Tuesday, December 4, 2007

IUI Day (CD16)

Today was IUI day. Scott left super-early for an appointment at work, followed by his appointment at the RE's office. He called me at 9:15 to let me know that his "deposit" seemed to be a good one (in terms of volume, at least).

I got to the RE around 11:30AM. The nurse called me back to the exam room pretty quickly. I told her that I was going to use the bathroom, but she suggested that I should keep a full bladder because "it sometimes makes the procedure easier."

She returned a few minutes later holding a long catheter which appeared to be resealed in its original plastic packaging. Our names were on the outside, and the nurse said that she had made sure that it was S's sample being pulled up into that catheter.

I was kinda nervous, so I was flipping through a random magazine..."Country Living" or something like that. Dr. A came about 5 minutes later. He's the one that I just met last Friday, at the time of my CD12 ultrasound. At that visit, he was very upbeat and I liked him a lot. Today, he was a lot more hurried. When he entered the room, I started babbling about my concern that I had felt my ovary aching all weekend, but that the aching feeling was completely gone as of Monday morning, before my LH surge. Thus, I wondered if I already ovulated more than 24 hours earlier. Rather than addressing this concern, he said something like, "Well, let's do this insemination now," and got busy with the speculum, etc. I think after it was all over with he sort of tried to smooth it over by saying, "You may feel things all the time, but you can't really know what is happening in the ovaries."

Anyway, the post-wash total motile sperm count was 11 million. Decent enough, I suppose, considering our MFI issues. Dr A said that he likes to see at least 5 million. On most of the websites that I have found, the goal is more than 10 million. So, I am satisfied.

Anyway, the insemination itself felt like something worse than a Pap smear, but better than the HSG. It was maybe about the same as a Pap smear with cervical polyp removal.** Dr A had some difficulty inserting the catheter into my cervix. He said that my cervix was open, but that the angle made it difficult to insert the catheter. At one point, the nurse tried to help by placing the ultrasound probe over my bladder, but they couldn't seem to see much and it didn't seem to help.

However, just about a minute or two later, he suddently said, "Think happy thoughts!" without explaining himself further. Well, I tried to relax and waited about 30 seconds, and then I said, "Does that mean that you got in and were doing the insemination, or that you were still trying to get the catheter in?" He confirmed that the insemination was now complete. I said something like, "Well, not exactly how I thought I'd get pregnant, but I hope it works!"

I was told to wait there for about 10 minutes. I tried to stretch it out to more like 15 minutes, but I got bored after about 12 minutes. I read the magazine cover-to-cover, and then I tried to relax a bit.

Next, I went out to the main area and the nurse gave me a one-time dose of doxycyline. She also wanted me to schedule a pregnancy test (beta-HCG) for 12/20. I went ahead and did that, but told her that I obviously will cancel the appointment if my period starts before that. In reality, I'm going to take a $1 home pregnancy test, and if it's negative there is no way that I am going to come in and pay $50 for a beta-HCG to tell me that.

I then asked the nurse about whether Prometrium (vaginal progesterone capsules) would be recommended. When we initially discussed treatment with Dr G on 10/18, he had mentioned that I would be taking Prometrium after my Clomid/IUI. I remember being surprised at the time because I am Woman of Long Luteal Phase (always 14-16 days) and my post-O temps tend to be great. The fact that Dr A didn't mention it tells me that perhaps Dr G and Dr A have some differences in their practice style. I would think that if anyone could skip Prometrium, it would be me.

So, the nurse asked Dr A about it and he apparently said that yes, they do want me to take the vaginal progesterone. However, they do not want me to use standard Prometrium, but rather they want me to buy "their special own brand of micronized vaginal progesterone". This is available only in the pharmacy downstairs in the building, and costs around $80. Somehow, this entire thing seems fishy to me. I think that Prometrium is just fine, and in reality I don't think I need either one. I don't like the fact that my temperature curves will be essentially meaningless on vaginal progesterone. On the other hand, I suppose it can't really hurt anything but my wallet, so I'll probably go ahead and do it. I'm thinking about it overnight, because I don't have to start until Wednesday anyway.

Anyway, I'm happy that it is over. Now it's time for the dreaded Two Week Wait. I usually do pretty well for the first week, but start getting really excited and nervous around 8DPO or so...


** I had a small, recurrent cervical polyp that had to be removed on several occasions before it finally went away. The procedure itself is the same as a Pap smear (speculum exam), except that they then the grab the polyp with a long forceps and twist it 'til it breaks off at the base. Next, they general cauterize the base with silver nitrate. This thing first showed up as an asymptomatic finding on annual exam when I was about 25, and had to be removed about 3-4 times, up through the age of 30. It has been gone now for several years, and the doctors whom I have spoken with think that it will not impact my fertility.


Cindy Nguyen said...

I'm glad that the Dr. got it done. Did you have any cramping afterwards? I had some cramping over next few days but could not find any research on this. And what I found said that it was probably O pain.

Did they give you post wash count?

I think its fishy how it seems they are trying to "upsell" you on their cream. I would google it and see if there is the generic you can get.

Why would you go in for a Beta if AF comes and your hpt is negative? I so agree with you!

I'm really excited for you. Go spermies go!!! Someone has to get lucky on IUI #1 and it might as well be us. :)

alison said...

Welcome to the 2ww, I'll be glad to join you. :) Here's to lots of crossed fingers for a BFP!

Lauren said...

Thanks for sharing your IUI experience. My doctor has mentioned that as a possibility for me, and it's good to hear how it went for you. Good luck with the 2 week wait!

sarah23 said...

OH yeah!!! I can't believe that I forgot to put the post-wash count into by entry. I will edit it and add the info.

Anyway, the post-wash count was 11 million. Decent enough, I suppose, considering our MFI issues. Dr A said that he likes to see at least 5 million. On most of the websites that I have found, the goal is more than 10 million. So, I am pretty happy.

I did not have any cramping, but my temp dipped today, so I wonder if I am O'ing today. If so, I sure hope those spermies are still alive. (We also did another au natural attempt night, too...hee hee).

Thank you all for the good wishes!

JJ said...

Fingers, toes crossed for you!

Meghan said...

Glad it went relatively smoothly. They had a hard time with my cervix too...my dr said it was being stubborn.

Definitely check on the progesterone, that was one of the only meds covered by my insurance, there is no need for it to be that expensive. Do they know you're paying out of pocket??

Good luck with the 2ww

sarah23 said...

Unfortunately, I already paid for the progesterone. I'm 99.999% sure that my insurance wouldn't have paid for it. They will not pay for "anything related to the diagnosis or treatment of infertility." Grrrrrr!! Of course, if I were to be so lucky to get pg, I would feel like it was a BARGAIN. (Compared to the horrible expense of out-of-pocket IVF).

Lauren said...

This is totally off subject, but just wanted to tell you that I read through your archives and discovered that we have the same anniversary! M and I were married on October 1, 2005.