Clomid + IUI

Hi Pihu...
Responses to your questions...

I didn't find any fibroids in ultrasound scanning.
- Some fibroids may appear to be small in the scan but larger in size during the hysteroscopy when seen inside the uterus. Unless the fibroid is within the uterine canal, most doctors will not be too concerned.
But still you think that i should go for laproscopy or hysteroscopy?
- You would need to go for the hysteroscopy prior to moving from IUI to IVF. All doctors will insist on the same.
Till yet i have not gone for any IUI or IVF?
- First approach your doctor for the IUI process with tablets, then next with the injectables, and if nothing works, then the doctor will step it up to IVF. Prior to starting your IUI process, please ensure that you have gone through a HSG process towards ensuring that the tubes are clear and patent for the ART process.

very much confused what to do? Can you please help me out? You said that your doctor was able to find out the problem when you were not able to conceive..What was the problem? my husband have also done semen analysis in which everything came out normal. Don't know why i am not able to conceive naturally?
- IN my case, mu husband's sperm count was fine and so was the motility. No issues with my cycles, ovulation or eggs. What turned out to be the problem was th fragmentation of the sperm, which results in the lack of penetration into the egg for the formation of the embryo. This was the aspect which was identified by my doctor Madhuri and then treated by the andrologist. This helped considerably as once we knew that this was the problem, we knew that the only and probably the best solution would be ICSI as this is the process which involves the injection of the sperm into the egg directly thereby bypassing the penetration of the outer layer of the egg by the sperm head.

Its a difficult phase trying to find out exactly what the issue is. In this time of scientific developments, the challenge is that we expect science to have answers for everything. This may or maynot be the case for every case. The only hope is to go to the right doctor and hope that the person is able to identify the issue and advice on the appropriate protocol. Don't lose hope just coz you are not conceiving naturally...it might also be a case of just timing. If you and your husband have been trying for a while and more than 18 months and your age is beyond 30, I would recommend stepping it up and meeting a fertility specialist. Its important then not to lose too much time. Be patient...things will work. Best wishes!

 

Meghaa, if your doc is reluctant to operate on it, may be that's not dangerous and many insignificant fibroids dissolve themselves. If you feel that could be something more serious, or that might be cause of painful periods or any inconvenience, go for second opinion.
I have annovulatory cycles too because of pcos. Clomid + iui never worked for me. My follicle size increased and I ovulated with heavy doses of clomid, but it was bfn. Not all fertility treatments are sure shot success answers. More often than not, they are permutations and combinations of different options of treatments on what works on us. Donot get worried or disheartned, tension and restlessness is one of the major causes of bfn. Relax, divert your mind and enjoy

 

Hi meghaa..Do you know what type of Fibroid you have and what is the exact placement? Unless and until the fibroid is in the uterine canal or will obstruct the implantations, it is not required to be operated on. I would suggest that you check this detail before panicking that your doctor isnt operating on the same.

BBT varies for each and every person. As long as you have a cycle where you are ovulating, don't worry too much about it. Use a ovulation kit to get better idea of your ovulation cycles in case you are not monitoring it with follicular scans.

For a lot of people, Clomid has little to no impact in terms of incremental follicle count, but have ver good responses to injectables. Has your doctor discussed this option with you? Most doctors try 2 - 3 cycles of clomid and based on the response, decide on whether to continue or switch to the injectables.

Relax...don't get stressed...this is a long journey and you need to hold your wits and your engery if you intend to get through this phase!

 

Fibroids will only cause problems in certain cases.
However I would not waste any time with an ob-gyn for fertility issues. Go straight to an RE. If you are in Virginia, Shady Grove Fertility is a good practice.

 

Thanks winipooh for your reply.I have undergone HSG test in which both the fallopian tubes were found to be clear and open...Now according to you i should go for a lap or hysterectomy..can you please guide me? what were the charges for sperm DNA fragmentation and ICSI process? That would be a great help me...

 

Hi Pihu...I would recommend that you meet the doctor to decide whether you need to go through the lapro or if the hysteroscopy is sufficient.
With regards to the DNA fragmentation, if the DNA is fragmented, it is very dififcult for the sperm to penetrate the egg and so there is no fusion. To bypass this, the best sperm is selected and injected directly into the egg thereby bypassing the penetration of the sperms into the egg and so the ICSI process moves up the chances of implantation %.

 

Thanks winipooh for your reply..Can you please tell me what is the difference between IUI and ICSI? Is ICSI similar to IVF? how Hysterescopy is carried out...

 

Pihu....IUI is the basic protocol where the sperm sample is washed and then transferred into the uterus. ICSI is the advanced format of IVF. IVF involves extraction of the eggs from you and then placing them in a petridish with the best sperm to fuse and form an embryo. ICSI is the format where the eggs are extracted and the best sperms are injected into the eggs to form the embryo, thereby bypassing the sperm penetration into the eggs phase. IUI doesn't involve any anesthesia while IVF and ICSI require general anesthesia for the egg retrival and the embryo transfer process is the same as the IUI process.

Hysteroscopy is a disgnostic procedure done under anesthesia to evaluate the patentability of the uterus, endometrium, etc. In some cases, if there are any obstructions found in the uterine canal like fibroids, septums, etc these are removed in the process also. Typically a sample of your endometrium is also extracted to ensure that a culture is done for TB and other possible infections, etc.

 

Thanks a lot winpooh for taking out time to answer my question in such a simple way...Now i feel like you are a doctor to me...while i was reading your answer i felt like talking to a doctor.Thanks again.I am very happy to get such nice and helpful friends here in Indusladies.Can you please guide me according to your experience where should i go ahead...which means go for a Laproscopy or hysrectoscopy? My periods are regular every konth...several months i have done follicular studies in which it was found that without medication i ovulate on my own and my follicular size was also attainaing particular size to conceive..but don't know what's happening and i am not able to conceive.For cysts and fibroids recently i had undergone ultrasound in which no cysts or fibroids were found...So very much confused..If you could guide me according to your experience then it would be a great help for me...Definitely i will take opinion from doctor what should i do and in which direction i should move on now...But i want to know your opinion on this...Thanks again for your help and detailed reply...:thankyou2:

Can you please send me the cost of the procedures in Private message...if possible..what is the cost of sperm fragmentation in that clinic?