Doctor's Visit Tomorrow

[ksmith84]

Greetings From Houston!!

After hours of conversation, scheduling, and budgeting (don't you just love this generation of parents) my partner and I have decided to start our family. We thought it would be as simple as going to a website and ordering some sperm to be shipped home! Nope, most banks require a doctor (except for Midwest and Pacific, which I just read about here, a little too late It's good to go to the doctor first anyways, right? One of the sperm banks we were looking at using (Xyetx) recommended a doctor in my area, so I am going to him for an annual. I need some advice from people who have done this whole process before. What should I expect? Gosh, what should I ask!!!

If I have this process correct, I have to have a doctor's consent to order sperm right? Does that also mean he can say no for any reason (ie our sexuality) Should I bring him consent forms to sign for several banks? We are planning to do ICI at home, should I expect any hesitation from him?

I am so nervous about this appointment! Thank you for any advice you can provide! I am also having a hard time with the timing of my ovulation. We bought an ovulation kit, but I must have missed the window. Any suggestions how we can get this right?

Oh and one last question...what do all the different abbreviations used on the forum mean? I think I got TTC (trying to conceive). Should I know of any other ones that are frequently used?

Thank you in advance!!

-Mrs. Smith

[Beastie]

Hi Mrs Smith, and congrats on deciding to start TTC! I hope you have a quick and easy time and that you join the Queer and Pregnant list soon! Also, you should check out the Queer TTC thread, which is an incredible support system as you get started and brave the mysteries of timing and waiting etc.

As for your questions, I'm no expert, but I can tell you about our experience; like you, we wanted to do an at-home ICI with donor sperm from a bank, and we were also surprised that we needed a doctor's consent about it (especially when we read the language of some of those forms, like the parts where the doctor verifies that the sperm-buyer understands that sperm can make you pregnant, but not every time!).

Anyway, we ended up meeting with a local midwife with a reputation for being queer friendly, and she was an incredible resource for us. She was willing to sign the stupid forms (and our bank, CCB, accepted her as a medical expert: she'd also worked with Xytex and Midwest without a problem, I think). She gave us some great tips about inseminating at home, looked at my charts, and was available for email and phone consultations as we navigated the actual act. If we'd wanted, down the road, she also would have done an ICI for us. But, as it turned out, I got pregnant on the first try (!). Sadly, this midwife lives a little too far away to be our primary midwife, but she later gave us a referral to a closer midwife's practice.

So that's my experience with working around the medical forms from the bank and having the home insemination that we wanted.

As for the rest of your questions, there are tons of experts on here. I won't be the only one to recommend Stephanie Brill's book, which is a bible for queer TTC, and has lots of great info including answers to some of your questions about timing and ovulation patterns. Lots of people on these forums use fertilityfriend to chart online, and that was super helpful for me.

Anyway, I hope this helps. Welcome, and good luck!

[quasar]

We used Xytex and had no trouble using a midwife to help us. They allowed her to sign off on the forms and we were even able to have the samples sent directly to our house. I know some banks don't allow at-home deliveries, so for those, they'd deliver to your dr's office and you would have to have an agreement with them for at-home inseminations or do them at the office.

When we first decided to start TTC, we went the doctor route. The doctor seemed nice enough, but he wanted me to go through an HSG test, multiple hormone level testings, ultrasounds, trigger shots, etc. I think we went in prepared they might say this, but it all scared me and seemed extremely unnecessary. My cycles were fairly regular, so I didn't quite get why I needed all of that stuff right off the bat. I just wanted to try on my own, and if that didn't work, then we'd go through the hassle and expense of going through the doctor's office. I don't know if all doctors are like that, but I just want you to be prepared that some might require those things before they'll let you try. Ours also had the requirement of meeting with a counselor ahead of time so that we could explore what our thoughts were on using donor sperm. It really didn't help us at all, especially since the counselor seemed completely against having a known donor which is something we were considering.

Anyway, if we had to do it over again, I think we might have charted at least for a couple months before we dove in. It's really important to know what your body is doing. If you think you're going to do at home inseminations, I'd start charting (we used fertility friend; aka-FF) now.
Things to chart include:
cervical mucus (CM)- fertile CM is nice and clear and stretchy, like the whites of an egg. AKA- eggwhite cervical mucus or EWCM.
temperature (you'll see a temperature increase after you ovulate)
Follicular phase-time between cycle day 1 (CD) and ovulation
luteal phase (LP)- time between ovulation and the start of a new cycle. The LP rarely changes more than a day or so in duration. In general I think you want this to be at least 10 days so that the little embryo can stick. Anything less you might wish to have looked into further or there are some supplements that might be useful.
Cervical position (CP)- I have to say that for this one, I sometimes feel for it, but as it gets close to ovulation (O), I have my partner look at it. She can tell if it's starting to open and if the CM looks nice and fertile.
Ovulation predictor kits (OPK)- there are various brands and different types of ways to track when ovulation might occur. I use internet cheapies as well as the clear-blue easy fertility monitor. I was a pee-on-a-stick-aholic (POAS) when I was trying to conceive. OPK's tell you when you're gearing up to O. Usually O happens 24-36 hours after a positive OPK.

Frozen sperm doesn't live too long, so timing is crucial. If you end up going through a doctor, they'll often do an ultrasound to see how developed your follicles are and then give a trigger shot to make the follicles release. That way some of the timing aspect isn't left to chance.

There's a lot of great info on here in the TTC threads. If you do end up using Xytex, we liked them a lot and they were able to do a special delivery for us one time when I ovulated early on a weekend. So they're pretty accomodating... at a price of course...

[quasar]

You asked about timing for the OPK. What I would do is use the internet cheapies. We got ours through early-pregnancy-tests.com. I liked being able to test three times a day without feeling like I was going to go broke. I think I started testing around CD 10 just so I wouldn't miss it. It's important to note too that even if you'r egetting stark white test lines one day, the next day you might get a glaring positive so don't worry. My cycles before TTC were right around 28 days, so I just went on the assumption that my LP was 14 days, which would've put my O day around CD 14. As it got closer to CD 14 I would increase the number of OPKs I used from once per day to about 3 or 4.

As for the doctor denying you because of your sexuality, it all depends on the state you're in and the doctor. We didn't have any problems. It also seems that if Xytex recommended the doctor, they're fairly confident that particular doctor is easy to work with. So I wouldn't worry too much.

Have you started narrowing down your donor lists? This might be what helps you determine what consent forms to take to the doctor. I would caution that as I said in my previous post, there might be at least a little bit of a delay between when your appointment is and when you can start trying, but I definitely wouldn't let that discourage you! With Xytex we could order all the sperm we wanted without a doctor consent, but we couldn't have it delivered anywhere, so that wouldn't have done us much good.... Some of the banks have an "Account set-up fee" which is stupid, so I would really look at their donor lists first and call for availability before wasting time and money.

The MOST important thing is to have fun with this! Make the inseminations something special and try to lighten the mood a little. Being tense or stressed can cause your body to rebel and do fun things like delay ovulation. So maybe get a massage to prepare, or do something special with your partner. Our plan was plan "humpy hump". But my partner also was really awesome through the whole process and did things to make me feel comfortable. We did IUI's at home, which isn't the most comfortable thing, so you have to have a great deal of trust, love and confidence. Go into this believing it will happen the first time, but also realize that it may take several tries. That was the hardest thing for us, and that's why it really helped having these boards. Everyone here could lend an ear when things got frustrating and were there to cheer for us when we got our BFP. It's just an amazing process and I wish you the best!!!

[jjnoho]

welcome mrs. smith! good luck with the ttc process which can be crazy to say the least!

just like beastie, i highly recommend brill's book - was my bible and #1 resource for everything ttc including monitoring fertility, timing, selecting which procedure is best, how many insems each month, and so much more. i don't know how people proceed without this kind of resource.

you don't indicate where you live. that would be my main concern about how this dr will respond to you. i am fortunate to live in an area where nobody blinks an eye at 2 women together but not everyone is so fortunate. if you don't get a positive reaction and you live in an somewhat accepting area, find another doctor or midwife. your gp may be willing to sign the papers which really only indicate that you don't have any major health problems which would make pregnancy a bad idea and you don't have hiv.

if you want to do insems at home, make sure you pick a bank that will ship to your home or a doctor/midwife that will release the shipment to you for home use if you go with a bank that will only ship to providers.

best of luck to you both!

[chicagoml]

Northwest

[ksmith84]

Hysterosalpingography ???

The appointment went amazing! The Doctor Xytex recommended was amazing! He was very much a member of the family, which made both of us immediately comfortable. He has worked with lesbian couples before and offered us references. He also pretty strongly recommended a procedure called Hysterosalpingography before we inseminate, in order to clean everything out and help with insemination. Does anyone have any experience with this?

[Letitia]

I had a hysterosalpingogram. Some background - we conceived by using a very big fertility practice that didn't bat an eye about the queer thing, but did tend to treat us as if we were "infertile" from the very start.

I didn't do every thing they suggested. One of the things I did decide to do was the hysterosalpingogram. My main reason was because I was 40: if there was a problem I wanted to know right away so I wouldn't waste time.

You can still inseminate the cycle you have the procedure.

I found it not really that different from a pelvic exam, except it was in a radiology suite. There's a little stab of pain when the catheter is passed into the cervix, but that's the same as doing an IUI (intrauterine insemination). My experience was it was really not bad.

Good luck!

[kjm]

hysterosalpingogram = HSG
it is a procedure where they clamp open your os and put a catheter through your cervix. Dye is then pumped through our fallopian tubes and multiple X-rays are taken. The intention is to be sure that neither tube is ruptured or blocked. It is true that doctors often refer to this test as a "lube job" for your fallopian tubes as the dye can push out tiny microscopic particles that could accumulate way off in the future, but the intention is really to be sure there are no problems, the "cleansing" is a side effect.

I originally thought I my TTC process would be completely at home w/o an OB, no testing etc. But within 6 months I was begging my doc for an HSG test. TTC is a totally maddening process and I quickly learned that I needed to KNOW that everything was ok in there. I found it rather uncomfortable, and wished I hadn't looked at the tools before the procedure (especially the cervical clamp) but the discomfort was bearable. And the info certainly helped me to proceed on knowing that everything was ok on my end. It also became good ammo for me to use to get my KD to have his swimmers counted and assessed, "You can certainly produce a little sample at the clinic--I had my cervix clamped open and dye dumped through it"