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[hiddendragon]

I am now seriously considering IVF asap given my age, and have done research on what to expect and the calendar proceedures expected, which is twice as intense as doing an IUI.  Can anyone here tell me if it's possible to juggle an IVF schedule with a rigorious teaching schedule?  I'm at an R1 and teach brand new courses this semester.

What I worry about are the two days required for egg retrieval and then egg implantation.  I understand the egg retrieval process requires anesthetics--not sure about the implantation.  Would these two procedures take an all day toll on you and would I have to miss classes if my scheduling should fall on a teaching day?

Thank you so much for any response.  I feel like I'm at the end of my wits and I would appreciate any insight into this.  I am also considering going to a free support group, but I don't know if I have the courage to express my failed attempts in person with live people.

[niceday]

Hello Hiddendragon,

This is second hand knowledge. (A very close friend of mine considered IVF and we researched it together). But, yes, IVF is a lot more taxing and intensive and can sometimes knock you out for a day or so. (Egg retrieval, I hear, may or may not be a picnic).

But, there is a wide range of responses to IVF. For some people, it's almost breeze, at least physically. However, IVF, more than anything, can help pinpoint why you might not be conceiving. Is the embryo fertilizing but not implanting? Is it implanting but not surviving? Are you having lots of chemical pregnancies? There are options and treatments for many of those conditions but doctors generally won't just start you on all of them until they diagnose you. (Even though most of them are otherwise harmless).

And age, unfortunately, really matters. Most people are advised to start as soon as possible. Also, you cannot normally do IVF every month. I think you get four-five shots a year anyway so it is not like you would be doing IVF every month of the spring semester. In fact, if you started now, you might not even get your first cycle till, say, April and another one till June. There are tests, scheduling, queuing at the clinic, etc.

The other thing we learned was that the doctor and the center really matters. I remember from an early thread that you had a doctor that would have you keep doing IUI. You might want to consider getting that second HSG anyway if that will help make things clear in your mind. (Or not, but you really need a solid doctor). The general advice we found out was:

1- Go to the best center/doctor you can possibly afford/reach. Lab techniques, tests offered, etc. all differ and success rates are dramatically different. Since this is such an expensive treatment, having to go extra rounds really adds up. Plus there is the toll on you.

2- Start as soon as a few cycles of IUI fail.

3- You cannot know how it will turn out for you until you try it. It may be easy; it may be tough. If it is too tough, you can always take a break till summer. I think you can count on missing a day of classes for egg retrieval but that might only happen once or twice during the whole semester and maybe you'll get lucky and be able to schedule it for a non-teaching day. (And, please, everyone misses a day or two during the semester). They don't retrieve eggs every cycle. They retrieve eggs once; fertilize them, implant one or two during that cycle and then freeze the other fertilized survivors. So, you might have one retrieval that ends up with six embryos. They might implant two immediately, freeze four and thaw and implant two per cycle the next two tries (which might not even end up being consequent months).

Also, I do really recommend that you join some sort of support group, online or offline. I know that this has taken a toll on you and people who have gone through what you are going through can offer better advice as well as help you find good doctors in your locale.

If I were in your shoes, I'd start and see how it went. Also, frankly, I liked having things to take my mind off conception, etc. when I was trying to conceive. It can be an all-consuming process; unfortunately, most of it is out of your hands. Sitting around and brooding about it achieves very little and there are long periods of waiting. When I have things that require waiting (and I'm usually impatient and really like to take control), I try to find other things to do so that I don't just pointlessly obsess (which I understand can be very hard not to do!).

I wish you the best of luck.

[notepad]

I normally just lurk on these boards, but was moved by your question to respond. I did IVF this fall and am now about 20 weeks pregnant. This is a tough process, even with good insurance and a very supportive spouse. The time commitment is one thing, but keeping calm and sane during it (essential to teaching and keeping your job) may be even harder. Still, if you need to do it, you need to do it, and I suspect you will feel as I did that it is your top priority. I ended up canceling a day of teaching for the transfer, as bed rest was recommended by my doctor and I could not have managed emotionally to go back to the office anyway. I was just "out for a medical procedure that could not be rescheduled." You could be "sick." There are a few life-changing events that can legimately disrupt work and I'd argue this is one. Think hard about things that could improve your chances of success, such as donor egg (you wouldn't go through egg retrieval yourself in that case). You have already endured a lot of grief and disappointment. And don't hesitate to go to that support group. Precious few people understand this situation and you might make some friends, badly needed OUTSIDE your university for this stuff.

[hiddendragon]

niceday and sloth,

Thank you so much for replying.  I had not considered a live support group before because I thought IUI would succeed for me.  My RE was very encouraging in this regard, too, since neither he nor my OB detected any physical or hormonal issues (FSH very low).  Now, both of them are stumped that I had four failed IUI's.  I have no other major health issues either--not overweight, exercise three times a week, etc.  I have looked up Resolve's monthly support groups and I think I may drop by their free monthly meeting group this month.  Also, I've started joining other online groups to get more information, too, but I still find this sight helpful because you're all in my profession and know the demands of teaching first hand and how to coordinate that with IVF.

I am considering another center.  I will research the success rates of the centers near me.  This current center where I'm visitng was just recommended by my OB, and being new to the area, I just followed her referral.  After a lot of research, however, I found that nearly all the RE in the few clinics in my area were trained at the large university in the town--the same school.  I don't know if that has any bearing on their qualifications and if that means they would have comparable treatments as my current RE and, therefore, be only equally effective.  You both are right, however, that it IS an expensive task and I should go with someone who has shown higher success rates.

I do feel that I can no longer delay this task.  I've put it off for over three decades and it is now the big thing that's biting me in the behind every month.  I've prioritized other things before and have achieved these other things, but not this, which I've placed on the backburner.  I think you're both right that I should just proceed and not worry about teaching or evaluations this semester.

[notepad]

I really hope this is the step that works for you. It is great to hear that you are planning to dive in. When I got to this point myself, finally I had this surprising ability to NOT FEEL BAD if I put something I needed in front of work and just scraped by. I did my best to disguise that fact and my distraction, and I'm not sure anyone in your department ever notices such struggles if you keep your mouth shut. I had new preps at a R1 too. It was not pretty, but I would have moved heaven and earth to make sure I went through this procedure. After my years of failure this was the only spot of hope! GOOD LUCK.

[cms99]

Hiddendragon, I'm also at and R1, and my wife went through IVF.  We had to travel 2 hours one way for appointments, so I made requests to teach late afternoon, and made sure I always was ready with lectures in case a guest lecturer need to step in.  I was fortunate in that I discussed it with my department head, who had gone through IF troubles years before, so she was understanding.  You can do it, you can do it!!!!!  I'm cheering for you!!!!

[ideagirl]

I am now seriously considering IVF asap given my age, and have done research on what to expect and the calendar proceedures expected, which is twice as intense as doing an IUI.  Can anyone here tell me if it's possible to juggle an IVF schedule with a rigorious teaching schedule?  I'm at an R1 and teach brand new courses this semester.

Have you tried acupuncture too? I'm not being a hippy here--there's peer-reviewed evidence that certain types of acupuncture can be helpful in treating female infertility. The main researcher I'm aware of that does this is Dr. Judith Balk, at UPMC in Pittsburgh (she's a research professor and also a clinician specializing in gynecology for women at midlife). There are others who research it too.

I'm not suggesting that you NOT do IVF--you can do both.

I don't know a whole lot about this, but I'm just mentioning it as something worth looking up.

[hiddendragon]

Hi, ideagirl.  I am considering it, but my insurance does not pay for it and I'll have to come up with my own funds if I wanted to go that route, too.  You know how big paychecks tend to be for those of us on the tt.  Finance is definitely a problem here, but thanks for the suggestion and I may very well just squeeze my belt and bit the bullet.

[quote author=ideagirl
Have you tried acupuncture too? I'm not being a hippy here--there's peer-reviewed evidence that certain types of acupuncture can be helpful in treating female infertility. The main researcher I'm aware of that does this is Dr. Judith Balk, at UPMC in Pittsburgh (she's a research professor and also a clinician specializing in gynecology for women at midlife). There are others who research it too.

I'm not suggesting that you NOT do IVF--you can do both.

I don't know a whole lot about this, but I'm just mentioning it as something worth looking up.

[/quote]

[hiddendragon]

Thanks for the encouragement.  Did you both ended up with a positive result, and how many IVF's did you end up doing?  Also, was your wife's condition diagnosed or was it like mine--a mystery?  I am really scared of failure because my condition so far is a mystery so my doctors don't really know what to adjust or what to do for me.  I think my RE keeps hoping it's a physical thing that he can do something about, which is why he's ordering another HSG for me.

Hiddendragon, I'm also at and R1, and my wife went through IVF.  We had to travel 2 hours one way for appointments, so I made requests to teach late afternoon, and made sure I always was ready with lectures in case a guest lecturer need to step in.  I was fortunate in that I discussed it with my department head, who had gone through IF troubles years before, so she was understanding.  You can do it, you can do it!!!!!  I'm cheering for you!!!!

[hiddendragon]

Hi, sloth.  I'm gonna go have one more HSG and see if any reason can be pinpointed but, yes, I have a feeling that I have to go to the next step since nothing has worked so far.  Can I force more questions on you?  If you feel it's too private, please don't answer them.

Did your doctor pinpoint a reason for your IF?  Also, how many IVF's did you have to do for this pregnancy?  For me, the fear is the "mystery" of my IF--I fear that it might be as simple as someone else here put in another post, that "me eggs are old and moldy".  But I got suggestions from others online that if I do the IVF, they may finally be able to tell me the reasons why I'm not succeeding, and may be able to correct it (or not).

Thanks for sharing your experience and I am really happy for you.  Get a lot of rest.  You deserve it.

I really hope this is the step that works for you. It is great to hear that you are planning to dive in. When I got to this point myself, finally I had this surprising ability to NOT FEEL BAD if I put something I needed in front of work and just scraped by. I did my best to disguise that fact and my distraction, and I'm not sure anyone in your department ever notices such struggles if you keep your mouth shut. I had new preps at a R1 too. It was not pretty, but I would have moved heaven and earth to make sure I went through this procedure. After my years of failure this was the only spot of hope! GOOD LUCK.

[cms99]

Hiddendragon,

My wife's condition was indeterminate.  They never found anything physically wrong with her or me, other than I have slightly low sperm counts, but not abnormally low.  We did 3 IVFs and one FET, with the FET between the other IVFs, and were blessed to have twin boys off the final IVF.  My wife did accupuncture, and she swears by it to this day.  Some thoughts.  Ask for progrestrene blood counts.  My wife's was a bit low, so we started progestrene right after transfer.  Take baby aspirin every day, it's supposed to help with blood flow.  I'll add on as I think of more stuff!

[notepad]

I'm glad to answer. In my case, my FSH was fine and so I started out with Clomid, and then a medicated IUI. An ultrasound of my ovaries revealed that although I was in my mid-30s (and FSH was fine), I had almost no antral follicles left (= almost no eggs left). That rules out stimulating them for IVF egg retrieval, since not enough eggs would be produced to make it through all the various steps. And of course this did explain why nothing was working. I was VERY lucky my university had a donor egg program at the med school. Sure, I was initially shocked and resistant, mainly at logistics/price and the whole mad scientist aspect of it. My insurance covered enough to make it possible (again very lucky) and I got over the mad scientist thing. Our kind anonymous donor (age 32) responded well and it worked on the first try, although I'm not sure our other eggs in the freezer are viable. Maybe a few questions based on this would be relevant for you. Have your IUIs been medicated? How have you responded to ovarian stimulation so far? (multiple eggs?) Have you had an ovarian ultrasound? Undoubtedly you'll go through this stuff as part of the workup for IVF. The whole process can seem overwhelming--once you are in the pipeline, I suggest trying to focus only on the next appointment/prescription/test and avoid looking at the big picture for a while. . .

[notepad]

Hi hiddendragon, I saw an earlier post and of course you've been through the whole medicated IUI thing. Sorry. We all mean well and are cheering for you--remember that when we drive you insane with advice!

[hiddendragon]

Please keep the advices coming!  I need to be as informed as I can be and online and published stuff are good but, again, it's good to have advice from someone in the same profession and know how they've juggled IF with teaching loads, etc.

My RE has no complaints about the egg supply.  My IUI was done with clomid and HSG combined (first two attempts).  The clomid, unfortunately made my uteral linings too thin.  So, went off clomid and did only HSG for two more rounds.  Lining now nice and thick, but less eggs and still no success.  Yes, plenty of eggs left as revealed by ultrasound.  Had multiple eggs when stimulated with drugs (it actually scared me how many eggs were being stimulated into maturity.  I was conflicted with simultaneous fears when undergoing IUI--one, that I would up with multiples and have to face several more hard questions; two, that it would not work and I'd have to go another round of invasive procedures.  I'm not sure which fear was more pervasive, I think both were).  In my four rounds, I wasted enought eggs to last over several years!  But, each time there was less and less eggs so this shows that I am definitely developing resistance to the stimulation, too.

I have mentioned the donor egg possibility to DH who was quite shocked.  I told him, I'd be fine with doing it.  He did not seem fine and did not want to talk about it until we have to cross that bridge. He said, "What if I'm the problem?  Would you do the donor thing?"  I told him I would consider it seriously, which he was, again, not very happy to hear.

Thanks for sharing.  I haven't checked to see if my insurance covers IVF, but they've covered the IUI and expensive medications so far.  I have to pay 20% for the ultrasound, drug co-pays, and other small items. It still gets pretty expensive for my small budget.

Hi hiddendragon, I saw an earlier post and of course you've been through the whole medicated IUI thing. Sorry. We all mean well and are cheering for you--remember that when we drive you insane with advice!

[hiddendragon]

Thanks for sharing.  The baby aspirine sounds like something I will definitely do.  I'm looking into acupuncture, too.

Hiddendragon,

My wife's condition was indeterminate.  They never found anything physically wrong with her or me, other than I have slightly low sperm counts, but not abnormally low.  We did 3 IVFs and one FET, with the FET between the other IVFs, and were blessed to have twin boys off the final IVF.  My wife did accupuncture, and she swears by it to this day.  Some thoughts.  Ask for progrestrene blood counts.  My wife's was a bit low, so we started progestrene right after transfer.  Take baby aspirin every day, it's supposed to help with blood flow.  I'll add on as I think of more stuff!