IUI#3

I don’t know what to say about IUI#3 except that in hindsight, it was a mistake. I don’t regret it because I know that based on all of the information I had at the time; I would have made the same decision again. IUI#3 was 6 weeks from my fibroid surgery and even though I thought going in that I was ready to cycle again. I wasn’t. For the first time ever, the IUI hurt and I had cramping and spotting after it. I went home and just laid in bed for a few hours afterwards. I had cramping on and off almost the entire 2ww. Beta number one came in at .16. Beta number two was .15. When I had my consult with my doctor after IUI#3 and in preparation for IVF#1, he asked if I wanted to talk about it. I said “no” and we left it at that. What was there to say? I pressured my doctor into letting me cycle at 6 weeks instead of a full 8 weeks or two months and I shouldn’t have. It was a mistake.

Here is a very long email that I posted to the SMC-TTC list that explain some of my thoughts around IUI#3

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I am having a very difficult time making a decision about what to do
with my next cycle. My dr. is recommending an inj IUI cycle with 1 amp of Gonal F for 7 days (which gives me a 20% chance of success), but said he would also be comfortable with another clomid cycle (which gives me a 10 - 15% chance of success), or a natural a cycle (at 5%), or even move to IVF (50%). In many ways, the move to IVF is appealing because it will give me a better feel for the quality of my eggs. However, I have ruled out the natural or IVF cycle at this point and decided to give another go round of IUI (at least today). If I knew my eggs were crap (or should I say are in line with the statistic that at age 38, 75% of all eggs are not chromosomally viable), I would have no problem moving to the Gonal F. I have no fear of shots or pouring extra, fake hormones into my body. But, because Gonal F causes more eggs to be produced and released (thus increasing the chances of success) and if I have good or better than average egg quality, it is also more likely to cause multiples. I don't have the percent for twins, but was quoted 5% chance of triplets (compared to 1% for clomid). The problem is that statistics are just that statistics. Someone has to fall into the 95% and someone has to fall into the 5%.

The good news is that I have tried twice and believe that I have conceived twice one unconfirmed, one confirmed). However, this is the reason I am having such a difficult time with this decision. I am concerned about multiples. I could live with twins, but it would be difficult and it is not my first choice as a single mom. Does the fact that I can seemingly conceive give more or less credence to the loss(es) being chromosomal in nature and/or increase my odds of multiples? I think I am asking a question that can't be answered.

Assuming scar tissue doesn't become an issue, I have rule out the last potential environmental issue with my myomectomy earlier in the month. I have had one immunity test (natural killer cell) that came back in range and have blood drawn tomorrow for the blood clotting immunity issue. I have decided that if the blood clot immunity test comes back out of range (which is unlikely), I will go with a clomid cycle with 2 potential factors, fibroids and immunity, either likely to have caused the loss resolved). However, if it comes back in range, I really don't know what to do. ince I started this ttc path, I have always been so sure and the decisions have been relatively easy. I just "knew" I was on the right path. Everything felt "right" and I have been at peace with all of my decisions. The problem here is that I just don't like any of my current choices and none (so far) leaves me at peace.

Some other considerations are as follows: 1) my insurance only covers 3 IUI's (and the next one is #3) at an 80/20 arraignment. After that, I either need to move to IVF (for my 1 covered IVF cycle) or pay 100% out of pocket which would about equal the amount of my co-payment for an IVF cycle). This is a big part of the pressure I am feeling for this to "work", but not work too well; 2) after try #1, we found out that even with clomid I have a luteal phase defect and my progesterone was too low to sustain a preg. 3) my day 3 FSH was 6.5 and estradiol was 31 when tested in March 2004.

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Ultimately, I decided to do an injectable IUI with 2 amps of Repronex/Pergonal. I was glad that I had done an injectable cycle before moving to IVF because it made it a lot less stressful since I had already mix vials and injected shots, etc.

I started out with 5 follicles on cd9, which reduced to 3 at the next ultrasound, which reduced to 2 at the time of the IUI. I guess that was the first sign that I would have a lead dominate follicle issue, but the Lupron was supposed to take care of that.

It is funny in hindsight that I was worried about the cycle working “too well”. Oh well, you live and you learn.

I’m not sure what I would have done if my doctor didn’t let me do an IUI in September. Probably, I would have gone for IVF in October. But, maybe not. Maybe I would have chickened out at the last minute and just done the injectable IUI then.

IUI#3. Probably, the biggest mistake of my ttc journey.