Joy and I have a very similar type of pain. I have literally had almost every test you can think of without any answers. joy - They've ruled out every thing else for you, right?
I have IBS. This is unrelated.
I have kidney issues that lead to kidney stones. This is unrelated.
I suppose gall bladder could be a thought, but the pain really only happens late in my luteal phase and during heavy bleeding days, which leads me away from a random gall bladder problem. But, hey - I'm not a doctor of medicine.
Usually gallbladder pain is in the upper right quadrant. I'd say after all this time they probably have ruled that out.
I'm not a doctor either though. So my next logical guess is an alien invasion for both of us.
For those with unexplained infertility and regular cycles what is usually the treatment plan? Do you go straight onto IUI?
Like goldenlove3 said, our plan was also originally: 1. Femara (or Clomid) + IUI (3 cycles) 2. Injectables (Gonal-F, Follistim) + IUI (3 cycles) 3. IVF
After our third Femara cycle, though, my doc said we were good candidates for going with injectables or heading straight into IVF. I wasn't ready to accept IVF as our route, so we did one injectable cycle. When that was a bust, my doc looked me in the eye and said there were zero medical reasons for me to be in his office, other than I can't get pregnant. "So let's get you pregnant and get you out of here." We decided to move on to IVF, and here we are!
For those with unexplained infertility and regular cycles what is usually the treatment plan? Do you go straight onto IUI?
RE wanted to move us directly into clomid and trigger with IUI. I'm the one who asked if I could start with clomid, trigger, and timed intercourse (I also take endometrin and estrace). He warned us that our chances with just TI wouldn't be THAT much better, but it was what I was more comfortable with at the time. We are now moving into clomid, trigger, and IUI this cycle. If nothing happens in the next three cycles, he wants to move us on to IVF.
In terms of regular cycles, I'm practically fucking textbook (avg length = 28 days, avg O = CD13).
I guess my question is why if you are ovulating as proven by temping would they put you on clomid.
RE wanted to move us directly into clomid and trigger with IUI. I'm the one who asked if I could start with clomid, trigger, and timed intercourse (I also take endometrin and estrace). He warned us that our chances with just TI wouldn't be THAT much better, but it was what I was more comfortable with at the time. We are now moving into clomid, trigger, and IUI this cycle. If nothing happens in the next three cycles, he wants to move us on to IVF.
In terms of regular cycles, I'm practically fucking textbook (avg length = 28 days, avg O = CD13).
I guess my question is why if you are ovulating as proven by temping would they put you on clomid.
I am ovulating and my diagnosis isn't unexplained. It is ovulatory dysfunction (and I have 28-30 day cycles)... so until they actually check your hormone levels don't be so sure that you will end up unexplained (also it could be a sperm problem). If you are unexplained they put you on clomid for two reasons:
1. You might still have something subtly off with your hormones that the clomid will help compensate for... 2. There are more targets, so more chances of success.
Clomid (or Femara) alone does not improve your chances much if you are unexplained. It might take you from 3-5% up to about 7%. The medicated IUI gets you up to more like 15% because the IUI helps you bypass issues with your cervix, your cervical mucus, subtle and not subtle issues of sperm, etc. I forget the numbers the RE told us at the first meeting but it hugely increases the number of sperm that meet egg.
I guess my question is why if you are ovulating as proven by temping would they put you on clomid.
I am ovulating and my diagnosis isn't unexplained. It is ovulatory dysfunction (and I have 28-30 day cycles)... so until they actually check your hormone levels don't be so sure that you will end up unexplained (also it could be a sperm problem). If you are unexplained they put you on clomid for two reasons:
1. You might still have something subtly off with your hormones that the clomid will help compensate for... 2. There are more targets, so more chances of success.
Clomid (or Femara) alone does not improve your chances much if you are unexplained. It might take you from 3-5% up to about 7%. The medicated IUI gets you up to more like 15% because the IUI helps you bypass issues with your cervix, your cervical mucus, subtle and not subtle issues of sperm, etc. I forget the numbers the RE told us at the first meeting but it hugely increases the number of sperm that meet egg.
RE wanted to move us directly into clomid and trigger with IUI. I'm the one who asked if I could start with clomid, trigger, and timed intercourse (I also take endometrin and estrace). He warned us that our chances with just TI wouldn't be THAT much better, but it was what I was more comfortable with at the time. We are now moving into clomid, trigger, and IUI this cycle. If nothing happens in the next three cycles, he wants to move us on to IVF.
In terms of regular cycles, I'm practically fucking textbook (avg length = 28 days, avg O = CD13).
I guess my question is why if you are ovulating as proven by temping would they put you on clomid.
For us, it is two-fold:
1. Clomid just stimulates your body to make more FSH which increase numbers of eggs and/or egg quality. It's possible there's an egg quality issue. Progesterone is a tricky thing to measure and get an accurate picture of anything.
2. A huge stumbling block for sperm is the cervix. IUI bypasses the cervix (a common place for inflammation, actually, that also hurts sperm) and places washed sperm directly in the uterus.
This has been really helpful, especially all the 3T/IF related questions. Thanks ladies.
My question is related to IF as well... for those of you who go to an RE, and there were multiple RE's in your area/covered by your insurance, how did you decide which one to go with? Did you visit multiple RE offices and "interview" them? Did you look for reviews and recommendations online? Did you pick whichever one your insurance/OB recommended?
I'm curious because I'm starting to research RE's in our area, so that I'm informed and ready in case we still aren't pregnant at the 1 year mark. I know that many people might only have one option in their area, but I'm curious how you pick if there are many to pick from (which seems to be the case for me).
This has been really helpful, especially all the 3T/IF related questions. Thanks ladies.
My question is related to IF as well... for those of you who go to an RE, and there were multiple RE's in your area/covered by your insurance, how did you decide which one to go with? Did you visit multiple RE offices and "interview" them? Did you look for reviews and recommendations online? Did you pick whichever one your insurance/OB recommended?
I'm curious because I'm starting to research RE's in our area, so that I'm informed and ready in case we still aren't pregnant at the 1 year mark. I know that many people might only have one option in their area, but I'm curious how you pick if there are many to pick from (which seems to be the case for me).
A friend of mine who I knew was dealing with infertility recommended her doctor to me. So, I went to him. He is lovely.
Many months later, another friend who I knew was also dealing with infertility and recently had a miscarriage was talking to me about her doctor. I asked who he was. SAME GUY. I started laughing. It's like he's the only RE in Philly.
Being in Philly also made my first decision easier - I wanted someone in the UPenn Health System. Penn has consolidated all its practices into large practice groups so Penn Fertility became the obvious choice. I think I really lucked out, though.
My pain is sharp, completely associated with my bowels, and can be so strong as to take my breath away. It lasts a few seconds then recedes. But comes back in waves.
I have this too, have for years. My PCP says IBS. But I'm thinking of getting a second opinion.
Have you had any testing done to rule out other issues? Endoscopy? Colonoscopy? Allergen testing? Have you seen a GI specialist?
This has been really helpful, especially all the 3T/IF related questions. Thanks ladies.
My question is related to IF as well... for those of you who go to an RE, and there were multiple RE's in your area/covered by your insurance, how did you decide which one to go with? Did you visit multiple RE offices and "interview" them? Did you look for reviews and recommendations online? Did you pick whichever one your insurance/OB recommended?
I'm curious because I'm starting to research RE's in our area, so that I'm informed and ready in case we still aren't pregnant at the 1 year mark. I know that many people might only have one option in their area, but I'm curious how you pick if there are many to pick from (which seems to be the case for me).
I read every review possible on not only the doctor but looked at how their staff was. Mine was highly recommended by my step-sister's mother who is a Midwife but I figure if I don't like her when we meet with her, I have another solid option.
This has been really helpful, especially all the 3T/IF related questions. Thanks ladies.
My question is related to IF as well... for those of you who go to an RE, and there were multiple RE's in your area/covered by your insurance, how did you decide which one to go with? Did you visit multiple RE offices and "interview" them? Did you look for reviews and recommendations online? Did you pick whichever one your insurance/OB recommended?
I'm curious because I'm starting to research RE's in our area, so that I'm informed and ready in case we still aren't pregnant at the 1 year mark. I know that many people might only have one option in their area, but I'm curious how you pick if there are many to pick from (which seems to be the case for me).
I picked the one my OB recommended. My insurance covers nothing. My initial consult with the RE was $500 out of pocket. Because of that we don't have the flexibility to "interview". I don't love my RE so I may ask to switch to a different one. The practice is part of a large and very good hospital system so I have no problem staying at the current office, just maybe a different actual doctor.
This has been really helpful, especially all the 3T/IF related questions. Thanks ladies.
My question is related to IF as well... for those of you who go to an RE, and there were multiple RE's in your area/covered by your insurance, how did you decide which one to go with? Did you visit multiple RE offices and "interview" them? Did you look for reviews and recommendations online? Did you pick whichever one your insurance/OB recommended?
I'm curious because I'm starting to research RE's in our area, so that I'm informed and ready in case we still aren't pregnant at the 1 year mark. I know that many people might only have one option in their area, but I'm curious how you pick if there are many to pick from (which seems to be the case for me).
****ticker warning****
For me: 1) insurance coverage (there were only like 4 in my very urban area). 2) recommendations. My RE came recommended to us, but wasn't listed under my insurance so I called &checked their website and low and behold they accepted my insurance. 3) proximity to home or work. I think this is very important too. During my monitoring, I had to go in like 5 times through our IUI (and weekly after). Not being out of my way, as well as their super flexible hours was great. My appointments were all at 7:15 am, other than our IUIs at 6:30 am so DH could come before work.
It's overwhelming to choose. Some REs charge a few for the consult, so shopping around/ interviewing can be expensive. GL!
Last Edit: Jun 9, 2015 15:48:16 GMT -5 by ldubhawksfan
**siggy warning**
TTC #1 starting July 2013, RE last 2014 First Angel baby lost July 11, 2014 IUI #1 with injections successful: EDD 11/24/15 Rainbow baby DD born 11/14/15 TTC#2 October 2016 Second Angel baby lost Jan 5, 2017
This has been really helpful, especially all the 3T/IF related questions. Thanks ladies.
My question is related to IF as well... for those of you who go to an RE, and there were multiple RE's in your area/covered by your insurance, how did you decide which one to go with? Did you visit multiple RE offices and "interview" them? Did you look for reviews and recommendations online? Did you pick whichever one your insurance/OB recommended?
I'm curious because I'm starting to research RE's in our area, so that I'm informed and ready in case we still aren't pregnant at the 1 year mark. I know that many people might only have one option in their area, but I'm curious how you pick if there are many to pick from (which seems to be the case for me).
Ditto all of this. Thank you to all of the ladies with RE experience for sharing some of your knowledge.
I am steeling myself to connect with an RE in a month or so. If you've seen one - did you do your initial testing with your regular OB/GYN and take your results to the RE, or wait and have the RE do bloodwork, HSG, etc?
Ditto all of this. Thank you to all of the ladies with RE experience for sharing some of your knowledge.
I am steeling myself to connect with an RE in a month or so. If you've seen one - did you do your initial testing with your regular OB/GYN and take your results to the RE, or wait and have the RE do bloodwork, HSG, etc?
Here's my dumb question, how do you temp? I'm doing under my tongue when I wake up, but I must be a mouth breather, or the mouth guard is messing it up bc my temps are all over the place. Do any of you vaginally temp? I'm looking for details, I'm going to try it next cycle.
I vaginally temp. I'm not a mouth batter but I do have a guard and I'm an insomniac.
I generally don't temp during my proud because I wear a cup, what if it leaked, it's dark etc. Plus what's the point? Once it's gone I'll start.
I basically insert the thermometer until it starts getting wider. Wait. Hopefully hear the beep, then check it.
This has been really helpful, especially all the 3T/IF related questions. Thanks ladies.
My question is related to IF as well... for those of you who go to an RE, and there were multiple RE's in your area/covered by your insurance, how did you decide which one to go with? Did you visit multiple RE offices and "interview" them? Did you look for reviews and recommendations online? Did you pick whichever one your insurance/OB recommended?
I'm curious because I'm starting to research RE's in our area, so that I'm informed and ready in case we still aren't pregnant at the 1 year mark. I know that many people might only have one option in their area, but I'm curious how you pick if there are many to pick from (which seems to be the case for me).
There are actually A LOT of RE's in my area. I live in a state where it's a state mandate that health insurance cover infertility treatments. I just went where my GYN referred me to because I needed a referral. It's also about 15 blocks from work. Super easy to go to monitoring appointments first thing in the morning. I like them. I looked up reviews afterward and they were really good.
This has been really helpful, especially all the 3T/IF related questions. Thanks ladies.
My question is related to IF as well... for those of you who go to an RE, and there were multiple RE's in your area/covered by your insurance, how did you decide which one to go with? Did you visit multiple RE offices and "interview" them? Did you look for reviews and recommendations online? Did you pick whichever one your insurance/OB recommended?
I'm curious because I'm starting to research RE's in our area, so that I'm informed and ready in case we still aren't pregnant at the 1 year mark. I know that many people might only have one option in their area, but I'm curious how you pick if there are many to pick from (which seems to be the case for me).
Ditto all of this. Thank you to all of the ladies with RE experience for sharing some of your knowledge.
I am steeling myself to connect with an RE in a month or so. If you've seen one - did you do your initial testing with your regular OB/GYN and take your results to the RE, or wait and have the RE do bloodwork, HSG, etc?
GYN did none of the testing. I told her some things about my cycle that I was concerned about and she confirmed I should be concerned and referred me to an RE. The RE ordered all of the initial testing.
EDIT: Also, my GYN was kind of an idiot, so I'm glad she didn't do any of the initial testing. I've since switched to an amazing obgyn.
This has been really helpful, especially all the 3T/IF related questions. Thanks ladies.
My question is related to IF as well... for those of you who go to an RE, and there were multiple RE's in your area/covered by your insurance, how did you decide which one to go with? Did you visit multiple RE offices and "interview" them? Did you look for reviews and recommendations online? Did you pick whichever one your insurance/OB recommended?
I'm curious because I'm starting to research RE's in our area, so that I'm informed and ready in case we still aren't pregnant at the 1 year mark. I know that many people might only have one option in their area, but I'm curious how you pick if there are many to pick from (which seems to be the case for me).
There are actually A LOT of RE's in my area. I live in a state where it's a state mandate that health insurance cover infertility treatments. I just went where my GYN referred me to because I needed a referral. It's also about 15 blocks from work. Super easy to go to monitoring appointments first thing in the morning. I like them. I looked up reviews afterward and they were really good.
There's all sorts of loopholes to that law. I live in ohio which is a state that is mandated to have insurance. So the loophole in our case is the insurance companies must offer infertility insurance however employers do NOT have to offer it. So when employers choose their plans they just nix the infertility coverage to lower their premiums. I'm pretty sure that's how it works. I did some extensive googling on this subject. But please correct me if I'm wrong so I can bitch to my insurance company.
There are actually A LOT of RE's in my area. I live in a state where it's a state mandate that health insurance cover infertility treatments. I just went where my GYN referred me to because I needed a referral. It's also about 15 blocks from work. Super easy to go to monitoring appointments first thing in the morning. I like them. I looked up reviews afterward and they were really good.
There's all sorts of loopholes to that law. I live in ohio which is a state that is mandated to have insurance. So the loophole in our case is the insurance companies must offer infertility insurance however employers do NOT have to offer it. So when employers choose their plans they just nix the infertility coverage to lower their premiums. I'm pretty sure that's how it works. I did some extensive googling on this subject. But please correct me if I'm wrong so I can bitch to my insurance company.
I live in a different state, so maybe the mandate is different? I'm doing this all through the health insurance offered by my employer.
There's all sorts of loopholes to that law. I live in ohio which is a state that is mandated to have insurance. So the loophole in our case is the insurance companies must offer infertility insurance however employers do NOT have to offer it. So when employers choose their plans they just nix the infertility coverage to lower their premiums. I'm pretty sure that's how it works. I did some extensive googling on this subject. But please correct me if I'm wrong so I can bitch to my insurance company.
I live in a different state, so maybe the mandate is different? I'm doing this all through the health insurance offered by my employer.
Yes there are different mandates. Mandate to offer and mandate to cover. Ohio is a mandate to offer state.
ETA: that info isn't necessarily directed at you. Just general knowledge for anyone reading this thread :-)
This has been really helpful, especially all the 3T/IF related questions. Thanks ladies.
My question is related to IF as well... for those of you who go to an RE, and there were multiple RE's in your area/covered by your insurance, how did you decide which one to go with? Did you visit multiple RE offices and "interview" them? Did you look for reviews and recommendations online? Did you pick whichever one your insurance/OB recommended?
I'm curious because I'm starting to research RE's in our area, so that I'm informed and ready in case we still aren't pregnant at the 1 year mark. I know that many people might only have one option in their area, but I'm curious how you pick if there are many to pick from (which seems to be the case for me).
I read reviews online. I had many options, from private clinics to large academic practices. We are very hesitant about IVF and thus my prerogative was to avoid places that had a reputation for trying to sell you on IVF immediately (and per online reviews, several did). We went with an academic practice, which has its own shortcomings but we're ok with them for now. They were also who my DH's uro recommended. If possible, I would ask your OB for several that come recommended and if there are any they would not recommend, and couple that with online reviews and interviews if possible.
For those with unexplained infertility and regular cycles what is usually the treatment plan? Do you go straight onto IUI?
My RE wanted to start with just Clomid + TI and if that didn't work to move onto Clomid + HCG injection + IUI. I chose to skip over Clomid +TI and go straight to the IUI(+Clomid and HCG). If I remember correctly, she told me our odds of conceiving with just Clomid and TI was 5% and adding the HCG injection and IUI brought it up to 8-12%. If that doesn't work, she wants to do Clomid + Injectibles + IUI. Then the last step would be IVF.
TTC #1 since August 2013 DX: Endo November 2014: Hysteroscopy, D&C June - September 2015: Clomid + Novarel + IUI #1-3 January 2017: Laparoscopy - endo removed
I live in a different state, so maybe the mandate is different? I'm doing this all through the health insurance offered by my employer.
Yes there are different mandates. Mandate to offer mandate to cover. Ohio is a mandate to offer state.
Just googled it again. Health insurance agencies must cover fertility treatments, including insurance you receive through an employer (unless the employer is self-insured).
RE wanted to move us directly into clomid and trigger with IUI. I'm the one who asked if I could start with clomid, trigger, and timed intercourse (I also take endometrin and estrace). He warned us that our chances with just TI wouldn't be THAT much better, but it was what I was more comfortable with at the time. We are now moving into clomid, trigger, and IUI this cycle. If nothing happens in the next three cycles, he wants to move us on to IVF.
In terms of regular cycles, I'm practically fucking textbook (avg length = 28 days, avg O = CD13).
I guess my question is why if you are ovulating as proven by temping would they put you on clomid.
My RE said Clomid can produce a "stronger" ovulation (i.e. better quality eggs and more of them).
TTC #1 since August 2013 DX: Endo November 2014: Hysteroscopy, D&C June - September 2015: Clomid + Novarel + IUI #1-3 January 2017: Laparoscopy - endo removed
Thanks! The more I'm reading, the more I'm thinking this might not be the best time. I'm a nanny, and taking time off can be hard. When her mother is traveling ( dad commutes almost two hours) so id potentially have to bring her to appointments with me and DH is only available Tuesdays.
Do not take a child to RE appointments. My RE's office has a policy against it. Not all do, but it is really tough for many of the patients...
Agree. I understand sometimes it's not preventable but the day I went in for my D&C at the RE's office there was a woman with an adorable baby. Bad day for me and cue ugly crying and needing to be moved to a consult room before my procedure. You never know what someone else in that waiting room is going through.
Yes there are different mandates. Mandate to offer mandate to cover. Ohio is a mandate to offer state.
Just googled it again. Health insurance agencies must cover fertility treatments, including insurance you receive through an employer (unless the employer is self-insured).
HMO plans yes. PPOs no. Again I might be 100% wrong. But that's how I understand it.
Just googled it again. Health insurance agencies must cover fertility treatments, including insurance you receive through an employer (unless the employer is self-insured).
HMO plans yes. PPOs no. Again I might be 100% wrong. But that's how I understand it.
HMO plans yes. PPOs no. Again I might be 100% wrong. But that's how I understand it.
You could be right. I have an HMO.
Digging a little deeper I think it also has to do with the state the insurance company is based out of. So Anthem (my insurance) operates out of 14 states, none of which are mandated so they are not obligated to cover infertility? Insurance is confusing. But they do cover a lot of testing and meds. As long as it's not coded as "infertility" then it's probably covered. So it's not 100% crappy lol.
For those with unexplained infertility and regular cycles what is usually the treatment plan? Do you go straight onto IUI?
I have unexplained and I'm doing monitored TI cycles. I've already done 3 clomid and now I'm starting an unknown number of femara (+/- injects at some point). My RE does not want to do IUI since MH's SA came back normal AND I've gotten pregnant in the past with losses.
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