Unexplained to Multifactoral Sub-fertility

[LadyBee]

Hello all.

I have been to a specialist today and in view of my records, hormone testing and BBT charts, I was told that I have Unexplained to Multifactoral Sub-fertility. I understand that's not very conclusive, especially considering I haven't had FSH, LH, and Thyroid testing via bloodwork, but he suspects that they will come back normal since everything else looked 'perfect'. Very strange indeed...

Also before I get too far, DH and I have decided to finally have the SA done, and will schedule as soon as money permits.

I have stage 3 endometriosis, had a lap done in Feb of last year and have been TTC for ages.

My options have been given me and my reason for posting this question is as follows.

Given the success rates for women with unexplained infertility is 10-12% using IUI in conjunction with clomid, I'm intrigued at how much help the intervention is since clomid is being used.

Are IUI's that wonderful? I know they work, but should I try the clomid and preseed route first (after DH's SA of course)?

 

[LadyBee]

Ok...I see it must be a weird question.

I am just having a hard time knowing what to persue. I feel IUI though, cheapest option to help me on my way, is also the least effective aside from trying 'naturally'. I just need input.....

I just had information overload and I'm having a hard time processing it.

 

[Bexy]

Hey Meli Tia,

Afraid I can't give you much advice on that - UK consultants seem to like to prescribe Clomid and ask questions later...

I would suggest once DH has had SA, then you might want to try Clomid for 6 months as it is the least invasive of all treatments...however if you have blocked tubes or anything like that the 6 months could be wasted....tricky to know what is best really..

 

[LadyBee]

Thank you for your response
My tubes aren't blocked thank goodness, as of February 08 (and they are most likely still clear in the opinion of my docs).

I was told clomid can only be used for 2-3 cycles before it becomes counterproductive??

 

[wishn2Bmom]

yea here in the states they don't like to give Clomid for more than 3 months. I personally think your course of action really depends on your DH and his SA results. I had the lap done in May and instead of getting his SA done right away post op we put it off and tried naturally all summer thinking that I was temporarily "fixed". Come to find out DH has really crappy #s. Know I wish we hadn't wasted that time.
For you, given the reluctance of long term Clomid use, I would be afraid you would do 3 months on clomid with no luck only to find out it was DH also and you need IUI (which they normally prescribe Clomid for). I don't know. They've given you tons of options which makes things confusing. Only you know what's best for the two of you and your specific situation though.

I hope i've helped with some sort of insight
Good luck!

 

[LadyBee]

I'm leaning most toward the lap clomid and IUI route. I was wondering if anyone had any advice on this option?

 

[Diana_]

With your endo history, a lap is a good idea. If they also can check your tubes again, I think that'd be ideal. Then you're sure. I'd also get a SA done (we did even though we got pg once), because it's good to know that's not an issue.

Your options after the lap are really natural, clomid + timed BD, clomid + IUI, injectables + IUI, and IVF. The invasiveness increases in that list, and so do the odds. If Clomid works well for you, I'd definitely start there. Beats shooting up every day. I have done three ovulating clomid cycles (plus one cycle , and for the next month I want injectables. Clomid isn't very fun, but it's a good place to start.

Can you plan on two cycles of IUI + clomid and then decide to go further or try something else?

 

[LadyBee]

Thank you so much Diana!

I agree, it would be ideal. My tubes are most likely still clear the Doc said, but I agree that the Lap would give me the optimal chances.

I keep forgetting that if DH's SA doesn't come back with good news, that my options then will be limited, correct? At least for a time...you can build up good right?? I believe you can...

So I should wait for the SA, then make my decision.

I'm leaning heavily on another Lap, Clomid and IUI. My endo has been under control for the most part, but my new OB doesn't think that the cauterizing in the last surgery was the best way as I have some very deep adhesions. He wants to laser it.

I was under the impression though that multiple Lap surgeries cause a lot of scarring that isn't good either??

 

[Diana_]

Honestly, as our fertility problems are all me, I haven't looked into ways to improve sperm count at all. I'd get the SA first so you don't waste time, but that's a personal preference.

About multiple laps, I haven't had one, but I've heard a lot of endo ladies getting regular laps ... so it can't be that bad, I guess.

When are you going to talk with your doctor about your plans?

 

[LadyBee]

...I just put in a call!

The SA WILL happen but we have to wait to have cash in hand as DH wants to pay for it outright...just a couple of weeks for the extra cash. I hope to do something by December, if not sooner.

 

[Diana_]

Exciting that you have gotten started! Hopefully the time will go quickly until your appointment.