It’s been a year of living with our diagnosis, 20 failed cycles including four failed IUIs, but it’s time to pick up the pieces and head into our fifth IUI. Is there such a thing as “lucky number 5”? I hope so because we keep referring to this cycle as that!
Testing day for our fourth IUI was on a Tuesday and CD 31 for me. And if you remember, I’m pretty much always have 28-day cycles. Not this time though – the world wanted to continue playing this sick joke on me. The next few days came and went until 3 a.m. on that Friday morning when I woke up feeling like complete garbage. Off to the bathroom, I went, and BAM, it all made sense then. The next step was waiting until the clinic opened to make my baseline appointment, which I knew would be on Sunday that week.
CD3 (Sunday, September 22): Baseline Ultrasound
Being that the FIRM has six REs, it is common to not have your primary RE for weekend appointments, this was no big deal as we had never had an issue and I didn’t expect to have one then. But I spoke too soon. The RE on rotation, who I will refer to as Dr. X, seemed to be loved by all of their patients. I knew that Dr. X would be the one seeing us, but like always, I asked: “Is Dr. F here by chance today?” Side note: up to this point, we have had 19 appointments in five months and have seen a different RE for eight of them, Dr. X brought our count to four REs. If Dr. F were to actually walk in the room when I ask for him, I would probably cry tears of relief! Anyway, he wasn’t there, so I had to get over my fears and know that Dr. X is a successful RE too.
In came Dr. X who immediately asked: “How many cycles have we done?” I responded “20 trying but this will be our fifth IUI.” Dr. X looked up from the clipboard and had the biggest bug eyes that immediately made me feel shameful for not having had success yet. I know that wasn’t the intention as my response was followed with “Have you talked about moving on?” (This meant IVF.) Yes, we have talked about it alone and with Dr. F but that was not something I wanted to get into right then. I asked a couple of questions with the main one being “Why would my lining have shrunk 1.5mm from CD12 to CD15?” Dr. X explained that this is simply a user discrepancy, not every RE measures the same points. Fair enough, but I wasn’t happy with that answer.
As soon as my exam started, Dr. X asked “Do you have endometriosis?” With a shaky voice and tears immediately welling up in my eyes, I said no. That wasn’t a good enough answer as Dr. X then turned the monitor towards me to show each ovary side by side. My lining was measured, a healthy 3.5mm which is perfect for CD3, and the exam was over, but now the tears were streaming down my cheeks.
I sat up and Dr. X said: “I know it’s scary seeing a new doctor on a weekend and I’m telling you something you’ve never been told before, but I’ll relay the message to Dr. F with your ultrasound photos and you can discuss it further with him.” Dr. X then proceeded to explain how endo is cleared out, which is through laparoscopic surgery. Surgery. With anesthesia. AKA, one of my biggest fears. Once our conversation was over, we were given an RX for 150mg/day of Clomid, CD3-11. If you do the math, that’s NINE days – THREE days longer than I’ve ever taken a drug in the past! The reasoning behind this was to give me the extra boost as I didn’t respond well last cycle and was redosed by Dr. F, so this time Dr. X said we would hopefully avoid a redose and just pump me full in the beginning. Whatever, I’m not a doctor, so if Dr. X thought this was a good idea, I was fine with it.
CD4 (Monday, September 23): Phone Call with Dr. F
Dr. X assured us that the possible finding of an endometrioma would be passed along to Dr. F along with my ultrasound photos for picture evidence. From this, I understood that Dr. F would review and then call me to discuss and possibly ask me to come in for another scan. I was told by our nurse the day prior that Dr. F would be doing an egg retrieval for his first appointment at 8:30 that morning, so I knew I wouldn’t hear from him right away. But you’ve caught on by now that I am entirely too impatient. So promptly at 9:05 that morning, I broke down and called the clinic. They put me through to his voicemail and I just word-vomited, you know, my specialty!
The next three and a half hours felt like an eternity waiting for him to call me back, but as soon as he did, my fears were 99% subsided. He explained that endo is not able to be detected by ultrasound and that his hunch was that this “blob” was a leftover egg from my previous cycle that hadn’t fully dissolved yet. He also informed me that my voicemail was the first he had heard of any of this, no notes, no ultrasound photos. I say this because if I didn’t speak up for myself, this wouldn’t have been addressed. After about 20 minutes, a lot of answered questions and a ton of reassurance, he decided that we would wait until my regularly scheduled follicle scan the following week to see what was going on. Phew, what a relief!
CD6-8 (Friday, September 27-29): Clomid Crazies
WHOA. So far, this cycle was bad, just all around bad due to the Clomid Crazies. Luckily though, I was prepared with Gatorade and flavored water to make it through the horrible taste of the pills this time.
CD12 (Tuesday, October 1): Follicle Scan
I don’t think I can quite explain the excitement I had for this appointment, mainly to see Dr. F and have him tell me that there was absolutely no endo and it was just a scare. *Fingers crossed* As usual, I took the last available appointment of the day, which happened to be at 2:30 this time, so J and I met each other at the office. For some reason when we were walking in, I was silently hoping there wouldn’t be any other patients in the waiting room. I normally don’t care, but I did this time.
We waited just a few minutes before being called back but Crystal wasn’t the one calling us back. QUEUE THE PANIC. We had a new nurse, whose name I didn’t catch, I know she told us but I was too nervous to remember. New Nurse (I’ll call her) instructed us to go into the vitals room for weight, height, blood pressure and temperature. I was really missing Crystal at this point. I let New Nurse know that their scale wasn’t accurate and that Crystal lets me bargain with her on my weight… no such luck this time. Once all of my vitals were good (aside from my BP which was 148/101), she showed us down the hall to our exam room, and off to the bathroom I went for my urine sample.
Once my sample was done and I undressed from the waist down, we heard a knock. And the most beautiful sight came from behind the door, it was Crystal and Dr. F! Hallelujah! Dr. F started by asking how I did on Clomid and if I was any less crazy than last cycle. I warned him that I had several questions but he wanted to get to the exam first as he thought that may answer several questions, which it did, of course! This exam was longer than any in the past have been as he was searching for the possible endometrioma. After about three minutes of searching to no avail, he deemed me clear of endo and we moved onto my follicles and lining. On my right ovary, I had a 21mm follicle and on my left, an 18mm and a 25mm! And for more good news, my uterine lining came in at a nice 9mm! Woo hoo! These numbers were so great meaning that the extra days of my crazy pills really paid off. Dr. F explained that the felt the 25mm may fizzle out as it was already very mature, but that was okay as the 21mm was extra promising. Dr. F gave us a few options for when we would trigger and do our IUI, after hearing him out I said, “I don’t care what option we do as long as we have you for our IUI.” He completely understood as I was a little guarded after my last appointment with Dr. X. The only catch was that we would need to travel to the main office as he had several planned surgeries that day and wouldn’t be in our local office. No biggie as I had already warned J that we would go to whichever office he would be at this time. We were given the trigger shot to do that night and anxiously awaited our appointment.
CD12 (Tuesday, October 1): Trigger Shot
This was our third cycle having to do the trigger shot at home. I’ll give you one wild guess of who was too chicken (again) and who had to actually do it! That’s right – J wimped out and took off to the bedroom before I could even think of asking him. This time though, I decided that because I am so proud of myself for overcoming this hurdle, I would record the shot process. Just like always, it was over in a few seconds, and I can promise you, the shot is nowhere near as painful as my face makes it out to be.
CD14 (Thursday, October 3): IUI
For each IUI, we are given two appointment times, one for J and then one for me an hour later. It’s the same whether he collects at home or in the office, this way there is plenty of time for collection and the sperm wash. For this IUI, J’s appointment time was 8:30 am and mine was 9:30. We left the house in what should have been plenty of time, but I didn’t account for rush hour traffic AND two accidents. As we were nearing the 8:30 mark, I called the office to let them know we would be late (always do this if you’re running late)! Of course, it was no big deal as they would just push my time back accordingly. But then I was worried about the 36-hour trigger shot window. After so much traffic, we pulled into the parking garage at exactly 8:56 am. (insert eye-roll here) *By the way – we weren’t speaking to each other at this point!
J was called back a few minutes after we checked-in while I anxiously kept looking at my watch, timing him and counting down the time on my shot. He returned (with a snack), we continued to wait, and then it happened – something that hadn’t happened to us before. A patient came in with her two children. First of all, rude. Second of all, rude. (You may disagree with me but until you sit in the waiting room of a fertility clinic, you don’t know what that guy-punch feels like.) Unlike me, I was anxiously counting down the minutes to be called back just to get out of the waiting room. We heard my name and are greeted by a nurse we’ve never had before – nice as can be but just like for our last IUI, we were asked if we had ever done this before. So I replied “Yep, this is our fifth. I know all the rules.” When I really wanted to ask why she didn’t know this from looking at my chart. Who knows, maybe she was new or was having an off day, either way, I was just glad to be out of the waiting room. I emptied my bladder (as instructed) and before I was undressed, Dr. F knocked on the door. I yelled “Hang on,” wadded up my jeans, tossed them to J and hopped on the table before shouting “Come in!” After Dr. F’s initial “Who is ready to get pregnant today?” question, I asked why knock to come in, it’s not like they aren’t seeing everything anyway. He just laughed as he didn’t have an answer.
He gave us our numbers while dropping the line of “Jeremy, you always have a good sample!” This time we had 55 million sperm post-wash with 55% motility, not our best but not our worst either. Once that was out of the way, I said: “I forgot socks, I’m trash, I’m sorry!” He assured me that he doesn’t notice if his patients are wearing socks or not (I didn’t believe that for one second though). Dr. F reminded me that the IUI would only take as long as it would take for me to scoot down on the table. I guess it’s like a game – let’s see if Dr. F can do this while I’m slightly more comfortable than he needs me to be. Newsflash: I’m always the loser in the game as I’m always being told “Give me just one more big scoot!” One, two, three and we were done. But I knew what was next (in addition to the IUI voodoo), the talk about what our next steps would be if this IUI were to fail. Way to be a buzzkill, Doc! Dr. F also addressed my concerns of if I’m actually ovulating or not with the shot, so he offered to do a post-ovulation scan in eight days so we could be sure. (I wish I would have voiced this concern a long time ago just for peace of mind!)
Once our voodoo was done, we headed home but not comfortably, for me at least. Hands down, this was the crampiest (and crappiest) I have felt after any of our IUIs, which I totally took as a good sign. They were the kind of cramps that every pothole in the road hurt, and they lasted for about two days.
CD19 (Tuesday, October 8): Charlie Horse (or is it Charley?)
OW – I woke up in the middle of the night with a horrible Charlie Horse in my right calf and immediately thought “I’m pregnant! I know this is a pregnancy symptom!” After trying not to wake J, I took to Google to confirm that yes, Charlie Horses are in fact related to pregnancy. Bingo.
CD22 (Friday, October 11): Charlie Horse #2
It happened again, surely this was a good sign especially on the morning of our ultrasound. I just needed to get there so I could ask about this!
CD22 (Friday, October 11): Post-Ovulation Ultrasound
We had an early appointment at 8:15, but I realized I never called to confirm if the appointment would be an ultrasound or bloodwork. In the past, I only had bloodwork done to confirm ovulation (which was negative) but I was almost positive that Dr. F said this would be an ultrasound. Either way, I pumped myself full of water knowing that my veins can be a smidge tricky. I felt like I was going to explode walking into the clinic, so I immediately asked Krissy what kind of appointment this was going to be. An ultrasound – phew! Before we could get comfortable, out came Crystal who kindly told me that she needed my vitals this time, (insert eye roll) so in true Kate fashion I responded with “Look, I know how much I weighed this morning when I woke up. So can I just tell you that and not get on the scale?” She agreed and laughed! All was good except for my blood pressure which was elevated at 158/108. I knew what was coming. She took it again with another cuff. Still high. Okay, three times now or I can’t leave until it comes down. I eventually got down to 139/101. She said she will let that slide but will mention it to Dr. F. I reassured her that this was strictly due to nerves of not knowing what the outcome of this appointment would be.
She requested a urine sample in case Dr. F wanted to run any tests, and this time I beat his knock on the door by already being on the table! He could sense my nerves (or is just used to it by now) and let me know that everything would be fine and we would likely see that I ovulated one of my eggs rather than all three, which was normal. UM NO, everything would only be fine if I did actually ovulate. If I didn’t ovulate though, we would know right then that this IUI didn’t work and wouldn’t get to hold onto the extra few days of hope. (But then it would get me out of taking a test…). He explained what we did and did not want to see. Oh, and one more thing – this was going to be a longer exam. Cool.
Before the exam started, I heard “Kate, you know that’s not enough. One more scoot!” UGH. He started on my right ovary, where I had my 21mm follicle, and drumroll…..it released! We looked closer at that egg and saw debris in the middle, which he was looking for and a thicker white outside circle, all good things! Before moving to my left ovary, he checked my lining which was still a good size, then he showed us the fluid that collected after ovulation (and urine….but how, I had just peed?). Then onto my left ovary, after about a 15-second pause we hear “Well damn. I didn’t expect this!” (This is never something you want to hear your doctor say. Ever.) “You ovulated both of the eggs on your left, Kate. So you hit the jackpot this month and ovulated all three!” Say what?! We examined the two eggs on my left as well, bright white outer circles and debris on the insides. The exam lasted about 10 minutes, although it felt like 30, and for the first time, Dr. F printed my ultrasound photos “for safekeeping”, which he followed by reiterating that it was too early via urine, blood or scan to know if I was pregnant, but a girl can dream right? And as far as the Charlie Horses go, Dr. F explained that my body is producing more progesterone than in the past being that I ovulated three eggs this time. (When an egg releases, your body produces progesterone which is needed to sustain a pregnancy.) So he chalked it up to the extra production, but again, he couldn’t tell me if I was pregnant, although he knew that’s what I was hoping for. Instead, he told us to call with good news on testing day. Easier said than done though.
Now, I know what you’re thinking. The answer is yes, I have Googled “what should an egg look like after ovulation” just for confirmation of the “debris” he explained. And now we wait… and stay off Google!
As always, here are the medications I took this cycle:
– Dose: 150mg/day
– Days: CD3-11
– Side effects: uncontrollable emotions and raging hot flashes
Ovidrel HCG Trigger Shot
– Dose: 250 micrograms – equivalent to 6500iu
– Day: CD14
– Side effects: none