And I am back, after much deliberation. I have spent the entire morning and early afternoon debating whether or not to sign in to blogger and write a post, some thoughts verged on never signing in again. This break was much needed, and as much as I love following the journeys of my fellow iffers and sharing my experiences and support, I have dreaded this reinstatement to the land of IF. I have returned from visiting family and my brother. I waited 3 days since my return to call the Fertility Center, 4 days to google my favorite infertility blogs, and finally, 5 days since my return to sign in.
Here I am. I have a lot of catching up to do. I will begin by giving an update on my treatment.
4 months ago, F and I decided we were not comfortable with the risks of multiples that go along with injectable gonadotropins and IUI. We planned on one more clomid + IUI this summer and then to begin the IVF process this fall.
Well...
Maybe it is cold feet, maybe it is utter disappointment with clomid, maybe it is that infertility treatment feels like a gamble no matter what path you choose, but the closer it came to another clomid cycle, the more inadequate and inefficient my treatment seemed. Yet, jumping from clomid to IVF seemed like a huge distance to cross, even if it had been a year in time. I simply felt like we were skipping a possible success. Decisions are so difficult. What if we could get pregnant with just one round of injectables?
So we are changing our plan and gearing up for an injectables cycle with IUI.
We have been economical in our choices in the past, because money is a big issue for us and fertility medications are expensive. After adding up costs with the nurse, we decided on IVFmeds.com. Instead of paying $2000 at a pharmacy in the US, we will pay $700 (plus needles and syringes) for a generic HMG (human menopausal gonadotropin) from Europe. Additional savings comes with a sacrifice: these are intramuscular injections. The vials for I/M medications are $18.75 each, compared to $38.75 for sub-cutaneous. I hope this painful choice is worth the $500 it saves.
I do not know much about medications yet, but it seems that most patients take Follistim or Gonal-F, which are FSH only, rather than HMG like Repronex or Menopur that contain both FSH and LH. Maybe I am wrong? I am trying not to question what medication Dr. A has decided on. Of course the questions begin to form after the medications were prescribed and ordered. Honestly, I did not realize that there were differences, that some REs do not use LH to stimulate follicles, that sometimes synthetic hormones make a difference, or maybe they do not. It is amazing that you can still feel like a tiny rookie a year into treatment. I hate that I missed asking an important question. Was the decision based on my diagnosis and outcomes so far or was it based on finances? What is the difference? Does Dr A always use HMGs as opposed to rFSH?
Meanwhile, I will not worry about the medication, will not compare my treatment to others' treatment, will stop googling generic HMG, Menopur or Repronex. Feel free to share your thoughts though, and medications that you used, if I still have any readers! Also, if you know of a good resource that breaks down all the fertility medications and how/why they are used, please share the link.
One year ago I started this blog. Happy Anniversary?
9 comments:
Hi Jill,
Welcome back to blogland. I hope you have had a nice break. Since you did sustain an implantation with your first IUI it looks like IUI may really work for you. I did 4 with clomid with no success so we are going straight to IVF this month. I'm no scholar on stimulation hormones, but I will be taking both Menopur and Follistim with IVF. So it looks like you are on the right track. I have no idea how they decide which protocol is right for you, but I suppose alot of it is trial and error.
Hope the needles are not too bad, here is a link to a website that talks about how to reduce the pain with the needles - http://www.fertilityplus.org/faq/ivfhints.html
Good luck with you cycle!
They choose the protocol for you based on what your issues are. Most PCOS patients won't be prescribed Menopur/Repronex because they already have high LH. In my case, I was only borderline PCOS, so i DID use Menopur without overstimulating (in fact, I responded pretty slowly and had only 1 follie at trigger time). Because you have unexplained IF, I'd say that's pretty typical that they'd put you on the Menopur protocol, b/c your LH levels and overstimulating aren't a big concern. Hope this helps!
Welcome back. :)
PS - I used IVFmeds (though I paid for the subcutaneous ones) b/c they are SO much cheaper, and my injectible cycle resulted in a BFP. I hope the same for you!!!
I'm glad to read you again and breaks are only normal in this journey, I'm sure everyone understands.
On the medications, I wouldn't be too concerned, the low doses required for IUI don't require such a fine-tuning (FSH or FSH+LH) that and IVF cycle would. I did IUI just with FSH and then my clinic added LH only when we moved on to IVF. Love, Fran
Welcome back! And, "happy" blogaversary -- wish your blog had moved on to happier waters already!
We did a few injectable rounds after femara and clomid IUIs, too. And, originally we'd had the same thoughts about moving directly to IVF. I'm glad we did the injects, though, because it makes me feel more certain about moving to IVF, now. And, for so many it works and your doctor will take care not to let you trigger if you're overstimmed -- they don't want to see the higher order multiples anymore than you do!!
No idea on the combo drugs. I know some go that way and some don't -- I assume it all depends on the diagnosis or a doctor's preference. Good luck with it!!!
Welcome back! Glad to hear from you, and I hope you had a nice break!!! I did three rounds of injectible IUI's - the clomid IUI's didn't have high enough success rates to seem worth it. Good for you for shopping around and getting some cheaper meds, I know this is tough. For my IUI's, I only used Gonal-F, and then for the IVF, I used Menopur in addition to Follistim. Every doctor seems to be a little different - I wish it was more standardized! Good luck on this cycle!!!
Hi Jill, nice to have you back, I was wondering how you were doing.
I think the different variations on meds depends on the individuals age and circumstances (estrogen, progesterone evels, etc). I'm sure he picked the best protocol for you! Its hard to trust and not question, but I learned the hard way that if I didnt I would drive myself bonkers. I used Follistim for my IUI's.Glad you shopped around and found yourself a deal! (well comparatively speaking).
happy anniversary... while it's not the ideal anniversary to have, there are some positives of meeting people that you wouldn't have met before, right? ... congrats on making a decision to move forward w injectibles and IUIs. ya know, each new cycle brings a new decision and i'm sure it's the right one. thinking of you.
Okay, so the medication I am taking is Lepori, a European generic hmg. IM injections are indicated for this med, but the nurse said I can give them sub-q, as long as I don't have a reaction at the injection site. Confusing, but, whew! Relief, no self administered IM injections!
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