I had my first surgery in August 2006 and takedown in October 2006. My husband and I started trying to conceive last June after a trip to my gynocologist who told me that it was okay to start trying. We have been trying for about a year now and I have an appointment to see my gynocologist next month. Is there anything I need to tell him (he already knows of my surgeries)? or ask him? I want to be as prepared as possible because he suggested IVF if we did not conceive naturally. How long does the IVF process take? I'm guessing he will refer me to a fertility specialist?

Thanks for all of your advise!

Missy

The first step is to have some basic testing done. You defniitely want to work with a specialist in this area. Don't forget that 1 in 4 couples WITHOUT our surgical issues has trouble conceiving (meaning no pregnancy after 1 year of unprotected sex), so it is possible you would have had issues regardless - there is no way to know.

First they'll test your bloodwork on day 3 of your cycle, checking for your FSH levels, thyroid levels and a few other things. They'll check your husband's labs and sperm as well. Then you'll have an HSG test to determine if your tubes are open. This test usually has to be done at a specific time in your cycle, so depending on where you are in the cycle, it could take up to 2 months to get these tests done.

Should you decide to go ahead with IVF, the process will probably take about 2-4 months depending on how your clinic/dr approaches the process. There is a lot of paperwork in addition to all the other stuff you'll have to do. Just be sure you go to a reputable clinic, preferably one taht is familiar with pouches or GI issues. You want to be sure that they don't try to push your body to produce more than 20 eggs or so because Ovarian Hyper Stimulation Syndrome is a complication of the IVF cycle and a major symptom is dehydration which can be severe (obviously an issue for us).

Find out what, if anything your insurance company will cover (most companies will cover testing, not many cover treatment) and when you research drs/clinics find out what financial arrangements they may offer. Some clinics offer a shared risk program where you pay a flat amount for a certain number of cycles (usually 3-5). If you get pregnant in the first cycle, you still pay the same amount. If it takes 5 or never happens, you never pay more than the original amount.

Let me know if you have more questions and good luck!

BTW, we did two fresh IVF cycles and one frozen transfer. I got pregnant all three times, but miscarried the frozen cycle (which was the middle one). So, from our first cycle we were blessed with Alex who is almost 2 1/2 and from our second fresh cycle I'm due to deliver on July 16th (a baby girl we are naming Meghan).

Thank you Jill for all of the valuable information! Congratulations on your upcoming birth!

How often can they retrieve the eggs?

Also, is it likely they will try something else before IVF?

Thanks for all of your help!

Usually an IVF cycle consists of injections at the beginning of the cycle to stimulate egg production. Then a trigger shot to force ovulation. Then the retrieval happens.

Once the eggs have been retrieved they are immediately mixed with the fresh sperm (hence why the retrieval cycle is called a "fresh" cycle - because eggs and sperm have just come out of the respective bodies). This creates embryos. Embryos are then transferred after 3 or 5 days (5 day embryos are called Blastocysts and have a higher implant rate, but fewer embryos will survive 5 days outside of the body; my first fresh cycle we used 2 3 day embryos and had a single pregnancy; this time we transferred one 6 day - they had us go to blast because I miscarried my frozen cycle - and have a single pregnancy).

If, after the implant, you are not pregnant, most clinics would recommend using any frozen embryos first (any that you didn't use from the fresh cycle would be frozen). If you didn't have any and wanted to do another fresh, most clinics would have you wait at least one menstrual cycle as it is a lot on the body physically to do a fresh cycle.

It is possible that a clinic or dr would recommend trying Intrauterine Inseminiation first (IUI). This is where they monitor your cycle, determine the best day to try to get pregnant, have your partner give sperm that day and then they place the washed sperm into your uterus using a very small catheter. You may be given meds for this, maybe not. Obviously this is much less invasive, but it also has a much lower success rate (8-10% is what I was quoted for "normal" people, vs as high as 40% for IVF).

Depending on if you have identifiable issues, other things may be suggested. In my state, you ahve to do 3 IUIs with oral fertility drugs and three with injectibles (all covered by insurance) in order to get insurance coverage for IVF (which is then covered 100%) However, with my history, my drs told the insurance co that there was less than 1% chance IUI would work and they did not want to risk me having a multiple pregnancy, something that can't really be controlled with IUI (since the sperm are being released into the body, if I had 8 eggs, 8 might fertilize) so I got permission to skip 4 IUIS and go straight to IVF.

Research your clinic for successful implant rates, but also for successful live births. While not a guarantee, it will give you a sense of how well the clinic manages the life cycle of the IVF or IUI process. If you end up going down this path, let me know and I'll share more with you about what to look for in a clinic.

The whole thing can be very overwhelming, so don't get discouraged.

Jill thanks so much for all of the information. I know that my insurance plan states that IVF is not included - but there are many exceptions. Hopefully one of the exceptions will apply if I need to have it done.

Once I talk to my doctor I will probably be asking many more questions!

Missy