Monday, November 22, 2010

Next Steps?????

It is so hard to decide what your next steps are going to be when going through IF, especially unexplained IF.  I can appreciate that we have only been going through this for a short while, compared to many other bloggers out there.  But it is still tough to make such large decisions, with such little information.

So far we have ruled out all of the main factors except for endo.  I do think I have endo, but not severe enough to go straight to a lap.  I have the heavy, long periods, TONS of cramping, major lower back pain when on my period, etc.  But since nothing was showing as damaged in my HSG or ultrasounds, there shouldn't be a HUGE concern, should there?

Also, should we just dive into IUI or keep trying on our own for awhile, since we could just be, as my doctor calls it, unlucky?

There is a part of me that thinks Clomid for the next three months might not be a bad idea, but since I have no trouble ovulating, would Clomid really be worth trying?

Sorry for the whining, I am on CD2 and sad and hormonal and confused.  I guess I am off to visit Dr. Google to get some of these questions answered!!!!!


  1. I'm definitely no expert, but I am on my 2nd month in a row of an unmonitored Clomid cycle. I did a cycle of Clomid+IUI in the beginning of 2010. I ovulate on my own every month, and I am not certain that the Clomid is upping my chances by much. I suggest going the IUI+Clomid route, and not for any real, concrete reasons. Just because the Clomid doesn't seem to be helping me on its own :(

    Best of luck to you, I'll be following! :)

  2. Just curious, but how old are you? I have never had time on my side so I would be inclined to go for the Clomid with the IUI but if you are young then I guess no harm in just starting with Clomid.
    As far as endo goes, have you ever had any cysts? Do you have IBS symptoms near around the time of your period? Have your periods been getting worse as you get older? I have endometriosis and my tubes are clear and my uterus appears to be normal. Endo is a mysterious disease that can impact fertility in a number of ways. Does you doctor think you have it?
    I always feel for people who have unexplained infertility. On the one hand they seem to have more hope because there is nothing really wrong with them but on the other hand it must be so frustrating.
    I hope that you get your happy ending soon no matter what path you take.

  3. KC, I am 27. So not super pressed for time (just patience!).
    I had one cyst burst, I had appendicitis that my doctor thinks could have been caused by endo.
    A little bit of IBS symptoms the week before and of my period.
    My periods are no worse than when I was younger. They are not always painful, some months are fine, some are bad. Not nearly as bad as some people have talked about on their blogs though. On the bad months, as long as I catch it with six naproxin every four hours I am usually ok, but if I have to catch up to the pain, it sucks.
    My doctor says she never goes one way or the other with endo until the lap, because she has been wrong (both ways) many times.
    Yea, I think both ways are frustrating, but at least when it is diagnosed, you ahve some kind of direction/plan!
    I am enjoying reading your blog!

  4. I think sometimes, especially when its unexplained IF, it can be impossible to know which is the best route to take. It took us FOREVER to get to the RE (and my OBGYN would do nothing other than a HSG, no meds or anything), but then when we finally got there I didn't want to waste any time. Now I'm thankful I didn't. My first IUI cycle was also my first medicated cycle. I responded well each cycle and still no BFP. Now I'm glad that I didn't take it a step at a time because at that point we were just ready to get moving, and now I guess we can get moving in a different direction. Whatever you choose as your next step just make sure its something you and Ray agree on. I think thats all that really matters, that you go at a pace you feel comfortable with.
    BTW I don't regret doing the IUIs before the lap. I think it just adds another piece of the puzzle to me and my suspected endo. GL!!

  5. I would definitely do Clomid (or some other drug like Femara or injects, but probably Clomid to start). Lots of women take it who O on their own. It's just that added boost, plus it makes for a stronger O & raises your progesterone level (natural progesterone).

    IMHO, IUIs are a great way to go. Especially for unexplained IF. I got pregnant 2 out of 5 IUIs, so those are pretty good odds. The only reason they weren't sticky is due to my poor egg quality.

    It depends on the cost of things. If you could try a few rounds of Clomid or IUI or both for cheaper than a LAP - I would do that. If that doesn't work or if it would be cheaper - you could do a LAP first. LAPs are known to make women more fertile.

    Those are just my opinions though. I remember being at a cross roads, trying to figure things out. It's really hard.

    The best things to keep in mind are 1) How hard is it on your body and mind, 2) Cost, and 3) Effectiveness.

    :-) Good luck!! If you need anything, just let me know!

  6. Oh, I totally understand how hard it is to make decisions. I was always feeling my WORST when I didn't know what to do next. Once I decided, I felt much better! Here are my opinions:

    Endometriosis, as someone mentioned above, is a mysterious disease, affecting blood flow, hormones, structure, etc. When I finally went to my 2nd RE who I LOVE and I told him my first RE found "mild stage 2 endo" during my lap, he became serious and said ANY endo will affect fertility greatly. So, in my opinion, it's nothing to mess around with.

    Clomid - I can't stand Clomid. It created more problems in me than it helped. It gave me more follicles BUT messed up my cervical mucus. I MUCH prefer femara. I got pregnant on it once (like the second cycle I was on it). Clomid has really strong side effects, too - the hot flashes were awful!

    IUIs - I did 5 I think, with no success. I have been pregnant three times, NONE with IUI. IUI is great for SOME problems, but not all. When the sperm count is great and your cervical mucus is fine, I don't see the point of messing with nature. But I say that AFTER going that route and dealing with it failing so many times. It was a really stressful process for us, too, which probably didn't help.

    Anyway, those are my opinions, everyone has their own. Good luck, hun. I know that trying to decide your next move can be SO Hard. But, I TRULY believe that our babies come when they are ready, no matter what we do. I started feeling that after my experience and watching a bunch of women on a discussion board I visit frequently conceive at such random felt like there was no one answer and so I decided babies are just stubborn even as they are being conceived and come how they want and when they! Good luck!

  7. Thanks ladies, I really appreciate all of your advice! It really helps to have so many viewpoints!

  8. Hi, I'm here from the ICLW list. I was in a similar place to you a year ago--"unexplained" infertility. Of course it turns out our first RE was a total chucklehead and we now have a diagnosis, but that unexplained piece is a really hard one to navigate. It's a difficult thing to do a treatment when you don't really know what's causing the problem. But looking back I do wish I had been more aggressive. We wasted a lot of time waiting, hoping that we were "just unlucky" as your doctor said, and we could have been making progress in that time instead of just getting more and more depressed. So I would definitely argue for charging ahead, whether it's with Clomid or something else--even if the treatment you choose doesn't result in a pregnancy on the first try, at least it will give you more data.