Third Times a Charm? – IUI #3

Going into this third IUI was so refreshing that I felt like I was having an out of body experience watching someone else be so calm, and so connected to the infertility process. I was excited with our first round but I had so much anxiousness that it wouldn’t work, the second time I felt more bitter than anything, but this time, I was just calm and accepting of whatever the result would be.

I let go of this fear that my biological clock is ticking. My concentration on that was all consuming and it was just leaving me more and more anxious. If we are paying this much and struggling with conceiving baby number one, how much more time and money will it take for baby number two or maybe number three? I let go of this subtle doubt I had, what if these IUI’s actually work? Will my egg quality be good in two years when we try again for a second? Am I best to hold out for IVF so I have a chance to possibly freeze some embryos and preserve my 45 year old eggs before they become eggs of a 50 year old women. I let go of concentrating on my biological age and instead focusing on my chronological age. I’m young, I’m 26 years old. Other than infertility, I’m healthy. I let go of all the fear and doubt I was having and just focused on being grateful for where I was and for this opportunity to become pregnant. Instead of asking why is this happening to me? I asked myself what is this trying to tell me?

I stayed focused on the thought that every failed IUI cycle, every failed attempt at natural conception, every injection, every single penny spent, is just bringing us that much closer to our future baby.

But as usual, this IUI cycle did bring forth some delays. But anyone with infertility understands this – there is ALWAYS another delay and anything hardly goes as planned. We had planned to start my estrogen patches at the end of October, before I got my next period following our negative of IUI #2. Robbie had just left for a 3 month long course in Montreal and of course the clinic doesn’t do sperm freezing on the weekends. Since the course was Monday-Friday, Robbie couldn’t get time off to drive to Ottawa for the sperm freeze.

Originally we thought we would have to wait until January to do our third IUI (which obviously didn’t settle well with me because I simply was tired of waiting), I was able to get Robbie in for his “donation” on Remembrance Day Monday. So the only delay this IUI cycle was by a month, which came as a huge relief.

I was able to start my estrogen patches on November 25 and my weepy personality carried on but wasn’t quite as severe as the last time. My patches did leave me with quite the headache but luckily that went away after I took my last patch off.

I got my period, called to report my day 1, and started my gonal-f injections on December 1. I received a new protocol where I would do alternating doses on gonal-f, one day 62.5 units, and the following day 75. I had my first ultrasound on CD5 (cycle day 5) and ended up with 25 follicles (11 on the right – only one measurable at 11.5 mm and 14 on the left with one measuring in at 9.5 mm). I was happy, my body is at least capable of producing follicles, a small task accomplished although it was all in part to the hormonal injections.

I continued with my alternating doses, and had my next ultrasound on Friday morning (CD7 – ultrasounds are done every other day for monitoring purposes). My follicle count dropped down to 12 on my left side (two follicles were now measuring in at 10 mm and 9.5 mm). My “maybe baby” that was previously measuring in at 11.5 mm was now 16 mm, just 1 mm over the baseline of where they wanted to see it. I started cetrotide (the injection to stop me from ovulating) after my Friday ultrasound just so we could grow that one follicle a little bit more without worrying that my body would ovulate knowing it was “technically” ready.

I came in again on CD9 for my last ultrasound. My “maybe baby” was looking good at 17 mm. My right ovary had also produced a 14.3 mm and 9 mm follicle, and my left ovary had 3 measurable, all around the 10 mm ball point. After my ultrasound, I had my consultation with the nurse to go over my ultrasound results (they do this after after every ultrasound as a protocol) and my nurse was looking over my past two IUI’s and said “your body is a little unpredictable with how it produces follicles, isn’t it?”

My follicle count dropped quite drastically this time, leaving me with only 4 on the right and 8 on the left. The ultrasound tech told me this was quite normal as our bodies tend to naturally be quite wasteful with our eggs. Your body naturally starts to cater more towards the larger follicles and lets the smaller ones drop off, as if it knows which follicles have the most potential and which follicles need the most energy to grow. My endometrium (uterine) lining was measured at 8.3 mm which was a relief to know one more thing was lined up for success (ideally a lining over 7 mm is ideal for implantation).

Monday evening I took my ovidrel injection at 10 pm (this is the injection that triggers you to ovulate) and patiently waited for Wednesday, so hopeful and eternally optimistic again that this would work.

Tuesday morning I received a call from the clinic nurse asking me which batch of sperm I wanted to use. I remember saying “what do you mean which batch should we use?” I was so confused, we had already used Robbie’s frozen sample from September, so that meant we only had his November freeze left, right? Wrong.

Essentially when Robbie did his first freeze in September, we thought we didn’t have any sperm left. Hence why we delayed the extra month, paid an additional $750 for yet another sperm freeze (that doesn’t even include the $850 we still had to pay for the sperm wash) that we apparently didn’t even need. Turns out we had 8 test tubes of sperm from the September freeze (we had 10 but IUI number two used 2 viles) and now we had 11 additional viles from the second freeze. An IUI uses 2-3 viles, and a cycle of IVF only needs 1 vile. WHAT EVER DO I NEED 19 VILES OF SPERM FOR?

I was so calm up to this point in our IUI cycle and I was determined to not let anything ruin that now. I vented to Robbie, my Mom and sisters about my frustration about having to pay the extra $750 for nothing because no one could be bothered to call or tell me that I still had 8 viles at the clinic when I called to make the second appointment. I tried to fight back to get a refund on the $750 but “apparently” my Doctor had called Robbie and left a message, but he never received anything. I decided to stop trying to get a refund on that because it was a battle I wasn’t going to win and honestly, at this point, the last thing I needed was this stress when I was completing this IUI alone.

Under direction of the nurse (since both samples were very similar in terms of numbers) we decided to use the first sample again, just so that in a years time we would toss the first sample and keep the second freeze. This way we would only have to pay $500 for a yearly storage fee, instead of $1,000 and then we would still have 11 viles in storage.

Wednesday morning came around, and brought us to our insemination day. I was so calm, so patient, so hopeful that today was going to be the day that this worked.

Third time is the charm, right?

I had a viable follicle, and a possibility of another follicle being mature (I’m not opposed to having twins so the possibility was exciting). My lining was great, I felt good, not only physically but mentally as well. I can’t explain it any other way than I just felt ready.

As per last cycle, our sperm count wasn’t great but I didn’t let it affect my mood this time. Our washed sample (aka ready-to-inseminate-me sample), was only 3 million count and 65% motility. The pre-washed sample was 41 million but only 12 million of those sperm were motile (moving), and the motility was 39%, which was less than sub par. I was hoping for better but I remained content, already having fixated in my mind that the numbers wouldn’t be great so that I wasn’t stressed out when I got them just moments before the IUI.

Thankfully I didn’t find this out until after (as I probably would have had a hard time staying so positive), but Robbie’s sperm sample had immotile sperm aggultination present. This is an immune response that when sperm is exposed to certain conditions that disrupt the sperm, it leads to the formation of antisperm antibodies. Essentially these antibodies have a cytoxic effect on the sperm and causes cell death and immobilization of sperm cells. In summary, his body created these antibodies that were killing off his own sperm AND immobilizing them.

The IUI procedure itself went well. Just as simple and quick as the previous two insemination’s. The Nurse and I talked about our dogs, and I showed her pictures of Buck and Hemingway and she showed me pictures of her beagle. All in all, just your typical possible conception conversation while being inseminated with your husbands goods by a stranger.

I laid there afterwards alone for 15 minutes, thinking again we are worthy, we are fertile. Over and over again, a saying that I feel is etched into my soul.

If I am being honest with you, the first week after our IUI I really thought that I could possibly be pregnant. I didn’t feel that way the previous two cycles so I thought maybe this is it? 6 days after insemination day, I started cramping which was something that didn’t happen in the previous cycles. I kept thinking, this would be around the time implantation cramping would start. I was so hopeful at the new sign but also knew the reality of our situation and other than the cramping, I didn’t feel anything. For a whole two days, I was open to the possibility that my luck had changed and this could be it.

After the two days though, I was still so hopeful that we would have success in the future but my heart was telling me that this wasn’t it. Our blood work results were scheduled for December 29, but despite swearing that I would never take another pregnancy test (it just becomes so upsetting seeing negative after negative) we decided that on Christmas Eve we would take a test. If there was the tiniest chance it was positive, we wanted to go Christmas Day knowing that our greatest gift of the year would be this baby. We took the test, and sadly, it was negative. Our blood work on the 29th confirmed it.

Although it was negative, it was the first time seeing only one line where I didn’t feel like my life was spiraling out of control. Naturally we were hoping it was going to work, but it didn’t break my heart into a million pieces either. There was this moment of peace, where we acknowledged this failure but I knew that together Robbie and I, we were going to be okay.

And just like that we did our three IUI’s and now we were maxed out. Our next step is waiting for our name to come up on the funded IVF wait list. At this point we on the wait list for 9 months and we were estimated roughly 12 – 16 months on the wait list. By the time we get the call and get all the pre-testing done, we mentally prepared ourselves for a transfer come the end of summer of 2019. In the mean time, we would just enjoy the break from all the injections, all the driving to Ottawa, and all the money spent.

For a little while, it would be nice to have our life back. So much gets postponed and put on hold when you are actively pursing fertility treatments, that you almost forget how to live in the day to day actions.

We are parents in the making, and this journey is long but it is our journey and we are making it worthwhile.

Fall in love with your journey, value what your journey has taught you and learn to embrace yourself in aspects of your life you are struggling to accept.

Rebecca

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