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Questions to my RE

October 29, 2008

I had my talk with our RE today. And took the liberty to have rest of the day free from work since I’ve already sneezed half of my brains out.

I thought I’ll post the questions I asked and the answers she gave me, because someone else looking for similar information might be reading this. First my questions, then below doc’s answers (freely translated).

I can feel my endo coming back, what should we do?

It’s unlikely that the endo has spread a lot during these 5 months after laparoscopy and it’s not going to explode instantly. Still we shouldn’t wait too long but move on to IVF if IUI isn’t working soon. We’ll do 1 or max 2 IUIs and if they fail we’ll proceed to IVF in the beginning of 2009.

I have unmedicated elevated blood pressure (140/90 at highest), is that a problem?

-It shouldn’t be a big problem, but during pregnancy you would get monitored more closely and might have to take drugs to get the pressures down.

Can flu delay ovulation?

-It is possible that especially a tough illness or stress will delay ovulation. But it’s also normal to have longer cycles every now and then without any specific reason.

My luteal phase is usually 11 or 12 days long, is that enough?

-LP of 10-14 days is normal BUT longer LP would be better. We’ll add extra progesterone to this cycle after IUI.

Why do I get the sore nipples during ovulation only every other cycle, does that mean there’s something wrong with my hormones?

-It’s hard to say only regarding one symptom, but it might indicate a hormonal problem. Let’s hope that the extra progesterone will help this cycle.

I got the positive OPK on your first IUI cycle on Saturday evening, was Monday too late for IUI?

-It’s better to have the sperm waiting for the egg than do the IUI after the egg has already been released. It might have been too late. Next time, if you get positive OPK on an afternoon and then next morning, we’ll do the IUI on the same day.

Can you tell is your problem with the fertilization or implantation? I have backache at 3DPO, does my body know at that point that the fertilization has failed?

With IUI it’s impossible to tell, we only see you are producing eggs but we cant’ see if they are fertilized or not. About the back pain, it’s really hard to tell why do you have it.

What about having more eggs with clomid or other drugs?

As there seems not to be any problem concerning ovulation, extra drugs aren’t necessary. In Finland doctors don’t support producing lots of eggs and then doing selective reduction. With older patients and patients with ovulation problems they do add hormones to the cycle but if a woman produces more than 3 eggs then the cycle will be canceled because of the risk of multiples. Selective reduction isn’t done in FInland at all.

Could we do IVM? (=IVF without the drugs)

With endo patients the results are better with IVF, as the procedure is more controllable. Also some of the IVF drugs moderate endo. I would recommend IVF.

What about IVF then, how many eggs would we transfer if we will do it?

Probably one. 60-70% of embryo transfers in Finland are one embryo transfers, rest two embryos. Doctors favor SET and they are able to select the best embryos for transfer. The amount depends on woman’s age, medical history and general condition. In your case we would probably transfer only one embryo, as a twin pregnancy would cause much stress on your body since you have also highish blood pressure. The success rates with IVF are much better than with IUI as it’s more precise and we will learn if the problem has been the fertilization or implantation.

More about SET vs. DET here. Favoring SET means lower success rates than if three or four embryous would be transfered, but less risks as well. It’s not uncommon to couples to have to do two or three rounds of IVF before succeeding, as the doctors here like to play it safe. Of course it’s much cheaper here than in the US as government pays part of it, but still around 2000 euros a round.

I love my RE, although she couldn’t answer everything straight away I always get the feeling with her that she knows what she’s doing. There’s a certain wise aura around her. She told me not to worry, as we are only in the first steps of our if treatment, and that we should still try out at least one IUI before IVF. She also told me I can email her any questions I have. That’s great, so I don’t have to skip work all the time.

So this cycle its IUI #3 with progesterone. If that fails, probably IUI#4 in December. And if even that fails then IVF with SET in January. And I don’t want to think about the option of failing that as well.

This morning we got frost on the ground. I’m not a big fan of winter (especially the Helsinki “winter” with 5 months of rain and darkness), but there are some things in winter season I love. Like glogg and gingerbread cookies! Yesterday I watched a BBC’s drama Cranford with a mug off glogg and a jar of those christmas cookies, curled up on our sofa. I love BBC dramas too, they are so hiqh quality with good actors (this one with Judi Dench), great costumes and setup. And so British!

For two nights in a row I’ve dreamed of a town I’ve never visited, yet there was something familiar to it. It was a mixture of Tallinn, Maastricht, Paris and maybe some place in Italy too. First night I was there alone and it was 5AM with people getting home from bars, last night I was there with my parents and sis during the day. It was an old town with pretty buildings. There was a big market place with a white church tower, and picturesque restaurants surrounding the market place. Does anyone know where I’ve been? Maybe I’ll go there next night too 🙂


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3 comments

  1. I’m so glad you have answers! You must have such a sense of relief. I’m so glad you’re moving forward so positively.

    Regarding progesterone, I have two words for you: panty liners.


  2. The answers totally made me feel better. Thanks for the tip :)!


  3. Good post. It may help others. Thanks for sharing.



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