I had intentions of keeping you all up to date with each cycle, but when the first cycle ended, I found it difficult to put into words how I felt. Spoiler alert: the first cycle was unsuccessful.
Despite our lack of success, I find it necessary to share with you the exact process and details of this cycle. Going into this whole process we didn't know much other than what I had read online - and a lot of times, when you do your own medical research online, everything tends to vary, contradict itself, or scare the poo out of you. So, if any of your are curious about what it may be like to go through a cycle with a fertility specialist or maybe you're just about to get started with one, hopefully this will provide you with the information, the understanding, or the peace of mind you may need.
My cycle began on June 5th. This was cycle day one (CD1).
On day three of my cycle (CD3) I went to the doctor for baseline ultrasound and blood work. The ultrasound looked great - I had 23 follicles that had the potential to grow. My estrogen and FSH were both at satisfactory levels and I was given the go ahead to start with my medication.
As I mentioned, I had done five round of Clomid in the past. All five rounds were extremely successful with egg growth and ovulation; however, the end result of all those cycles was still a negative pregnancy test. With the help of our RE, we decided to move to a more aggressive medication and complete an IUI (if you are unfamiliar with the process of an IUI, ask you doctor for information or read a little bit about it here). I specifically remember our RE giving the option of continuing with Clomid or moving on to a similar, but more aggressive medication: Follistim. Our RE referred to this medication as The Ace in the Hole for patients who have been unsuccessful and dealt with early miscarriages. I'd read about Follistim. I knew it was similar to Clomid in that it stimulates the ovaries to help with egg production, but instead of a pill, it's an injectable. And I knew it was definitely going to be our next goal. We were sitting in her office for a reason. Time to be aggressive.
So on the night of CD 3, I started Follistim injections. Yes, injections. I gave myself nightly shots for six nights in a row. I'll be honest, I was initially petrified. Questioning if I had the willpower to stick my belly with a needle. That first night, I loaded my medication cartridge, filled the pen with my prescribed daily does of medication - which was 75IU - and then just stared at the needle. Several minutes passed as I battled fear and hesitancy. Chris wanted to hang around and watch, but I had to ask him to leave. That's just how I am. I needed to be alone. Most times when I'm scared or enduring pain, I prefer to be alone. After he stepped out, I felt bad. I wanted him there, but I also wanted to do it alone just in case I cried. Or squealed. Once he left, I knew the time was now. I grabbed some belly fat and pushed in the needle… I immediately yelled to Chris, "That didn't hurt AT ALL!" And it didn't! I was amazed and relieved. If you fear needles, it's OK, you can do it! I preferred to give myself all the shots, but if you can't handle it, your husband or RN friend can definitely help you out. The good news is that, it doesn't matter who sticks you - because it doesn't hurt!
In order to not make this post too incredibly long, I'll do a separate post on Follistim - if any of you are interested.
So, I stuck my belly for six nights in a row. On the day after my sixth shot, which was CD 10, I had blood work drawn and a second ultrasound to take a look at how my ovaries were responding to the injections. And they were! I had a total of six eggs growing. Three were on the right and three more were on the left. Unfortunately, they weren't to a mature size after six days of the injections. I had three larger eggs at this time were all 1.3mm - an egg needs to be 1.8mm to be considered mature. My estrogen was also pretty low at this time (I believe in the 60s) which also indicated it wasn't quite time. So I was told to continue the injections for three more nights and then reschedule another visit to repeat blood work and ultrasound.
So I did three more nights of Follistim 75IU and went back to the office on CD 13. The ultrasound that day showed that one of the three larger 1.3mm eggs had grown. It was 1.75mm. The nurse stated that with an egg being 1.75mm, they rounded up - which made it a 1.8mm - which meant it was mature enough to be released. She informed me that the reason they round up is because the egg continues to grown until it is released. So by the time this egg releases, it would be over 1.8mm. So pending my estrogen level, I was told to take my HCG trigger shot that night and schedule our IUI for two days later.
Leaving the office that day, I was a little bummed out. I was disappointed that out of six growing eggs, only one had grown to a mature size - and it was barely mature! This particular visit fell on a Sunday and we felt kind of rushed through our visit and I didn't really have time to gather my thoughts and voice them. So the next day, I called the nurses line and spoke with my doctor's nurse. She assured me that it was typical and wasn't anything of concern that yes, six were growing at one point, but only one took the lead. This is what happens in most normal cycles. So I took a deep breath and moved on.
I received a phone call a bit later that Sunday stating my estrogen had risen some, but still wasn't great. Despite that, I was still instructed to move forward with the HCG shot that night and IUI in two days.
The HCG (human chorionic gonadotropin) is the pregnancy hormone. A large does of this hormone helps mature eggs complete their growth and release into the fallopian tubes in hopes to be fertilized. I was given an injection of 10,000IU.
Now. The HCG shot wasn't a small needle. And wasn't given in the stomach. No. Flip it and reverse it. This was a long, loooong needle as the medication needed to reach the muscle tissue. And it was to be injected in my rear. I knew I couldn't do it. No way. Sticking a one inch needle in my stomach was one thing, but sticking a two and a half inch, thicker needed in my butt cheek just wasn't something I could do. And I wasn't quite keen on Chris doing it either. Lucky, lucky! for me, my next door neighbor is a nurse. And she was able and willing to give me the shot. Surprisingly enough, this shot didn't hurt either!
The shot was done! 36 hours later we were scheduled for our first IUI. I'll talk about that in the next post!