Upping the Ante

I've been playing phone tag with email follow-ups all day, talking to Nurse E about what Dr. E recommends that we do next time around.

When we originally met, she talked about trying "two or three cycles" unstimulated before we considered anything more aggressive, so I figured it was time to check in on that.

What she's recommending is that I take 50 mg Clomid on days 3 - 7 of my next cycle, followed by FSH injections on days 7 through 9.

(Or days 7 and 9? I guess I need to clarify that).

I'd then go in for ultrasounds starting on day 11, and I assume it would be basically the same from there - wait for the follicles (the goal of the drugs being to have multiple follicles) to get to 18 mm or larger, then do the HSG trigger shot, followed by the intrauterine insemination 36 hours later.

She'd really like for us to do two inseminations, at 12 and 36 hours after the trigger shot, but it would cost an additional $480 to buy a second vial.

(Popeye only has washed sperm available, so it will already be more expensive than last cycle, we when were able to get the unwashed.)

The second insemination would up our odds, but probably not enough to justify that much of an increase in the cost, so I'm pretty sure we'll stick with just one.

Speaking of the odds . . .

For your average man/woman couple, under age 35, trying to make a baby the old-fashioned way, the odds of getting pregnant in any given cycle are about 30%.

(The odds per cycle decrease with each attempt, because the fact that they're not pregnant yet indicates that there might be a problem.)

The way we were going about it the past couple of months (taking into account my age???) our odds were about 5% per cycle.

Well, hell, no wonder I'm not knocked up yet!

If we were to use clomid alone, our odds would be around 10% (with about 10% of pregnancies being multiples (mostly twins) - so an overall 1% chance of multiples).

With the clomid and FSH, we're looking at around a 20% chance of pregnancy, and a 15% chance of multiples (overall 3% chance of multiples).

I still want to get a bit more information (such as what's the cut-off number of follicles for cancelling a cycle, because of the risk of higher order multiples) but we're pretty sure that we're going to go with the clomid / fsh, with just the one IUI.

It will be more expensive (don't know yet how much, depends on the insurance coverage for the drugs) but will quadruple our odds. As long as it's not four times as expensive (and it won't be) that's definitely worth doing.

I just wish we'd had all those statistics a couple of months ago, because if we'd realized how bad the odds were, I think we would have pushed to be more aggressive from the get-go.

So, now, we're just (once again) waiting to bleed. I got nothing so far, not even spotting, so I'm thinking it won't be any sooner than Saturday, meaning day 3 will be Monday.

In the meantime, I'd appreciate all the information I can get, whether scientific or anecdotal, so if you've got experience with either clomid or injectable FSH, please let me know what it was like, and what I'm in for.

I'm tentatively planning to go down to OldWorkCity that morning for the ultrasound and to pick up the drugs - or maybe they'll be shipped to us? That's one more thing I'm waiting to find out about.

More phone tag tomorrow, I'm thinking.

Speaking of tomorrow, I'm taking the day off work, and around noon will be heading up to CapitalCity for a couple of days of political workshops, meetings, schmoozing, etc, and I'll be back Saturday evening.

Of course, I have all intentions of posting here before I leave tomorrow and when I return Saturday.

Priorities, you know.