Next Steps

I’ve taken a step away from this blog for a couple of weeks. Mostly lots of personal reasons – I’ve been in the depths of thesis-sizing and in the midst of that, had to go across the country for a wedding.

Tomorrow we have an appointment with our RE to figure out next steps. Namely, do we try IUI again or go for IVF? In my head, the pros of IUI are that its an easier procedure with fewer side effects. Big con is that it carries with it a 15% risk of another ectopic (as does any method actually). Pros of IVF is that is controls the ectopic risk (not sure how. In reading, it seemed like IVF was a cause of ectopic but somehow it can control that risk?). Lots of cons — more side effects, more expensive, longer treatment protocol.

I think there’s a psychological factor too. It’s taken me a long time at each stage to admit I need a bigger step — for example, moving from the gynec prescribed clomid to actual IUI protocols took a while for me to admit to myself that I need it. After all, some people with PCOS clearly get pregnant. Right now, I’m just scared of IVF. It seems so involved and complicated. I worry about risks of OHSS (which I should ask my doctor). I think there’s also a sense of ‘saving’ harder treatments for when they’re needed. In some sense, I like having the cushion of “oh, if this doesn’t work, we can try IVF.” But on IVF, is there any such further out cushion? Added to that is the stress of starting a new job right around when I’d be starting whatever treatment I decide on. Do I really want to deal with egg retrieval surgery within the first month on a job? When I wouldn’t really be able to explain to my boss what’s going on? And the side effects just sound kinda scary to me. As do the injections but I’m trying not to think about that. Honestly, fear is a stupid reason to not doing something. But I guess it’s just if an easier-on-my-body protocol is available, why wouldn’t I give that a better shot?

From our last meeting, my RE definitely seemed to be pushing for IVF. Without the increased ectopic risk, I’d definitely stick to IUI — after all it worked. Admittedly not successfully but clearly I ovulated, sperm met egg, and zygote started growing.

Before this whole ectopic craziness, my husband and I had a conversation about what/when to do if the 3-4 IUI cycles didn’t pan out. My gut then was to take a break and wait till Nov or so, after I’ve been at new job a few months to try IVF. So some part of me is thinking maybe I should stick with that timeline — try IUI in Aug/Sept. If we do get unlucky again and have an ectopic, then that puts us around Nov/Dec for trying IVF. Then again, do I really want to carry the ectopic risk again? On the other hand, knowing that I have the increased risk, I know this clinic is going to be super particular about testing early so we’d have a head start.

Apologies for the rambling post — I’m going round and round in my mind about what to do. Hopefully my my RE can offer some clarity.

 

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9 thoughts on “Next Steps

  1. My first IVF cycle we paid extra for “embryo glue”. One of the reasons I choose it was I read a study saying it reduces the risk of an ectopic. I guess because it sticks the embryos to a certain place so they are less likely to float back into the tubes? I know embryo glue isn’t really offered so much anymore. Hopefully your doctor can help you find the best protocol to minimize the risk. Starting a new job the same month as starting IVF sounds like a lot of extra stress to be honest. It’s not impossible though. You could try to get extra early appointments at your clinic before work and then you only need to take off the egg retrieval day as sick leave, in theory you could work again the next day. Personally I would take the transfer full day off too but it’s a personal choice I’ve heard of some women going to work after. There are ways to make it work and fit around your job but on the other hand maybe it would be better to wait and get settled into your new job first.

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    1. Thanks for all the advice! It’s useful that my job is somewhat flexible but usually in my field, that means you can shift about work hours but you’re typically also working sometime during the evenings/weekends.

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  2. Just wanted to say hello. I found your blog somehow when looking for infertility blogs. I’m gearing up for my 2nd medicated IUI and started blogging about it. Thanks for sharing your story.

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  3. As far as I know, neither IUI or IVF increases the risk of having ectopic. I was told with IVF there is 1% chance of ectopic because the embryo is delivered directly in the uterus. So the chance of it traveling upwards to the tubes is low. But personally I agree with you, if this is the only reason to try IVF, then I would wait at least a couple month, after all, IVF costs much more than IUI. We eventually did IVF because we were getting nowhere after rounds of IUI. But for you, IUI has worked. Maybe you can ask your RE about the risk of recurrence for ectopic then go from there.

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      1. Right, I have heard of people lost tubes due to ectopic and had to do IVF as well. I am very sorry to hear that. Whatever you decide, wish you all the best!

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