IUI Cost

So far, IUI #1 cost about $640 and IUI#2 cost $670.   So far my insurance has been paying for my ultrasounds all but $30 which is great this cost is for medications, ultrasounds and procedure.

IUI #2

Had IUI #2 today.

My ovulation predictor was positive on Sunday.   I went in yesterday for an ultrasound and had a follicle on my left.  Since he is trying to lengthen my leuetal phase he had me do an injection of 2,500 iu of HCG yesterday. I'll do another on Wednesday, a third on Friday and the last on Sunday.   On Friday I will also start Endometrium, a progesterone suppository.

The sperm was not nearly as good today.  There were very few motile, he let me look in the microscope.  He made sure I knew how small the chances of success were before he did the IUI.

Since I'm on the HCG a home pregnancy test won't work (would be false positive) until 5 days at least after my last injection.

I'm not going to get my hopes up this cycle like I did  last time.

This month's cycle

When I went in for my last ultrasound he found a cyst, which is basically when a follicle does not collapse after a cycle. They usually continue to grow and can become painful until they are either reabsorbed or in my case usually burst.

When you have a cyst they can't put you on Clomid because the cyst can become dangerously large. So I was instructed to get a blood draw on CD10 (yesterday) to check my estrogen level. It came back at 134. That's about the same level it as last time I had a cyst.  I had some sharp pains yesterday and figured the cyst had burst. He had me come in for an ultrasound today and confirmed that there was free fluid, indicating the cyst had burst.

I have 3 follicles now, 2 on the right and one of the left.  We will not be doing Clomid this cycle because of it being so late in the cycle. We might be able to do an IUI anyway though, depending on if the follicles mature properly.  I go back on Monday morning for another ultrasound.

Oh and there were 3 people in the room today staring at my crotch during my ultrasound. Doctor, intern and nurse. It's a good thing I'm not modest.

The Fat Lady Sang

This IUI cycle is over, the fat lady sang yesterday.

I go into the doctor for an ultrasound on Friday to make sure all of the follies from this cycle emptied before starting meds for a new cycle.  We also will be discussing timing this cycle a little more closely as it may have been about 12-24 hours too late this time.

Some lessons and the signs

So a couple of biology/anatomy/physiology lessons before today's update.

More about the IUI process
During an IUI the washed semen is placed, using a catheter directly into the uterus, bypassing the cervix.  The timing of this is critical.  The sperm needs to be waiting for the egg when its ovulated from the ovary but washed sperm has a much shorter life than raw sperm, 12-24 hours as opposed to the 3-5 days of raw sperm.   The woman has an ultrasound which measures the size of the follicles in the ovaries and determines if they are large enough to induce ovulation.  Typically doctors want the follicles to be around 20mm before triggering.  The trigger is a 10,000iu shot of HCG which quickly finishes the egg maturation process and incites a "forceful" ovulation.   The HCG shot is normally given 24-36 hours before the IUI procedure.

Basal Body Temperature Tracking
Basal body temperature (BBT) is the lowest body temperature attained while at rest (usually sleep).  A woman's basal body temperature fluctuates in a predictable pattern throughout the course of her menstrual cycle.  Many women track BBT as a way to pinpoint ovulation and predict the onset of their period.   At the beginning of a cycle the temperature is typically low, usually rising slowly up to the point of ovulation where it drops down usually for one or two days before making a quick rise.  These changes are triggered by hormones, the surge of luteinizing hormone (LH) at ovulation causes the drop and then the rise of progesterone after ovulation keeps the temperature high.  The body temperature usually starts to drop a couple of days before the onset of the period.  If pregnancy occurs the temperature remains high.

The Two Week Wait (2WW  or TWW)
Trying to conceive (TTC) is all about the 2 week wait. Its called a 2 weeks wait even though it can be slightly less or slightly more.  Each woman cycle varies slightly in length and can vary from cycle to cycle.  The cycle is broken down into 4 parts, the follicular phase where the ovaries are maturing an egg (or multiple eggs if on fertility drugs), ovulation where the ovaries release the egg, the leuetal phase where if an egg is fertilized it will start to become an embryo and implant into the uterus and menstruation.   The IUI procedure starts the two week wait and marks the beginning of the leuetal phase.  In most women the leuetal phase is about 14 days.  During that two weeks if the egg is fertilized then a lot is going on.  HCG, which is what is measured by a home pregnancy test is not produced by the body until after implantation.  Once implantation occurs then HCG is produced and the amount doubles approximately every 48 hours.   It typically takes about 4-5 days after implantation for the amount of HCG to reach a level it can be measured on a home pregnancy test.

The update

So now that you've had your lesson of the day here is what's going on with me.  My leuetal phase is typically 12 days long.  Today is day 12 for me.  I took a home pregnancy test yesterday and it was negative and my body temperature had dropped for the past two days.  Both of these things indicate that we are likely out (not pregnant) this cycle. It is of course not over until the fat lady sings but all biological signs point to that being the case.

The wait

Just a quick update to say no news!  Just waiting.

I tested out my trigger shot and as of last night the hcg tests were almost completely blank so that is out of my system now meaning that any pregnancy test I take will have accurate results.

 I went and got progesterone blood work done yesterday and it came back this morning with a level of 27.8 which is great!  Anything over 10 is good. That was a relief because I'd been worried that the supplement dosage I was on was not enough.

I had a temp drop yesterday on my basal body temperature testing and then it spiked back up today, that is a good sign (and making me obsess more).

Inseminated!

We are inseminated!!!  

I was SUPER nervous waiting this morning for them to process the sample, then we waited what seemed like forever but was about 40 minutes and at that point we had decided they didn't find any sperm and were waiting on the doctor to tell us. Then they called us back and the embryologist said "come look at the microscope" and my heart fell to my knees.  Then she's like, There are good swimmers in there!  

They said they don't do an actual count but  '2.5 mil after wash" was written on the thing beside the microscope with our name on it, so I'm guessing that is their estimate which is WAY better than we ever had before.  So I'm hopeful. The doctor seemed very happy so I'm happy now too. 

I'm a little annoyed though because they don't schedule a beta, just said to do home pregnancy test.

What's next?  If an egg gets fertilized then it takes 5-7 days for it to implant in the uterus and start growing. Another 3-5 days after that HCG levels ( HCG is secreted by the growing embryo) should rise to a point a pregnancy test would showt positive.  On Saturday I start a progesterone supplement to help sustain an embryo.

Between now and then I mostly wait. I can test out my trigger.  The trigger is a shot of HCG given before IUI to help mature the eggs and ensure strong ovulation.     testing out the triggrt means taking pregnancy test now until it's negative so that I'll know the result on the one in 3 weeks is a true result and not leftover HCG from the trigger shot. 

IUI Eve

Went for my follicle check today and had 3 mature ones, doctors office went ahead and gave me HCG trigger shot and I go in at 7:45 tomorrow for a date with the turkey baster. Hubby has to do his collection at home and we bring it in, hopefully there are lots of swimmers.

IUI

On Sunday I started Clomid, 100mg once a day.  Today was the final dose,  I go in Tuesday for an ultrasound and then should trigger and do the IUI late next week.

While the Clomid is MUCH easier than the IVF drugs it triggered the worst migraine of my life today with tingling hands, dizziness and excruciating headache.

What's next

It's been about a month since my last post.  We have been taking a break while we figure out what we wanted to do.  Earlier this week we talked with our doctor and have decided to do an IUI with hubby's sperm only, no backup.  We know this has a quite low chance of success but we want to give it a try before moving on to donor.   So at the start of my cycle I will go on Clomid then will have ultrasounds to confirm ovulation and then we'll do the IUI.

Speaking of next cycle, I am still not back to normal after IVF. My cycles are usually 27-29 days and I'm on day 36 now and no sign of AF.

IUI= Inter Uterine Insemination.  The ejaculate is washed of all seminal fluid until only sperm is left and then its placed directly into the uterus that the time of ovulation.

Options

Saw our RE today to talk over what happened with the IVF and discuss options.

He is afraid, based on our IVF that the issue does not lie with just one of us, but both of us.

Our REALISTIC options are as follows

1. Donor IUI (low cost, 20% chance of success each cycle)

2. Donor egg with combo of hubby's sperm and donor sperm (high cost, 40% chance)

3. Adoption (high cost, success rate unknown)

4. Embryo adoption (mid cost, 40% chance)

He think embryo adoption is the best way to go and gave us some literature on it..

He does not think that we have any realistic chance doing an IUI with hubby's sperm.

So now we will research and talk and come to a decision about how we want to proceed.

Improved count!!!!

For those of you following along at home the reason we were doing IVF is because hubby had basically zero sperm, highest count ever was 14 (not million, just 14). He had varicocele repair surgery just over a year ago but the only improvement was going from zero to the 14 or so.  When we started going down the IVF path he stopped the soy based protein shakes he was drinking twice daily, started taking Fertility Blend and CoQ10 and increased his caloric intake (he'd lost a LOT of weight in the past 2 years).

We have an appointment next week to talk to our RE about our options post IVF.  Hubby did a semen analysis yesterday in prep for that meeting. So nurse calls me today with results of yesterday's test. Get this 1 MILLION!!!!!  I know that most people would be devastated at a sperm count of one million but we are elated!  That opens up the possibility of IUI for us, maybe, hopefully.

This is the best news we've gotten in awhile!