IUI #2 in Omaha

Finally a few weeks later our round of birth control to regain our baseline was complete, the cysts had gone away and we were excited and ready to try another IUI.

June 12, 2013: Baseline ultrasound (Cycle day 1)
June 13-18: Injection 150iu Follistim
June 18: Ultrasound- Largest follicle 11mm
June 18-21: Injection 150iu Follistim
June 21: Ultrasound (8 Mature Follicles at 17mm) HOLY SMOKES!!
June 21: Trigger shot
June 23: IUI #2

http://www.montereybayivf.com/infertility-services/ivf-process/injections-of-follistim/

The large number of mature follicles we had was all because of my diagnosis of PCOS.  The normal woman with non PCOS would not respond with this many follicles.  This was good but it was also bad, we ran the risk of multiples, and a possibility of extreme multiples.  This scared us but we knew our chances were fairly small of all of them taking, or so we hoped.  We started the same progesterone vaginal suppositories as the last IUI cycle.

On July 7th I yet again woke up early, quietly I took the test then while waiting for the results, I brought the test into the room that we had always planned on being the nursery.  I sat there, I prayed and hoped even more, thinking we had 8 mature follicles one of them had to of been cracked into and made into a baby... When I looked down at the test the wicked eye game began.  I sat there and although in my heart of hearts I knew it was just one line, my eyes wanted to see two lines.  I swore to myself that I saw the faintest second line, that it was there.  There was hope for a little baby growing inside.  I had us get up and make it to the Omaha office by 7AM for the beta hcg (pregnancy hormone), that would be a blood test that is official.

I was hoping that my double vision was even just slightly correct.  I didn't want to stop my progesterone and medication until I was 100% positive there was no baby, knowing that if I stopped my medications I would lose a baby if we happened to be pregnant.  Sadly that afternoon I got a call from the office that I was NOT pregnant.  No baby.  Still barren.

Cost for IUI#2 in Omaha: Ultrasounds $221, Medications $918, Lab $43, IUI $300 (These costs are out of pocket after deductible)

IUI #1 in Omaha

April 16th, 2013 we had our "baseline" ultrasound,  this was always a ultrasound at the start of my cycle usually day 1 or 2.  This would tell us how my ovaries look prior to any stimulation.  The medication that we were started on to help grow my follicles was an injection called Follistim... Here is the following schedule we did...

April 17-21: Injections 75iu Follistim

April 22: Ultrasound

April 22-24: Injections 100iu Follistim

April 25: Ultrasound (cycle day 11)

April 25-27: Injection 150iu Follistim

April 28: Ultrasound (3 follicles measuring 15mm- wooohoo!!)

April 28: Injection 225iu Follistim & Bravelle 150 Injection

April 29: Trigger Shot

May 1: IUI #1

Towards the end of stimulation we wanted to make sure that the 3 follicles that were getting close to mature size pushed into the mature 18mm size, so we added one more medication called Bravelle.  On the 29th when we were ready to release the mature eggs from the follicles we did another injection called a "Trigger Shot" this does exactly what it sounds like it releases my mature eggs and they start their decent down the fallopian tubes.  Since there is a bit of a distance that the mature eggs have to go we release about 12 hours prior to our IUI.  We then arrive and perform the IUI procedure with the "washed" sperm and lay there after the procedure for 15 minutes to allow things to settle.

http://www.sandiegofertilityspecialist.com/fertility-services/iui-intrauterine-insemination/

After this point we head on our merry way and then we start the fun (but not so fun 2 week wait).  During this time we started vaginal suppositories of progesterone.  Progesterone is a hormone which helps to sustain pregnancy.  Progesterone is vital to a healthy long pregnancy and not all women can produce sufficient amounts of progesterone during pregnancy.  This is where hormone supplements come into play.  In many reproductive cases they add in progesterone just to assist and even prior to knowing if there is a production problem. 

On May 15th we took our pregnancy test.  I remember waking up before Derrick was up, I was so excited to test, so excited to deliver the good news.  I snuck into the guest bathroom and followed the instructions, while I sat there and waited the two long minutes, I hoped, I prayed.  Then just to see one line, one stupid stupid line.  Back to the drawing board....

A few days later I was feeling pretty uncomfortable, I was full and puffy.  Due to the stimulation's I had grown many follicles although with the trigger shot we released the mature follicles there were still other medium sized follicles that had continued to grow into large cysts.  I had another ultrasound on May 18, 2013 to find many cysts, the solution for this was to start a round of birth control pills that would help to return my hormones to baseline, along with my ovaries, as a sort of 'restart'.  Although I didn't want to sit out a cycle in between I knew due to the cysts that I would feel better getting those resolved before starting again. 

Costs for IUI#1 in Omaha: Ultrasounds $295, Medications $695, Labs $64, IUI $300 (these costs were our of pocket costs after deductible was met)

Gearing up for IUI in Omaha

On March 13, 2013 we went to Omaha for a SHG (Sonohysterogram).  During this procedure they place a small catheter past my cervix into my uterus and inject a small amount of saline.  During which time they are watching through ultrasound to see if my fallopian tubes are open and if there are any blockages that they could see along with a few malformations of the uterine lining.  Thankfully we had the all clear from the SHG that my tubes were open, my uterus was clear.

During this same time we did another sperm analysis on Derrick to see on their testing if anything had changed that might inhibit our fertility process.  At this point Dr. Maud was willing to try IUI with us for a few rounds, hopeful that injection stimulation would be what we needed to have a successful conception.

For those who are unaware of the IUI process here is the short over view of how IUI works.  During IUI (Intrauterine Insemination) the sperm which has previously been collect is "spun down" and the best sperm are drawn up into a small catheter.  Then while in stirrups the small catheter is placed past the cervix into the uterus and deposited.  Some women can do a natural cycle with out stimulation (medications) of their ovaries to produce mature follicles/eggs, however with some such as myself we would need the assistance to grow the mature follicles and then help to release the mature follicle when we were ready.

IUI is often a good starting point and less invasive.  Although still pricey it tends to be a cheaper option compared to IVF.  Our actual procedure for IUI was $300, with usually 3-4 ultrasounds during the 2 weeks leading up to the IUI date to monitor growing follicle size.  Each ultrasound ranged from $125-$200. Thankfully our insurance helps to cover portions of our fertility journey.  Our plan would help to cover 50% after deductible of ultrasounds/medications/lab work.  However, insurance would not cover any actual IUI/IVF procedure. We were thankful to have at least a little bit of help when it came to the medical bills that were starting to add up quickly.

We were excited, we were hopeful that this IUI with injection stimulation would be what we needed.

IUI attempts in Lincoln

After trying to conceive naturally wasn't resulting in two pink lines, our OB suggested we try a common medication called Clomid.  We started in January 2013 and would take progesterone for 10 days to start my cycle then day 5-9 would take Clomid 50mg pill every day, after going in for two ultrasounds we found that none of my follicles were large enough to do anything with. So we stopped and cancelled this cycle.

The average woman in an average cycle will produce 1-2 mature follicles/eggs that are 18-30mm in diameter.  Although PCOS women have many follicles they are usually are very immature and even if they are released would not be large enough to be inseminated.

Knowing that I didn't respond well to the 50mg of Clomid we tried another round of Clomid in February this time bumping it up to 100-150mg.  Sadly, after two ultrasounds to measure my growing follicles, the largest one we had was 13mm, not big enough to do anything with.  We sat down with Dr. Friesen our wonderful OB that said he thought we might be to the point of needing injections to help stimulate my ovaries into producing mature follicles.  His hunch at that time was that we were going to need to do Invitro Fertilization (IVF) which at that point I was completely against and was hoping and praying we wouldn't have to go that far.  Not that IVF is against my beliefs, religion or I wouldn't do it, it just sounded so scary.  It sounded so expensive and it sounded so final.

Dr. Friesen encouraged us to make an appointment with a Reproductive Endocrinologist (RE) who is a specialist of conceiving one could say.  Thankfully a co-worker of mine had encouraged me a few weeks earlier to contact and get on the long schedule for a primary appointment with Dr. Maud Doherty a RE at Methodist Women's Hospital in Omaha.  After we had Dr. Friesen's blessing to go to Omaha we called weekly to see if there were any canceled appointments that we could snag so that we could get in and start the process earlier.  Much to our surprise we were able to get our first appointment with Dr. Maud on February 20, 2013.