How many months to try after HSG?

[thatgirl2478]

I had a HSG in Feb right before cycle 13 started.  There was a small blockage that was cleared with the dye, so we should be good to go.  We tried cycle 13 (good timing as usual) and then ended up getting my period 2 - 3 days early.  Obviously THAT was a big fail.  So now we're in the 2ww on cycle 14. 

My question is this, how long do we try the conventional way before consulting the Dr for further assistance?  We've had the blood work, the SA and the HSG which all indicate NOTHING is wrong.  Also, our insurance covers NOTHING related to IF (with the exception of some medications & the diagnosis of fertility issues), so we're pretty limited to what we can do.

[lola]

Mar 18, 2013 13:07:39 GMT -5 thatgirl2478 said:

I had a HSG in Feb right before cycle 13 started.  There was a small blockage that was cleared with the dye, so we should be good to go.  We tried cycle 13 (good timing as usual) and then ended up getting my period 2 - 3 days early.  Obviously THAT was a big fail.  So now we're in the 2ww on cycle 14. 

My question is this, how long do we try the conventional way before consulting the Dr for further assistance?  We've had the blood work, the SA and the HSG which all indicate NOTHING is wrong.  Also, our insurance covers NOTHING related to IF (with the exception of some medications & the diagnosis of fertility issues), so we're pretty limited to what we can do.

We are in pretty much the exact same situation.

My H's SA came back great, my blood work all looked good, my HSG reported no issues (she said there may have been a minor blockage that was forced loose with the dye) and we're STILL not pregnant.

I had my HSG in late November, and I think we're four cycles out from that point now. I am headed to my GYN's office in an hour to see what we do next. Unfortunately, some IF is just "unexplained" meaning everything looks good and there's not really a "medical reason" for you not getting pregnant - you're just not.

My insurance also covers NOTHING once there's been an IF diagnosis. It covered part of my HSG but I paid about $900 out of pocket. No meds, no visits, no IF txts are covered at all. I have no idea whatsoever we are going to do next.

Sorry my answer wasn't more positive. I can come back and tell you what I learn at my appointment today? Maybe she'll have some answers that apply to you as well?

[thatgirl2478]

Mar 18, 2013 13:23:37 GMT -5 lola said:

Mar 18, 2013 13:07:39 GMT -5 thatgirl2478 said:

I had a HSG in Feb right before cycle 13 started.  There was a small blockage that was cleared with the dye, so we should be good to go.  We tried cycle 13 (good timing as usual) and then ended up getting my period 2 - 3 days early.  Obviously THAT was a big fail.  So now we're in the 2ww on cycle 14. 

My question is this, how long do we try the conventional way before consulting the Dr for further assistance?  We've had the blood work, the SA and the HSG which all indicate NOTHING is wrong.  Also, our insurance covers NOTHING related to IF (with the exception of some medications & the diagnosis of fertility issues), so we're pretty limited to what we can do.

We are in pretty much the exact same situation.

My H's SA came back great, my blood work all looked good, my HSG reported no issues (she said there may have been a minor blockage that was forced loose with the dye) and we're STILL not pregnant.

I had my HSG in late November, and I think we're four cycles out from that point now. I am headed to my GYN's office in an hour to see what we do next. Unfortunately, some IF is just "unexplained" meaning everything looks good and there's not really a "medical reason" for you not getting pregnant - you're just not.

My insurance also covers NOTHING once there's been an IF diagnosis. It covered part of my HSG but I paid about $900 out of pocket. No meds, no visits, no IF txts are covered at all. I have no idea whatsoever we are going to do next.

Sorry my answer wasn't more positive. I can come back and tell you what I learn at my appointment today? Maybe she'll have some answers that apply to you as well?

That would be wonderful! 

We're lucky that we have a wonderful DD, but we'd like for her to have a sibling.  We never pictured our family as 'complete' with one, but maybe we'll have to learn to accept it?

We were lucky that we only had to pay $115 for the HSG - but other than that we get no coverage.   

[changedname]

I had my HSG in September and then started femara/iui in October. It felt like the natural progression of things. I am unexplained so was pretty anxious to get the ball rolling as the old fashioned way doesn't seem to be working.

[thatgirl2478]

Mar 18, 2013 14:14:03 GMT -5 changedname said:

I had my HSG in September and then started femara/iui in October. It felt like the natural progression of things. I am unexplained so was pretty anxious to get the ball rolling as the old fashioned way doesn't seem to be working.

Out of curiosity, how much did that cost?  If you don't mind sharing.  Just wondering if it's even an option for our budget...

[G22]

I had my HSG in Feb. It show everything looked great. I had labs done before that. My labs had some off stuff, and my doctor recommended we do femara/trigger shot/iui because my H also has issues (he had a varicocele surgery last July).

When I went in for my CD 3 ultrasound three weeks ago before starting femara, a cyst was found. So now I'm stalled until we get rid of the cyst. But between my HSG and now things have moved forward pretty fast. But we had been trying for 3 years leading up to that.

I'm pretty lucky in that everything has been 100% covered up to now. My H is military, and our insurance covers everything up til the actual IUI/IVF procedure. It will cover meds though which is nice.

[mae141]

I had an HSG in August and started IUIs in September. Getting the HSG done was a result of going to the RE for help, so we just started going with the treatments after all the testing was done and the dr knew what he was working with.

[changedname]

Mar 18, 2013 14:53:35 GMT -5 thatgirl2478 said:

Mar 18, 2013 14:14:03 GMT -5 changedname said:

I had my HSG in September and then started femara/iui in October. It felt like the natural progression of things. I am unexplained so was pretty anxious to get the ball rolling as the old fashioned way doesn't seem to be working.

Out of curiosity, how much did that cost?  If you don't mind sharing.  Just wondering if it's even an option for our budget...

  I assume you mean the Femara? It is super cheap. It cost $80 for the whole cycle and as it is not an actual fertility drug (my MIL takes it for her breast cancer) my insurance covered it straight away. My IUI cost $350.

[thatgirl2478]

Mar 18, 2013 14:56:54 GMT -5 G22 said:

I had my HSG in Feb. It show everything looked great. I had labs done before that. My labs had some off stuff, and my doctor recommended we do femara/trigger shot/iui because my H also has issues (he had a varicocele surgery last July).

When I went in for my CD 3 ultrasound three weeks ago before starting femara, a cyst was found. So now I'm stalled until we get rid of the cyst. But between my HSG and now things have moved forward pretty fast. But we had been trying for 3 years leading up to that.

I'm pretty lucky in that everything has been 100% covered up to now. My H is military, and our insurance covers everything up til the actual IUI/IVF procedure. It will cover meds though which is nice.

My DH is a Fed - you'd think the coverage would be better - but I get that this is pretty much 100% elective .  Though legitimately, if the gov is forcing birth CONTROL drugs be covered the opposite should be covered too... I know, I'm dreaming.

[thatgirl2478]

Mar 18, 2013 17:51:54 GMT -5 changedname said:

Mar 18, 2013 14:53:35 GMT -5 thatgirl2478 said:

Out of curiosity, how much did that cost?  If you don't mind sharing.  Just wondering if it's even an option for our budget...

  I assume you mean the Femara? It is super cheap. It cost $80 for the whole cycle and as it is not an actual fertility drug (my MIL takes it for her breast cancer) my insurance covered it straight away. My IUI cost $350.

That's not awful - was that after insurance? (the IUI)

[G22]

thatgirl2478 You know, I feel pretty lucky considering we have done tons of labwork, many ultrasounds, an hsg, and my H's surgery last summer and not paid anything out of pocket yet. And I'm looking at possibly having surgery to remove a cyst, and my understanding is that will be completely covered to if it comes to that. It will cost about $500 per IUI cycle, but meds will be covered so I figure thats not bad.

Either way, I agree that its unfair that people who consciously have decided they are ready to start a family and yet cannot do it without medical intervention have to pay so much just for a *chance* at getting pregnant. Not even a guarentee.But life isn't fair, right? It sucks..

[KaraOrNot]

Are you working w/ a RE or just your OB/GYN? I would meet w/ an RE at this time, just to get their recommendations. We are OOP and the initial meeting is $250. Pricey, but it was good to wrap our heads around what was going on and what the next steps are.

FWIW, I just got a quote for IUI w/ clomid. It will be ~$1300 plus the cost of meds (clomid is cheap H's is $24 per month)

[jewel]

I had my HSG (clear) last month, and started IUI with clomid this month. We have a known dx of MFI, though. The doctor really wanted to go straight to IVF, but I wanted to try a few cycles of IUI before throwing down that kind of money.

I'm fairly lucky with coverage. I have 50% covered, not including IVF. My entire IUI cycle this month was $181, including meds. So, without coverage, it would have been double that, which still sounds like a good deal.

Looking back, my only regret is not moving things along more quickly.

[thatgirl2478]

Mar 18, 2013 18:52:52 GMT -5 KaraOrNot said:

Are you working w/ a RE or just your OB/GYN? I would meet w/ an RE at this time, just to get their recommendations. We are OOP and the initial meeting is $250. Pricey, but it was good to wrap our heads around what was going on and what the next steps are.

FWIW, I just got a quote for IUI w/ clomid. It will be ~$1300 plus the cost of meds (clomid is cheap H's is $24 per month)

Right now we're just working with the OB/GYN.  We have 1 DD so either she was a HUGE lottery win (we think so anyway ) or something changed fertility wise in the past 3 years.  I suppose it could have changed - we're both older etc. but I find it hard to believe that with NOTHING wrong with us medically it wouldn't have happened earlier. 

I suspect that I had the minor blockage for a while, which would of course drastically reduce our chances from slim to down right impossible.

However, I'm a little uncertain about my OB/GYN's ability to do much ... when I first saw him with my concerns he said I might have PCOS & that I should aim to lose 10% of my weight.  The PCOS thought came from the fact that I have a lot of body hair (always have, I'm 50% italian) and the fact that I was holding on to all the post baby weight a year later (though I didn't even try to lose it until last year).  So when I went back to see him for the blood work he says if I've been ovulating (based on opk results) I probably don't have PCOS and now he suspects endo.... but I've never had a lot of period pain or heavy periods until after I had my DD.  

[bronxgirl]

Mar 18, 2013 13:39:41 GMT -5 thatgirl2478 said:

Mar 18, 2013 13:23:37 GMT -5 lola said:

That would be wonderful! 

We're lucky that we have a wonderful DD, but we'd like for her to have a sibling.  We never pictured our family as 'complete' with one, but maybe we'll have to learn to accept it?

We were lucky that we only had to pay $115 for the HSG - but other than that we get no coverage.   

That's my exact situation right now and I'm having such a hard time dealing with it.  I was going to start a thread about it tonight, but then I just felt too tired.  I'm really sorry you're going through this.  We recently had 4 failed IUIs (2 ended in early CPs) and one failed IVF.  We're trying on our own now, but that's probably just a pipe dream.  My daughter would be such an awesome big sister and I feel so bad that I can't make her one.

[thatgirl2478]

Mar 18, 2013 20:29:43 GMT -5 bronxgirl said:

Mar 18, 2013 13:39:41 GMT -5 thatgirl2478 said:

That would be wonderful! 

We're lucky that we have a wonderful DD, but we'd like for her to have a sibling.  We never pictured our family as 'complete' with one, but maybe we'll have to learn to accept it?

We were lucky that we only had to pay $115 for the HSG - but other than that we get no coverage.   

That's my exact situation right now and I'm having such a hard time dealing with it.  I was going to start a thread about it tonight, but then I just felt too tired.  I'm really sorry you're going through this.  We recently had 4 failed IUIs (2 ended in early CPs) and one failed IVF.  We're trying on our own now, but that's probably just a pipe dream.  My daughter would be such an awesome big sister and I feel so bad that I can't make her one.

I'm sorry you had so many failed attempts, that's part of the reason I'm not sure if I even want to TRY IUI / IVF ... I don't know if I can handle a) paying out that kind of money only to have it b) end in disappointment.  I know what you mean about your daughter being a great big sister, I really think ours would be too.  I really wanted two kids closer in age so that they could grow up together like my brother & I did and not essentially be only kids with an older/younger sibling like my DH - his brother is 7 years older than he is (his mom was diagnosed and treated for thyroid cancer while his older brother was in utero.  She was told to abort him, but she wouldn't do it.  Then she was told not to have any more kids - or at least wait 8 years for the next one ... she didn't listen to that advice either.)

[lola]

Alright thatgirl2478, I'm back!

Here's what my GYN said. I debated posting this even, because I'm afraid it's going to be controversial and I'm not really up for it, but I'm going to post because it might provide you somethings to consider as well, so here goes.

My HSG and blood work all look great, as does my H's SA. Our IF is "unexplained" which she says is the case in 40% of IF cases (so we're in good company, she says! lol). Her recommendation at this point was to try two to three rounds of Clomid under her supervision.

I asked her about being referred to an RE for monitoring during the process, and told her all of the things I've read here about how this process goes. Her opinion was that yes, a RE might be necessary and that Clomid is usually prescribed and monitored by an RE. She said, though, that we are not really good candidates for IUI since my H's SA was so good. Generally, under an RE we'd do a round or two of Clomid followed by Clomid + IUI, which is a big part of the monitoring, ultrasounds, etc. She said if it was even "borderline" we'd move immediately to an RE.

IUI with Clomid increases the chance of pregnancy only by minor percentage points (three to five, best case) over just Clomid. Given that, and knowing that IUI can be super expensive (I live in an expensive city, go to a very expensive hospital, and I have absolutely no coverage for IF treatments under my insurance plan) she doesn't feel like this is the right step for us right now.

Her plan for us is to try the Clomid, along with timed sex (using OPKs) and hope for the best. If after two cycles we haven't had any success, she'll refer us to a RE while we go through the third cycle. So, that's what we're going to do.

I know people have a ton of opinions and knowledge on using Clomid and REs and I totally respect all of that. I also respect my doctor and believe she wants the best for me and my H, and that she's making the recommendation she is based on that. I don't know if this will work for us, but I'm cautiously optimistic because I really have no other choice at this point. I'll give it the 2-3 cycles with her, and move on if we have to. IF treatments out of pocket are probably not an option right now, so this seems like a good option for us.

In other news, she was super calming about a number of other questions I had. She said I can keep drinking green tea on all days of my cycle, that I don't have to keep temping and charting if it stresses me out (and it does, so I plan to stop), and that I don't really have to worry about all the "eat this, don't eat that, take this supplement but avoid the other," stuff. Her advice was to just live my relatively healthy life. She also recommended acupuncture. She says it's the only "non-medical" step that she always recommends, so I plan to do it. There are a ton of places here, and it's not super duper crazy expensive really.

So, there it is. If you have any questions, or I have missed anything just let me know. I'm happy to share.

[thatgirl2478]

Thanks lola, that was in fact very helpful. I think I'll give it this month (we'll see in a few weeks right?) and call my OB/GYN for advice if I get a BFN.

I'm pretty sure that this is the same path my Ob/Gyn would want to take. And, given that we have ZERO coverage, I'm pretty sure we'd feel the most comfortable going this route too.

[bronxgirl]

Mar 18, 2013 21:21:17 GMT -5 thatgirl2478 said:

Mar 18, 2013 20:29:43 GMT -5 bronxgirl said:

That's my exact situation right now and I'm having such a hard time dealing with it.  I was going to start a thread about it tonight, but then I just felt too tired.  I'm really sorry you're going through this.  We recently had 4 failed IUIs (2 ended in early CPs) and one failed IVF.  We're trying on our own now, but that's probably just a pipe dream.  My daughter would be such an awesome big sister and I feel so bad that I can't make her one.

I'm sorry you had so many failed attempts, that's part of the reason I'm not sure if I even want to TRY IUI / IVF ... I don't know if I can handle a) paying out that kind of money only to have it b) end in disappointment.  I know what you mean about your daughter being a great big sister, I really think ours would be too.  I really wanted two kids closer in age so that they could grow up together like my brother & I did and not essentially be only kids with an older/younger sibling like my DH - his brother is 7 years older than he is (his mom was diagnosed and treated for thyroid cancer while his older brother was in utero.  She was told to abort him, but she wouldn't do it.  Then she was told not to have any more kids - or at least wait 8 years for the next one ... she didn't listen to that advice either.)

we got PG with my daughter on our 2nd IUI so I went in this time rather hopeful. Honestly, b/c we had previous success I just assumed we would again. How naive I was.

[mae141]

Mar 18, 2013 20:13:07 GMT -5 thatgirl2478 said:

Mar 18, 2013 18:52:52 GMT -5 KaraOrNot said:

Are you working w/ a RE or just your OB/GYN? I would meet w/ an RE at this time, just to get their recommendations. We are OOP and the initial meeting is $250. Pricey, but it was good to wrap our heads around what was going on and what the next steps are.

FWIW, I just got a quote for IUI w/ clomid. It will be ~$1300 plus the cost of meds (clomid is cheap H's is $24 per month)

Right now we're just working with the OB/GYN.  We have 1 DD so either she was a HUGE lottery win (we think so anyway ) or something changed fertility wise in the past 3 years.  I suppose it could have changed - we're both older etc. but I find it hard to believe that with NOTHING wrong with us medically it wouldn't have happened earlier. 

I suspect that I had the minor blockage for a while, which would of course drastically reduce our chances from slim to down right impossible.

However, I'm a little uncertain about my OB/GYN's ability to do much ... when I first saw him with my concerns he said I might have PCOS & that I should aim to lose 10% of my weight.  The PCOS thought came from the fact that I have a lot of body hair (always have, I'm 50% italian) and the fact that I was holding on to all the post baby weight a year later (though I didn't even try to lose it until last year).  So when I went back to see him for the blood work he says if I've been ovulating (based on opk results) I probably don't have PCOS and now he suspects endo.... but I've never had a lot of period pain or heavy periods until after I had my DD.  

You mentioned that you don't have IF coverage, so I guess this might just be something to think about, but an Ob/Gyn is there for when you are pregnant, and and RE is there to get you pregnant. My gyn told me I do not have PCOS (I don't really have any physical symptoms) and my thyroid is fine (I do have symptoms there). I actually took the bloodwork from my gyn to my RE and he immediately put me on both metformin and synthroid after seeing it. I ended up getting pregnant shortly after (although I did m/c). While I really like my ob/gyn and I trust her, she's really not the expert in getting people pregnant, and that's why I quickly moved to an RE at her suggestion. If my insurance didn't cover it, I don't know what I would have done, but I think if I were you I would at least go for a consult and see what an RE would suggest. 

[changedname]

thatgirl2478 - my IUI was $350 with no insurance. My insurance only covers meds, nothing else. However, I am in Canada. A friend of mine at another clinic also in Canada paid nearly $1000 for an IUI (she got pg though) so it really varies. Most clinics post their prices online so I would recommend that you check them.

lola - I didn't do clomid just femara (which has a very low incidence of multiples). I think the controversy is about the chance of clomid producing multiple eggs and you ending up with twin/triplets etc. Saying that, I did am IUI with Gonal F in Dec and I had 4 mature follies. My RE still let me go ahead and when I posted on MMM there was outrage that my RE was irresponsible. Didn't work anyway........
I'm sorry you are joining our unexplained camp. Not a fun place to be but you do have a chance of getting pg each month which can either be hopeful or a mindfuck depending on which way you take it. As soon as I was diagnosed I did 2 x IUI w femara and 1 x IUI w gonal F. Now I am on IVF. I'm fast tracking it though.

[changedname]

Mar 18, 2013 20:29:43 GMT -5 bronxgirl said:

Mar 18, 2013 13:39:41 GMT -5 thatgirl2478 said:

That would be wonderful! 

We're lucky that we have a wonderful DD, but we'd like for her to have a sibling.  We never pictured our family as 'complete' with one, but maybe we'll have to learn to accept it?

We were lucky that we only had to pay $115 for the HSG - but other than that we get no coverage.   

That's my exact situation right now and I'm having such a hard time dealing with it.  I was going to start a thread about it tonight, but then I just felt too tired.  I'm really sorry you're going through this.  We recently had 4 failed IUIs (2 ended in early CPs) and one failed IVF.  We're trying on our own now, but that's probably just a pipe dream.  My daughter would be such an awesome big sister and I feel so bad that I can't make her one.

  Hugs you two. I obviously can't imagine what it is like to have secondary IF but it must really suck. I am so focused on the end goal of having one baby that I never look past that even though I assume I will have two. bronxgirl - I have been rooting for you since the beginning. Did you ever have a WTF appointment after your ivf? Did the RE have any explanation as to why it didn't work or just one of those things? I hate that because of $$ we can't all do as many iuis/ivfs as it takes.

[lola]

Ahh, thanks @icedgems, that makes more sense to me now. My GYN was really honest about the chances of multiples, saying of that chance most likely twins, sometimes triplets and rarely more. She said, "We would NOT consider that a success," and was pretty honest about how much harder it is to be pregnant with multiples. I am not posting about this anywhere else, especially MMM (lol! i never post there anyways!) because I honestly am not up for a great debate about who knows more - my doctor or GBCNies. I am happy to assume that all of our doctors are smart, educated women and men who wouldn't do anything they thought was dangerous to us or our unborn (hell, unconceived!) babies.

Yes, I feel like "unexplained" is just a total mindfuck. It's like, "There's a chance, but we sure as shit don't know what it is or how to improve it! Let's try this for a while..." I guess I'm going to choose to believe that this will work, and we'll go from there.

She has me on Clomid days 3 - 7, so I start tomorrow. Fingers crossed....

[discogranny]

lola - I wish you luck. Maybe Clomid alone will be your lucky ticket. Unexplained is such a weird place to be. Even now I still have trouble with the idea of my body "working perfectly" when it obviously doesn't when it really matters.

At my RE, a Clomid IUI was $1000, I never did a Clomid IUI because I felt like skipping to injectables was a better choice given the higher success percentage. Injectables IUI was $1600 with meds.

thatgirl2478 - I had my HSG in Feb. 2012 and did my first injection leading up to IUI in mid-June. We waited a few months to see if the HSG would work it's magic so many people raved about online.

[bronxgirl]

Mar 19, 2013 8:04:54 GMT -5 lola said:

I am not posting about this anywhere else, especially MMM (lol! i never post there anyways!) because I honestly am not up for a great debate about who knows more - my doctor or GBCNies. I am happy to assume that all of our doctors are smart, educated women and men who wouldn't do anything they thought was dangerous to us or our unborn (hell, unconceived!) babies.

You are a wise woman, lola.  I've learned to keep my IF talk to this board, no matter how much I feel like mentioning it elsewhere.

I had a f/u appt. with my RE last week. He didn;t have any explanation for why it didn't work, esp b/c everythiong looked so good.  He said my age might have something to do with it b/c that obviously can't be fixed.  He did an u/s and I didn't have any cysts, which is good.  He said everything looked fine., so I'm back to being unexplained. (I'm an enigma- wrapped in a riddle) 

[thatgirl2478]

bronxgirl - not to be too nosy - but how old are you?

I agree about not bringing up certain topics on certain boards It's a good thing we have different boards for different conversations!

[bronxgirl]

Mar 19, 2013 14:28:00 GMT -5 thatgirl2478 said:

bronxgirl - not to be too nosy - but how old are you?

I agree about not bringing up certain topics on certain boards It's a good thing we have different boards for different conversations!

I'll be 40 in June. 

[thatgirl2478]

bronxgirl, you're not much older than I am. Sucks getting old huh? Though, I don't know if I would want to be a YOUNG mom ... the timing wasn't right then and I know SO much more about myself and how things should be (though, not an expert certainly).

[sonrisa]

My HSG is next week. The doctor was okay with doing IUI the same cycle, but we are taking it slow. We will do meds + sonogram dating for ovulation + timed intercourse starting next month.

I think "unexplained" is often a euphemism for age related (for those of us over 32).

[changedname]

Mar 20, 2013 18:17:14 GMT -5 sonrisa said:

My HSG is next week. The doctor was okay with doing IUI the same cycle, but we are taking it slow. We will do meds + sonogram dating for ovulation + timed intercourse starting next month.

I think "unexplained" is often a euphemism for age related (for those of us over 32).

I agree with the bolded. I'm pretty sure I wouldn't have had trouble getting KU if I was 22. Damn those old eggs.