Our Next Attempt: IUI
January 29, 2012
To pick up where we left off, after I went on Clomid (and then cried), we decided to try IUI with injectable medications. For one reason: Better odds than IUI with Clomid, and better odds than Clomid alone. Not to beat a dead horse, but the age factor is always the giant elephant in the room when we’re making our decisions about this. It’s what our doctor recommended, too.
I have friends who hired nurses to administer the shots at night, but we decided we could handle this part on our own, as long as we knew what we were doing. After a few months of doctor appointments I’d already had my blood drawn dozens of times—shots weren't the scariest part of all this. The needles are tiny, and for some reason this just didn’t concern me enough to feel it was worth spending $1,000 a week on to have a nurse come to our house to do it for me (that and Jay was more than happy to do it).
My insurance company required me to mail order for injectable medications (instead of just picking them up at our local pharmacy). My luck: The meds arrived at our house on Friday, July 1—the night we were supposed to start them, before a holiday weekend. As in, I had no time to bring them into the clinic for a live demo. As in, we had to figure out how to assemble and administer the shots ourselves. Also my luck? My doctor was on vacation over Fourth of July.
Follistim was the first ingredient in this IUI recipe, injected subcutaneously (in my stomach). Follistim contains a follicle stimulating hormone (FSH)—in basic terms, it helps stimulate your ovaries to produce eggs. The prescription that accompanied the Follistim said 75-150 IUs (“international units”)—ummm confusion no. 1. Which is it!? That’s a pretty big range. We couldn’t seem to get a hold of anyone at the clinic after-hours on a Friday before the holiday, and since I got my doctor’s out of office reply over email I was beginning to panic a little that I wouldn’t hear from him in time to start the medications that night and, as anyone who's been through this knows, the timing of everything is so crucial to the overall success of your cycle. Meaning you can’t skip a single day. Shots + confusion = stress. Which is the last thing you need when you’re going through something like this…
Not only did I not know which dose to be taking—I had no effing clue how to administer the shot (it comes with a pen, a cartridge you need to load into it, a package of needles, and the pen has a dial on it to help control the dosage). I had never taken shots before that I had to do myself so this was completely foreign to me. I called a friend who’d been through this: Her husband suggested I go to Walgreens’ pharmacy (open all night!). I brought everything with me and asked a pharmacist to help me understand the prescription better (it wasn’t clear to her either); and she showed me how to assemble everything and administer the shot correctly. Crisis temporarily averted. This instructional video I just found on YouTube gives you a very good idea of how this is done (would you have known what to do without clear instructions first?).
Sometimes I think doctors forget that this whole infertility process is not as intuitive to the patient as it is to them. I decided to err on the side of caution and give myself a lower dose of 75 IUs that first night. Thankfully my doctor emailed me back the next morning to reassure me that I did the right thing. He apologized for the confusion, and let me know that the side effects I was experiencing after the first shot (mild burning, tender at the injection site and nausea) were all “normal.” It’s amazing what a little reassurance from your doctor can do when you’re going through this... His response gave me the peace of mind I needed before moving forward.
I was on Follistim from July 1-July 8—the symptoms persisted, but were managable. I think the idea of it was worse than anything. We did the trigger shot, Ovidrel, on July 9—it contains the hormone human Chorionic Gonadotropin, commonly referred to as hCG, which induces ovulation within 24-36 hours post-injection. That’s your peak fertile time, so it was instructed by my doctor to have timed intercourse after the trigger shot. It sounds about as sexy and romantic as it was. I mean, what could be hotter than timed intercourse?
Our intrauterine insemination was scheduled for the following Monday.
Only a single insemination was ordered by my doctor, though some will order two inseminations (I’ve read two inseminations only increase your chances of getting pregnant by about 6 percent). I’m still not sure why he didn’t order a second one, but I’ve learned that every doctor does things a little differently; there’s an art to all of this.
The actual insemination process is fairly simple and painless, not unlike a routine pap smear—it takes just a few minutes, and is done by threading a very thin catheter through your cervix to inject the washed sperm directly into your uterus so they can reach your fallopian tubes where they'll hopefully connect with your mature eggs and fertilization will occur. Simple enough, right?
While it's not a pleasant experience, most would probably say an IUI is no big deal. Most everyone except me.
The two-week wait period was brutal, but no different than any other natural attempt at getting pregnant. Sadly, we never got to the point of taking a home pregnancy test…I had my telltale sign before the two weeks were even up.
After months of letdowns, this one hit us a little harder. There’s nothing that should be stopping us from getting pregnant, yet we can’t seem to get there. Our first IUI attempt with injectable meds wasn’t successful for us, but I was not about to give up. This is what's called, in the infertility world, a BFN (big fat negative—I didn't make that up, that's really what it's called).
How long have you waited to start trying again after getting a BFN, whether naturally or through the help of fertility treatments?