Journey to Baby: First Cycle with RE // Part II


I took my HCG "trigger shot" on the night of CD12 (June 15, 2014) and our first IUI was scheduled for the morning of CD 14.

So that morning of our IUI we went in for part one of the visit - the husband's part. You know. So he did his thing. Now, we had the option of collecting the specimen at home as long as it gets tot he office within 30 minutes, but we lived 20-25 minutes away from the office and I just didn't want to take the chance. Of course it's a more comfortable way of doing things, but my comfort was in making sure all those swimmers stayed alive and swimming. I wanted them to go straight into the cup and then straight into the hands of the lady cleaning and preparing them for the injection. That's what made us most comfortable.

So the cleaning of the sperm - which is to concentrate only the rapid-motility sperms - took about 45 minutes. So we left and had breakfast as our little guys were being prepped for the long race!

Once we returned to the office, we were immediately called back to the "IUI room" - a small room with the typical exam table - stirrups included, the exam lamp, and a sink area. Very small and minimal. Much like any gynecological visit, I had the pleasure of removing the lower portion of my clothes and covering up with a paper blanket.

Shortly after undressing, the nurse practitioner came in for the procedure. She handed me the vial of our swimmers to double check information - that is was indeed my husband's and not someone else's. Time out - this is my biggest fear. BIGGEST! The idea that samples and specimens could get mixed up. For this reason, I scheduled all our appointments for 7a.m. insuring we were the first. I know it's very unlikely - especially since this office is so small, but it's a legit fear. Luckily, that day we were the only couple doing an IUI. Shew! The information checked out - it was my husband. So we moved forward. I held the little guys and kept them warm in my palm while the NP got set up.

The IUI procedure was a combination of getting a yearly physical and the HSG I had back in October 2013. It was very quick. Painless. Mildly uncomfortable at the worst (mostly because of the speculum). Once that was in place, a catheter was inserted into my uterus and on the other end of the catheter was a syringe. She took the swimmers from my warm grip, immediately placed them in a syringe, and just like that, our little swimmers were injected directly into my uterus. I felt a little bit of cramping, but honestly nothing compared to the HSG. And then it was over. I was instructed to continue lying down for 15-20 minutes and then I would have an ultrasound.

The ultrasound was just to double check that there was indeed some fluid on the ovaries - indicating ovulation was imminent and everything was done correctly. And it was. Bring on the two-week wait (TWW - a common acronym for women with infertility).

I had a week between my IUI and my next appointment. Which felt slightly odd as I had spent the past week or so either at the doctor's office or at least giving myself shots of some kind. So it kind of felt like a vacation. Exactly a week later I came in for blood work to test my progesterone. A certain level of progesterone indicates if ovulation occurred. That's it. It does not indicate pregnancy - just ovulation. The higher the number, the better quality of the egg and/or the more likely that there was multiple eggs released. I can't recall my exact progesterone level this cycle, but it was satisfactory - I want to say just above the recommended number. So I definitely ovulated. Yay!

So I was to then again come back in a week to do a HCG/beta blood work (which tests for the pregnancy hormone, HCG) to see if infact I was pregnant. I was told HCG needed to be 25 or greater to be considered pregnant. Since this was our first cycle and I was feeling good about it, I requested that the nurse leave the results on my voicemail. I knew the results would be in before either of us got off work and I thought it would be special to listen together. So whether it was positive or negative, we'd be there for each other. Well around 2p.m. I saw I had a new voicemail from the clinic. It about killed me to know that the results were there, but I had to wait. Chris got home a little earlier that evening and we immediately sat down on the couch and pressed play.

I already had a feeling that this cycle wasn't successful. After months and months of trying without success, you get very familiar with what it feels like to not be pregnant. And I didn't feel pregnant, but still had some hope. Maybe it feels exactly the same?

As soon as the nurse started her message, I knew. I could hear it in her voice. She left a very sweet message, but ultimately said my beta test was negative and it did not work out this cycle. She never said what my beta number was, but it was obviously less than 5 (5-25 is considered possibly pregnant and requires additional testing a couple days later).

We were quite for a few seconds. Chris put his arms around me and immediately became the comforter and cheerleader saying it was OK and that we'd try again next time and he seemed to move forward from this a lot faster than I did. I stayed on the cough for a while, just starring into space. I considered all the money, straight out of our pockets, that was spent (and now feels wasted) on visits, ultrasounds, and medications. We also received six bills this day from the lab company totaling over $1,000 - just from our first initial visit. Nothing like rubbing salt in the wound.

This negative cycle really hit me hard. I considered the idea that we may move forward and do two or three more IUIs, but what if they don't work? And what if we move on to IVF and that doesn't work? What if we waste another year or two years and thousands of dollars more and none of this works? What if I'm not physically able to become pregnant? What if none of this works and we waste all this money and time that could be used towards adoption? A thousand "what if's" just running through my mind. I was not myself. I was super negative. And I didn't know what to do next. I was scared to try again and fail.

I took the rest of the evening to be sad. I think that's important to let yourself grieve in these situations. Others not going through this may not understand, but I do. You need the time. It's a tough road to walk and it's not good to suppress feelings - especially when you hurt - because it does hurt. I've said it before - because infertility is such a quite subject, those of us dealing have limited outlets.

Fortunately I had one friend. One. She was going through the exact thing - and one friend was all I needed. Just someone that was there to listen with an understanding ear. Someone who could share similar experiences. Between her and my faith, I made it through my first negative cycle with the specialist. My mom also was scheduled to fly in the following day to visit for a couple weeks - it was wonderful to have her there immediately after getting the negative test to take my mind off of everything.

So between the negative test and my next cycle, it was time to decide what was next - taking a break or keep moving forward. I had no clue what I wanted to do.


Journey to Baby: First Cycle with RE // Part I


Although our first cycle with the fertility clinic was quite a while ago (early June), sitting down to write about it was difficulty. Mostly because the cycle carried quite a bit of emotions - a roller coaster, if you will. We juggled emotions of joy, excitement, fear, doubt, and hopefulness. At times the days and weeks flew by and other times they crawled. Ultimately, it was disappointing.

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!