The poking yourself in the leg thing? Not so much...

Monday was clinic appointment day. Having waited six weeks for an appointment, you'll forgive me if I was expecting it to be a big thing. Instead I showed up (v slightly late due to broken down taxi. Bastard), we were immediately ushered in to see the Nurse, who told us off for not having done all the forms (to be honest, it had been so long since they'd given them to us, I'd forgotten that we had to do them!), then spent most of the time telling me stuff I already knew, and the rest of the time showing me how to use a Puregon pen. From the googling I think this is the same thing as Follistim, that drug of which you all speak so fondly. Is that right (Mare, you probably know this)?

One question I asked, to which she did not have an answer, was why I have to take the insanity-inducing clomid, followed by the fun drug Puregon, for an IUI cycle when I don't seem to have any trouble ovulating. Her answer was: "the doctor must think that you could do with some help". How does the doctor know? He hasn't even observed a cycle yet, let alone given me any drugs.

Did anyone else take drugs for an IUI? I've done some googling and a couple of studies say it increases success rates but that it's not indicated if there's no trouble with ovulation, which there (according to temperature, OPKs and progesterone levels) isn't. Colour me slightly irritated to not get a good answer to this question. I'm not so much with the stabbing or the insanity if it isn't essential.  Meanwhile H is really thrilled about the idea of me having extra insanity-inducing medication. That's his idea of a good time...

She proceded to read us the riot act about not travelling at all during treatment, about the likelihood I'll have to drop everything to come to the clinic on a regular basis...have these guys absolutely no clue about the kind of jobs we do? At least they open at 7am so it will be possible to work during the week before the IUI.

Anyway I went away with my nifty pen, in its own handy maroon case with a sharps bin and all. Now I feel like a proper infertile. £700 lighter, not including the drugs. They gave me a company to order from, not sure if it's worth going offshore. Any UK ppl tried offshore drugs cos? Does it make a big difference?

So many questions for you all, I'm so glad you exist!

Comments

[Julianna]

I have never had trouble ovulating and was given clomid for a couple of my IUI's and the rest were un-medicated. Of course, they are trying to increase your chances - the more eggs, the better but there is a fine line if they start to see too many follicles - then they'll pull back on the meds.

Good luck with everything and glad you are faring well.

[Panda]

Medicos...mostly they just shit me. Really, do they have deals with the drug companies?
Grrrr.

[persephone]

I had the same experience as Julianna - no reason to think I wasn't ovulating, but all my IUIs have been medicated. When I asked the doctor about it he said it would just maximize the chances for sperm to meet egg if there were more eggs available.

The internets also told me that even if you ovulate regularly, there might be subtle issues with egg quality, etc. that can be helped by medication.

If you're unexplained after the infertility workup, I'm pretty sure medicated IUI is the recommended first step.

Good luck good luck!

[OvaGirl]

ooh...pen! With maroon case! And sharps bin! Goody!

... oh sorry, was there a question there?

[Em]

I have no idea about IUIs...yet but I am damn scared by the expense that is involved. I am in the UK as well.

[Emily]

IUI's were medicated even though I had confirmation that I was ovulating on my own. Like Julianna said, the idea behind it is the more eggs, the increase in your chances. However, for me, clomid (because I was over 35) was an evil, evil drug and actually cost me time by screwing up my cycles for 6 months. The injectible cycles were o.k., but I kept getting cysts after a cycle and said, "Enough of this".

Good luck!

[Mellie]

As a fellow IF who seems to ovulate just fine, thank you, my RE had me first do 3 iuis on clomid. He explained that the clomid, while not necessary producing many more follicles (although perhaps one or two more) does increase the chances of conception through both the added eggs and that the quality of the egg is improved. When those IUIs didn't work, we moved onto the injectible drugs - the gonadatropins, which produce more follicles, thereby giving more targets for the sperm and, again, I think an increase in the quality of the eggs.

[Katie]

Many RE's are reluctant to do IUI's without meds, especially if you ovulate, because it provides only a slightly higher chance than intercourse. They want to up the odds for you. Best of luck with his cycle, I hope you can work everything out with the clinic.

[PJ]

I hope the meds do the trick for you Thalia.

Sorry the appt. didn't answer all of your questions.

[chee chee]

I was in the same boat as many of the other women who commented. I definitely ovulate on my own every month. My RE recommended Clomid and Bravelle with my IUI cycle. I suggested that we try for an unmedicated IUI but he advised me that without the meds, our odds of success would be about the same as with timed intercourse.

It sounds like your protocol is similar to mine -- a combination of Clomid and FSH (Bravelle/Follistim/etc.) I was told that the combined regiment was recommended both to increase the number of eggs I produced in that cycle and to accelerate their growth/development. I ended up with 3-4 mature follicles, so the meds did their job. Unfortunately the IUI was not successful.

[Tania]

I've done both medicated and unmedicated IUI's. 16 in all to be exact. (First time around my 7th cycle (3rd with clomid) resulted in a pregnancy.) When I started this time around, they put me on drugs right away. I too ovulate, but my husband has some issues. Like everyone else said, the drugs are to give you more eggs and better chances. I've never had a mix of clomid and injectables, however. Should be an interesting ride.

Maybe you'll get a set of twins out of the deal. Good luck!

[B. Mare]

Yep, spot on- Purgeon is the same thing as Follitism. My clinic muttered a few times about it, then shrugged and said that they had no idea how much it costs. Did they tell you to order from Ferring/Serono? I think their rates are competitive- though I have not checked out the overseas idea, since at this point, the idea makes me lose the will to live.

[millie]

All of my iuis were medicated, even though I always ovulate on my own. I took clomid for a cycle or two, letrozole/femara for a couple of cycles (soooooooo much better than clomid), and letrozole+gonadatropins.

Many REs feel that you get a 'stronger ovulation' with drugs. I think it has to do with developing a stronger corpeus luteum (what's left after ovulation that pumps out the progesterone).

Also, if you're being monitored you'll get some information about how you respond to drugs/your lining/ all good stuff.

Hoping this is it for you.