Getting to IVF

I would like to first say that Mike and I are among the very fortunate few whose insurance actually covers fertility treatment.  I didn’t realize until we started going through all of this how lucky we are and my heart goes out to anyone who is paying out of pocket for their treatment/meds because I know we wouldn’t be able to afford this if it weren’t for our insurance.

One of the requirements that our insurance has is that we have to start with the least invasive options first (Intrauterine Insemination, IUI) before we could move on to more invasive options (In Vitro Fertilization, IVF). 

Simply put, IUI involves monitoring and timing your ovulation. Once you ovulate, the doctor will inject your partner's sperm into your uterus through a catheter. Even on a good day the odds of success for this procedure is only 20% which is pretty similar to the odds that an average couple will conceive on any given month. This procedure is usually helpful for couples that have an issue in getting the sperm to meet the egg. 

In IVF, a women is put on various medications that are injected into the stomach to stimulate follicle growth in the hopes of developing multiple eggs. Once the follicles get to a mature size indicating mature eggs that are ready to be fertilized, the woman undergoes surgery to remove the eggs. The eggs are then fertilized in a laboratory using the partner's sperm. After several days of growing and dividing (usually 3-5 days) the best embryos are then placed back into the woman's uterus where they will hopefully implant into the uterine wall and become a baby! 

For our first IUI Dr. Lee put me on a low dose of Clomid for 5 days. Clomid is an oral fertility medication that is used to stimulate follicle growth. However, in the end I still only produced one good follicle. Never the less, I was still really hopeful that one was all it would take. But on the day of the IUI we got some bad news – Mike’s sample came back with a large amount of the sperm not viable. Dr. Lee said that we may as well continue with the IUI but between me only having 1 follicle and Mike’s bad sample that he thought we only had approximately a 10% chance of it working. I remember lying on the table crying because I felt so crushed! Mike sat next to me and held my hand the entire time and just kept telling me that it was only our first try, and that it would happen. I was surprised at how fast the dreaded 2 week wait went by (This is the amount of time you have to wait before taking a pregnancy test). Even though I kept telling myself not to get my hopes up, I did. I started imagining tons of pregnancy symptoms… When I did finally get my period, I was crushed all over again.

For our second IUI Dr. Lee decided to put me on a higher dose of Clomid and Menopur injections. He was hoping for multiple follicles to develop to combat Mike’s low sperm count. My body reacted too-well to the medications because I ended up developing 16 follicles! At that point I had actually gained about 5 pounds and was feeling so bloated and extremely crampy. Dr. Lee was concerned that if we went ahead with the IUI I might develop Ovarian Hyper Stimulation Syndrome once we took the trigger shot, not to mention the possibility of becoming the next octomom with having that many egs! OHSS is something that can occur when you have too many follicles. Basically your ovaries swell in size because they are so full. In a mild case this swelling can cause discomfort and bloating. At it's worst, it can cause extreme abdominal pain, extreme bloating due to your body retaining fluid, fluid can even leak into your stomach cavity and need to be drained. HCG, the pregnancy hormone as well as the hormone used in trigger shots can cause the symptoms of OHSS to get worse. So after a long conversation we both decided it was best to not go ahead with the IUI. Again, I felt crushed. I understood going into this that it would likely be a long road and wouldn’t happen overnight but I couldn’t help but feel like it was never going to happen for me.

After that experience Dr. Lee said that he thought it would be best if we moved onto IVF. I clearly was a good egg producer. And it seemed that while he didn’t have a lot of it, the sperm that Mike did have was good quality. Dr. Lee thought that our issue is really in getting the sperm and egg to meet. Because of that, he said IVF will eliminate a lot of the problem and it would just be an issue of hoping the egg implants. I must admit both Mike and I were really shocked when he said this. We had only been through one actual IUI so mentally I don’t think we were prepared to move on to the next stage. But once we went home and thought everything through we decided that we agreed with Dr. Lee and were willing to do whatever it took to hold a baby in our arms.

And so began our IVF journey!