Spotting is annoying

I didn’t have spotting for very long after the previous IUI’s, so the spotting 2 days after my last one is taking me by surprise. Hoping it stops soon. I really don’t want to think about cycles or fertility for the next week, though I’ve decided I’ll start testing next Saturday, which will be 11dpo per FertilityFriend or 10dpo per the nurse practitioner. I am really hoping I don’t start my period on the plane. I have some serious packing to do. Only 9 days until our big 10th anniversary trip!

2nd IUI complete, onto the 2WW

Had my 2nd IUI done this morning. It’s so nice to actually have the same provider for this whole cycle – this NP saw me from day 3 to today’s IUI on day 16, which is unheard of at this clinic. She fought hard to make sure I was on her schedule, and I love her for it. She’s also the best at making the IUI’s the least uncomfortable. Out of the 3 she did for me, she only struggled once, but even that wasn’t nearly as uncomfortable as some of the others I’ve had. Fortunately, this morning’s went very smoothly, and I didn’t need the plastic tampon afterwards – which feels fine while it’s in, but pulling out was very uncomfortable.

She also spoke with the supervising OB/GYN yesterday about me, and he told her to send him my chart if this cycle isn’t successful. He wants to speak with me by phone at that point to determine the next best step. He also told her that my seeing the nearby out-of-group RE would be covered?! I don’t know exactly how true that is, but that would be lovely to avoid another 2 IUI’s before seeing him. I’m still going to keep my appointment with the hour-away in-group RE though – I have to drive there anyways, so why not…

The surprise 19mm follicle on CD15, and decisions, decisions…

After explaining my BBT observations and the positive OPK yesterday morning to the NP, she decided to scan me again first before doing the IUI. The 10mm follicles on the right from 2 days ago were long gone, then she swung over to the left – which she couldn’t fully visualize 2 days ago due to my intestines moving (I really need to figure out what it is that keeps setting it off because it’s making the scans really difficult). 3 follicles – the largest at 19mm, and 2 others that were probably 14-15mm. I nearly laughed out loud when she told me. So in went the sperm (which looked great per her – combined with great EWCM she saw), and I’m going in again tomorrow after all.

So we’re definitely giving it our best shot this cycle, no matter what day I ovulate. The main thing that bugs me is knowing when to test, because we fly overseas on June 2. I may have to use the Lunette on the plane for the first time. Yikes.

Now I’m at a crossroads, if I don’t get pregnant this cycle. 4 IUI’s down, 2 more to go before my insurance will cover 80% of IVF costs at a nearby out-of-group RE’s office. This RE happens to be super-close to where I live, and is smack dab in between my house and my office – but because he’s well-liked and inexpensive compared to others, he gets a long waiting list. I asked the NP, and they only give Clomid at my current clinic, no Femara and no injectables. She actually pushed me to just pay out of pocket for IVF if this cycle doesn’t take because she really feels like everything we’re doing should be getting me pregnant, and if it’s not happening this way, she doesn’t feel injectables + IUI would really give me that much of an increased chance. This leaves me with the following options:

  • I could go back to the office that’s at least 30 minutes away, because they do use injectables, but they don’t perform IUI’s on the weekends – which could end up wasting my time then.
  • I could also just try to do non-medicated IUI’s these next 2 cycles – this NP was willing, but the OB/GYN may not be – though he is very hands-off. Or I could take Clomid 2 more times, but at just the half-dose I’d read about.
  • Start the IVF referral process – because given the wait at the out-of-group RE’s office, by the time we could start, we’d probably have the 2 IUI’s done anyways.

Regardless, I’m going to self-refer to the in-group RE that’s an hour away, have her re-check my labs since it’s been a year, and then decide from there what to do.

Round 2

So yesterday was a fluke with how easy the catheter passed through. Even with the tenaculum today, the NP just couldn’t get it quite past the internal os. She ended up placing a cap to help ensure the sperm stay up there for the next 4 hours when I’ll remove it. So I’m glad I opted to have 2 IUI’s this time around, especially since my temperature came up a bit this morning. With the pains I felt yesterday, I’m pretty certain ovulation happened yesterday, as expected just over 24 hours after the HCG trigger.

First IUI done

Hurray, according to the NP, the sperm looked great! She was awesome, threaded the catheter through without a problem. Whole thing went much more smoothly than my previous two IUI’s. She wished me lots of good baby ju-ju, and ordered me to lay low as much as possible the next 3 days. Now just hanging out for 15 minutes before I get up.

IUI #2 done… hopefully with good timing?

There’s been a lot of confusion regarding my ovulation these last few days, but to make a long story short, I had my 2nd IUI done today. The midwife who performed it used some sort of tool to pull on my cervix to help with threading the catheter in, so there was none of the trouble with insertion like the first time. It was a little more uncomfortable and I had a bit of bleeding afterwards, but nothing terrible. I was terrified of having this done in Urgent Care, but turned out I just had to check in there and then she walked me across the lobby to OB/GYN clinic to do the procedure. The worst part was the nosy receptionist who kept asking why I had no copay, while 10 patients were waiting behind me to check in. Is that really necessary??

For those who want to know the details and may have some insight to offer, I’d like your take on the following. 3 days ago, I had a 16 mm (I mis-heard her and thought it was 19 mm) and a 14 mm follicle on my right ovary. The next day, I was feeling bloated and had some back-ache along with increased egg-white mucus and a slight temperature dip, but had yet to get a positive OPK. When I returned for another ultrasound yesterday morning, a different NP could only find smaller follicles on my right, though they didn’t have the “collapsed” appearance that I understand you should often see after ovulation. She did feel though that I may have ovulated recently, and went ahead and booked me for the IUI today. I didn’t argue, because at this point, I want to get through 6 IUI’s as quickly as possible so that I can get to IVF if needed.

Here’s where it gets confusing though. After the ultrasound yesterday morning, I came home and tested and got a positive OPK. Her theory is that my LH surge wasn’t strong enough (huh?) to get picked up until yesterday morning, even though in the past I have consistently tested positive in the morning before every temperature shift for a year now. And out of curiosity, I tested again this morning before I went in for the IUI, and it again came back positive.

And for those who like to analyze BBT charts, here it is so far. Clomid has definitely made my chart harder to interpret compared to before. Will be interesting to see how Fertility Friend interprets this in the days to come.

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Come on, follicle B!

It’s CD13, and I had my monitoring ultrasound this morning. My lining looks nice and thick, and I have 2 potential follicles, both on my right ovary. Strangely enough, when my massage therapist worked on me 4 days ago, she said she felt like my right ovary would be the active one this cycle. So crazy… Anyways, the follicle A is 19mm, and follicle B is 14mm. NP wants to try and catch both, so I go back in 2 days for another ultrasound with HCG trigger, and IUI the following day. In the meantime, we definitely need to get going with timed intercourse to make sure we don’t miss follicle A’s release. The Clomid wiped me out and hubby is in delayed-onset-muscle-soreness hell after a physically draining weekend, so yesterday just didn’t happen. So the PreSeed’s definitely getting used tonight 😛

Infertility by numbers

What does infertility look like numerically? This is how it’s broken down for us so far…

3500+ – dollars I have spent, and I am lucky since my insurance covers all my Western treatments, other than a nominal $5 copay for prescriptions. I’m paying out of pocket just for acupuncture, herbs, supplements, and ovulation prediction tests. Thank goodness for Amazon!

83 – number of ovulation prediction test strips I have used in the last year.

75 – micrograms of levothyroxine I take each morning to manage my anti-thyroperoxidase antibodies.

36 – acupuncture sessions I have had since starting 10 months ago. I try to go weekly, because it does help my stress levels.

16 – months we have been trying to conceive.

12 – days in my luteal phase, the dreaded waiting time after I ovulate to see if AF arrives.

11 – blood draws I have had in the last 9 months, and expecting another 2 every IUI cycle. Blah…

6 – the number of intrauterine inseminations (IUI’s) we need to go through before my insurance will cover 80% of the cost of an in vitro fertilization (IVF) cycle. 1 IUI down, 5 more to go…

3 – the number of 1+ hour round-trips I have made to my REI’s office. Also the number of trips I will need to make per monthly cycle if I start Clomid – I plan to switch to a closer specialist who is 15 minutes away, even if it means losing some of my privacy protection :/

2 – times I have had a catheter inserted through my cervix into my uterus, once for a hysterosalpingogram, and another for IUI. Also the number of times my husband has had to produce a sample into a cup.

0 – positive pregnancy tests I’ve taken. If I start Clomid with the HCG trigger in a couple months, I plan to take a pregnancy test right after the HCG trigger shot just so I can see what a positive test looks like.

Natural cycle IUI – done!

I slept pretty well despite the anticipation of today, and thankfully work went by quickly in the morning with no fires to put out or anything else to keep me late. Came home to eat lunch with my husband, and 45 minutes before we needed to be at the clinic, I sent him to the bathroom. Less than 10 minutes later, we were on the road, with the prized sample staying warm between hubby’s legs (have to thank my friend P who’s gone through this for that tip!). Unfortunately, traffic was awful just leaving our house, and also close to the clinic. In between, I took advantage of the carpool lane, but it wasn’t enough to get us there on time. I ran up 2 flights of stairs and checked in 10 minutes late, ready to profusely apologize, but the receptionist just smiled and said “You must be here for an IUI.” The look of panic and my heavy breathing must have been dead giveaways. They checked me in, having to check my blood pressure twice because it was high from the stress of getting there, confirmed my identity and made sure to label the sample with my name. At this point, it was an hour after the sample was obtained. I was sent out to wait for 45 minutes while the nurse washed it and prepared it for microscopic viewing and the insemination.

Husband had dropped me off to look for parking and we never managed to find each other during that time, so he just hung out in the car and in the clinic courtyard, while I tried to while away the time playing games on my phone. Also chatted with couple of the friends who knew I was heading in for this today. It felt really good to have so many people rooting for us, including my closest coworkers. I jumped up when the nurse called my name and as we headed to the exam room, she turned to me and smiled, saying “They look great!” I must have given her a quizzical look, because she laughed and said “The sperm – they’re definitely alive!” I’m guessing infertility workers get super excited about this since they have a fair number of male factor infertility patients. She took me to the room and let me look at my husband’s sperm under the microscope, then left to let me get undressed. I told hubby his sperm looked great later, and he was pretty proud, haha!

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The nurse practitioner came in and we started. I had seen her before when I thought I was going to start Clomid, so was worried she’d be upset with me for not doing so, but she was totally fine as we discussed when my positive OPK test was done. I figured the procedure itself would be similar to the HSG, and it was pretty close. After inserting the speculum, she remarked on the good amount of cervical mucus (again guessing a big deal since their patients on Clomid tend to run dry), and began threading the catheter in. She had a little bit of trouble at the internal os, and asked if my HSG was normal. I said yes, so she backed out a bit then asked me to cough a few times as she reached it. That did the trick and the catheter passed on through. Think I actually felt the tip of the catheter hit the fundus of my uterus before she pulled it back a bit, then she warned me I might get some cramping as she pushed the sample in. Felt fine as she took everything out, then they had me lay on my back with a pillow under my butt and legs tucked up. Stayed like this for 15 minutes while they gave me my instructions. To be absolutely sure nothing gets out, I inserted a Softcup cervical cap, then got dressed and left to find hubby.

I was instructed to “have relations” (yup, exactly as written on my instructions) tonight and tomorrow. I’ll have blood drawn in a week to check my progesterone level, which will give a sense of how good my ovulation is, then blood drawn in 2 weeks to check for pregnancy. They require this even if I start what seems to be my period, since they’ll want to proceed to treating the next cycle, and won’t do so until they confirm you’re not possibly pregnant. So back to being a pincushion again, but hopefully with more exciting results this time around!