Happy New Year is what we keep hearing over and over. But if you are in a position like I am, it is just another benchmark of how long you have been trying to get pregnant. My first appointment with an RE happened shortly after a new year, and I wanted to let you in on what to expect during your first IUI or intra uterine insemination if you have made the goal to have 2020 be your year.
With the start of the new year, I move into the “almost four years” of trying, and I can’t pretend like that doesn’t hit me like a ton of bricks. So many periods. So many appointments. And lots of tears wondering if it will ever end. I use to dream of a family of four or five, and I have to wonder if I will ever make it to two.
As I finished what I hope to be my last IUI before moving forward to IVF, I wanted to give a little insight as to what a typical cycle looks like. Whether you are embarking on your own fertility journey or know someone in a similar position and want to offer support, this should give you a pretty good idea of what to expect.
Obviously, this protocol could vary drastically based on your reproductive challenges, your doctor, and your own personal needs. This breakdown is based off personal experience and your’s could be different.
The Process
Day 2 Monitoring – At this point, you have most likely been trying for a while, done a few tricks or tried some drugs prescribed by your doctor and are finally in at the reproductive endocrinologist. The process for an IUI usually begins on the second or third day of your cycle.
You will generally head into your clinic on Day 2 or Day 3 for monitoring. This consists of an internal ultrasound to check your uterus and ovaries, as well as bloodwork to track your hormone progress through the month.
Medication – Your doctor will prescribe you some sort of ovary stimulant to make sure that your ovaries get ready to go in a timely fashion. If you have PCOS, you will most likely be prescribed Letrozole or Clomid at varying dosages.
I was so worried taking Letrozole for the first time, but I found that I was able to tolerate it pretty well and didn’t have too many side effects. I do have some discomfort and cramping feelings of my ovaries around ovulation.
Don’t be scared. Know going in that you might be a little sensitive (both emotionally and physically. I can’t stand being touched too much during ovulation while on a higher dose. Super helpful to the baby making process…) and let your partner and family members in on what is happening to your body right now. Ask for sympathy and understanding in case your hormones get the best of you.
More monitoring – Yep. More internal ultrasounds and bloodwork to come! Usually, the medications your doctor gives you will have your body ready to ovulate on day 14 of your cycle. You will probably head in for monitoring around day 10 to see how things are progressing.
There might be a month where things AREN’T progressing. In this case, your doctor may ask you to take a bit more of the medicine, and come back in. There was a month where I had to go in five times (every three days or so) for monitoring because my eggs just weren’t maturing. Be patient with yourself and trust that things WILL progress.
Trigger Shot – This might be the most intimidating part of the whole fertility process. Poking yourself with needles. But once you do it that first time, it because a piece of cake. It hurts like a bitch, but I promise you can do it! Mr G couldn’t handle the thought of injecting me in the butt, so I did it the first time on my own. I survived, and it wasn’t as bad as I thought!
Your trigger shot is usually an artificial HCG hormone, or pregnancy hormone that forces ovulation to occur within 36 hours. This allows your doctor’s office to time things properly for the insemination. Expect lots of cervical fluid and some mild cramping leading up to ovulation.
Insemination – It’s go time! Your partner will have most likely been asked to abstain from ejaculation for two days prior to giving a sample. They will head into the clinic an hour or two prior to your appointment. The sample is washed, checked and optimized for the IUI process.
At this point, there has been someone checking out your uterus a few times in the past two weeks, so putting those legs up in the stirrups is no big deal. Your doctor will use forceps to open your cervix and a catheter to place the optimized sample as close to the top of your uterus and your fallopian tubes as possible.
The whole process takes about five minutes tops, and isn’t any more uncomfortable than a pap smear. Deep breaths and don’t forget to lay there for 10-15 minutes!
Have sex – Yep! Go ahead, double down and have sex again later that day. Can’t hurt, and it sure does help to reconnect with your partner. It can feel very impersonal and really hard on your emotions to go through this. Give each other some love and increase your odds a little bit more.
Wait. Wait. Wait. – Because you took that trigger shot to guarantee ovulation, you will automatically get a positive pregnancy test. Depending on the dose of HCG, it will usually take about 14 days for the HCG to leave your system. My office schedules me to come in 16 days post trigger for a pregnancy test, or to come back in on Day 2 of my next cycle to repeat the process.
Don’t take a home pregnancy test. It will cause so much heartache to see that positive and you can’t really know for sure if the HCF left your system fully or is just showing the last remnants. Wait for the blood test or the start of your period to know for sure what is happening.
I hope this helps some of you prepare for your upcoming treatment or makes it a little less intimidating to step into that fertility clinic for the first time. Getting into a doctor is scary, but there is so much hope in creating a plan and moving forward.
Sending you lots of love in your journey. Cheers to our future babies!
