It has occurred to me recently that while I am fully fluent in all things infertility, the majority of you aren’t (and trust me, that is SO ok….). As we are approaching IUI #3, I thought I would take a moment and actually explain what a full IUI cycle looks like for us.
As some of you may know, every cycle starts with a period making the first day of my period cycle day 1 or, CD1. On or around CD3, I go for a baseline ultrasound and blood work. I have a full bladder ultrasound as well as a transvaginal ultrasound. These ultrasounds take place at a clinic about 5 minutes from our house on a first come first served basis between 7:00 a.m. and 8:30 a.m. I have arrived at the ultrasound clinic as early as 6:20 a.m. so when those doors open at 7:00 a.m. I am somewhere in the top 3 in line to get in and out. After the ultrasounds are done, I then head to Procrea (our fertility clinic) for my CD3 blood work. From there, we wait for the nurses instructions but it usually includes me starting my injectable medications that night.
So far my protocol has involved 3 injections: Menopur, Orgalutran and Ovidrel (I will explain each as they come up). From CD3 usually until about CD13 I take a daily injection of 75 units of Menopur. I think I’ve explained before that Menopur “contains follicle stimulating hormone and luteinizing hormone activity. These hormones stimulate healthy ovaries to make eggs”. In other words, Menopur helps my follicles grow. Around CD6 I will have another ultrasound to see how my follicles are developing. For example during our first IUI cycle I only had one follicle on each side and only one actually grew large enough that we triggered (at about 1.7 cm). During our second cycle I had 3 follicles but, again, only one made it to 2 cm and we triggered. Our doctor will not let you trigger if you have 3 or more mature follicles due to risk of multiples and I’m okay with that. So around CD10 or 11 I start another injection called Orgalutran. Basically that stops me from being able to ovulate on my own (since I actually do ovulate on my own). They do not want me to ovulate until I have at least one mature follicle (being anywhere from 1.7 to 2 cm). So from that point until I trigger, I am taking two injections each night (Menopur+Orgalutran). From around CD11 on I never know how often I’ll be monitored as it all depends on my follicle(s) growth. Once I reach the point that my follicle is ready and it’s go time, I stop the Menopur and Orgalutran and take my final injection – Ovidrel. Once I have taken that injection, I will ovulate within 36 hours and that is when we schedule my insemination. So far, Shawn has not had to provide a sample on insemination day as we have been working with the sperm we froze before our Thailand adventure. That is about to change. FINALLY after 6 long months, Shawn is deemed Zika free (not that he had it in the first place but that is how long a male has to wait after returning from a Zika country). This month we will use a fresh sample for the first time.
After the insemination, life carries on like normal. The next morning after the procedure I start taking progesterone twice a day and that’s a whole other can of worms that I can get in to if you have questions but it’s probably my least favourite part of all of the steps of this. I think I’ve mastered it now and while I can’t control the side effects, it’s seemingly more pleasant than when I first started.
We then wait about 12 days after the IUI to have our pregnancy test and so far, both have been negative. This will be our last IUI before IVF and if we get to that stage, it will be a whole new protocol with many more steps and a completely different injection list. So for now, this is what we go through on a monthly basis to bring us that much closer to our babe. It’s exhausting (emotionally and physically) but there isn’t a single thing about the process I would change except maybe getting a positive on our next pregnancy test.