Wednesday, April 6, 2011

Different Fertility Procedures

Yesterday I shared some acronyms common in the infertility world.  Some of those were different techniques to achieve a better success rate. I plan to explain those more in detail as well as discuss alternative options as well in this same post. I am not even going to attempt to discuss all the preliminary testing they would have you do before they consider you for fertility treatments. I will leave that for another post! I want to share all the information I have gained (even some in the last 24 hours!) for you to better equip yourself or a family member/friend that happens to be going through this.

First, I can explain in the most detail what I have gone through personally. I skipped Clomid, which is usually the first stop for doctors on the infertility train. Women can use Clomid, then try naturally or go through a procedure called IUI. Intra-uterine insemination is essentially what I like to call "turkey basting". They take the sperm and inject it right into the uterus allowing for less "travel" time and distance.  This helps with both male and female infertility. Most men will be tested as well before this happens to check for motility and count. Be gentle with your husband during this time, his pride is at stake!

From my experience, you can attempt IUI several times before there's nothing "new" they can try to get a success. They can change only so many variables in the equation before the answer will almost certainly be a no every time.  For me, that was trying new and sometimes higher doses each attempt. Instead of Clomid, I was on FSH or follicle stimulating hormones, gonadatropins, to create many follicles in my ovaries. Throughout the shots, they carefully monitor you by ultrasound and blood work to make sure the follicles are growing at a rate that they should and your estrogen level is rising as well.  After the follicles mature to a certain size, then they can make you ovulate by giving you an HCG shot to release the follicles (which hopefully contain eggs). After a certain amount of hours from your HCG shot, you go in for your IUI procedure.  After that, it's the usual two week wait to see if it worked.

After Clomid and IUI, the next step for me was IVF. In vitro fertilization can be controversial if you have certain religious beliefs. Some women choose not to go through this for medical reasons as well. It is extremely taxing on a woman's body, her emotions and not to mention the husband and their checkbook! This is more in depth than IUI. You go through the same follicle stimulating hormones, but this time tack on antibiotics for both you and your husband, a strict schedule and regimen you have to follow and paperwork to sign. It seemed nothing short of overwhelming when we first met with the IVF nurse in our doctor's office. They give you your timeline to follow: when to stop your pill, when to come in for your blood tests, order your meds, paperwork, semen analysis, sonohisterogram, trial transfer, when to start antibiotics, when to start your FSH shots, when to come in for check-ups (several times a week, near the end it could be every day), when to give yourself the HCG shot, when to come in for your egg retrieval, when to start progesterone shots, when to come back for your embryo transfer, when to be on bed rest, when to come back for your pregnancy test. By this time your head is spinning. But you can ask questions at any time, the nurse or doctor can go over and over that schedule with you until you understand it. Your husband will be there to help keep everything on track.  For me, the next IVF attempt will also include Lupron shots into the mix! Fun times! Just what I always wanted, more shots! I actually had a dream last night that my doctor was explaining that unfortunately for Lupron, the needles have to be bigger. Which thankfully, is not true. That's just how obsessed your mind and subconscious become about it. Add on top of all that stressful planning that your hormones will be through the roof! I plan to explain each step of IVF as I go through it starting in a few days with an MRI to check the size of my benign pituitary tumor.

Along with IVF there are several techniques the doctors can try to give you the best scenario for success. The ones we have done and will be doing again are ICSI and Assisted Hatching. ICSI or intracytoplasmic sperm injection is where a single sperm is microsurgically injected directly into an egg. They literally cut off their tails and put one inside each of your eggs. Pretty cool, huh? That helps the fertilization process significantly! Assisted hatching is when a small section of the embryo's outer "shell" is removed to improve the embryo's chance of attaching to the uterine wall. All embryos have to leave this outer covering prior to implantation anyways and they can help in that process as well. Mind-boggling, isn't it? Also hard to believe that with the help of all this you can still get a negative. That just goes to show how much of a miracle conception truly is. Even with all the science in the world, a greater being, in my case God, has to intervene and have it be on his terms.

There are alternatives if all of this sounds scary and too expensive. We all know insurance companies aren't the greatest at helping with fertility treatments even though Viagra is covered! Just recently someone handed me a brochure on a natural technique termed Naprotechnology.  Worth a shot if you want to try everything possible before turning to shots! It says that it uses the Creighton Model Fertility Care System to monitor various events and to telegraph abnormalities in the menstrual and fertility cycle. When your cycle functions abnormally this Naprotechnology identifies problems and treats them cooperatively with the cycle.  Now from just glancing at the websites it reminds me a lot of taking your basal temperature and "acting" when the time is right. However, for those of you out there who aren't sure exactly why you aren't conceiving, there might be something to this. Check out more at if you're interested. There is apparently a study being conducted that you might be able to get in on as well if you are serious enough about it. Couldn't hurt, right?

Another alternative which a lot of women swear by is acupuncture. Now that to me is WAY more needles than I would ever want to be subjected to all at once, but to each his own. Apparently you barely feel them if at all and it is very relaxing. So if you're not a strong believer it will get you pregnant, you might want to try it for a stress reliever during the process. This also couldn't hurt if you're not terrified of needles that stay in you for long periods of time. In all seriousness if you are interested in either Naprotechnology or Acupuncture I know two female doctors right here in Wadsworth, OH, that can help you!

The last alternative that I am somewhat familiar with is Bioidentical hormones. It seems to be the more homeopathic approach to fertility. More natural hormones and supplements as opposed to synthetic. Most of what I read talks about then being used to lessen the symptoms of menopause, but I have heard several people who have tried them in lieu of fertility treatments. If you would like to learn more, click here. But most importantly, do your homework.

With any of these approaches, you need to do what is the best fit for you and your husband. Do your research and make smart decisions.

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