Our "what's next?" fertility consult

Pending the results of our third IUI (two week wait: one week down, one week to go!), John and I put together a new fertility plan with our doctor. I feel fantastic about it!

Our history in brief review:

Testing and Diagnosis: 
We tried to conceive for 15 months starting in 2010.
John had a semen analysis done after 7 months which came back normal.
We stopped trying when we initiated the adoption of our son from Russia in 2011.
We started trying again after our adoption for about 9 months with no success.
We saw our RE (Reproductive Endocrinologist) in August 2013.
I had an HSG in September: all clear.
I had blood work in September that showed elevated FSH and decreased AMH; both indicate diminished ovarian reserve.
I had an ultrasound done in September that showed a cyst on my left ovary.
We are currently (as of December 2013) at about 28 months of TTC with no success.

Our RE put me on The Fertility Diet (which is detailed in a book by the same name.)
Both John and I were told to take fish oil and Co-Q10 supplements.
IUI#1 (with 50mg Clomid and Ovidrel trigger) October 2013 - negative
IUI #2 (same meds) early November 2013 - negative
IUI #3 (same meds) late November 2013- pending

Which brings us to today.

Remember that cyst on my left ovary that was described as "probably nothing?" Well, it hasn't gone away. Based on this fact and my diagnostic and treatment history, our RE is "99% sure" that I have endometriosis. Endometriosis is when endometrial tissue (uterine lining) grows outside of the uterus. Exactly how it causes infertility is a current area of study, but about 30-40% of women with endometriosis are infertile. It is likely do not have it only on my ovary, but also in other places not revealed by my ultrasound.

I am surprised by this diagnosis, but also relieved and optimistic because it gives us a way to move forward that isn't IVF, which I was not ready for. The treatment for endometriosis is a laparoscopy which is a small surgery done to remove the tissue. When we first saw our RE he offered to do a laparoscopy but since I did not have any symptoms of endometriosis, I declined. (Some women do not have any symptoms, as I found out!) The surgery itself can cause scar tissue to form around the reproductive organs, which I did not want to unnecessarily inflict upon myself. However, now that our RE is so positive that this is indeed a problem for me, I am not only willing to do the surgery, but excited for it! A step toward healing our infertility.

After the surgery, we will have about one year of increased fertility before- statistically- the endometriosis grows back. I'm okay with that. I have come to peace with the idea of only having one pregnancy and birth experience.

Our RE reiterated my elevated FSH and diminished AMH and also told us that John's sperm count was coming back on the low end of normal. In itself, those numbers would not stop us from getting pregnant, but coupled with my two diagnoses of diminished ovarian reserve and endometriosis, they help explain our infertility.

He also gave my some interesting statistics: 80-90% of couples become pregnant within one year of trying. Of the couples who are left trying after that year, 50% will become pregnant in year two. Once you hit year three of trying, only 20-30% of those couples will conceive. Since we are now entering year three, I feel really good about taking this next step and having the laparoscopy.

Two more pieces of good news that had me praising God:

1. Treatment for endometriosis is not considered treatment for infertility by our insurance company, so our insurance will help pay for the surgery (finally!!).
2. Usually our RE is booked out a month or two for surgeries, but they had a cancellation and I got to scoop up that OR time! December 18- less than two weeks away.

In January we can decide if we want to do more IUIs with injectables or try on our own. Our RE seemed hopeful that we could conceive on our own after the surgery, but I am feeling like I want to start with injectables and more IUIs right away. We'll see. We will use the rest of the month to think it over.

In the more "natural" front, I'm going to up my Co-Q10 dosage (incidentally, does anyone know an affordable place/brand to get this stuff? It is expensive!), and start taking vitamin D3 & DHEA. I also asked about baby aspirin as many of you recommended; he gave the go-ahead but said he doesn't think it is necessary or that it will help since it is supposed to help with recurring pregnancy loss, which I have not experienced. Since it can't hurt, I'll probably start after my surgery.

He was very clear that I should not take any herbal supplements so I will avoid those while I am on prescription treatments.

Phew! Kudos if you made it this far. I'm trying to share the somewhat boring details of our journey with the hopes that it will help someone else out there!

I'm still praying and believing that all of this will be for naught. I am believing that I will get that positive pregnancy and make one glorious phone call to cancel my surgery. Either way, it feels really good to have a plan in place.



  1. Praying for you!! Very much hoping you'll get your BFP and can cancel the surgery!!

  2. Anonymous12/05/2013

    I love reading your blog, and am praying for you guys

  3. Sounds like a great plan!! Still praying your third try was a success, but so glad you've got a plan that has a high probability of working for you guys. Best of luck on the rest of your journey!

  4. Prayers for answers, understanding and patience.

  5. Prayers for answers, understanding and patience.

  6. Continuing to pray for you! Thank you for sharing your journey.

  7. Anonymous12/05/2013

    This was not boring at all. Amazing news all around. Very hopeful and my prayers for your 3rd positive IUI

  8. Praying for you. I've been right where you are and it is such a roller coaster of high, high emotions. I pray you get the answer you have been hoping for so long in a few days.

  9. I had a laparascopic hysterectomy in September, and I bounced back quickly. I hope your healing goes well, and the new year brings new life.

  10. Anonymous12/05/2013

    Jillian- have you tried vitacost.com for supplements? They have pretty good prices, and I have ordered from them. Also was wondering if you had heard of NaPro technologies for infertility. You had mentioned not being ready for IVF, and it might be worth looking into. Thanks for sharing your story. Michelle

    1. One other person messaged me to check our vitacost! I will! Thanks. I have hears about NaPro and I did some reading about it, but nothing really stuck out to me as worthwhile. I already know all about charting and have had so many diagnostic tests... not sure what would be different about their approach?

    2. Anonymous12/06/2013

      Jill- It is my understanding that the difference is their surgical techniques… Where mainstream physicians have gone more towards Clomid and IVF to treat infertility, they are more focused on specialized surgical techniques to correct the problem. I have heard that their success rate is similar to or better than IVF. I found the following link helpful.


      I realize that blogging leaves you open to unwanted suggestions, so I hope I am not offending, I am just really rooting for you! I am praying for you as well. :)

    3. Hi Michelle! No you are not offending at all. I would much rather have too much information than not enough! Thank you for sharing!

  11. Anonymous12/06/2013

    Trader Joe's is a good place for inexpensive supplements. I also wait for BOGO coupons or offers at Safeway.
    (a lurker, used to live in Russia)

    1. Wish we lived by a Trader Joe's! Too bad. Where in Russia did you live?

  12. Costco has pretty decent prices on CoQ10- that's where we get ours :)

  13. Anonymous12/06/2013

    "GO YOU ARE GOOD THANKS FOR SHOWING THE WE TO MY SISTER",i am happy and proud for you. Wish you the best and at the end the famous "pregnant" love you

  14. Anonymous12/06/2013


  15. So excited y'all have such promising options, but I sure hope you won't need to use them!

  16. Wonderful news! It's great to have a plan in place and options ahead of you. AND the bonus of having insurance cover some of it! Praise God! :)

  17. I've prayed for you and will keep it up, Jillian! Are you gluten-free? One of my friends tried for four years, went gf and just had a sweet baby girl last month. She didn't have to use any medical intervention to conceive. I know for me, I always had crazy girl issues, which have cleared up since going without gluten. It wouldn't hurt to try it and give yourself all the best chances! If you do try it, let me know if I can help! Some of the research I did during my pregnancy showed that gluten in an intolerant body can cause infertility, miscarriage, and stillbirth. Again, let me know if I can help! Best wishes!

    1. I'm not gluten free. I did some reading about it and the relationship to fertility but I'm not convinced there's enough evidence or that I have symptoms to warrant going gluten free. If you have any peer-reviewed research on the subject please send it my way! And thank you for your prayers!

  18. Jillian, God has obviously used your journey thus far to impact many lives, and I'm confident He will continue. My husband and I tried to conceive for about 3 years with no luck. We did 2 IUI's and 1 IVF last December that failed. Our heart was led to adoption and your blog was one of the first I read. Thanks to your blog, I realized little ol me could get creative and raise money. Well, by this summer we had all the funds raised ($22,000) and were waiting for the call. Well, God "called" and on October 12th I found out I was pregnant?!?! It was a total shocker, but He has used our testimony as well to further His kingdom and draw others to Him. I know He will do the same for you, His faithful servant. Anything is possible in God's hands and this 13 week pregnancy is a testament to that! Good luck!

  19. Really hoping the laprascopy for the endometriosis is the answer for you. I know I said this before but it really sounds like your RE is detailed and wonderful, making sure to recommend a treatment plan that is the best fit for you. BTW, there are a couple of peer reviewed research studies that found a higher incidence of endometriosis in red heads. The sample size was really small, but it does make me wonder.

  20. Anonymous12/08/2013

    I was diagnosed with DOR and after two rounds of IVF (second being successful), ended up with a diagnosis of undiagnosed ovulatory dysfunction. My husband has severe MFI, under 200k sperm per sample and extremely poor motility and morphology. Unfortunately for us, we were told IUI was never an option after two consults with different doctors. We are both young (25 at the time we began our journey with infertility) and very healthy. We found out that through genetic testing, my husband also was a carrier of cystic fibrosis which just makes some men infertile. Our first round of IVF unfortunately ended in an ectopic loss and I almost lost my tube, and my second round of IVF was successful yet bared a lot of complications- so if you do get discouraged with IUI, there ARE other options. My baby boy is due in 13 weeks and I can honestly say that I am so glad I never gave up even when we were told by RE's that we should. My FSH at its highest was 18 (I'm 105 lbs and 5'6 to give you some insight on me), and the lowest it has ever been is 15. My AMH was very low as well, but I still responded to stimulation injectibles yet at times yielded less than good quality embryos. I ordered CoQ10 from Amazon in a chewable form, I was already having to do so many injections and pills that one less pill to swallow was a good thing. They are definitely not cheap but if you can acquire anything to do to help you get pregnant it's well worth it in my opinion.

    I will also say, through my time dealing with infertility I have met several women who have been able to conceive with endo, and others who unfortunately even through multiple lap surgeries they weren't able to subside it. All you can do is be positive though, and just hope for the best.

  21. Anonymous12/13/2013

    I am excited you are going for the laparoscopy, it will give you so many answers. As someone with severe (stage 4) endometriosis, my lap not only gave us a diagnosis (although I have very painful symptoms), but a relief from pain. But, I urge you to look at the success rates of IUIs after a lap or endometriosis. The numbers aren't the best. I'm not trying to take away your hope, I want you to keep being as positive as you can! But I wish that I had known when we spent over 4K on IUIs after our Laparoscopy that IUIs are not very successful and that IVF is your best and most successful route with Endo. Check out Dr. Sher's research if you get a chance, there is a lot of evidence behind a more aggressive treatment to get pregnant. I had to sort of accept that we wouldn't have a simple process, and looking back I wish I had gone straight into IVF within the 6 month window after surgery. We switched RE's and even he was baffled that we were pushed into doing IUIs after surgery.

    Our second IVF was successful though, so I can't complain about the journey. I have also met other Endo moms who have gotten pregnant and most of them did IVF or got pregnant without fertility issues. It's a strange disease!

  22. You can check prices at Swanson's Vitamins online - that's where I order a lot of my stuff. I pray success for you!


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