Sunday, September 17, 2006

Everything I Ever Wanted To Know About Infertility (And Am No Longer Afraid To Ask)

As I read all the blogs out here in Blogland, I am constantly faced with the reality that I have more questions about these processes (both infertility and blogging itself) than I do answers. So I thought I would dedicate a post to just asking simple questions that I think many of you might know the answers to.

1) When most of you include a brand name of any kind in your posts, you bleep out the name, like "Coc*a Col*a" or "F&llistim". Why do you do that? I have a couple theories on why but I wanted to ask you directly.

2) What's this acupuncture business all about? Did your Dr tell you to get acupuncture? Did you have to ask for it yourself? Is it part of your treatment? What does it do? Does it work? Should my wife be doing that? Our RE once mentioned acupuncture many months ago, in our first (AND ONLY) conversation...are we missing something here?

3) When you do a FET, are you taking drugs? If so, what for? Do you want follicles in an FET cycle, or do you not? I am assuming not, but I want to be clear.

4) For IVF cycles, did you all have a "mock transfer" first? We had an IUI to IVF conversion and we didn't get a mock transfer. In fact, no one ever mentioned that to us. We learned about it on the internet.

5) How common are cancelled cycles? Does it happen often?

6) Does it upset you when I mention The Buggins on my blog? Would it upset you if I posted pictures of her?

7) When my wife had her IUI-IVF conversion, she was told that her chances with the IVF were the same as they would have been with a regular IVF cycle. But the time from the beginning of taking drugs to the pregnancy test was only 4 weeks (like a regular IUI cycle). If the IVF conversion had the same chances as a regular IVF, why does a regular IVF cycle take 6 or 8 weeks? What's going on in that extra time? What does Lupron (or Lu*pron) do? (Other than apparently make women miserable?)

8) Why do we have to seek answers from the Blogosphere instead of learning this from our quack doctor?

Thanks for any info you may have -


My Reality said...

I can answer some of your questions!

1. To avoid hits from search engines.

2. My RE recommended acupuncture after I asked about it, it really can increase the chances of pregnancy by a few percentage points. It helps increase blood flow to the reproductive organs and can help with egg quality and implantation. There are lots of theories about it and it does help with relaxation.

3. It depends on the clinic/doctor.

4. No mock transfer for me, nor do I believe my clinic does them. (Krista, maybe you can give more info!)

5. Don't know.

6. I don't get upset when you mention The Buggins and would love to see a picture of her. But don't do it if your wife won't approve!

7. It depends on the drug protocol. Some doctors use a long flare protocol with supression before stimulation drugs. Some use a short protocol that starts with stims on day 2. My cycle will be a short protocol. Lupron is a supression drug.

8. Because the IF blogosphere rocks!

I am sure you will get a variety of different answers to your questions, and that is a part of why we go to the blogosphere for answers. You get all kinds of different perspectives.

OHN said...

The only one I can answer is #5--nothing was more frustrating than using Pergonal for a cycle, popping out a whopping 13 eggs and having the doc say--sorry, need to skip this month. This happened quite frequently and would send me into a desperate almost homicidal state. I remember being so physically uncomfortable and not being able to do a damn thing about it! Hopefully medicine has progressed since then and you won't have to put up with this too much!

Beagle said...

1) I assume it avoids search hits
2) I had to ask about acu then my doc said "oh yes, studies show increased success rates. But it did not help us that I can tell and it cost lots$$$. All it did for me is reduce stress (which is significant) but massage does the same and feels better.
3) FET can be done with or without drugs. Most do with from what I can tell. They don't want follies, they just want to shut down the ovaries and get the lining ready. I think they often medicate just for the sake of timing. My clinic is not busy enough to run the IVF all the time, they do cycles every other month or so, so the lab has to be up and running for FET too for the thaw.
4) We had a mock transfer. It's just for the docs benefit to get the lay of the land so to speak so they don't get any anatomical surprises at the actual transfer. Everyone's cervix is different, so they do a mock to get an idea what size catheter how easy to insert, etc.
5) I have no idea, but it must be dreadful
6) Post away, if I can't handle baby stuff, I don't read that day. I figure we're all here trying to have one, so success stories are a happy part of blogging. (I may not tell you how cute you child is that day I get another BFN, but I won't be upset either).
7) NO exactly sure but some of it is timing as above with FET answer. I also kind of figured that if they shut the ovaries down then hit them with drugs, they will get more eggs. My doctor explains Lurpron as driving with your foot on the gas and the break. Not sure if that translates better to you as a guy, to me I'd have preferred a medical explanation!
8) I agree, there should be more patient education in ALL branches of medicine, but until we have that perfect world, thank God for blogging and Dr. Google!

Lyrehca said...

I can answer a few things. I did twice-weekly acupuncture for a few months while doing IUIs #1 and 2. It cost about $50 a pop (not covered by insurance), and while it made me relaxed, I didn't think I would feel any less relaxed if I just lay quietly in my own house for a half-hour without the needles. After no success following IUI #2, I had a meltdown in the acupuncturist's office (had just gotten a negative result the day before; it wasn't personal) and never went back.

I *did* do acupuncture sessions just before and after my IVF egg transfer (very likely at the same large Mass. clinic you and your wife go to) because there is some study saying it helps with success rates with IVF. It cost $150 for both sessions (again, not covered by insurance), and at least for now, I'm considered a positive cycle about 8 weeks in.

Never did a mock transfer with IVF. Not even sure what it is, and frankly, why do an extra scoping downstairs if not absolutely necessary?

And I'm happy to read about your daughter. Post away.

Krista said...

Smarshy, I have only some answers and some guesses:

1. I believe it is as much for copyright infringement as it is to avoid search engines.

2. My doctor has never mentioned acupuncture and I have never asked. Frankly I have enough issues with the needles already involved in IVF. Acupuncture does not sound overly relaxing to me. I choose to do Yoga for relaxation instead.

3. FET cycles can be medicated or non-medicated. Medicated cycles are used when women do not get thick plush uterus linings on their own. The drug (I've used Estrace) helps build the lining). You are not trying to build follicles during a FET and the drug actually works as a supressant but it doesn't matter if you have follicles (during a natural cycle for instance), they will just ask that you abstain from sex during ovulation time.

4. My clinic does not routinely do mock transfers, although sometimes I wish they did. If your wife has a wonky cervix or have had troublesome transfers in the past, she might want to request a mock transfer so that the doctor is sure of his/her way. I was once sent home from an IVF transfer (when I had 14 fresh embryo's waiting) because they could not get the cathedar in through my cervix).

5. Not sure. But I have heard of a few here in blogosphere.

6. I love hearing about the Buggins and would love to see a picture of her. I loved the picture on the beach, even though it was a back shot. I agree with Reality though, probably not a good idea to post a picture without speaking to your wife first.

7. Some IVF's are the same time frame. As Reality mentioned, there are long and short protocals. The short protocol starts after your period arrives and follows a "normal natural" cycle. I have always done the long protocol and the extra time is spent in "suppression". Basically they put your body into "menopause" so that it is not making the reproductive hormones on it's own. That way they have greater control of hormone levels.

8. Ahhhh.... I have the same problem. Doctors are so friggin busy that they seem to forget that some of their patients aren't content to treat them like God's and assume they know everything, or at least everything they need to know to get us pregnant.

Rumour Miller said...

I can only answer a few for you (and I certainly hope you don't mind as I am a newbie commenter on your blog)

1. I don't do this... I need all the traffic I can get..

2. I didn't do acupunture but did try a Chiropractor and am convinced that it helped (even if only a little).

3. don't know.

4. don't know.

5. don't know.

(I don't know much, do I?)

6. I love hearing about children and I doubly love seeing pictures of fellow bloggers children. It gives me a warm, hopeful feeling with fellow IFers talk about their success stories and show us the beautiful results.

7. don't know.

8. because the blogosphere is one of the best resources out there, of course.

Meg said...

Ones I can help with...

1. To stop spam comments from drug companies. (ever get the viagra spams on your emails? Well, Follistim etc. do it too...)

2. I credit acupuncture and Chinese herbs with my positive cycle (10 weeks now)... I took the herbs for three months, had weekly acu session six weeks prior to my cycle, oon the day of transfer and day after transfer, and every 3 days in 2ww...)

3. In Australia we mostly do natural FETS with no drugs. I really don't know why they make people take more drugs. To make more money?

4. No, no mock transfer. But my clinic does ultrasound guided transfer.. I don't know if that makes a difference.

spark said...

I can help with these ones:

2) helps address underlying issues that might be causing IF; at a minimum it's relaxing; studies have shown that it does provided benefit before/after an embryo transfef (you can google for the German study)

3) there are a couple different approaches - for a medicated FET the RE wants to control all hormones and you don't want follicles; for a "natural" FET you are trying to work with your bodies own hormones (with a little help here & there) and you do want to ovulate.

4) we didn't have a mock transfer

5) we've been "delayed" twice so it feels common to me

6) I'd love to see pics!

7) there are a million different protocols -- some include a suppression / down reg phase where the RE tries to calm the ovaries down and then have better control over the stims; not all protocols include this

8) that will be $300 for my responses - oh wait I'm not a real doctor - I only play one online...

serenity said...

My $.02...

1) I bleep out to avoid spam. And because it looks cool. :)

2) There have been studies done that say that acupuncture pre-and-post transfer increase pregnancy rates. I'm going to take advantage of it if we ever get to transfer this cycle. :)

3) In my case, I am on a medicated cycle and don't want follicles. Basically my "bad news" is that the estrogen isn't working for me for some reason this cycle.

4) I got a mock transfer, yes, but only because I have a uterine abnormality and my RE was concerned we might have issues at the transfer. It's not neccessary unless they suspect doing the transfer will be difficult.

5) Probably happens more often than people like. Unfortunately this stuff is still more of an art - it takes a couple of cycles to figure out how your body responds to meds. And of course that all can change over the course of time too. Good times.

6) I love hearing about the Buggins- she sounds like a pretty cool two year old. :)

7) I actually can't answer that one...

8) Honestly, the best thing we can do is be as informed as possible so we can act as advocates for our own care. I believe that my RE cares and wants me to get pregnant, but I also know that he has a lot of other people he's working with too. But I will tell you that any question I have, I can call my nurse and either she or my RE will call me to answer my questions. I like that about my clinic.


Katie said...

Thanks for the questions, Smarshy, and answers, fellow bloggers. I need even more clarification:

What is FET? What is a mock transfer?

Bring on the Buggins.

zhl said...

I can answer a few.

2) I'm on my third acupuncturist (with herbs) trying to address some of the underlying issues for my poor response to IVF--see #5. The tentative plan for us is to continue with acu for a total of six months, then try another IVF.

3) Don't know anything about FET; see #5.

5) Of my two IVFs, one cancelled, one yielded only three eggs (two embryos). I'm the same age as your wife.

6) Don't mind pictures of Buggins. Enjoyed the one of her and your wife at Crane Beach. My dad was a lifeguard there in his teens. His family still has a house in Ipswich. We were raised in the South, however, and when we would visit Crane Beach in August, my mom still had to pay us money to swim in the water. Way too cold but very pretty.

8) Because the docs are too busy buying their third and fourth homes with the money we just fork over to them on a regular basis.

Good luck.

One Mother's Journey said...

Wow... impressive answers. I thought I knew quite a bit but I have to say that I did learn a bit more.

I won't add anything because really... what could I? After all, the husband and I are still partially holding out hope that sex will get us pregnant. LOL

I love to hear about The Buggins, and I'd love to see pictures. That's what this is about after all...

Just another Jenny said...

I'll keep my answers to the things I actually have experience in.
1. To avoid excessive google hits
2. I didn't do accupuncture with IVF #1 - negative. I did do acupuncture (before and after transfer) for my FET - positive. No one could ever say whether it made a difference or not, but studies do show increased success with acupuncture (although my RE said it wouldn't help).
3. My FET was "unmedicated" which is very rare and it did work. The reason it was unmedicated is that we are MF so my hormones are doing what they should. I did take progesterone starting a few days before transfer and up until yesturday. That was more or less a "just in case" my body still hadn't fully recovered from the fresh IVF and wouldn't produce enough on it's own.
4. I didn't have a mock transfer but there was some "resistance" on the transfer for my fresh cycle which makes me wonder if it damaged the embryo's and that's one of the reasons it didn't work?
6. No, mentioning your buggins doesn't bother me in the least. I know which bloggers are dealing with primary or secondary IF so I expect it.
8. Because we have so much knowledge but very few places to share it - nothing an IF'er likes more than being asked for advice.

lola said...

hi there, smarshy, I found you through Serenity's blog. Another Boston IF'er here. I think it's great that you're blogging from a man's point of view!

So anyway, I'm late to the game but here are my answers:

1) I just learned the answer to this myself, and it's so that you can avoid being spammed and also so that search engines don't pick up your blog.

2) Everyone has different opinions about acupuncture. My experience is this:
IVF#1 - did not do acupuncture. Negative
FET - did acupuncture every week. Positive (but ended in a miscarriage at 9 weeks).
If nothing else, I find that acupuncture really relaxes me and helps center me when I'm in the middle of a cycle.

3) I did a medicated FET cycle, but there are also people who do unmedicated cycles. It depends on your Re. When you do FET, you don't take the stims, so you aren't creating any more follicles than you would on an unmedicated cycle. There is no ER, you just go straight to ET. They give you meds to make sure your lining is ready and that they can kind of time it out so they can decide when it's best to do the transfer.

4) I did have a mock transfer. My Re does them for everyone. Again, I think this changes from clinic to clinic.

5) It happens quite a bit but your Re should be monitoring your wife closely so that they can make sure the meds are doing their job, which helps to minimize the chance of a canceled cycle. Sometimes it just happens, though. Unfortunaetely you can't predict how her body will react to the meds :(

6) Post away!

7) Hmm, I don't know anything about converted cycles, I've only done straight IVF cycles and one FET. So I can't answer that. But I think what Lu*pron is supposed to do is to suppress your wife from ovulating on her own so the Re can control over when she does.

8) Good question! I think it helps to hear it from regular people who will answer you honestly and without medical jargon. I know it helps me...