IUI #1

We had our first of two Intrauterine Inseminations (IUI) this morning. I got there just before 8:00 a.m. and dropped off the the semen. They told me I had about an hour if I wanted to go have breakfast somewhere or something. So I decided to go to McDonald’s and tried their new Cinnamon Melts (yummy), relaxed in a booth there and read a book. I also got Sean one of the “Surf’s Up” movie Happy Meal toys, that he hasn’t gotten yet, as a surprise for later, as they were willing to sell it to me without me having to get a meal. I returned to the FCI Orland Park office just before 9:00 a.m. and they brought me to an examination room.

One of the nurses came in with a syringe with a small catheter on the end. She told me that Bob’s sperm sample had yielded 20 million sperm with 80% motility, which she seemed pleased with. She said they like to see at least 20 million sperm and 50% motility, so that Bob “did his job well!” The procedure itself was not bad, it felt sort of like a pap smear, but lasted longer and was a little more uncomfortable. The nurse said that my cervical mucus looked great, which was encouraging, as that will help the sperm survive longer in their quest to meet the one (or more) eggs that will be released when I ovulate sometime today or tomorrow. I am not exactly clear on when that may happen and am not sure that they know exactly either, hence why we will do this twice.

After the nurse finished, while I was still lying down, she had me close my legs and place them on the examining table with my knees bent. She set a timer for 10 minutes and after that I would be released. Some interesting discussion and observations took place during that 10 minutes, which I will share. First off, I had some questions for the nurse, which she was glad to be able to answer for me. She apologized again for how busy things were at the office yesterday and the way I learned the news that we would actually be going with neither Plan A or Plan B. I asked her what if any medications I would be taking during my “two week wait” after our second IUI tomorrow. She told me that on Thursday (the day after IUI#2) I will start taking Baby Aspirin daily (based on my history of miscarriages). On Friday I will start on Progesterone vaginal suppositories (200 mg) every night at bedtime for 15 days. The suppositories are in place of the Progesterone-In-Oil (PIO) injections that IVF patients begin after the ER, but should serve a similar role by adding progesterone to replace the natural hormone in my body which might not be strong enough right now and to help prepare my uterus for a potential pregnancy .

As far as restrictions with IUI, the nurse instructed me not to do any heavy lifting or aerobic exercise today or tomorrow following the procedures for the rest of the day. After that she said light exercise, such as, walking or yoga would be okay, but no high impact activities, such as running. She said I would be due to come in for my Beta blood test on Tuesday, June 26 to find out if this works/if I am pregnant. I explained that I would be in Vegas then and asked if I could come in one day early for the test, since our plane doesn’t leave on Monday, June 25 until late morning, and she said yes! So this way I will find out that first afternoon that we are in Vegas (via my cell phone or checking our voicemail at home) if we will be celebrating a pregnancy that week or if I will be free to partake in some spirits while we are there!

I also asked the nurse if, in light of what happened with this cycle being converted to IUI, she thought we weren’t good candidates for IVF afterall. She said definitely not, which I was encouraged by! 🙂 She reiterated what she had told me yesterday afternoon when she called me with the news (and what our RE told me when I spoke with him last night, which I will share about next), that our RE didn’t want to waste on of our “precious” insurance covered IVF cycles on a cycle that wasn’t going as he had hoped. However, that overall I appear to be a “good responder” to the medications (though she did say I respond a bit slow) and thus there should no reason why future attempts couldn’t be more successful. They just really want to have at least three follicles, measuring at right around the same level, to trigger and feel confident they will get a good quantity and quality of eggs. Unfortunately, this time there were two sets of two close in size instead (1 – 21 & 1 – 20.5 and 2 – 16s). Anyway, I trust our RE’s judgement and believe he is doing what he thinks is best for us right now.

As I mentioned above, I did end up talking with our RE last night. After the news, that we were converting to IUI, sunk in to Bob and I, we wondered if our RE, in the busyness of the day, recalled the concerns about my uterus (after the surgery to remove my interstitial ectopic pregnancy) being able to support multiples (a risk with IUI, especially given the two big follicles that we have right now, and the main reason we only transferred one during our IVF cycle). If he did and still felt that the best course was IUI, we knew that we trust him and were okay with it. But we wanted to be sure that he had considered it in his deliberations. So we decided that I should have him paged. He called back fairly quickly, which we were impressed with, and was very nice and patient in talking with me and answering my questions. He also apoligzied that the news of his decision for us to convert from IVF to IUI seemed to “come out of left field” as he put it, which we appreciated, as we were pretty shocked to find out.

As you may recall, last cycle we did have a scare when one “bully” follicle that tried to pull ahead, early on when I started stimming, and we were told we might have to convert to IUI, but our RE chose to push through and “overtake” it with other follicles and that was strategy was successful, in that we got as many eggs as we did, even though we did not get pregnant that cycle. However this time, there was no assesment or warning before hand that this might happen, which made it more suprising. That said, a friend, who has been through many IVF cycles, told me early on, before we began our first cycle, to try to take our IVF experience one day at a time, as you never know what might happen and not to take anything for granted, even when a cycle seems to be going well. I see now what wise advise that was.

When I talked with our RE last night, he said that he thought me getting pregnant with multiples through this IUI cycle was highly unlikely and “won’t happen,” but he did understand our concern. He said the chance of multiples in this situation for us would be less than 5%. He also said that if it did somehow happen, that we would cross that bridge when we came to it, but that we would have a variety of options to consider. One of the options he shared (which Bob and I are not comfortable with) is reduction. But rather than spend too much time debating it now, Bob and I have agreed we will deal with it if and when it were to become an issue.

We recalled that when my OB/GYN first raised concerns about my uterus being able to handle multiples that he wavered as to how serious it could be and in the end said, it might be okay, they just don’t know. Our RE also said that my situation is so unique that it’s not like there have been research studies on “women who have had interstitial ectopic pregnancies and then gone on to try an IVF cycle, that gets converted to IUI, where multiples are a risk.” He made his point and I appreciated where he was coming from, in that there are no real precedents to follow in my situation and that he and my OB/GYN have been making the best decisions they can based on the information, knowledge and experience they have available to them. Finally, our RE told me that about once or twice each year he has an IVF patient who has to convert to IUI that actually gets pregnant! I wasn’t quite sure if I should take that as a reality check of the unlikelihood that this will work or as a hope that it could! I choose to see it as some of both! 🙂

Getting back to the procedure today, as I was lying on the table, waiting for the timer to go off after my 10 minute wait, I noticed that there was a picture of a sperm on the face of the timer! I thought that was pretty amusing! 😉 After the nurse left the room, I was relaxing on the examining table and trying to think positive thoughts, when I heard a song playing in the distance. The song was Lee Ann Womack’s “I Hope You Dance!” As many of you know, I believe that most things in life happen for a reason and that God often speaks to us in mysterious ways, such as through sending us a message through a song at just the right time. Well, the verse of the song that I heard this morning was “Whenever one door closes, I hope one more opens. Promise me you’ll give faith a fighting chance. And when you get the choice to sit it out or dance, I hope you dance.” I took that as a great big sign of hope from God that Bob and I are doing the right thing and that though this cycle’s IVF door may be closed, that we could have success through this IUI door and if not we will not “sit it out,” we will “keep dancing!”

Okay, enough of the cheesy analogies, I know this has been a lengthy post. Thank you all for your kind words of encouragement, thoughts and prayers over the past 24 hours! It has not been easy for Bob and me, but we are trying to roll with this change of plans the best we can. I will report back tomorrow after IUI #2 and then it will be time to hope and pray that maybe this IUI conversion just might work for us!