We finished our initial testing in November 2008 and tried to start an IUI cycle right around Thanksgiving but getting insurance approval, medications and pre-paid travel plans got in the way. Honestly, I wasn't mentally ready to start fertility treatments and needed some time to sit with the information. Then we had family visiting for four weeks in December/January and needed to recover. In February I started 350 units of Follistim on CD3 (through 9) and got to know the clinic's ultrasound technicians on a regular and intimate basis. Also, I made a mental note to start getting regular pedicures and bikini waxes even though it was the middle of one of the snowiest New England winters in recent memory. That flimsy paper sheet was doing nothing to maintain my aura of confidence, I tell you. But I digress. My ovaries responded perfectly and by trigger day I had three nice looking follicles ready for action. The day of the insemination was stressful. My husband did not appreciate having his "gentleman's time" with a plastic cup at 7 am but he soldiered on and we ended up with a normal specimen. I was too overwhelmed with everything going on to note the numbers, but apparently they were perfect for IUI.
Unfortunately, fourteen days later I was back to CD1. I never felt like it had worked so I wasn't at all surprised or disappointed (truthfully). We were geared up to try again right away, but when I had the pre-cycle testing done there was still a follicle hanging around and my doctor said we had to skip the month. I was crushed. Up to this point, I had been very cerebral about the process, but when I took the call from the nurse I was angry and frustrated for the first time. Twisted-gut-ball-of-fury-how-the-hell-did-this-happen-to-me angry and frustrated, to be precise. Yeah, reality check #1 was realizing that trying to get pregnant was going to be out of my control.
Reality check #2 was realizing that I was likely never going to actually see or talk to my doctor. We initially chose our clinic on recommendation and because it is very convenient to get to from both home and work. After my initial consultation it was as if my doctor no longer existed; I communicated only with the nurses. So, so frustrating as I am the type of person who really needs to develop trust with my health care providers in order to feel comfortable. It became apparent very quickly that I was just one of the thousands of people who file through this particular clinic every year and that cozy relationship I had envisioned with my caregivers involving me bringing in cookies and sending them photos of my (hypothetical future) babies was total fantasy.
So, we waited out the month and started another IUI cycle in April. Same dosage of Follistim and things were looking good, three follicles on CD5, right on schedule. Until my monitoring appointment on CD8 when the ultrasound technician (the young, slightly rough one) spent a lot of time clicking and asked "you're doing IVF, right?" Warning bells were tinkling faintly in the distance, but I told her no, I was on an IUI cycle. When she was done I sat up and she turned the computer screen around and showed me the nine perfect follicles she had counted. Yikes.
When the nurse left a message a couple of hours later confirming that I had too many follicles for IUI, she also told me that the doctor wanted me to switch to IVF. I called back and another nurse was covering for her and told me I had to decide Right Now! because she needed to call in more medications Today! and I'd have to mix something with the Follistim and take something else and one of them was going to be an IM injection* and never actually asked me if I was ok with it. Which I totally wasn't because we had never discussed switching mid-cycle. In fact, I had told my doctor during my one talk with her that I wasn't sure I wanted to have that level of intervention but clearly that wasn't written in my file anywhere. It didn't help my stress level that I had been slipping into empty conference rooms at work from to make all these phone calls and I was having an incredibly busy week at work and had a final exam in a few days. My husband managed to talk me down and agreed that there was no need to rush so I called the clinic back and cancelled the cycle. They were, shall I say, a little surprised. I had responded so well, it was a perfect situation for IVF, why wouldn't I disrupt my entire life for unplanned surgery in 3-5 days? I mean, really, my reproductive organs do not exist purely for them to do procedures on, and I didn' t like having to explain that.
Then in May, the timing was all wrong as my husband had to have surgery and my cycle was completely thrown off from the nine party-crashing follicles from the previous cycle, so we skipped another month. We spent the last month talking about our options, and even had a follow-up appointment with Dr. Frosty (even my husband thinks she is cold) who reminded us that our chances of getting pregnant via IUI were only ~12% and she would only recommend doing one more cycle before switching to IVF. So, here we sit won the brink of starting an invasive procedure that I never in my life thought I would elect to participate in. The most surprising thing? I think we're going to do it.
*All my medications had been subcutaneous and I my husband had been giving them to me. I freaked at the thought of having to have him or me figure out how to give me an intramuscular injection after work that day. Turns out the nurse covering the phone (not regular IUI nurse for my doctor) was wrong, and in fact the clinic hadn't used any IM injections in years. When I learned this I was pissed and even more frustrated with the communication channels.
