[Cecelia]

I wanted to begin a new thread concerning pre-evaluation before fertility treatments. Before we began trying with IUI, we made it clear that we had a limited amount of sperm available from my spouse, 13 vials, that's it. We thought it would be easy to get pregnant with just the IUI and no meds...nope. Supposed unexplained fertility.

Before we began all this, I had bloodwork done, FSH, Estradiol, Progesterone...etc. My RE then had me do an HSG to make sure my tubes were open and my uterus was okay. Everything looked great. I have had a regular 29 day cycle since I began menstruating, so it was easy to track ovulation, etc. I haven't ever had a problem with Endometriosis, PCOS or anything similar. We started TTC when I was 35, so age isn't a huge issue. So WHY after 7 IUIs (4 with no meds and 3 with meds) am I not pregnant? Why has there not even been a hint of a pregnancy? (If I sound bitter, I am) We only have a very limited supply of "swimmers" (6 vials left) and I am currently taking a cycle off. I want to make sure that I have gotten every conceivable test my RE can give me to make sure we are not wasting "swimmers" when there may be another problem they just haven't found because they haven't looked.

I wanted to know what tests others here have done before you started any sort of fertility treatment and then any test(s) you may have had done later as your unexplained infertility continued. Did anyone find anything unexpected that when corrected allowed them to have their ?

I know I may be grasping at straws here, but we only have a limited number of tries left. We can't move on to IVF, no way to afford it, so IUI will have to be the way we go. I desperately want to make sure that we have done everything we possibly can to make this happen. My heart just breaks everytime I see that or shows up. Then my anxiety level shoots up knowing we only have a few tries left.

If any of you can remember any of the tests you've had done, if you found anything out from them and if it helped your fertility issues, please post it under this thread so I and others can see the pathway others have taken. To everyone in the 2WW. to everyone!

[Krista]

Hi Cecilia,

I'm so sorry you're having difficulty. I really really understand the frustration, through we have "unlimited" supply my DH's count was low last time which REALLY annoyed me!

It looks as if your RE has run all the same tests my RE ran. Have you tried adding accupuncture to your list? I did accupuncture before I went to the RE but I haven't used it in the 2 IUI cycles I've done so far. It's often covered under your insurance (my Accupuncturist codes it for back pain but adds the needles for fertility etc) It can't hurt to try.

Good Luck to you and Audrey!

[lovingwife]

The only other test/procedure I had done during my fertility workup was a lap to diagnose and remove endo. I had no idea I had endo. I had no symptoms other than infertility. My RE discovered a tender spot on my uterus while doing an interal exam and was pretty confident I had endo. He removed it during the lap and I was pregnant the next month. Unfortuntately, the only way to diagnose endo is with the lap and some people have no symptoms. I'm not saying you have endo or need a lap, just giving you my personal experience. I was worried that I was going to end up in the unexplained category, but thankfully I have a wonderful RE who was able to spot the signs of endo even without symptoms. I can understand your frustration and I hope someone else has some other thoughts on the matter.

[fairiedusst]

Have you tried getting a second opinion? One doctor might not think a lap is necessary, but another might. I remember the way my doctor put it when he told me I needed a lap, he said, "We're going to go in and see what's going on." He didn't find that my tube was bad until during surgery. Hehehe, I woke up and asked the nurse, "What do I have left?" Best of luck to you, and please keep us posted.

[rebekkahlahey]

Sounds like the tests Ive had done. Your eggs may be fertilizing but not implanting. Maybe you have a lining issue? I take baby asprin and progesterone cream to help implantation.

[rebekkahlahey]

One more thing, have you looked into IVF clinical studies? You could get IVF for free on the trials. Its worth looking into with your limited suply.

[DeannaRN]

I totally understand how frustrating it is to do IUI after IUI and not be successful. I also used donor sperm for 6 IUI's. I think you have covered most of the tests. It's important that the tubes are clear so the HSG is good to have which you've done.

A few questions for you: Did you do cultures for mycoplasma and ureaplasma? How about thyroid? I have heard from my new RE if the TSH is even slightly elevated it can be difficult to get pregnant. My old one never thought it was a problem. Do they check your linings each time before ovulation to make sure it's not too thin or too thick? Do you think the timing of your IUI's were good? I was always concerned about the timing of mine thinking I had ovulated early. Best timing is 6 hrs before or after IUI. How is the sperm count of your donor? We had to change donors because some of them were not as good as others.

Sometimes it can just take a number of IUI's before it works. Don't lose hope. It can take a little longer for us ladies over 35 since our fertility starts to decrease.

Also, acupunture can help bring more blood flow to the ovaries and uterus. I haven't had sucess yet myself and am moving on to IVF so I can't really say that any of this has helped for me but I also have diminished ovarian reserve so I think that is the reason why it hasn't worked for me. I wish you the best.

[babygood1]

I have said it before and I'll say it again...I think they dont always do the IUIs right. I pay more and have them do a Us with it...they never know where to go...read some of my all posts. this last one I had a US both times and saw it being done..so I know for sure. I should know by 8/7 if I'm.

good luck!

[casb77]

In addition to everything you mentioned, I also had a hysteroscopy. It's a color camera to check out the uterine cavity. That's how we discovered that I had polyps, which can interfere with implanting. We had them removed and are now in the 2WW for our first IVF cycle.

[annajacob]

Hi
My husband had a test called Antisperm Antibody.We had a slight issue concerning the same.Had Homeopathic medicines for that since in Allopathy there are no medications for the problem.I got pregnant on the 4th month after taking the medicines.But was a misscarriage.Just wanted to tell u the particular test we had during our treatments
Will pray for u for a BFP.
Regards
Anna

[mgmsrk]

To date you have had all the basic test, less a U/S. And the Lap or Hysteroscopy along with genetic testing is all I can think of. The sperm you have banked is all good I would guess?

At 35-36 you do have to consider that age is a issue. The reality is that our fertility is ont the decline at our age and our chances are less each cycle than say a 25 yo. It doesn’t mean to give up we just need to be more proactive.

Have you looked into shared risk programs for IVF or trading your IUI’s for IVF? I just did the math based on what my clinic charges and the difference between 6 more IUI’s and IVF would be very little.

Are you changing your protocols with the IUI’s? My RE firmly believes in not continuing with something that doesn’t work. She will not do a protocol more than 3 times.

Good luck!

[colleen]

I have 4 suggestions:

1) acupuncture acupuncture acupuncture!! I am a big believer. Only a few months of weekly acupuncture completely regulated my irregular hormone levels. It's so far made a big difference for me.... although no yet, I feel very positive about it.

2) changing the donor you use. Which may not be an option if you have pre-paid for a certain number of vials. We are using donor sperm as well but pay as we go.... sometimes particular sperm and eggs are just not compatible.

3) Timing your IUI more closely with perhaps a well-timed trigger shot? You could give it yourself at home and then come in just before you ovulate.

4) Do the math again on 6 IUI's versus IVF. Not sure where you are.... but at our clinic, the cost of only 3 IUI's with the associated costs of sperm, equaled the cost of one IVF. That's what clinched the decision for us. IVF has a 40-50% success rate, much higher than IUI and it can also be diagnostic, allowing the RE and embryologist to directly look at your eggs. And you may get enough embryos to freeze some, allowing you to have more than one cycle with one vial of sperm. Yes, it's a lot more money up front, but the success rates are so much higher, and it may end up costing less than continuing to do IUI after IUI after IUI, month after month.

Good luck!

[babygood1]

I hear people talking about the lab for endo...how is it done & does it hurt and does it cause delays?

[Cecelia]

Hi Krista,

Thanks for your response. I am sorry about your DH's low count. Hope it isn't anything they can't correct. I am seeing an acupuncturist now and I have been since September or so of 2007. I has helped a lot with my depression issues, but no BFP yet. : ( Unfortunately my acupuncturist isn't covered under our insurance, but paying for that to get the best out of our IUIs is still tons cheaper than an IVF procedure. We will keep trying of course. I am taking this month off to give my body a break, but my new cycle starts around August 23rd or 24th. We'll keep our fingers crossed.

[Cecelia]

Hi Lovingwife,

I am thinking of asking my RE for a laparoscopy (lap) to see if there is anything else we just haven't caught yet. I have seen so many cases of women on the boards having unexplained fertility and then when getting lap done something is found (that they had no symptoms of), it was corrected and they get preggers. I am totally willing to go through it if it will get us some answers or at least eliminate some of the possible unknown causes. Hopefully my RE will understand and we can get this additional test done before next cycle.

Good luck to you and congratulations on your . I just hope that can be us someday soon.