Intro

[anonymess]

Hi, I'm Kat. I'm a frequent reader, but rarely post due to my introverted nature I suppose.

I'm 39 as of this month, DH will be 48 in Feb. He has a son from his first marriage. I've never been pregnant. I've been off the pill for 13 months now with regular cycles & seemingly regular ovulation (have been temping and using CBEFM since October).

I work at an academic health center & am on a limited PPO plan where I agree to only see our univ doctors/residents/fellows for GREATLY reduced premiums,  co-pays, deductibles, & out-of-pocket maximums. Our employer does not offer infertility coverage on any of our medical insurance plans, but testing for infertility is covered. We do not have a full-time RE on the ob/gyn faculty, just two REs from a local private practice come to the clinic 1-2 days/month as adjunct faculty to teach residents and see patients. I was told the REs do not take my plan & (incorrectly) that the consult would be $100. I figured that was well worth it so I made an appt, only to find out at the appt that it was $272 (ouch!), & then the RE didn't even come into the exam room. He just instructed the ob/gyn resident who examined me, who he consulted with in a different room. I was less than thrilled after that visit & will not be scheduling on RE days at our univ any longer.

DH will be having his SA next week, I have my HSG scheduled for Monday & have had the following bloodwork done. Not sure when I'll be consulting with the ob/gyn resident on my results, but if anyone here wants to play Internet Doctor, feel free to give me any insight you may have. From what I can tell by Googling, most of the results seem to point to diminished ovarian reserve. I'm just wondering if there will be any chance of conceiving naturally since IUI/IVF will not be an option for us financially.

7 dpo: Progesterone 7.1 ng/mL & AMH 0.52 ng/mL

cd3: FSH 11.8 mIU/mL & Estradiol 18.7 pg/mL

[KaraOrNot]

Welcome! I don't have any insight into your numbers, but will say that the situation w/ your RE sucks. I would be pissed if they didn't even come into the room to consult.

[discogranny]

I don't have any advice either but I hope you get some good news from your further testing. You are in good company here but hopefully your stay with us is short.

[changedname]

Hey anonymess, welcome and sorry you are here. From your numbers it does look like you might have low ovarian reserve. I think an RE would probably tell you to go to IUI or IVF straightaway. A good friend of mine is going through the same right now.

If IUI/IVF aren't on the cards for you could you try acupuncture/Chinese medicine? It might be worth a shot as they look really deeply into your cycle etc.
The other things I could recommend are checking out this book - Inconceivable by Julia Indichova. My friend gave it to me and I found it pretty insightful. This woman was told she couldn't even do IVF because of her low ovarian reserve and through diet/lifestyle changes she managed to improve her numbers. Also my RE has me taking 400mg coenzyme q10 every day as supposedly it's good for egg quality - can't hurt.

I think you will get more answers after your DH's s/a and your hsg. Good luck!!

[kershnic]

Your numbers do indicate diminished ovarian reserve. I know you don't want to hear this, but if being pregnant and giving birth to a biological child is important to you, I think you probably need to think very seriously about finding the money for IUI or IVF, primarily because of your age. Have you looked into IUI at a midwife's practice? The actual IUI procedure may only cost you $200 or so (obviously your mileage may vary). If an RE recommended Clomid, Clomid is a very inexpensive drug. The costs do go up significantly with recommended (required by some) ultrasound monitoring, but it's still a lot less than OOP IVF. I know the idea of having to pay any money for this at all is painful, and even little things add up. But I also hate to think how you might feel down the road if things don't work out and you didn't try. Good luck.

[changedname]

kershnic has some really good advice. Also want to add that two things if you do decide to go ahead with meds.

1) Femara is sometimes used instead of clomid and my insurance covered it 100% because it is actually a breast cancer drug and used off label for fertility. Might be worth asking about - my RE prescribed it instead of clomid.

2) The.bump infertility board has an out of pocket meds thread where people donate meds to others.

[anonymess]

Thanks for the well wishes & great advice. It truly means a lot. Fingers crossed that all of us have a short stay on this board!

I can probably borrow the money from a family member for IUI/IVF, but I was really hoping it wouldn't come to that.

[Cheesecake]

Welcome! I don't know anything about numbers yet, but I agree with the others, especially considering age, I wouldn't want to take chances :-( so I'd probably proceed towards IUI/IVF.