Injectibles with IUI

[Maria2]

Hello
I am a client of R.P. And had a few questions...of course I forgot to ask Dr. Yee when I met with him on monday. I have used clomid 50 mg with my iuis. This next cycle I'm going to injectibles...to be more aggressive since I'm 41.

I just read about a combination cycle using clomid for days 5-9 and then using injectibles for balance of days to lower cost since my insurance doesn't cover any of injectibles. Do you practice this at R.P.? Could I have this as an option?

Thank you.

[Dr. Wisot]

Hi:

You need to discuss this with Dr. Yee to see if he thinks that is appropriate for you.

But in general we do not use that protocol for IUI cycles as we do not find that as effective as the injectables alone in an IUI cycle. It's mainly used when patients do not respond well to the injectables alone.

Good luck.

Arthur L. Wisot, M. D.
Reproductive Partners Medical Group, Inc.
Redondo Beach, California

[Maria2]

Thank you Dr. Wisot. I will ask at my next appt.

I was wondering about purchasing the injectibles. Is it R.P.'s practice to have us purchase them through R.P. or can we purchase them independently online? I heard there's often rebates, etc.

Thank you.

[Dr. Wisot]

We usually refer you to the specialty pharmacy that your insurance uses (if you have insurance) or the one with the best price. We will give you whatever discount coupons we may have from time to time.

Arthur L. Wisot, M. D.
Reproductive Partners Medical Group, Inc.
Redondo Beach, California

Dr. Wisot
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[Maria2]

Sorry, one last question. I was waiting to do my next IUI with injectable meds (for first time),but wanted to wait until my cycle where my right ovary will release egg (since its the good side)...my left follicle is blocked. I keep hearing that it doesnt matter but is there any increased success rate doing the iui with injectables when you will ovulate on unblocked side? my ovaries pattern is that they alternate ovulation, right left right left...since I have been monitored for months.

Does the medication force both ovaries to release eggs regardless? Im just anxious to know if I should go in 2 weeks or 6 weeks. And really want to make sure I do my last iui on the most optimal cycle. Thank you.

[Dr. Wisot]

Actually you only have a real chance of getting pregnant when you ovulate on the unblocked side. Sometimes on the Day 2 ultrasound we can get an idea of which side has the more advanced follicles but we never know for sure which side will produce an egg or sometimes both sides.

All you can do is come in on Day 2 for an ultrasound and see if we can get a notion of where the follicle is developing. Then if you come in after a few days of injections we can have a better idea of which side. Then you continue if it's on the unblocked side; stop if it's only on the blocked side.

Arthur L. Wisot, M. D.
Reproductive Partners Medical Group, Inc.
Redondo Beach, California

[Maria2]

So I guess I should wait 6 weeks when I know I will ovulate on my right side (good side)??

[Dr. Wisot]

No. You don't know that. So you should come in in two weeks with the start of your period and see if we can get a notion of which side will likely ovulate. It does not necessarily go back and forth but is random.

Arthur L. Wisot, M. D.
Reproductive Partners Medical Group, Inc.
Redondo Beach, California