It’s Really Happening – Our First IUI

After 16 long months, the time for our IUI finally arrived. I’m writing this after the fact so I could give the entire process in one post and also because I was too busy researching every old wives tale to help make this first IUI stick. (In the TTC community we use the word “stick” a lot such as “stick baby, stick” or “sticky baby dust” – it’s just another way to say implantation!)

Cycle Day 1 (Thursday, May 23): I woke up with my period and I knew exactly what to do as I had rehearsed this for months, so I called the FIRM.

“Hi, this is Kate one of Dr. F’s patients. I woke up with my period this morning so I’m making my cycle day one call to schedule my baseline ultrasound and my follicle scan but I want to move forward with my HSG this cycle, I talked to Alaina about it last week and I think I should do it even though Dr. F said I could put it off for now but I know it needs to be between two and five days after bleeding stops, so that will be before my follicle scan but I wanted to make sure he can prescribe me something to take beforehand?”

Phew! Krissy at the office is always on the receiving end of my word vomit, but she calmed me down and gave me the good and bad news. Bad: we likely wouldn’t see Dr. F this cycle due to the way the days fell. Good: we would luckily be seeing the other RE that rotates at the local office, Dr. E for this entire cycle.

Here’s how it all unfolded!
CD2 (Friday, May 24): stopped by the office to pick up two Rx, Doxycycline and Valium, both for my hysterosalpingogram (HSG). *I will explain all medications at the end.

CD 3 (Saturday, May 25): Baseline Ultrasound
This was done at the main office due to CD3 falling on a weekend. No biggie, I just had to remain calm for our 1.5-hour drive at 6:30 am. The normal ultrasound prep stuff happens, I give a urine sample, forget to lock the shared bathroom door so another woman walked in! A quick knock and in came Dr. E, it was the first time we met her. We introduce ourselves and the word vomit starts, “I’m really nervous, I don’t know if Dr. F told you but I’m nervous about everything even this and I’ve had an ultrasound before but never when I’ve been on my period and not since he diagnosed me with PCOS!” With a chuckle, she told me not to be nervous and got to work. The US started and immediately she said “Did you know you have a decent size fibroid in your uterine cavity?” Cue the tears because no, I did not know this. The ultrasound itself was quick with good news, everything was “quiet” as it should be. At a baseline, your RE is making sure there are no cysts meaning your ovaries are quiet. We agreed on Dr. F’s treatment plan and were sent home with a prescription to start Letrozole that night.

CD5 (Monday, May 27): MY FIRST HOT FLASH

CD7 (Wednesday, May 29): HSG Day
My HSG was scheduled for 3:00 pm, but I needed to take any OTC pain killer (I chose Ibuprofen) and valium beforehand. The local office doesn’t have the needed equipment for an HSG, so it was performed at a local radiology center. My mother-in-law met us there as we didn’t know how J would handle being with me. (The man is a fainter!) We got called back and J decided he could handle it, so I gave another urine sample but really we KNEW I wasn’t pregnant otherwise I wouldn’t have been going through all of this but whatever, another appointment, another sample. While waiting for Dr. E, I look around the room and see it…..the balloon. I tried not to freak out but I think we all know how that ended. Once Dr. E arrived, she explained everything, including the balloon and that yes, it will be INFLATED. It’s a miracle I didn’t faint right then. I assumed the position and was as ready as I was ever going to be! What happened next is something I pray I never have to go through again. Prior to this, I had never had a catheter, so I felt every bit of it, then came the balloon which is my definition of hell. She explained each step, so I knew the balloon was being inflated but I couldn’t help but think she was making a balloon animal down there! Then I felt her touch my shoulder and ask if I was okay or if I needed to stop (I was very vocal about how much pain I was in – clearly the valium hadn’t kicked in). I knew if I stopped, I was never doing this again, so I just asked her to hurry up! In came the radiologist, Dr. E went back to her perch, released the dye, a couple of photos later and we were told everything looked great! As she left the room, we thanked our nurse and I said “I pray you never go through this.” She replied, “I just became a patient of the FIRM.” My heart broke for her because I knew exactly what she was feeling. We left there happy that this was behind us and that my tubes were open and flushed, which some say leads to higher pregnancy rates right after the tubes are flushed. THEN the valium kicked in…

CD10 (Saturday, June 1): two hot flashes back-to-back, as if June in Florida isn’t hot enough!

CD12 (Monday, June 3): Follicle Scan (Ultrasound)
During a follicle scan, your RE is looking for follicles that are either mature or very close to mature size. The first order of business was another urine sample needed for an OPK which resulted in a faint positive! I had two nearly mature follicles, a 16mm follicle on my left ovary and a 19mm on my right ovary and my uterine lining was 6mm. Based on conversations with Dr. F and research, I knew these were good numbers, which Dr. E confirmed! They like to see a lining 6mm or over and have 1-3 follicles somewhere between 17mm and 20mm. Follicles continue to grow 1-2mm a day, so I knew it was looking good but I wasn’t ready to hear “Okay, we’re going to trigger you now and we’ll see you tomorrow morning at 9:30 in Jacksonville!” I’m sorry, WHAT?! We were ready but not that ready, I needed to be able to stress over this, but there was no time as our nurse, Crystal, quickly returned, she had me pick a butt cheek, pulled the trigger and it was done!

CD13 (Tuesday, June 4): IUI DAY!
Our IUI was at the main office because we used J’s frozen sperm (read why here). We had to be there an hour before my scheduled IUI for J to give permission to thaw his sperm, this was the quickest and longest hour of my life. Then I heard my name, AHHHH, there was no turning back. Much to my surprise, I didn’t need to give a urine sample. Once I got undressed (from the waist down) and was “comfortable”, Dr. E and our nurse came in and she had me review the information on the catheter and needle containing J’s sperm. I would have been just fine not seeing those two things. Here goes nothing! Like always, Dr. E explained everything – speculum in, my cervix was found, cath in (ouch), insemination, speculum out, follow up instructions and lay still for 15 minutes. The IUI took about a minute and is very similar to a pap, however, I was warned it can be tough if the cervix is closed or hard to find.

We check out and started on the list of old wives tales. First up: McDonald’s fries because the amount of salt in their fries specifically is said to help with implantation. (Like I needed a scientific reason to eat fries!) Before that though, we made a detour to the hospital gift shop (the main office is in a large hospital in downtown Jacksonville) and we stumbled upon the most perfect picture frame that we had to have (shown below)! The rest of the day was filled with laying on the couch, a nap and cramps.

Now what? Wait. For 14 long days. And I was to “act like I was pregnant”. For 14 long days. And do not, for the love of God, take a pregnancy test before 14 days. (explanation below.) Two Week Wait is one giant mind game where it felt like I was in timeout! We went from seeing Dr. E, and our nurses, four times in 10 days to not seeing or talking to any of them for at least two whole weeks. Didn’t they know we all became friends and I needed them? Plus, I knew I would have plenty of questions on how to “act pregnant”. This didn’t mean to rub my stomach, take weekly photos and plan a nursery but to avoid food, drinks and strenuous activity that pregnant women do. Dr. E reminded us that most pregnancies aren’t known of right away, so I shouldn’t stress over every crumb or move, but too late, I overthought everything. Lastly, I needed to check off every old wive’s tale. Next up, after McDonald’s fries, was pineapple core! WHOA, that is not easy to get down but I managed because science shows that the bromelain found in the core of pineapple helps with implantation.

So, there you have it. Our first IUI, as you may know, was a failure. (Read more about that here.) Below is the list of this cycle’s medications, in addition to my normal prescription and supplements (I’m working on that post now).
Letrozole (also known as Femara)
– Dose: 5mg/day
– Days: CD3-8
– Purpose: To induce ovulation by suppressing estrogen and causing an increase in FSH, stimulating follicles to reach maturity causing ovulation (also a breast cancer chemotherapy drug).
– Side effects: hot flashes and food cravings
– Note: I started on the middle dose to see how I would respond. You’ll hear of women taking smaller doses, typically 2.5mg CD5-9, which from my experience, means they are being treated by an OBGYN and not an RE. (I’ve said it once, I’ll say it again – OBGYN’s and RE’s are not the same.)
– Dose: 100mg/twice a day
– Days: CD5-9
– Purpose: to prevent a bacterial infection from my HSG. Hello, foreign objects where they don’t belong!
– Dose: 10mg
– Day: CD7
– Purpose: to calm me down for my HSG but in reality, to give me one of my top five naps ever.
Novarel Trigger Shot
– Dose: 5000iu
– Day: CD12
– Purpose: to stimulate ovulation, plain and simple
– Side effects: bruising, swelling and pain at the injection site
– Note: Novarel is HCG, the pregnancy hormone, meaning if I were to take an HPT, I would receive a positive result. A lot of women “test out” their trigger shot so they know towards the end of their TWW that a positive is a true positive. Depending on the dose of a trigger shot, a false positive can still show up to 14 days after the shot.