Today I am 4 days post IUI (4dpiui). It turned out that my estradiol continued to creep, despite massive doses of stims. When I last posted, I was off the Menopur and on 225 iU of Gonal-F twice daily. My estradiol level that day (Friday) was 416. He wanted me to keep on the same dose of Gonal-F for the evening and next morning, pee on another stick to once again confirm my body hadn't gone rogue and ovulated on its own, and come back Saturday morning for yet another ultrasound and one last estradiol blood test.
That morning I was an emotional wreck. Thankfully Paul left for a bit to gas up the truck and go get our borrowed stock trailer (we were moving cattle later in the afternoon), because I needed that time to myself to cry. I thought it would help...but it really didn't. I drove us to the appointment in near silence and had very little to say the entire time we were there. My two lead follies appeared large enough, so Dr. M.'s nurse gave me the trigger shot of hCG (pregnancy hormone) in the butt to force the largest eggs to mature and for those follicles to move toward bursting. We had our back-to-back IUIs Sunday and Monday.
(It turns out my estradiol level did climb to 691 the day of the trigger, do-able for having only two mature follicles...but given what he'd said before about my abysmal 867 the cycle we conceived twins - with what he said then were 5 follicles but claimed on Friday had been only two, so whatever! - I was feeling blue about it.)
Some have asked what IUIs feel like and how they're done. (Yeah, I'm in a position to say, since technically these were 11th and 12th catheters passed through my cervix.) They used to hurt me and cause cramping, so the actual procedures were uncomfortable. Now that I've actually had babies, it doesn't hurt at all. Plus, Dr. M. is much more familiar with intricacies of my not-quite-straight cervical canal, so he's more prepared to maneuver the catheter when and where he needs to on its journey into my womb. The procedure is insert speculum (oh, hi, cervix!); wash cervix four times with giant cotton swabs dipped in mystery, slightly burning solution; verify sample in the little pouch attached to the very thin catheter belongs to my husband and not someone else; carefully and slowly feed the catheter through my cervix and into my uterus; pause 60 seconds to give the uterus time to relax; very, very slowly inject the sample into just the right place in my uterus; wait 30 seconds for things to settle; slowly pull the catheter out; remove speculum, then help me roll over onto my tummy for 30 minutes of rest because my uterus tips quite a bit forward.
I will say that Sunday I felt numb and resigned, not the best place to be when hoping to conceive. I also spent a lot of my 30 minutes of tummy time researching perinatologists in our area who are covered by my insurance...just in case we do get pregnant.
Monday's IUI was even less eventful, except for the furtive whispering between Paul and me in the waiting room as I filled him in on the consultation appointment I booked earlier that day for May 25th. Why so late? Because, in the event we DO get pregnant this time, we'll have had our first ultrasound (7 weeks) earlier that week and will know whether or not there's a heartbeat (or, beats, as with last time). If there are, I'll have plenty of time to cancel the consultation. (This is also what happened last time, although the consult was with different clinic.) If there aren't signs of life within, then we'll proceed to the consultation at the week's end knowing that we've had another failure and even more anxious to hear what.the.Hell. and what can be done to help our case.
So, here I am, 4dpiui. Tonight will be my third evening injection of progesterone in oil (PIO), another intramuscular shot (mine is in cottonseed oil because I'm allergic to the normal soybean oil...wicked itchy lumps!). Today I had the follow up ultrasound to find out how many follicles had burst.
For sure, the big one in my right ovary burst. (No shit, says the girl who was in terrible pain and discomfort all day Monday due to Mittleschmerz, or ovulation pain...which I get every month.) He suspects the large one in the left ovary burst as well, but the ultrasound wasn't quite as definitive.
What else did we see, besides my "lovely" uterine lining? Oy. Six unburst follicles, the largest of which is 23mm. I am really, really hoping I don't end up with a cyst problem next month (or, God forbid, a painful residual cyst in pregnancy, which could require surgical removal). I took one look at the array of photos Dr. M. slid carefully into this week's plastic photo sheet and said, "Why couldn't my photos looked like this LAST week, when it mattered?!" Seriously. I would have killed to have had that many growing follies. (For the record, the others today were 17, 14, 13, 11, 11 and 8mm. That, on top of the two we think burst, would have made IVF not only possible, but a good idea.)
So...progesterone blood work on Monday to see how well my levels are doing (I never have a problem with that, especially on PIO or suppositories), and blood pregnancy test (i.e. beta) on Monday, April 30th. And maybe a little faith and hope. We're definitely accepting outside prayers, should you feel so inclined. Oh, and Dr. M. called for a little bit of luck, since that's what seemed to work back in May 2011.
With today's ultrasound being free of charge (buy three, get one free!), I'm already feeling a little lucky.