Injectibles? Ques to ask RE

[docsaf]

Hello-

I am 36 years old. My DH and I have unexplained fertility - all tests came back normal. I just went through my first round of clomid (50 mg, CD5-9) + trigger + IUI and it was not successful. My RE thinks I released 2-3 follies, but my AF came 2 weeks later. My RE told us to try one more round of clomid - clomid (50 mg, CD3-7) + trigger + IUI. he also told me to schedule a consultation with him to discuss using injectibles just in case this round is not successful. He won't start prescribing injectibles until we have a separate consultation and he wants to meet mid-cycle so that treatment is not interrupted. I'm always processing the information when i go to my RE and can never think of questions when I am in his office. I would like to bring a list of questions with me. I tried doing a search and since I don't know what injectibles he is thinking of prescribing, I have no idea what to ask. has anyone been in a similar situation? Do you know what injectibles he may recommend? any questions I should ask when we meet?

Thanks so much. I want to be prepared this time.

-Shannon

[docsaf]

Thank you for your answers! No matter what he says, I'm always surprised by what the RE says and I feel like a deer in headlights - I don't have any questions and everything sounds fine. I want to be prepared this time.

So far I've been lucky - the only thing my insurance hasn't covered is the Clomid. Every visit has just cost $15 for the co-pay - it's adding up - but it's still managable. I will check my insurance for the drugs you've mentioned and see if they are covered as well.

Good luck to all of you! Sending lots of warm wishes and baby dust!

[scienceteacher79]

Some questions: Hope this helps!

See if you can up the dose of clomid. 50mg over and over is like beating your head into a wall over and over :)

Ask if they have any donated meds in case your insurance doesn't cover them.

Ask how much the u/s and bloodwork is every time you will have to come in (I never realized how much I had to shell out every time!! And God forbid a new protocol wasn't working - ugh! Many u/s and fees later...)

Ask what his "normal" protocol is with most patients in your situation. What meds does he use? How often do you go in for monitoring? etc

Ask if he is going to put you on a FSH/LH injectible or a FSH only injectible. The FSH/LH grows follies and matures them. The FSH tends to grow follies (and helps a little bit with maturation).

I was on menopur (FSH/LH) with clomid (50mg) for about 3-4 rounds (can't honestly remember now!) with natural baby dancing. I got preggo with the first round but had a m/c. We haven't progressed to the IUI stage yet :) I am going to start Bravelle (FSH) shots with clomid next month. So, hopefully this will work better :)

Be tough, ask lots of questions (even ones you may think are stupid!) and everything will work out wonderfully!!

Good luck!

Jen

[YvetteY]

With IUI they generally start you out with what you're doing now.  A bit more aggressive method is 5 days of clomid and 2 days of injections.  

Personally I did 5 days of clomid and two days of repronex ( i don't think it's quite that expensive)

Next time I just did injections (follistime that time). They started me at a higher dose but then it gradually went down because I was responding well.  This is more expensive that the above method.  but it's more agressive.

You're fairly young so you have lots of time to try to get pregnant with the IUI's.  

I
You will always do a trigger shot....I used Ovidrel at night then they have you come in for the IUI not the next day but the following day.

As far as questions....maybe ask him about using clomid VS femera.   I hear femera works better.  I never used it however.

Ask about your age and see if he thinks jumping to only injectibles is an issue or if you should just stick to less agressive approach.

What's your FSH level and how well should your ovaries respond to injectible drugs? Under 9 is pretty good.

Ask if you should also have sex the night of the IUI, although you may not feel up to it.

Good luck to you!!

[Tanker Chic]

I was on follistim.  They come with an injection pen and micro needles so it doesn't hurt.  I experienced some minor bloating but nothing too bad. I started it early in the cycle, around cd3 or so and would take it daily until trigger.  

Injectables can be very expensive if your insurance doesn't cover them.  I would discuss that with him and possible side effects.  

best of luck to you!!