The Quiet Time
First off: if you haven't yet, please go give some love to Statia.
Now, a little update. Admin Tardy has redeemed herself, by calling me back first thing yesterday morning, even before 9 AM. She set us up for a visit with Dr. Quixotic at 4:30 on April 27, and set the wheels in motion for us to have an injections lesson at 3:30 that day. And, yes, that's all a week earlier than I originally said we were going to begin this cycle. I took a second look at the calendar and realized that if we began this cycle around May 6, then there'd be a decent chance that my IUI would fall out on May 21, when I will be a bridesmaid at an out-of-town midday wedding. No go. Pushing the cycle off by a week could maybe-kinda-sorta work, but finally Ezra and I decided that it's silly to let our reproductive lives be completely governed by work, and if I could get a late-afternoon appointment during the last week of April, I would just work late on the other days that week and hopefully it would all balance out. And that's where we stand now.
Our injection lesson time has since been confirmed. Good.
We don't need insurance pre-approval for this cycle, so that's one fewer thing to worry about. The financial coordinator was kind enough to remind me that we have a $10,000 lifetime maximum with our current insurance plan, so now Ezra and I are seriously considering jumping directly to IVF if this first IUI cycle doesn't work. Something else to discuss with Dr. Q.
I'm also starting to look into acupuncture as a method of complementary healthcare.
Nurse Space Cadet asked Dr. Quixotic about an HSG for me, and it looks like we'll be doing it during the first half of my treatment cycle. There are some halachic issues with regard to this test, so we'll be talking to Rabbi Spock before the cycle starts. There may also be issues with a possible IUI before I go to the mikvah, both with the question of conception while niddah and also with potential spotting during a time when I am still doing bedikot. I'm guessing that it will all be fine, but we probably should discuss these issues with R' Spock as well.
I'm back on birth control, which I consider a concession to my ovaries' unreasonable contract negotiation tactics. But, hey, they have a stranglehold on the business, a near-monopoly, so I have to obey their whims. For now.
Since there won't be much happening medically until the end of the month, this blog is likely to be on the quieter side for a while. If I feel inspired, there may be a post or two between now and the end of the month, but don't count on it. If you use a reader, be sure to add my feed to your subscriptions, so you'll know when I start posting again in earnest.
Labels: Inj/IUI
posted by Robber Barren at 10:43 AM
comments (11)
Hi, I did acupuncture for infertility before starting on the Western stuff. I really liked the idea of it, though it didn't happen to work for me. You should be able to see pretty quickly whether it's working for you or not. However, it can be really expensive - mine was $100 each time and she wanted me in once a week, which adds up really fast.
Religion really complicates infertility. It would be much easier if we could turn the world off, I have to play bridesmaid in May too - let's swap ugly dress pictures.
Jenny, in my case, it's not the dress (which is a lovely shade of red and very flattering, enough that I can overlook the sequins around the waistline), but the shoes (also red and, um, not so flattering)! And, yes, religion really is complicating things, but I suppose that the fact that I keep taking it into consideration means that, deep down, it's still important to me. Ah, what I wouldn't give some days to not care so much!
Aviva, I would do acupuncture in conjunction with Western med, not before/instead of. I'm not sure how I could quantify whether it's helping, though.
I read that in IUI/injectibles cycles, success is mainly due to the injectibles and not the IUI. This is in comparison with non-injectible cycles.
But I don't remember where I read it. :-/
I'm usually all for unionization, but ovaries just don't seem to understand the concept of give and take. Get with the program, Robbie's ovaries, get with the program!
I guess if you start acupuncture at the same time as injectibles it may be hard to tell what is helping, but if you introduce one before the other you should be able to tell based on how your cycle changes (or becomes a cycle) once you're on it. I saw some immediate changes in my cycle with acupuncture, but then the improvement stopped and even regressed a little, so I quit.
We thought about going forward with some injectable cycles, since they're less invasive, but when I found out that they could cost upward of 8k at some clinics (since our insurance doesn't pay anything), I figured it was better to just go straight to IVF.
This also might be something to think about if your rabbi isn't keen on selective reduction.
Or you know, if you're one of those people who likes PIO needles.
I remember where I read about the IUI vs. injectibles cycles: Dr. Silber's book "How to get Pregnant".
He says that
- the success rate of IUI insemination alone (no stimulation) is so low it isn't worth doing.
- IUI+ovarian stimulation yields a succes rate of 12 percent per cycle, all of it due to the stimulation.
- timed intercourse+ovarian stimulation works just as well.
- for many couples it would be best to do three timed intercourse+stim cycles and then go straigt to IVF.
This is without the cost and insurance factor taken into account.
I liked this book, it's no-nonsense.
So IUI + injectibles would be preferred over timed sex + injectibles in a case where (your Rabbi okays it and) Dr. Q wants sperm present before you'd make it to mikvah.
Hatzlacha, praying that you achieve success at a rate that won't make you worry over needing to do selective reduction, and hoping you don't need to progress to IVF, but wishing you success with that if you do need to go that route.
Lut - Miriam brings up the good point that timed intercourse would not necessarily work for us, if things fall such that I ovulate before or just after I can get to the mikvah.
There are also medical arguments to be made for having IUI instead of just timed intercourse. The book you read says the outcomes are comparable, but there are other studies giving IUI a bit of an edge (just a few percentage points) over intercourse alone. It's not much, but it's something, and that something may be enough for us to decide to go ahead with it. (I don't have the time to look up specifics now, but just off the top of my head I can tell you that I've seen statistics as high as 20% success rate per IUI-injectibles cycle with about 15% for injectibles and intercourse.)
Finally, many insurance companies that do cover IVF will not allow coverage for it until the couple has had three IUIs, no matter how well intercourse has been timed. (I know you said that what you wrote doesn't take insurance and cost into account, but I just wanted to make that clear to anyone else who may read this thread.)
Robbie, I had no idea that all of this was so very complicated for you. I knew there had to be some issues but my knowledge of Judaism never went toward Orthodoxy so it's shallow at best. I'm impressed with the sincerity of your belief; trying to fit fertility treatments around rituals is complicated and shows the depth of your faith.
Speak up!
<< Home