Monday, August 20, 2007

Hrm. IUI cycle will be cheaper this month?

My RE's office called me ~4~ times today. I must be a VIP there suddenly.

1st - nurse called to tell me she got the message it was cd2 today and wants me in first thing in the morning.
2nd - front desk called to tell me that if doc approves IUI, I'll need to pay tomorrow. (duh.)
3rd - nurse called again to see if I had a surgical report from my surgery. Nope. They'll get it from my OB who did the surgery.
4th - front desk called again to tell me that an IUI this cycle will be $572 instead of $650. No idea why.

I'm really nervous about what they are going to tell me.
~ Doc can suggest I take another month break before ttc again. This will break my heart.
~ Doc can suggest a non-med cycle to allow the best uterine conditions possible for another month.
~ Doc can suggest Femara IUI cycle due to lining isn't put at risk like it is w/ clomid.
~ Doc can suggest another 100mg round of clomid IUI cycle.

I'm really up for ANYTHING ~except~ TAB. The one thing I am worried about though is a non-monitored cycle.

As you may remember I have a history of follicular cyst. Everything looks great right up until actual ovulation. I get a mature follicle. I get an LH surge. And then, "leggo of my eggo" doesn't happen. Instead, the follicle freaks out and grows to amazing proportions in just 3-5 days. The largest measured cyst was 9.5 cms. The most were 3 at one time - (2) 7cms and (1) 9cm. THAT was really fun. So nice and comfortable.

Thankfully, these cysts go away within 3ish weeks. Which means they are still present on the next month's cd3 baseline. True, they always collapse and disappear in the first week or so of the next cycle, but no freaking RE will allow me to pursue a treatment plan with a big ole 9cm cyst in place. I have to say though, it's quite amazing how it can go from 9cm to literally zero in a span of a week. The first time my RE didn't even believe it.

Anywho, it's a vicious cycle (no pun intended). Each month I will have a left over cyst from the previous month. So to counteract this, once I get a cyst, I have to go on BCP for the next month, so I can get clean ovaries on the next cycle. Do you follow that? I would only get a chance at a cycle every other month. And "chance" is relative here, because with the cyst present, there was no ovulation, so no "chance" actually even existed in the first place.

Which leads me to my panic.

I would like to see if the 8 straight months of cysts have suddenly fixed itself. But if I wait, I'll screw myself for 2 months. But if I don't wait and just continue to be triggered by act of an IUI cycle's monitoring, I will be spending A LOT of money out of pocket for each month's monitoring. I don't mind having natural cycles really. As long as I have a chance. So I don't need IUIs. We'll be going to the big IVF next year if no pregnancy anyway, so I really don't want to spend $650/month until we get there (okay, $572 each month?).

I have a solution but I don't know how plausible it is. On a non-IUI cycle, allow me to do the opks. Once I get a positive, get an u/s 48 hours later. This should be over the 12-36 hours timeframe of ovulation. And if I just have a big ole massive follicle that STILL hasn't burst, trigger me then. Wouldn't that work? There may be more to it if it's already in the process of becoming a cyst. I know the cyst grows to enormous proportions very quickly, so adding in hcg to it may really trip it out and make it explode. Hell, I don't know. But I'm still going to ask.

The nice thing is, my appointment is in 8 hours from now. I get to be violated with the magic wand bright and early at 7am. Nice, eh?

1 comment:

Kaci said...

Good luck Nancy. I think your thoughts about having a monitored non-IUI cycle doing OPKs and if no o then trigger is a good one - it will be interesting to see what the doc says. I'm thinking "non-TAB" thoughts for you!