Questions ...... Answered!

So, I decided to e-mail the nurse at my RE's office with the questions that I have been going over and over in my head since my last appointment. To my surprise I got an e-mail directly from my RE with a phone call to follow, just to make sure I was ok with her response. (If I have not said it before I will say it now .... I love my new RE)

My e-mail to her:

Hi Kendra. Here are my questions ...

1) Is it worth doing the IUI without having my thyroid regulated? I know Dr Littman said she was going to re check my thyroid in 4 weeks from when it was first tested but that would put me right around my insemination date.
2) Would it be beneficial to go on birth control for a month before my IUI to see if I can get rid of some of the cysts I have?
3) Does the quality of your eggs get better after your thyroid is regulated?
4) I know Patrick's sperm count came back normal but is it an option to use fresh and frozen sperm for my IUI? Will that increase my chances?
5) I got a call from the pharmacy and they said the injections would be $580 is there a pharmacy that is any cheaper or do I have to use this one?
6) last but not least what injectable am I going on? I know you said follistim but after watching the video you gave me I did not know if it was the one with the pen or just the strait injection.
Sorry for all of the questions. I have just had to much running through my mind and I want to make sure I make the right decision.



Dr Littman's response:
Hi Amy,I must say, my usual rule is that if it takes me more than five sentences or five minutes to answer questions, I usually request an office visit because it is just easier and better for both of us... but for you I will make an exception.
1. Your thyroid was not very abnormal... therefore... given what I know and my past experience in treating thyroid issues, in 4 weeks you should be right on target as far as your thyroid is concerned which is why I thought it would be fine to proceed with an IUI in the upcoming cycle.
2. You have polycystic ovarian syndrome... going on birth control is not going to change that fact, it does not get rid of the cyst... nothing but time and aging does that...
3. Nothing increases the quality of your eggs, the quality of your eggs only decreases with time... it is a one way street unfortunately and there is nothing you can eat, drink, take, that will change that... sorry to be so blunt but its the truth...regulating the thyroid simply helps with whole picture of reproduction. There are other factors besides the egg quality that play a role in reproduction and regulating the thyroid helps to keep some of these other factors in line... it is kind of complicated....
4. Doing two back to back insemination's has been shown to increase chances around 2-3%, given the fact that his sperm is normal... it is not necessary but if you would like it can be done. You will have to ask Kendra about the extra cost. I would not freeze a specimen, I would do insemination with two fresh specimens around the time of ovulation...
5. Actually you seemed to have gotten a good price on that medicine, in general it is pretty expensive... depending on how you respond, you may not need very much medicine, unfortunately, I can't tell that until you actually start taking the medicine.
6. You will be taking the follistim starting cycle day #3... this medicine helps the eggs to grow. Once the eggs are big enough, then you will take the straight injection or the HCG trigger shot to release the eggs. I will be monitoring you with ultrasound the entire time and I will let you know when to take the HCG injection so don't worry about that medicine for now...I hope this answered everything. My personal email is @hotmail.com... please feel free to contact me directly if you have any further medical questions... Sincerely,Eva Littman, M.D.