IVF #4: Saline Ultrasound

I had my saline ultrasound (SHG) this week. I�ve had this test two times (?) prior. The first time was with my initial fertility tests when I first started back in Dec 2014/January 2015. At that SHG they found some uterine defects, which they thought were fibroids: 


This finding delayed TTC since I had a hysteroscopy and turned out that I had a polyp: 


That was my first ever surgery (besides wisdom teeth removal). 

Going into this SHG, I didn�t really think much of it. I wasn�t really nervous or worried too much about the results. Mostly because worrying doesn�t change the results. I actually expected them to find polyps. 

The actual SHG wasn�t too bad. Some cramping and discomfort, but nothing crazy. Well, turns out I have a lot of uterine defects this go around. Like a bunch! They are most likely polyps. 

The suggestion is to have another hysteroscopy to remove them a cycle prior to a transfer. 

A few things to consider: 

1 - I won�t be doing a fresh transfer. There won�t be time to do the hysteroscopy prior to the October retrieval week (unless I pushed it back - which I don�t want to). 

2 - when do I have the hysteroscopy? If I do it this year, the cost is significantly lower because I�ve met my deductible and have almost met my co-insurance. If I wait until next year, it would be approx $1400 vs $250 this year. 

3 - it�s better to do the hysteroscopy the cycle prior to a transfer because it�ll serve as an endometrial scratch. Which I did for my successful FET that led to my son: 


4 - I wasn�t planning a transfer until summer 2019. Do I move it up? Maybe do the hysteroscopy in Dec and a FET in Jan? 

So... I�ve been thinking about all these different scenarios / possibilities. I�ve decided not to really make a decision until we see how my cycle goes. Since I�ve had 2 failed IVF cycles before, I�m still really cautious to keep my expectations realistic. Nothing in my lab work is leading me to believe that I�ll have an easier time this cycle. 

Right now, the plan is to still wait until summer 2019 for a FET. I think the age difference between baby #2 and potential baby #3 is more important to me. 

Lab Results 

My AMH went down since Dec 2017 from 0.75 to 0.64. Which is bad. 
My FSH went down since July 2018 from 10 to 7. Which I think is good. 

A low AMH is supposed to show diminished ovarian reserve (DOR) and also that I may not respond well to follicle stimulation... 

Costs 

I received the cost for my cycle and it�s not too bad, considering I am in co-insurance land. I also have a lifetime max fertility coverage from my company, which I will exhaust with this IVF cycle. If I need another IVF cycle, it�ll be completely out of pocket (~$13k + ~$5k for Meds). 

- Cycle Cost: $1300 My out of pocket co-insurance - includes IVF monitoring + retrieval 

- PGS Cost: $2250 to my clinic + costs to the PGS testing company. $150 per embryo + $150 shipping 

- Fertility Meds: TBD 

Thoughts 

In a way, a lot of stuff is riding on this cycle working! Between DOR, polyps, & costs... Things can go so many different ways... I almost can�t wait to get it over with, just so the mysteries of the �what if�s� can be resolved. 

I�m still not feeling too overwhelmed with the cycle yet. However, I am pretty short-tempered on birth control and I�m also retaining a lot of water. I really hate being on birth control! 

Overall though, I�m doing ok. I just want my IVF calendar so I can start planning. I should get it next week / week after, once AF starts. 

Next Steps: 9/17 stop birth control and wait for AF 





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