Summer IUIs – Gravida 3, Para 0

Super-Secret Post
Concerning cycles 44, 45, and 46 (May, June, and July 2015)

In May, we kicked off a “three-pack” of IUIs. Our clinic has a pricing option where you pay upfront 200% the price of one IUI and get three credits. You can use those credits within a two-year window unless you have a live birth from one; in that case you lose any unused credit. But basically it’s no extra money unless you get pregnant on the first cycle, and then the third is free if you don’t get pregnant after the first two.

We did change our inputs from the last IUIs by adding progesterone support. This is somewhat controversial. Are early embryos lost because of low progesterone, or is low progesterone just a symptom of a lackluster follicle whose egg sucks and whose resulting embryo wasn’t going to make it anyway? In my case, it held off pesky spotting until my period came in earnest, even though I don’t think it actually extended that phase of my cycle. It’s inexpensive and not too invasive so we just went ahead with it. (Clarification: in other kinds of cycles where no ovulation took place (e.g. in preparation for a transfer of a previously-grown embryo) progesterone support is extremely important since the body isn’t producing any of its own and, as the name implies, it’s crucial to pregnancy support.)

We had also been super sneaky scheduling our May IUI just a few days after our appointment with the doctor debriefing us post-IVF. I thought we had four days before I ovulated so the clinic gave a green light, but I suddenly got a “positive” two days earlier than I expected, sending us scrambling to get my chart ready, fees paid, and IUI scheduled for the morning after that.

The surprise timing also meant we had lackluster numbers to work with but we went ahead anyway to feel like we were doing something.

Later my therapist would ask me how the IUI went. “It was fun!” I exclaimed. Oh man, the look on her face.

The thing is, this was the first treatment I’d done since finding my online circle. I was typing to them on my phone from the gurney, and sent them a picture of my feet wearing special pretty socks (I like dressing up my feet when they’re the only thing wearing clothes). They were messaging me back and, as the therapist described, high-fiving me as if they were right in the room. And the nurse was fantastic that day so the procedure itself was trivial.

Nothing to do then but wait and take the progesterone. The clinic is a little cruel in this department and makes me wait 17 days between IUI and a bloodtest. I have a friend in town I met after she “graduated” from IF really similar to ours and she came up with the idea of picking me up from the clinic and going to breakfast after the bloodtest. Best. Idea. Ever. I had a great visit instead of moping around all morning, and luckily I’m still in a place where I love my friends’ kids so yay for some time with the little one too. The thing about a bloodtest that late is that you are almost certainly already bleeding and so the GOOD news is for a pregnancy-hormone level of 0, which we had. On to the next one.

Between IUIs I’m supposed to lay off the ibuprofen. I would throttle someone for that decision, if I could uncurl from the fetal position.

There was no problem chaining our unstimulated IUIs together, meaning we were all set to have one each in May, June, and July. So a week after my negative pregnancy test, I started testing for ovulation for the next one. I even had the presence of mind to request my follow up appointment to this three pack for a couple weeks into August, leaving time to start the next IVF on the cycle after that (only one in downtime between Summer IUIs and Fall IVF).

The good news is that we found the perfect routine to guarantee good timing for an IUI even if it was always possibly the next morning. The one downside to our careful planning was me needing to be awake at 5:30am before Mr. EAP left for work. One morning, I saw the PICTURE of the test on the packaging for my OPK test and was like “…. Why is there one positive test and one negative test?” and then realized I was looking at a picture as the “second” test.

And then 3 minutes later I had the exact. same. thought.

A few days later, off to another IUI with my feet in a different pair of pretty socks, with only a little mixup with the clinic (I left my voicemail so early they thought it was from the night before — what, you don’t have timestamps?). This time the clinic liked our numbers much better (yay for better timing!). I blogged how much I liked these IUIs — we only have to visit the clinic twice a cycle and they really feel like we’re doing something productive.

It was about this time I had to buy another bottle of prenatal vitamins, which I’ve been taking since a few months before we started trying to naturally get pregnant. By now, it felt a bit like they were mocking me. At least I get the bottle with 300 so I get to feel like an idiot less frequently.

The one thing about being on the progesterone is that, depending on your perspective, it either a) makes you feel like you’re pregnant because of all the side effects, or b) masks any early pregnancy symptoms because you just brush them off as “oh, of course — it’s just the progesterone”.

Before my pregnancy test this month, I idly blogged “Progesterone-Boob-Status: Giant Sacks of Pain”. It’s hard to tell supplement boobs from pregnancy boobs, but I might start being able to tell after this new data point.

I had saved a bunch of money by buying bulk cheap ovulation tests online but they came with some free pregnancy tests too. They were calling to me, so I used a couple while my boobs were huge and my spotting pretty light compared to the month before. All strictly negative, unless you count “line eye”, the condition where you can stare at a negative test and see a shadow of the “positive” line.

I got to cut the wait for my bloodtest down by a day by planning to be out of town for the morning at 17 days after the IUI. I did the test on my way out of town, meaning Mr. EAP had to accept the results phone call himself.

He called me while my parents were driving me down the highway. The hormone level that should measure above 100 was 7. It had never been caught that low in me before.

Being an extra degree of separation from the nurses, I spent about 24 hours unsure if they were waiting in case it was a weirdly late embryo that was going to be able to take off, or if they thought the level was coming down already. It turned out to be the latter, so I went off my progesterone and waited 4 days to check the levels again.

The thing about being surrounded by pragmatic infertile women and lots who have miscarried is you start to say things like “Hey, at least I cleared my chemical pregnancy on my own and didn’t need a D&C.”

So… that brings us to three chemical pregnancies: 2 out of 4 IUI cycles, and 1 out of something like 40 for cycles on our own. It sure seems like the IUIs give us some kind of boost… even if it doesn’t pan out, we’re getting both sides of the equation together and we actually have proof of that. Yay, data?

After some discussion, we decided to use up our last IUI credit in July as planned. I already knew what I wanted to change as our input for the next protocol to make sure we weren’t repeating what we “knew” would fail, but there wasn’t a chance to meet with the doc to do so, so we just did the same thing again.

Having run out of pretty socks, and it being July and warm enough for sandals, I decided my toes should be painted for this one. Of course, I’m too cheap for a pedicure, so I had my infertility buddy over and we did them together.

I still had a bunch of cheap pregnancy tests but I was kind of in the weeds about whether to use them. They hadn’t been sensitive enough to pick up the June miscarriage, but (forgive me), we didn’t feel justified pissing away any more money on better tests. It also seemed clear that no matter what, I couldn’t help but test at home. Even with all these misleading results, it’s some sort of “do something, ANYTHING!” coping mechanism for the long wait for the bloodtest.

Leaving town again 16 days afterwards, I managed to get my bloodtest moved up again. Mwahahahaha. What a way to trick them into testing me early.

As the nurse took my blood 16 days after the IUI, she pointed out: if it was negative, I could drink like a fish at the wedding we were headed to. And so drink like a fish I did after the call came in while we were transferring flights: just a nice, boring negative.

Our follow up already booked for a date in a couple weeks, we were hoping for a smooth transition back to IVF — a cycle off for the follow up and then start the protocol the cycle after that.

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