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Ex/Current DTTCers
I've had my follow up fertility appointment today after bloods and HYCOSY and have come out with an action pan that I wasn't expecting at all.
I have been referred to another hospital that has a more specialised fertility depatment as my ovaries are being overworked. I will probably need to have an AMH to check the number of eggs I have to determine next steps. Best case is that I would have IUI (if I have a good supply), if not then we would be referred for IVF with donor eggs.
My Thyroid levels are also too high and have been referred back to GP and have appointment on Thursday.
just wondered if anyone else had experience of any of the above? Feeling a bit tearful, scared, but also positive to have a plan.
Thanks x
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Was there something wrong with your tubes? Have you tried clomid/letrozole/injections yet?
I will find out my action plan tomorrow, so will let you know. Although I know my tubes were fine so I doubt it will be IVF and IUIisnt funded here because of ts poor success rate.
No, tubes are fine.
From what I understand my hormones are already working hard enough to release eggs, so another stimulant wouldn't necessarily improve chances, and there is a chance that my eggs wouldn't be of the best quality if they were released (I'm 34). Consultant acknowledged that it may be better to go with the above from a speed vs success point of view. I've not heard of letrozole or know what other injections I could have, but guess my next appointment with new consultant will be best time to ask. Anything else I should be asking?
Thanks Ducky, I hope you have a successful appointment tomorrow, let me know how you get on.
Ah right. I'm sure they are making the best decision for you. I understand now why you're not trying the other methods of ovulation induction first.
To be honest I haven't looked into IVF much yet, mainly because we aren't at that stage, so can't really help with questions. Are you NHS or private? Do you know how many cycles you'll be entitled to? And how long will they keep any potential frozen embryos for? How many embryos can you have put back in? That's all I can think of!
As an aside, a good friend of mine is pregnant with donor eggs because hers were not good quality, her baby is due in April and I'm going to her baby shower Saturday :-)
Er yes, my thyroid levels were too high, I was diagnosed with graves disease. Have they given you a clue why yours are too high? I was told I wouldn't get pregnant while I was hyperthyroid, it makes your body work too fast. I could talk about thyroid for hours, if you have any questions ask away!
I had a lowish AMH but egg quality was good - 3 out of 5 eggs collected fertilised - and I was 32 at the time. I also had IUI first which worked on 3rd cycle with clomid (mc though). I would say wait and see what the new consultant says but I would be surprised if you needed donor eggs unless you had absolutely no ovarian reserve although I am not sure what your 'ovaries being overworked' means. The main question I had was 'how soon can I start?!' Can't really help with the thyroid issue sorry.
Good luck and keep us updated! out of interest which clinic are you being referred too?
Thanks ladies,
Ducky-I will be going NHS to start with and get 1 attempt at IUI or IVF (though AMH is not available on NHS so will pay for that). I've read this this evening which is a more accurate way of saying what the problem is:
One of the ways that doctors treat infertility is to use artificial means to increase FSH levels to force the body to ovulate or produce more eggs. If a woman is already producing a high level of FSH then artificially increasing her FSH levels will not likely improve her chances of getting pregnant. Also having high FSH levels can mean that the quality of eggs produced is diminished, not just the number of eggs being produced. So that even if a woman does become pregnant her chances of having a successful pregnancy are also affected.
Pombear:thanks for stepping forward! He didn't say why it was so hi-I'm not sure if I understand what you mean-can there be something that causes it to be high, rather than it being something that 'just is'? I have symptoms of anxiety and nervous energy but not at levels that I have been to docs about, just thought that that's the way nature made me :-) one thing that I am confused on is if high thyroid is a cause of infertility, why is he not treating me for that first? I guess it's the combination of increased FSH too.
Willow: Do you know if they can only test the wail its by fertilising the egg? Or did they have a good idea of this beforehand? The only question I could really think to ask was 'how long do I have to wait until my referral comes through?'! I've been referred to Coventry University Hospital. Consultant did say that after initial consultation that I would be able to chose to go elsewhere if I wanted so will have a read up on success rates etc in prep.
Thanks again, sorry for so many questions x
I was hyper thyroid which caused a goitre but it didn't affect my fertility - I have three children. I had to take tablets to bring the thyroid levels within normal range, this was only a medium term solution, last October I had a thyroidectomy. My mum had undiagnosed hyperthyroid for many years and it has caused her irreversible heart problems so it isn't something they will just leave but I don't think it is normally too much to worry about, it can be easily treated. Good luck with it all, sorry I can't help re. the ttc side.
They'll need to do several blood tests to assertain the reason for your hyperthyroidism, typically TSH, T4 and T3 in my experience. If the levels are high they'll want to ultrasound your thyroid or maybe just have a good feel of it to check for a goiter. You'd probably notice if you had one of those, a lump in your throar it quite clear! But like me, there may be nothing wrong with your thyroid at all. I have an auto immune disease called graves. This causes some of the anti bodies in my body which should be doing the things normal anti bodies do, aren't. They're mimicing a hormone normally produced in my pituatry gland, TSH. This is the hornone that tells your thyroid how much thyroxine to produce to run you metabolism. So because of the doppganger thyroid you produce too much thyroxine T3&4. In response the pituatry gland goes 'woah there, I didnt tell you to do that! And reduces the real TSH to slow down the thyroid. Thyroid doesn't notice because its busy being fooled by the mimic. So a test for graves disease is simple, you have high thyroxine and low or non-existant TSH.
Side effects of hyperthyroidism you make recognise in yourself... these were mine, there are others.
Tachycardia, or rapid pulse. On diagnosis day my resting pulse was 130
Short temper and blind rages
Sweatiness and intolerance to heat
Weight loss
Shorter cycles, mine were averaging 23 days back then
Going to the loo (number two) more often
Infertility...
What is Fab is that there are drugs they can give you to block the thyroid from producing thyroxine, and one of these PTU is safe to take while you're ttc, so no need to stop while they fix you. Bizarrely if it is graves, it normally gets its act together during pregnancy, its like your body knows it has to behave and gets its act together! Whatever you do please don't Google it. Trust me.
I'm in the unexplained category, as in all the tests came back ok, but have a slightly under active thyroid. I've been referred for IUI and am due to start the clomid next week if AF arrives on time. I also have an injection to use but not really sure when or why as the nurse was crap at the last appointment. Hoping when I call to tell them AF has arrived they will tell me the next step. I've been started on a low dose of thyroxine and feel great....hadn't realised I didn't feel 100% just accepted it as normal.
Kittykat, the injection is most likely HCG (mabye called ovidrelle?). When your follicle is ready to ovulate, based on your tracking scans, you'll be told to do the injection to trigger ovulation in the following 24-36 hours. It is called a trigger shot. Your IUI will most likely be scheduled for the day after the trigger shot.
Thanks Pombear, that's very helpful and reassuring. I'm sticking to the NHS pages only for thyroid and consultant gave me the HFEA website for comprehensive info on fertility treatment (a very useful site so far). It's interesting to read the symptoms, obviously infertility is/could be one, but I also read that anxiety and nervous energy are symptoms....KK, I do suffer from both of these and posted about my anxiety before-I thought these were just normal for me so that really would be great if these are 'treated' as a result. Anxious but positive times for you too KK x
Thanks ducky! Who needs a nurse 'specialists' when you have md?? That sounds the right name for the injections and now I know what to do with them. Hope they are epipens-wasn't expecting to use a needle
Hi looby, just wanted to let you know you are not alone with feeling like that. I know what it's like to come away from a fertilty appt feeling completely thrown as you just didn't expect the outcome. You do sound as if you are approaching the plan positively though. Can't help with thyroid levels or IVF. Regarding the amh test, I had one recently and came out pretty much on the bottom baseline. I was just above the 0.1 percentile for my age. My specialist has told me a number of times that it has an error margin, it's not a definitive result but its the best type of test available at present. He has also stressed that it does not tell you about egg quality.
When is your next appt? Good luck x
Hi Looby,
I didn't have your particular circumstances, but was a DTC-er and we conceived our LO through ICSI - we were lucky first cycle. Just wanted to say, it is so overwhelming at first, but you will soon get used to things, become quite an expert even, and it is very empowering after a wait to get started, and have an action plan as you say.
Wishing you lots of luck, and hope that the next few months bring great things your way x
Not sure they can tell the quality of the eggs before hand, think they do look at them under the microscope but before that it is just ultrasound - although they can measure the size. With IVF they mix the sperm in with all the eggs then see which fertilise - they then only transfer the very best one. If you get a choice definately go straight for IVF although emotionally harder there is a much higher success rate than IUI. I guess I was lucky as had 3 goes at IUI then could've had 2 at IVF (only needed 1 though!).
Don't know much about Coventry but if you are based in the midlands then it is not so bad for you to travel to a better clinic if needed I suppose!
I am another in the unexplained bench. Spoke to the Dr yesterday and she is going to refer us would 'assume' that they may go for IUI instead of IVF first. For me eveything is working fine and technically should now be pregnant....
The Dr advisd me that as everything was working fine she didn't want to give me more drugs as it may cause me to over stimulate then we can do nothing for 6 months.
Does anyong know why IVF would have a higher success rate than IUI?
Sorry, I don't think that was much help but must feel great to have a plan in place!
IUI is just putting the sperm where they need to be (the Fallopian tubes) then hoping nature takes its course meaning the sperm and egg meet, fertilise normally, implant etc.
IVF has several eggs to start with, rather than just the one in IUI. The sperm are placed directly with the egg to allow for fertilisation. Then only the eggs that have fertilised and are dividing well are considered to be put back in utero. Normally they pick the very best embryo that has the highest chance if implantation and healthy pregnancy. With IUI they can't tell the quality of the egg or if it fertilised, or if it is dividing ok, you just have to hope for the best.
If I recall correctly IUI has about 10% success rate per cycle. IVF has around 33-50% per cycle (depending on certain factors (age, weight, reason for infertility).
Thank you Ducky!
Thanks all for your replies. I'm feeling less scared and more positives today, thank you.
Diamonds, I'm not sure when my next appointment is yet. Letter should be sent to new consultant this week, so hopefully will hear within next couple of weeks. Sorry that you are going through this too but it's nice for us all not to feel so alone. Are you on first cycle of cloned? Is that with IUI?
Lamby-thank you for sharing your story. You really don't have long to meet your special bundle x
Willow-H recalls consultant saying we would get 3 IUI and 1 IVF, I only heard 1....could do with a dictaphone to take in next time-there's a lot to absorb! That makes sense about the quality. Out of interest, did you take H to all of your treatment appointments? I work in Birmingham so that would open up some options too but wouldn't be so convenient for H on a regular basis.
LC-hope you start to get some answers too, keep us updated x
Ducky-how did your appointment go today?
x
Hi looby, it went really well. I have my prescription for clomid and norithesterone so will start that tomorrow when I pick them up. I posted a longer update in the DTC thread. Thank you for asking, I'm pleased to see you're feeling more positive today x