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What to Expect From Fertility Treatments: Monitoring

Are you thinking about seeking treatment from a fertility clinic? Are you unsure about what to expect from the fertility treatment process? Last week I shared my experience with the pre-treatment consultations, financial aspects, and testing that are necessary in order to receive fertility treatments. This week I will focus on the monitoring phase of treatment, and next week I will explain Intrauterine Insemination (IUI). If you are suffering from infertility, I hope you can find a safe place here to get answers to some of your questions. Mostly though, I just want to encourage you. Suffering from infertility can be an emotional rollercoaster. You are not alone though. Many, many women have been right where you are. There is hope. For many women, receiving treatment from a fertility clinic is the best shot they have at becoming a Mommy. Read on to find out about the monitoring phase of fertility treatment.

What to expect from fertility treatments monitoring

What to Expect From Fertility Treatments: Monitoring

Stimulating Ovulation With Medication

There are a number of medicines your reproductive endocrinologist may prescribe for you, depending on your course of treatment. However, if you suffer from polycystic ovarian syndrome (PCOS) and are not ovulating on your own, it is likely you will be prescribed the drugs listed below.

Clomiphene (Clomid)

Clomid seems to be a standard fertility drug. Actually, my OBGYN prescribed Clomid for me before she ever referred me to Shady Grove. Clomid works by inducing the pituitary gland to release more of the follicle-stimulating hormone (FSH) on its own. Once FSH is released, the follicles in your ovaries are stimulated to grow and eventually one or more will become mature enough to release an egg… otherwise known as ovulation. Clomid is taken orally, and depending on my hormone levels, I was usually directed to take it day 3-7 or day 5-9 of my cycle.

There are a few potential downsides to taking Clomid. Some women can have a strong reaction to Clomid. It can literally make them feel like they are on an emotional rollercoaster. Additionally, there is a 7-8% chance of a twin or multiple pregnancy with Clomid.

Finally, apparently it is not safe to take Clomid for longer than one year because it can increase your risk for ovarian cancer. This was the case with me. I was unable to get pregnant (and stay pregnant) with just Clomid. Eventually, the reproductive endocrinologist changed my treatment so that I was taking Gonadotropins (a combination of FSH and Luteinizing hormone (LH) that are used together to stimulate ovulation).

FSH and LH

My experience with Gonadotropins was two-fold. When my treatment plan included Clomid, the gonadotropins were prescribed in the form of a trigger shot that I would take 1 1/2-2 days before the actual IUI procedure. This drug is administered in the form of a subcutaneous injection. In other words, you have to stick yourself in the belly with a needle. I have to be honest, I was incredibly squeamish about doing this at first. However, the needle used is actually not that bad… and my belly has a lot of extra padding, so I barely felt it.

Once it was determined that Clomid would not be effective for me anymore, the endocrinologist prescribed a more aggressive course of treatment which included multiple doses of injectable medicines. So, during the course of treatment I would have the thrill of sticking myself with a needle every night. Woo Hoo!

I have to tell you that the act of injecting myself with the hormones was not the most painful part of this procedure. These fertility drugs are mega expensive and they are not covered by insurance. Each shot was approximately $200. Yep, you read that right– $200! Ouch! Now, that hurts. Luckily, most women do not need many of these Gonadotropin injectable shots in order to stimulate ovulation.

Metformin

The endocrinologist also prescribed metformin. Metformin is commonly used to treat patients with diabetes. However, it also helps women with PCOS regulate insulin and blood sugar as well (many women with PCOS are either pre-diabetic or diabetic). A side benefit to metformin is that it helps promote a healthy ovulation process. Since many women with fertility issues can use all the help they can get, this is commonly prescribed by doctors. I am actually still taking it in order to manage my PCOS systems.

Vaginal Ultrasound and Blood Tests

In order to determine the best time to perform the actual IUI treatment, the fertility clinic will start monitoring your hormone levels and follicle production starting at around day 8 or 9 of your cycle (sometimes later). Monitoring appointments consist of four parts:

  • a blood test
  • a vaginal ultrasound
  • a consultation with the nurse
  • a phone consultation with the nurse later in the day, once the blood work comes back and the endocrinologist review the results

Once monitoring begins, you will likely be required to come to a clinic every other day until your follicles are large enough to finish the ovulation stimulation process with the trigger shot. There were also a few months when I had to come in back-to-back days because my body was moving too fast or because it was doing whacky things.

Mostly, this meant that before work I hauled myself to the clinic by 7 or 715AM. Sometimes the clinic was literally overrun with patients and the wait would be over an hour to be seen. Most of the time I was in and out of the office within 20 minutes (blood work, ultrasound, and consultation). These folks are fast! My experience was that Shady Grove tended to schedule the same phlebotomists and ultrasound technicians. Very shortly I started to develop relationships with these women, which was nice because they shared in my disappointment, sorrow, and joy.

It is important to note that the morning monitoring appointments did not just happen on weekdays. If your monitoring day fell on a weekend or holiday then, yep– you had to haul your tushy to the clinic at 7AM on the weekend too. The only day I think Shady Grove does not conduct business is Christmas day. If you are seeking treatment, you will want to be aware of the policies of the clinic you use.

What are they looking for?

So, what is the point of all this monitoring? What are they looking for?

Ideally, the vaginal ultrasound will show multiple follicles maturing, and eventually that would translate into 2-4 mature eggs. The ultrasound technician is very skilled at actually measuring your maturing follicles and very quickly you get excited and hopeful about the prospect of your body actually doing what it is supposed to do– ovulating!

Does it make you nervous that you would have 2-4 mature follicles/eggs? Don’t be. The number of mature follicles or eggs does not equate to the number of babies you will get pregnant with (hello, octomom!). Even with multiple mature eggs, the likelihood of getting pregnant through IUI is still only about 10% per cycle. So, more eggs equals more of a chance you get pregnant. I was certainly more than willing to risk a multiples pregnancy if it meant I would actually get pregnant.

What to expect from fertility treatments monitoring

For the most part, that is what the monitoring phase consists of. Every month that you don’t get pregnant, the reproductive endocrinologist tweaks the treatment plan and you start over again. Granted, there are some inconveniences and minor irritations. However, for the most part I was very hopeful during this phase.

Check back next week to find out more details about the actual IUI process.

In the meantime, welcome to Thoughtful Thursdays! I am so glad you decided to stop by, check us out, and leave a link to one of your thoughtful posts. There were so many thought-provoking posts this week and it has been hard for me to choose favorites. However, these posts really resonated with me and I hope you like them too!

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Thanks for reading and have a great week!
Sara

 

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What to Expect from the Fertility Process: Intrauterine Insemination - Sunshine Whispers

Thursday 30th of April 2015

[…] You have made it to the point where your Intrauterine Insemination (IUI) procedure has been scheduled! You just self-administered […]

Candace

Thursday 23rd of April 2015

What an important series! You will help many with this. Sharing on twitter :). Thanks so much for including my restlessness post.

sara

Sunday 26th of April 2015

Thanks for sharing! I know it can be discouraging when you are faced with treatments like this so I hope to encourage other 'mom-to-be' hopefuls. I loved your restlessness post btw!

Joy Healy

Thursday 23rd of April 2015

Sara, This is invaluable information, succinctly written. Thank you.

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