Jul 3, 2011

So testing is done, now what?

Now you're in the treatment phase. Treatment will depend greatly on your diagnosis. Some people only require simple treatments and some will skip straight to IVF. It really just depends. 


One of the most simple treatments is a medicated cycle with TI. Common medications for first cycles are Clomid and Femara. Here is the protocol that should be followed for almost any medicated cycle: 


CD3: baseline u/s and b/w - this will be a check to make sure you don't have any cysts, your lining is appropriately thin, your blood flow to your uterus is good and your hormone levels are good. 
CD10-12: Follie check & b/w - this will check to see how and if your follies are growing and to make sure you aren't over responding (OHSS) 
Then you'll go in every few days or so until you have mature follies. Then your RE will either instruct you on when to have sex or give you a trigger shot (to give yourself at home) so you'll O 36 hours later and know when exactly to have sex. 
7DPO: this will be to check your progesterone levels. If your progesterone is too low, then you cannot sustain a pregnancy and then you might be put onto prog. supplements. 


This monitoring might seem extreme but it is so so SOOOOO important. I don't know why anyone would want to risk their reproductive health when there are options to help. Many fertility medications (like Clomid) can be very dangerous. It can cause horrible cysts (read through my old posts and you'll find my personal experience with this), thinned uterine lining which may be permanent, HOM (wanna be the next Kate+8?) and other awful side effects. 


Ok, so you tried a few cycles of TI and it didn't work. The next step would be medicated cycle + IUI. You will follow the same protocol up until the sex part and then instead your husband will go give a sample about an hour before you go in to be sperminated. May the sperm be with you. There are varying levels of IUI protocol's. After Clomid/Femara there are then FSH injects. These increase the odds of pregnancy but then also increase the odds of HOM. They're also like liquid gold as the medications can cost thousands of dollars each cycle. 


Next, if you and your RE feel that IUI isn't working and they want to go to the next step, that would be IVF. IVF is very invasive and very expensive. You will inject yourself at home  (with similar drugs or the same drugs) as you used in an injects cycle. When your follies are ready you'll then go in for an egg retrieval. This is where your RE goes in and removes your eggs - as many mature ones as they can. This might be 20 or it might be 3. Of course higher numbers mean more chances but there are no guarantees. After the eggs are retrieved, they will be sperminated by your RE with your husband's sperm. They will then closely monitor your new embryos. Depending on the quality of your embryos that were fertilized (if any) they will transfer them back in 3 or 5 days after (I've also heard of day 6 transfers). Now, make sure you have a responsible doctor and only transfer 1 or 2 (mayyyybe 3). Don't go Octomom on us and transfer 10, mmmkay? 


Now, that was an extremely sugarcoated version of IVF. It's painful, emotional, expensive, and hard. I've never been in that situation but know a few people that have been through it. 


Now what a lot of people are interested in: Costs. 


These are general estimates based on my own personal experiences. 


Medicated + TI: $500-900 
Medicated + IUI: $700-1500
Injects + IUI: $1000-3000
IVF: $8,000+


None of these estimates include the cost of medications. Once you enter the realm of injects, medications can cost hundreds to thousands of dollars extra EACH CYCLE.


Okie dokie, questions? Comments? 

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