Does my Dr. have the timing right?

greta

My first IUI is scheduled for tomorrow (cycle day 14). While I'm really excited to get started, I'm a little nervous that this is too early. It is currently Cycle day 13 and I haven't surged yet (according to my LH kit). In the past months, I have surged (according to the kit) on cycle 14 or 15. I thought you were supposed to time the IUI for the day after the surge. Instead, I seem to be scheduled for the day of the surge (at best). Does anyone else think this odd?

I tried to tell this to both the Dr. and nurse, but they said my bloodwork showed I was surging so I should go through with it. (And what's the point of the LH kits if they're results are to be ignored??) We are doing two IUIs (day 14 and 15) so hopefully at least the second one won't be too early.

Does anyone have insights on this? Am I concerned about nothing, or do you think I'm scheduled too early also? Thanks!

Arkmom

Most people use the LH home kits instead of a blood test. If you are having a blood test, that is the best information to use, ignore the home kit.

jackiebrown

I think you are good to go. They like to have sperm waiting for the egg when it shows up when possible.
Good luck to you!!!

mabberson

I would think the blood test would trump the LH kit. Go with what your Dr. says.

greta

Thanks for the thoughts, everyone. I'm really excited and hopeful that it all works out!

MistyandCarla

Blood test is better than the kit...good luck, greta...this is going to be your month for a BFP!

greta

Thanks Misty!

Just had the first IUI, next one tomorrow. So excited! Now I'll finally get to see what this two week wait is all about. :)

I actually did show a surge on the home kit this morning, so I guess the timing must be close.

MistyandCarla

greta...oh, very exciting! I'm glad you got the positive on the home kit today too...I'm sure that made you feel better about the doctors decision. As for the TWW, my suggestion is to just relax and take it all in...listen to your body and enjoy every second of it. Good luck on the back to back IUI and I'll be praying for sticky, ooey-gooey baby dust!

rhenry7715

Hey all - I just read somewhere on the internet that the LH surge may not show up on a urine test for up to 6 hours. Thus, it would be reasonable to conclude, the blood test would be more accurate in terms of determining when the LH surge actually began. Some women also experience a drop in body temp when the LH surge begins...so this is another clue potentially.

This timing thing is the bit that is more worrying though. Our doc says we test in the AM, when the test is positive, you call for an apointment the next AM. Seems then you should be testing more than once a day or at least as close to noon as possible so you don't miss the deadline to call (noon) for an appointment the next day. A typical woman ovulates 36 to 48 hours after the LH surge (our doc says 40-42 hours)- but who is typical? How the heck do you know what to do...this is very perplexing to me....

Your thoughts?

greta

rhenry,

Great questions. I was confused by this as well. My nurse only wanted me to test once per day in the a.m. I asked her, what happens if I get a negative surge result in the a.m., but positive in the p.m. She said that doesn't matter, I would still wait and act based on my results from the next morning. I am skeptical of this as it didn't sound very precise to me. In the end, we scheduled based on my bloodwork, but I am curious for the sake of future cycles what others have been advised about testing multiple times per day.

rhenry7715

Hmm....yes as am I. if you only test once a day then you are leaving only slightly less than a 24 hour window of time where your surge could have started without you knowing. The timing works if you are typical and ovulate in that 42ish hour time frame as you can inseminate somewhere between 6-12 hours on either side of ovulation. I say 6 to 12 because I have read both 6 and 12 so who knows about that either. I'm almost positive you want to inseminate much closer to the beginning than the end. Frozen sperm doesn't live that long but you want them waiting for the egg when it drops (or whatever the term is....). This is all simply what I remember reading so anyone is welcome to step in and correct me!

cholland59411

Hello Greta
I have just been through 6 rounds of IUI and just found a DR. that will listen. My Dr's also tell me only to test 1x a day, but I would tell them that I felt ovulation happening that evening and they would not listen. Finally I found a Dr. who would want to prove me wrong and instead only proved that I was correct. We went in on the day 14 and did ultrasound and I had one follie and everything looked good. My OV kit was positive that morning so we were going to do back to back IUI's unless I thought I ovulated. Sure enough I had cramping that night and went in the next morning and did another US and I had ovulated. Long story short if we would have waited we would have missed it totally. It did not result in a BFP, but I am not ready to give up going next week for 7th IUI. Good luck and I hope this helps. Kelly

MistyandCarla

Girls...I have preached this many, many times...i my opinion it's imperative to test more than once a day! rhenry7715...you're so right on needing to catch your surge at the beginning instead of at the end. The sperm needs to be there waiting on the eggs arrival! For those of you who don't know, here's how it worked for us...

Negative at 5am, positive at noon on CD15...went in for the IUI at 9am on CD16 and got a BFP 12 days later! All natural cycle and first try.

My RE incouraged us to test more than once a day...I guess they all have different opinions. Just do what feels right for you. My thoughts was that you only get one chance per month and it wasn't worth missing that small window of opportunity. I also suggest to use the digital test strips...they cost more, but don't leave you guessing.

Good luck!

rhenry7715

Yes, I've seen your post on this topic. The conundrum is in the process itself. You have to call by noon to make an appointment for the following day. So testing after noon may be a moot point since you won't be able to get in the next day anyway. So if you tested positive at 5PM then you would be into your surge by a minimum of 38 hours if you went in at 7Am two mornings later (at a minimum as the pee stick may not register the surge for up to 6 hours after it's started.

However, i suppose it still matters as you will end up knowing more about when your LH surge really starts, how long it lasts up to ovulation etc.

We haven't even picked our donor yet, but I've decided to start stressing about this instead. :)

MistyandCarla

I really don't understand the whole "noon" thing. I've heard others say that their RE has the same rules. It's crazy to me. I guess my RE's hours are a rarity...they have someone there 24/7.

rhenry7715

Yep - it's a seemingly random cutoff time designed I'm sure to facilitate their process not the patient's. That said, we are at the best clinic there is here and are with the doctor that started it. My partner and I were just talking about that last night. Ideally, you would test frequently around the time you expect your LH surge to start - then you would call once that happened and schedule for the appropriate time for insemination. Shouldn't matter what time that is.

We did read it is better to inseminate more than 24 hours after the LH surge starts so at least on average you should be within the range even with the noon cut off.

What city/state are you in? We're Portland, OR.

MistyandCarla

We're in Southern Ohio...we are country girls. :)

rhenry7715

Giddy up

it's amazing what a diverse crowd there is here. Lots of good exchanges - great to have access to people's knowledge and experiences.

By the way, I spent part of my childhood in rural CA - horses and all.