The Pill before IUI or IVF question

Hi,

I have had all the tests done and have finally found out that DH is the prob with slow & abnormal spermies.

We are booked in with a FS on 19 Mar to be referred back to Westmead Fertility. I am so excited that finally we are on our way after a 17 long months. I read all the booklets and they say you need to go on the pill on the 1st day of AF (after you have appoint with nurse at clinic) and then EPU will be 6 weeks from that point. AF for me is due about a week after I see the FS. Then 6 weeks from that is during a week when there is no physical way for me to do a EPU. I really don't want to wait an extra cycle on top of that. I just want to get this party in my uterus underway!! lol

I thought if I started the pill now and let AF come a week later say - everything will be fantastic timing to start. I guess the problem is that I know so little such as - is the FS going to recommend IUI first or can we opt for IVF straight up. When will my appointment with the nurse be?

I have a super regular cycle and ovulate with no dramas every month (25 day cycle). My question is - should I delay AF for a week to be more suitable or just be alla naturale for my appointment with the FS?

Any help on this matter would be fantastic. I just don't know what the best option is. I just would be crushed if my first opportunity to have it all done - can't happen and I have to wait another month..

All these unknowns are just frustrating...I just want to see that BFP so that I can move on with my life! This has consumed be long enough!

Thanks

Hi Peachy

Congratulations on your appointment!! It's a big step isn't it!

In answer to your question, personally I would not start the pill for a couple of reasons.

1. Your cycle (25 days) seems pretty short. You may have a short luteal phase. A FS may try you on clomiphene (Clomid) to lengthen it before IUI or similar.
2. I am in Melbourne so not with Westmead but I have done two IVF cycles and neither involved taking BCP. There are a number of different protocols so yours may not even involve taking BCP.
3. I am not sure what tests you have had done but a lot of FS will do full blood work (even if you have had it done before) to check FSH, AMH, thyroid function, etc. A lot will also do a HSG (A test which injects dye into your fallopian tubes to check for blockage) and ultrasounds.
4. When it comes to checking hormones, au naturale is best!

It depends on the severity of your DH's issues, but my understanding is that most FS will only look at IVF as a last resort. Not as a first port of call.

Unfortunately, patience is required in spades!!!!

Good luck!!

n2l

there are lots of things they can do with the pill to manipulate your timing to work with you (and the clinic) - it's part of the reason they use the pill at all - your cycle may not work for the clinic (timing wise) so they can guesstimate when they want to put you in for EPU and countback as to when they need to start. the pill is (generally speaking) used so that you have a bleed when they need you to. like N2L i never used the OCP (actually, we tried it once - the side effecs put me in hospital with a painless migraine - they thought i was having a stroke - so it was definitely a one off!)

your first cycle will be very much an experiment to see how you respond to the medications. depending on the severity of your partners MFI, they may go straight to IVF, but if they believe IUI is a possibility, you may only be put on the clomid tablets (which you would take on a natural cycle more than likely). if you do go to full IVF, you may or may not need the pill depending on whether your normal AF dates "fit" - you may also need to have "down regulation" via nasal spray or injections - to essentially put your body into drug-induced menopausal state for a short time and give them complete hormonal control.

it is very hard to say what may or may not happen - but at this point, my suggestion is to keep everything as it is with your cycle - if it needs manipulating, let the FS do that side of things if it becomes necessary

good luck! and yes, patience is the name of the game here unfortunately

The one thing I've noticed with fertility specialists - you may think you have done all the right tests and had all the investigations done under the sun, but there's always more. You can bet that they will want to do their own semen analysis (the way IVF clinics do it is very different to the way pathology centres do it) and a bunch more tests on you. They need you to not be on the pill for those tests.

The other thing, westmead fertility centre is a public clinic. It's cheaper, has a lot more patients and has much longer waiting times. I know this is somewhat bubble-bursting and not what you want to hear, but definitely do not expect to just walk in and be able to start straight away. It's pretty much impossible even in the private clinics anyway.

BW

Thanks guys.

I have had a Day 21 BT which shows everything is normal. I've had a lap done with the tubal patency thingo (dye test) and I have absolutely nothing wrong with me. Tubes are clear, no PCOS, no endo. DH had his spermies tested through IVF Australia so that test should be cool unless they want him to repeat it.

I believe that we will DH will have to get a BT done prob. As for the waiting list - I'm not trying to get my hopes up too high but if I don't have some hope then I would prob just fall in a heap. I just have to keep on believing that it will happen soon otherwise - it's just too depressing!