IUI Time

This IUI went fairly smooth. There was a little problem getting the catheter inserted but once everything was in place, it seemed to go well. I went home and rested afterward, as there was quite a bit of pain and cramping for several hours following.

And now we wait!

Yesterday's IUI

Yesterday's IUI was one of the best and worst I’ve had so far. :) I also hope it will be the last!

It was quite an adventure. Once we decided to proceed with the IUI, we became excited to make a day of it. Ryan was so great throughout the process and I feel so grateful that he was able to be with me yesterday.

Because my doctor’s office loves me so much, they scheduled me for the afternoon, so I could avoid the morning rush. We still had an 8:30am drop off, but the IUI would be at 1:45pm.

That morning, Ryan realized they did not give him all of the needed “equipment” for his part of the procedure. Thus, being the awesome guy that he is, he improvised!

This would be the tube from his IUI kit, a kitchen funnel (that I will never use again) and some packaging tape.

And… done!

You have to have a sense of humor about these things.

We dropped off his men and headed home to get ready for the day. We then went to lunch at a Japanese restaurant and took a long walk around the local cemetery. It was peaceful and the day was gorgeous.

Back at the doctor’s office we got started with the IUI. Because of the number of mature eggs I had this time around, I had been noticing some symptoms I had not experienced before. Nurse H put my mind at ease.

My ovaries are so swollen they are pushing on my diaphragm, making it difficult to breathe, especially when lying down. The severe nausea I’ve been having is because there is so much fluid, it is seeping out into areas where it normally doesn’t go. I have to combat that with increased fluids, no matter how gaggy I get drinking all that water.

Nurse H also told me to expect a lot of cramping, pain, fullness, heaviness and bloating. And she was right! I got them all.

Even so, we decided the IUI was not the end of our day together and Ryan took me to the gun range. We had a great time and I enjoyed doing something he loves so much with him.

Upon returning home last night, I felt the full effect of the increased ovulation. This was the most painful IUI I've had to date. I was walking around like an old woman and had to be gentle when standing up or sitting down. Today, I still feel many of these same symptoms.

But I don’t begrudge them at all because I believe these aches and pains are just pushing me closer to holding my babies someday.

This IUI

Yesterday afternoon, I was at my desk preparing for a client meeting. All of a sudden, I felt a huge yank on the left side of my abdomen. It took my breath away. A few other yanks followed and then a dull aching and cramping. The cramping soon began in my right side as well.

I debated calling the doctor's office. I was afraid I was ovulating and my IUI wasn't until 10:30am the next morning. I pride myself on being a 'trusting patient'. I am still my own best advocate, but I make a conscious effort to trust their protocol and relax. They aren't perfect, but they know what they're doing.

I did a quick Google search and it appeared an egg has 12 - 24 hours to be fertilized before it deteriorates. This concerned me, so I gave in and called the doctor's office.

They put my mind at ease quite quickly. The yanking and pulling could be ovulation, but it could also just be my body preparing to ovulate. Either way, they assured me I wouldn't miss our opportunity. It was intense because of the amount of mature eggs I had this time around. Last time, I had 1 large egg and 7 smaller ones. This time around, I had 3-4 large ones (and 1-2 small) and I guess that makes a big difference.

The cramping continued until early evening, and then subsided. Later that night, I felt a bit more on the right side.

This morning, we dropped off our 'sample' at about 8:30am and had two hours to kill while we waited for the IUI appointment. We went and got some breakfast (Starbucks for me, Sonic for him). The weather was nice, so we just ate and relaxed in the car. Ryan fell asleep, poor guy. He worked last night and works again tonight.

Finally, it was time to head back to the doctor's office. It was super busy, but we eventually made it into the little room. This IUI was done by Nurse H. My cervix wasn't as "cooperative" as it has been in the past and it was a bit painful, but everything went smoothly. I've had some cramping since, especially on the right side and down low.

I came home and took a long 3 hour nap. I've been up for a few hours, but I could go back to bed. I'm exhausted. This process is emotionally and physically draining. But so worth it if it results in a baby that will be ours forever. :)

Gettin' Personal with the Nurse Practitioner... ;)

Other than last cycle, I believe the previous IUI I had done was in early 2007. I had forgotten the difference in IUI experiences between the 2 main nurses at Dr. S’ office. I quickly remembered yesterday morning.

Nurse H is an RN and does the IUI very quickly. She uses “petite” instruments, and although it is uncomfortable, it is pretty painless.

Nurse M is a nurse practitioner and uses larger instruments, takes her time and really ‘gets in there’. Although it is a lot more painful, it kind of feels like she does a more thorough job. You know everything is exactly where it needs to be, although your breath is knocked out of you during the process.

These are just my impressions, but who knows! Honestly, I think they both are capable.

Yesterday, I had Nurse M. Between her more aggressive approach and the fact I was carrying a lot more eggs, I think this is why I’ve had so much residual pain since the treatment. My stomach is huge, like a beer-drinkers gut, and it is impossible to suck it in. I’ve also had some spotting and cramping.

I was happy to have Nurse M do the procedure, as I had some follow-up questions from my last appointment. Nurse H had done my ultrasound and was conflicted about whether to do the IUI right away (and capture the large egg on my right) or grow the eggs on my left another day (and risk ovulating before the IUI). She consulted with Nurse M and, although they decided with waiting on the IUI, I hadn’t heard the reasoning.

Nurse M explained that the real reason for waiting had nothing to do with the eggs at all; it was because of the lining in my uterus. The lining needed another couple of days to get ready. That made sense because when we did my last mid-cycle ultrasound, my lining measured 8.1, and this time it was 7.1. Nurse M thought it would be better to wait and let that lining thicken a bit more.

I also asked if they could give me an ultrasound before the IUI to see if I’ve ovulated. It turns out, it’s too difficult to tell via ultrasound because the follicle doesn’t just burst at ovulation, the fluid seeps out slowly. You can’t tell for sure that ovulation has occurred for a few days.

It seems they made good call by waiting because Nurse M stated she was convinced I was ovulating yesterday. I spotted a bit before I got there, felt cramping and pulling and my cervix was wide open when she did the IUI. She also said my chances for higher order multiples are very slim, especially because many of the eggs are so small. Then she joked, “Now that I’ve said that, watch… you’ll have four!” Hardy-har-har. But in all seriousness, I feel at peace with our decisions.

So now we begin the lovely 2 week wait. After last cycle, hubby has decided to confiscate all of my pregnancy tests. He’ll give me one on the actual day I am supposed to test. I hope he’s prepared because, even though taking the tests early can be an emotional roller coaster, at least seeing all those negatives last time prepared me for the “final” negative on the actual test day. This time around, I’ll live in that undeniable 2ww hope until the day my dreams are either realized or come crashing down.

Today's Appointment

Today, we checked in on my ovaries to see how the Follistim has been working. It has been a tough treatment cycle. I was at a work retreat, and things just weren't as smooth as last time. My stomach was all bruised up and the headaches were intense. I didn't drink enough water because I didn't want to be running out of the meetings all the time to use the restroom, which just made it worse.

The cycle madness continued at today's appointment. I knew there was something going on in my left ovary because I felt a lot of pulling and cramping on that side. Sure enough the left ovary had at least 7 measurable eggs. Three of these were around 12mm and the other four were smaller, somewhere around 7-10mm. Nurse H called it a "heavy recruitment".

On my right ovary, I have one mature egg with a measurement of 18mm. No one knows how large an egg becomes before your body ovulates it. It varies for each person. It is possible that my body will ovulate this egg on its own. If that occurs, then the trigger shot and IUI will be for nothing, as I will have already ovulated. The problem is we can't tell if this will happen or if it did happen. Frustrating.

When Nurse H saw the situation on the ultrasound, she printed out the pictures and went to consult with Nurse M for a second opinion. It was a dilemma. Do we do the IUI right away in case I ovulate that egg on the right, or do we wait and grow the ones on the left, hoping I don't ovulate in the meantime?

They ended up deciding to "prescribe" sex, just in case I ovulate early, and continue with the Follistim for one more day. I took that dose today and the IUI is on Thursday.If I do ovulate early, I am not so sure I will become pregnant this month. Our odds aren't good at getting pregnant the "old fashioned way".

If I wait until Thursday to ovulate, it seems the chances for pregnancy are much greater. However, what happens if I ovulate all those eggs??? ALL those eggs! How many babies could that be??? This scares me to pieces. My babies have waited forever to get here; I want them to have every advantage possible. And cramming too many babies into my body would be devastating for them developmentally. That is not the start in life I want for my kids.

Having said that, for years I have seen women (including myself) worry themselves into a frenzy over their treatments, analyzing every little detail and second guessing every decision. Before all this treatment stuff started up again, I promised myself I would not fall into that trap. I was there last time with the Clomid/IUI cycles and I d0n't want to experience that again.

So, I am trying to think positively. Here are the thoughts I've been repeating over and over...

The doctor's office is very aware that I do not want to "selectively reduce" (abort some of the babies if you are carrying multiples). They have promised to take every precaution so that we do not end up in that situation. They would have cancelled the cycle if the risk was too great.

During one of my Clomid/IUI cycles, I had 4 very mature eggs, and I didn't get pregnant at all that time, so 8 eggs total doesn't necessarily mean 8 babies. Although I have a lot of eggs, most of them are very small, and may not amount to anything anyway.

If I ovulate early, than oh well. There is always the next treatment. Treatments 3 or 4 are typically the most successful anyway. The failure of cycle 2 doesn't mean a future treatment won't work.

Last cycle, everything went perfectly... not too many side effects from the treatment and 2 mature, perfect-looking eggs. The result? No pregnancy. This time, everything is difficult, chaotic and uncertain. A completely different experience than last time. Maybe the result will be different too.

Most of all, God knows us and He hears our prayers. We have been praying for our family: for the treatments to work if He sees fit, for comfort in case they don't, and for the right children to come into our lives, in the right way, at the right time, and in the speed or order they're supposed to.

At the end of the day, that's all we can do. Pray, make good decisions and pray again. The rest is out of our hands.

IUI Day

Today was the day. Ryan called into work so that he could experience the whole thing with me. (He had not attended the IUIs in the past.) We did a drop off at the doctor's office and then grabbed an early lunch.

Even though I have done IUIs before, it was nearly 4 years ago, so I was still pretty nervous. It all went perfectly.

Ryan's numbers were off the charts, literally. The actual procedure went flawlessly and it was fun having Ryan there to make jokes and keep the mood light.

Even so, I know there are many, many IUIs that are flawless, but there is no pregnancy. I understand the statistics we are dealing with.

But I can't deny the thrill of hope I feel when I think that this time might be different.

FINANCE UPDATE: Follistim and Ovidrel cost $600. Two ultrasounds at $95 each. Prometrium (Progesterone supplements) cost $35. Prenatals, baby aspirin and pregnancy tests were about $55. Today's IUI totaled $335. Cycle total to date: $1215.

Perception

Life is all about perception. How do we choose to look at our situation? Half-full or half-empty?

Half-empty: This new treatment I am pursuing (Follistim injectables with an IUI) has an 18% success rate. This means out of 100 couples who do this treatment, 82 of them will not be successful. I could become pregnant with this treatment, but it is much more likely that I will come out of this with no baby.

Half-full: Without treatment, Ryan and I have less than 1% chance of conceiving. With the treatment, our chances are 18%. I could interpret that to mean that we are 1700% more likely to get pregnant this month than in previous months. That is quite an increase!

The half-empty side is quite depressing. I don’t want to be one of those 82 people left disappointed at the end of the month.

However, I can’t help but feel a rush of excitement whenever I think of the half-full scenario.

So for now I am choosing to be half-full. After years of waiting, I am trying to enjoy feeling hopeful again.

Our Infertility Game Plan

I decided to write down a little Game Plan through the IUI level of treatment. I have no idea how successful this will be at helping me though those difficult days, but maybe leaning back on these things will help.

I am promising myself the following:

-Unless a situation arises which necessitates that we move on sooner, we will complete 5 (and only 5) IUI cycles before moving on to IVF.

-We will begin at the end of Summer 2010. This is purely for financial reasons.

-As finances permit, we will alternate one treatment cycle with one non-treatment cycle. During the non-treatment cycles, we will either try on our own or take a break, whichever we feel like!

-I will take the entire day off work for the IUIs, if able. I'll use this day to just "baby" myself. :)

-I will try to be kind to Ryan throughout this process, even when the hormones are screaming otherwise!

-I will try to minimize unnecessary 'infertility talk' as much as possible, and make my life about more than just makin' babies.

-As hard as this is, I will try not to over-analyze every symptom during the 2-week wait (time between the IUI and the start of the next cycle). To help with this situation, I will plan lots of time with close friends and my hubby, doing fun activities to distract me (nights out, movies, working on our home) .

-During this process, if I am 'not up to' a particular activity or obligation, I will be understanding of this and will not to feel guilty. I will expect that same understanding from those around me. I deserve that.

-I will be there for my friends who are mothers and experctant mothers, but I will also be there for myself. If something is too painful, I will decline to participate or will reward myself later for getting through it.

-We will begin getting our 3 bedroom ready for a child.

-If we experience a failed cycle, hubby and I will treat ourselves to some TLC; this could be a nice dinner out, a couple days away, or a purchase for our house, just something for the two of us.

Preparing for RE Consultation

Wednesday is our consultation with Dr. S. It has been three years since I've been in that office. I am beyond excited to be back and to start this next chapter. I have compiled a list of questions / topics that I want to make sure we address. I hope I am not missing anything...

Topic: Testing
- What tests do we need to repeat? Day 3 bloodwork? SA? HSG? (No, not the HSG!!)
- I want to be tested for MTHFR, a blood clot issue
- Should we do a postcoital? We've never had this test, and I sometimes wonder if my body is 'attacking' his sperm? Is there value to doing this test?
- Along those same lines, I have heard that immune system problems can be the cause of many "unexplained" infertility cases. Are there any other tests that can look for these issues?

Topic: IUI
- Is there any value to doing a monitored, 'natural' IUI cycle? Or are the success rates so small, it's not worth it?
- I will not 'selectively reduce', which means we need to tread carefully through the 'medicated IUI' process.
- How can we control the amount of medication to reduce the chances of multiples?
- Would we cancel the cycle if there are 'too many' follicles? Or would we switch to IVF mid-cycle and, if so, what is the cost?
- Does he feel a medicated IUI treatment plan would ultimately be successful? Is this the treatment he still recommends for me personally?

Things to do tomorrow:
- Call blood bank and confirm blood type. (Check! I am O+ and Ryan is O-. I don't believe there is any complications there, but I'll ask anyway.)
- Call Primary Care Physician and collect last year's blood test results (Check! They will fax it over to Synn's office.)

YES!

Oh, my gosh, it’s actually happening!

I called Dr. Synn’s office today and made an appointment for a consultation. It has been three years since the surgery, four years since I began fertility treatments, and six whole years since I saw Dr. Synn the first time for testing.

The last seven years have been a long, hard road. The most difficult part by far has been these last three years, dealing with depression and feeling stagnant.

We will see how the consultation goes, but as of now we are on track to begin a medicated IUI cycle in August.

FINALLY!!!

The Ups and Downs

These last few days have been quite the roller coaster. All this time, I have thought that I alone carried the stress and frustration of infertility, while Ryan escaped unscathed. Turns out, I was mistaken. Sparing the details, we came to the point that all of the strain and pressure was too much. And we snapped.

Although he would like to be a Dad someday, Ryan can’t take much more of the intense emotion that has been sharing space in our marriage for years now. He doesn’t want to see his wife fall apart on a daily basis and, you know, I can’t blame him. I am exhausted with this process as well. The most frustrating thing is that I want to DO SOMETHING, to MAKE PROGRESS, to be PROACTIVE, and our current situation does not allow for that. Because, you see, procreation is expensive for those of us who must pay for it…

So after a couple of talks, we have cleared up our misunderstandings and discussed our differences. Today, I am opening another bank account. I will funnel money there, a little at a time, as I am able. Once I have saved $3500, I will use the first $2000 for sinus surgery (I have to get this done before I can pursue pregnancy). Then, I will use the remaining $1500 for a Gonal-f / IUI treatment.

In the meantime, I will go back-to-basics and pull out that dusty ovulation predictor. Yeah, I know that the doc said my chances are <1%, but people beat the odds all the time. Doctors are good, but God is greater.

And all the while, I will concentrate on being happy. Happy with my husband, my family, my friends, and all those things I am so incredibly blessed to have. And those difficult days that will inevitably come? I’ll unload my feelings here, instead of dumping them on my husband. Because all he wants to do is make them go away. But he can’t.
No one can.

Life is like a roller coaster: There are ups and downs and sometimes you just want off! But other times, you just throw your hands up and try to enjoy the ride. Because, after all, you are not at the controls.

One Last Time

Last night, I took my last three Clomid pills. It was kind-of weird to think that this is the last time I’ll take Clomid. If we aren’t successful, we move on to the next step.

So this cycle will be a duplicate of last time: 150mg of Clomid (days 3-7), begin estrogen patch day 8, scan on day 12, IUI 2 days later, and progesterone supplements from that time until I take the pregnancy test. Doing all of this, the success rate is about 10%.

IUI

Definition of IUI: An IUI -- intrauterine insemination -- is performed by threading a very thin flexible catheter through the cervix and injecting washed sperm directly into the uterus.

I made it through the IUI today. Ryan had to work, so my mom went with me. Ryan called just before to tell me he wished he was there, which was really sweet. Maybe he'll be able to come next time (hopefully, there won't be a next time though!)

Last night, I felt a lot of pulling on my left side, and then this morning I felt the same thing on my right. I hope this is a good sign.

The procedure went well this morning, perfect is what the nurse said. It wasn't the most pleasant experience. There was this internal cramping going on that kind-of made me nauseous, but it wasn't bad. I have survived worse! Afterward, I laid on the table for about 20 minutes. Then I was done!

The nurse said it is certainly possible that all 4 of these eggs fertilize and stick, but it is unlikely. It would really frighten me to have 4 babies at once, but I would do it. Beggars can't be choosers, isn't that how the saying goes?

And now we wait...

2+ 2 = 4

Had my mid-cycle ultrasound today. Wow, the cycles are going by fast. Seems like yesterday I was finding out I wasn't pregnant and here I am trying again already!

The extra Clomid and early dosing schedule sure paid off! There are two mature follicles in each ovary. That's right; four total. Those seem like pretty good odds, one of these babies has to stick! If not, at least I know the meds are working, even if a pregnancy doesn't result...

The IUI is scheduled for Tuesday, Jan 2. This will be an experience for sure. It will all be worth it though, someday...

Pregnancy… or the lack thereof - Part 2

Struck out again this month! I'm mostly trying to keep myself busy with Christmas and the holidays to avoid the disappointment. Count your blessings and all that stuff.

So, as Emeril would say, we're kicking it up a notch. I am now on a triple dose of Clomid. I'm taking it earlier in the cycle and I'll still use the trigger shot, progesterone supplements, estrogen patch, and baby aspirin.

The one new thing we might add this cycle (insert scary music here)... The dreaded IUI.

More on that later.