be done better as such. Can anyone tell me why i am going down the clomid track rather than being given progesterone if thats where the problem is? Plus he doesn't seem to think he needs to check for tubal patency/endometriosis etc at this stage, he didn't think it was even worth checking for chlamydia antibodies. While i am relieved to not need more invasive procedures at this stage i am mildly concerned that other problems may be being missed which will ultimately prolong TTC What are other's experiences re. investigations at what stages? Thanks

[butterfly_warrior]

DrGirl, clomid is regularly used to treat luteal phase defects, not just to force ovulation when it doesn't normally happen. The reason is that it often makes you ovulate better or "stronger" - this means that the body produces more of the right hormones by itself, rather than being pumped full of artificial hormones. Progesterone can also be used, but I'm under the impression that things work better if the body is able to produce its own hormones - at least that's what my FS tells me.

In short - it's a normal treatment for LPD, so don't panic!

BW

[DrGirl72]

Thanks BW. I'm starting on 25mg cd3-7 which seems like small dose but i'm assuming its 'cause its to improve ovulation rather than make it happen in the first place. Does that make sense to others?

[briggsy's girl]

in light of Kel's recent poll regarding IVF, and the fact that a lot of members mentioned not knowing how IVF worked/what we go through etc, i thought i'd bump this thread. there are a number of IVF/AC members subscribed who will happily answer any questions you have regarding the process of IVF. knowing more about the process might also explain a little more why some of us are so highly offended at the portrayal of IVF being the "easy" option!!

please, if you're curious about any of it - ask away. i know in livechat i've discussed with a number of ladies bits and pieces of my treatment - and i'm sure they're not the only ones curious!

[Maruschke]

Ok I have a *silly* question regarding DH's sperm and where to go from here....

We have had 2 SA's done and each time his rapidly progressive % has been less than 5%. Is this too low for IUI? Will IVF still work if his count is that low, or will it have to be ICSI? If they do ICSI, do they still make the sperm swim uphill before selecting a sperm so that they get the best one / a healthy one?

Thanks, I have so many questions!

[briggsy's girl]

i think you'll find with rapid progressive sperm count as low as it is, IUI would have negligible value for you - the chances aren't that great that it will work even with a good SA result (they're significantly less than with IVF), so i'd think you'll be steered toward IVF

having said that, IVF doesn't have to involve icsi - because the egg and sperm are put in close proximity, the ability of the sperm to swim won't be a problem. what they'll look at is whether there are unusual deformities to the shape of the sperm that may prevent them being able to penetrate the outer shell of the egg. you might have an FS that prefers to use ICSI due to the higher fertilisation rates, particularly if you don't get a high egg count at epu

FWIW, my hubby has a good SA, with all his results being within the normal range, so we're able to try IUI (and have had two chemical pg's from IUI) - but when we next do IVF (later this year if we don't get a sticky IUI pg before then) we'll use icsi as our fertilisation rates in the lab weren't that great.

[Maruschke]

BG thank you very much for that response, it did help to clear things up a lot.

I'm really curious about whether or not to give up hope on natural conception, so that I dont get so disappointed each month, and just hang onto hope for AC? Going through cycle after cycle of disappointment is so hard, and I think I'd do better if I resigned myelf to only hoping on AC cycles.

Has anyone who has gone through IVF / ICSI / AC come to this point? Did it help? Sorry to intrude if it is a personal question. It isnt really the medical side of IVF that bothers me, its whether or not I'm going to slide into depression while trying to make it through it.

[briggsy's girl]

there is a social group about ltttc that you might get some benefit from hun - it's about our emotional struggles and how we've dealt with them. go give it a read - and if you want to join, pm dusty, gargy or sushee for access.

fwiw - i pin all my hopes on AC - but i also don't ovulate regularly, so it's different for me than for someone that has a "cycle" as such. i think that putting your faith in the AC procedure and just enjoying life for a while can have a lot of positives for you in the short term - but, realistically, you're like all of us - you'll still know when you O, you'll still know when AF is due, and you'll still feel that disappointment that you didn't get that miracle to stop you needing ivf...

[~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.

[BeautifulMadness]

what a great thread.

just wanted to know with all the drugs you need to have...are the side effects bad?

and are you glad for IVF? after everything you need to go through and the disappointment

[sushee]

I know I'm eternally grateful for IVF. If not for IVF, I would not have my son. It's as simple as that.

BUT it was very very hard doing all those injections, all those blood tests, being prodded, pulled, your modesty a thing of the past, your fertility short-comings discussed by all and sundry, your life dominated by drugs and appointments, your life ruled by the results of your hormone levels, to again and again find out your cycle wasn't successful. Never knowing if IVF would even work for you, if you will finally have a child after all this pain and stress and emotional investment.

It was hard always harbouring the fear that despite all you're going through, that you'll be the one of the small percentage of patients for whom IVF won't give you that longed for child. And if it doesn't, you have no where else to go from here. That was what screwed with my head each and everyday on IVF.

So yes, I am thankful for it in hindsight, but while in it, it was the most stressfull, hell-ish time of my life.

[briggsy's girl]

side effects vary drastically from one person to another - and even one cycle to another

the BCP is defininately different for each person - i have had horrific issues (GP thought i was having a stroke) so will never go there - for a lot of people, it's nothing to worry about

lucrin/synarel - headaches are common. it's also effectively putting you into a medically induced menopausal state - so think of what people go through with menopause (hot flushes etc) and you're there. not everyone gets this, and again it varies. i found i got very crampy - like AF was on her way - but she never showed

puregon/gonal-f - this one varies greatly. i found i was bloated and felt a bit nauseous, but nothing unmanagable. it was worse during IVF stim cycle than it was during IUI as they stim you to get more eggs. i also found during ivf stim i was fairly uncomfy (BD was out of the question after a while) as my ovaries were significantly swollen. this can be much worse for some, especially if they develop OHSS

pregnyl/ovidrel - think early pg symptoms!! these contain HCG, so you are likely to have some early pg symptoms (morning sickness at ovulation - FUN!). also a lot of people have a reaction at injection point from this one. red welts etc. this one is also that one that, if you're going to develop ohss, can tip you over the edge. it triggers ovulation, and can be the shot to start the fluid leakage into your abdominal cavity

progesterone/crinone - apart from the ick factor, they are similar to what you'd feel in early pg - depending on the person, you can have some consitipation (or the other extreme!), bloating, discomfort. will also delay the arrival of AF whether you are pg or not

add to all this the hormonal mood swings, and it's not much fun at all!

[sushee]

Oh and side effects I got from the drugs:

Follicle Stimulating Hormones - headaches, bloating, weight gain, abdominal soreness, mood swings including lots of tears, shortness of breath.

Progesterone - bloating, sore boobs, nausea, headaches, flatulence, abdominal cramps (yes all the symptoms of pg!)

[BeautifulMadness]

Wow i must say you ladies are so strong and brave

[~clover~]

Just subscribing.
My best friend is looking into IVF due to complications from endo. I'm reading through atm, but am sure to be back with loads of questions for you all.