IUI: Round Two

After waiting two VERY long weeks, on the night before I was supposed to take a pregnancy test, I started spotting. Aaron and I both tried to hold on to what little bit of hope we had left and decided we'd still test the next morning, just to be sure. Of course, when I finally worked up the nerve to put myself through the torture of taking a pregnancy test, we got nothing more than a big, fat negative.

I emailed my doctor to let her know and a nurse responded with her deepest apologies and told us to let them know if we wanted to do another treatment cycle. The whole process was so draining, mentally, physically, financially, and emotionally, that we decided to take a few months just to pray and give ourselves a break.
Being human, those months were so hard for me. It's one of the most difficult things to take your hands off of a situation completely and wholeheartedly give it to God. I guess I'm a slight control freak and I like to feel like I'm trying everything I can to move forward. In reality, there was nothing we could've done to better ourselves those months more than praying and trusting that in God's time, it would work out.

One afternoon, someone I had never met but my husband knew had seen our posts about our first IUI and messaged me. She told me that they had purchased a trigger shot (which costs $100) and just found out they were pregnant and couldn't use it. She said she wanted us to have it so it didn't go to waste. This sweet, sweet girl gave us the injection at no cost. *CUE THE WATERWORKS* It was truly one of the kindest gestures and such a blessing to us.
The injection sat in our fridge for a couple months as we decided what path we were going to take. After a lot of back and forth, we decided to go ahead with a second round of IUI since we had that injection and other forms of treatment are so expensive. We agreed that this would be our last attempt at treatment for a while as we plan to pursue some goals in other areas of our life.

Most of our IUI process this round has been nothing but a nightmare. When I tried to schedule my first appointment for the cycle, my doctor was completely booked so they told me I would be seeing a new doctor at their practice. That sent my anxiety through the roof right from the get-go. (Luckily, she turned out to be very nice and I didn't mind seeing her at all but at the time, it was a lot for me to process.) At my baseline ultrasound appointment, we found out that I had a cyst and we couldn't start the medications we needed because it would cause the cyst to grow. We then had to book another appointment five weeks out to see if that cyst was gone.
So, five weeks later we went back and my cyst had not gone away but had gotten smaller so the doctor gave us the okay to start our second round of Clomid. After my five days of meds, I went back for another ultrasound to see how many follicles had grown and what do ya know, my body wasn't responding to the medicine like it should've been. My doctor then put me on five days of Letrozole at a higher dose than I had taken the first time, calling it the "fast track." I was told that if I didn't have any follicles growing when I returned the following week, we would have to stop all treatment and give my ovaries a break for a few weeks. If there was growth when we returned, then we could schedule the IUI.

I am a firm believer that God's timing is absolutely perfect and I had to remind myself of that as I went in for my follow-up ultrasound. Although it took us a few extra appointments, a little more medication, and double the money, we finally got some good news. I have two follicles that are more than ready and my doctor instructed me to give myself the trigger shot when I got home from work.

So, the injection has been given and the rest of the night will be spent anxiously awaiting the morning with all sorts of emotions. Bright and early, tomorrow morning, we will tackle IUI: Round Two.

The Day of IUI #1

I'm not sure who was more nervous going into our appointment the day of our IUI.
Our appointment was early so we were up and on our 45 minute commute to the doctors office before the sun had even had time to rise. We made small talk and sang along to the radio but we were both filled with anticipation and had one thing on our mind.

When we arrived, we went through our normal check-in process, paid for the procedure, and they checked Aaron's ID. We signed some papers and then sat down in the waiting room. Other than the tv playing an episode of Friends and an occasional giggle from one of us because Joey said something stupid, the room was silent as we sat holding hands waiting for someone to come get us.
Before we knew it a nurse popped her head around the corner, asked for Aaron, and lead him to a room to do his part of the job. He came back and sat down beside me and all I could do was pray that his numbers would come back okay.

What seemed like hours later, the nurse came back and got both of us. She took us to a room where I was prepped for the procedure and given a spot on the exam table. We sat alone in that room for a little bit and I don't think there's anything that could've prepared us for the news she was going to give us when she returned.
She told us that it was totally up to us whether or not we wanted to go through with the insemination. "I can't say it'll never happen because anything can happen but it would be very surprising if it worked." Then she proceeded to tell us that Aaron's count was only 500,000 after the "wash". Before infertility I would've said that sounded like a lot but like I said, they want it to be 5 million and prefer 10 in order for an IUI to even seem worth it. My heart sank a little but we both agreed that we had already taken the meds, been to the ultrasounds, and done the trigger shot so there was no point in calling it quits this far in.
The IUI itself was relatively painless aside from the nurse not adjusting the speculum correctly. It didn't take long at all and once it was over I was left to lay there for 15-20 minutes. The nurses words played over and over in my head and I couldn't help but tear up. I felt Aaron nudge me and he softly whispered "I'm sorry." I wanted nothing more to hug him and tell him it was going to be fine but in that moment I couldn't seem to say anything at all. We sat and listened to the ticking of the clock until the nurse came in and gave me the okay to get dressed and head home. Her last instruction was to take a pregnancy test two weeks from that day and to not give up hope just yet.
As we made our way to the door, the staff members wished us luck and told us to let them know if we needed anything.
The ride home was long and emotional and the next two weeks seemed to be the longest of my life.

IUI: Round One (Almost)

After having some labs done to determine if I had actually ovulated or not, I scheduled an appointment with my doctor to discuss doing medicated cycles with monitoring. I wanted to know what was happening inside of my ovaries (if anything at all) when I took the fertility meds since my ovulation tests were never very clear.

When I went in to talk with her she confirmed that I did ovulate which was a positive even though it didn't result in a pregnancy. She then explained to me how a monitored cycle would work and gave me a breakdown of the options and their cost. Keep in mind, most insurances don't cover any fertility treatments and ours falls into that category so we have to pay everything up front each appointment.

Basically we had two choices, timed intercourse or an IUI. Both processes started out with the same instructions: Go in for a baseline ultrasound ($163), take medicine for 5 days starting within the first 5 days of your cycle ($17), go back in for a mid-cycle scan around cycle day 11 or 12 ($163), and use the trigger shot ($100) on the day instructed. Once we had reached that point, we would either do timed intercourse (which is pretty self-explanatory) on the day of the trigger shot and the following two days or we would come in a couple days after the trigger shot for an insemination ($260).
Now, if you've read my other posts, you're probably thinking "didn't they tell them that doing an IUI with Aaron's sperm was pointless?" and the answer to that is yes. On the day of the insemination, the man gives a sample and they then "wash" or "spin" the sperm to separate the good from the bad and get rid of the excess fluids and cells. When doing an IUI, they say a man should have 5 million sperm per milliliter and they prefer him to have 10 million so with our barely any on a good day, they didn't recommend wasting the time and money to even try. After our appointment at UNC I had made it very clear to my doctor that we wanted to exhaust all other options for having a biological baby before we even discussed IVF. I'm not sure if that's why she gave me the option but it was very surprising when she said we could go the IUI route if we wanted.
It just so happened on the day of my appointment I was already on day 4 or 5 of my cycle and we would have to make a decision that day if we wanted to do any treatments that month. The way I saw it, it seemed stupid to pay half the money for an IUI and just do timed intercourse. She probably thought I was crazy for being as excited as I was when I told her we'd do an IUI.
Aaron couldn't get off from work that day so when I called to tell him we were doing exactly what they told us we couldn't do from day one, I could hear the confusion in his voice. We didn't have much time to talk but I explained to him what was going on and told him that I was going to go ahead with my baseline ultrasound that day and she would start me on meds.

When my doctor performed my ultrasound she found two decently-sized cysts on my ovary. She said that they were probably caused from the Letrozole I had taken the previous cycle and that taking any additional fertility drugs would only cause them to grow. She recommended that we postpone treatments for a month and then I would come back in to see if they were gone, otherwise I'd have to go on birth control to make them dissolve. I was totally fine when she told me about the cysts but when she mentioned birth control my mind went into panic mode. Why would I go on birth control when I'm trying to get pregnant?

Thankfully I serve a mighty, mighty God and when I went back for my follow-up, those cysts were completely gone. My doctor said that she was also going to switch me to Clomid, the other fertility drug that produces a higher chance of being pregnant with multiples, in hopes of preventing me from getting anymore cysts from the other medicine.

So there we were about to start our first round of IUI (which they told us we couldn't do) using Clomid (which they told us I shouldn't take), I just couldn't help but hope that this was going to be the end of our infertility.

Our First Medicated Cycle

Now that you know a little more about Aaron's condition, let's go back in time to the weeks between the appointment that we learned about Y-Chromosome Microdeletion and our appointment at UNC.

Once we had been told that Aaron had a genetic condition, the researcher in me went wild. I was googling everything I could think of to try and find something, anything, reasonably priced that could give us even the slightest increase in our chance to conceive naturally.

I'm pretty sure that I read about every single vitamin and supplement that's ever been created. I read about diets and exercises, essential oils and acupuncture. The list goes on and on and believe me when I say some women try some CRAZY things in order to get pregnant. I spent hours at a time trying to figure out what other people had tried and had success with and what didn't help at all.

It seemed that in everything I read, women were talking about their ovulation, how they track it, and how they can tell when it's happening. I had spent months before I found out that I had PCOS taking ovulation tests every single day trying to figure out when I ovulated and never had any luck. The more I read and the more I thought about it, I began to wonder why the doctors hadn't been concerned with the fact that I don't ovulate on my own. I know Aaron's issue is time sensitive but how could we make a baby if I'm not even releasing any eggs?

I immediately sent my doctor a message asking her what we could do on my end to help us as we were waiting for our appointment at UNC to come. We had been told from the beginning that an IUI (with Aaron's sperm) would be pointless for us, so I asked if we could do a cycle with medication to help me ovulate. My doctor explained to me that since I am already considered "high-risk", she didn't want to do anything to increase my chances of becoming pregnant with multiples. "Our goal is to conceive one healthy baby." She told me about two different medications, one that would increase our chances of having multiples by a little more than the other.

We decided that I would take five days of the medication that was less likely to leave me pregnant with multiples, called Letrozole, and then test for ovulation on certain days of my cycle. Though we had been trying for almost a year and a half, this felt like the first cycle that we had a real chance.

In my hours spent researching, I read about all the side effects fertility drugs can cause. I had thoroughly warned my husband that I might not be a pleasant person for a little while and apologized in advance for anything mean I said while my hormones were raging. Lucky for both of us, the Letrozole didn't cause me to have any side effects aside from a couple moody days which Aaron would say is perfectly normal for me.

A few days after I had finished my course of medication, it was time to start taking ovulation tests. For those of you who have never had to use one, they are very similar to pregnancy tests. You test using a urine sample and it detects something called luteinizing hormone which your body has a surge of right before you ovulate. When you reach time for ovulation, the test strip will have a second line that is just as dark or darker than the control line. I tested a couple times and didn't see any signs of a second line. Over the next few days I started testing several times a day to make sure we didn't miss it. It was tedious but so worth it when I started seeing a second faint line showing on the test strip. I was so excited about seeing that line get a little darker with each test and I just knew this was going to be our month.

Having an irregular period is common for me so I waited a few days past the date it should've started and worked up the nerve to take a pregnancy test. I don't care what anyone says, you can try as hard as you possibly can to not get your hopes up over something like this but that's a lot easier said than done. 

The best way I can explain the way it felt to see another "NOT PREGNANT" flash across that tiny screen is to say that it felt like I was a child with a balloon that had suddenly been popped. 

Weighing Our Options

The weeks following our appointment at UNC were spent mulling over the options the doctor had given us for growing our family under our medical circumstances. We never imagined that we'd be facing a decision like this and it felt anything but natural.
If you've never experienced infertility yourself, you may not know what options are given to those who do go through it. I thought this would be a good opportunity to help everyone understand why this is such a difficult decision and the thoughts we had about each option when trying to decide which path to take. I will tell you about the first two of three options we were given because IVF has played more of a role in our journey than these two and I will elaborate on that when the time comes.

As soon as we heard these words come out of our doctor's mouth, we both knew it was a no-go. If physically giving birth to a child is in the cards for us, we want (and believe) that it should be both of our DNA or neither of ours. IUI can be done using the male partner's sperm if his count is normal but since Aaron's is so low, our doctor told us it wouldn't even be worth trying. With this process, I would take medicine to make my eggs grow, followed by a "trigger shot" to make them release. At just the right time, we would go in to our doctors office and she would use a catheter to place the sperm inside of my uterus so that it would be right where it needed to be when my eggs begin to travel down my fallopian tubes. A lot of couples try this treatment because it's much cheaper and closer to the natural conception process than IVF. This process costs about $2,000 when it's all said and done.


Let's talk about the "sperm donor" part. This was the craziest thing to me. The booklet that the doctor gave us for this treatment literally looked like a high school yearbook full of baby pictures. Beside each of the baby pictures there was a list of information about what that baby grew up to look like. This included: ethnicity, eye color, hair color, height, education/occupation, blood type, and whether or not they were still available at the sperm bank.
So if Aaron and I had decided that we wanted to pursue this option, we would look at the booklet and find the baby picture and information that seemed to best match us and then they would send in a request for that man's sperm sample. It would be shipped to our doctor and then we would do the procedure using that sample.

I am 110% confident when I say if this was the only chance we had at having a (partly) biological child, we would walk away without any hesitation. I married Aaron for him to become the father of my children, not some guy we find in a book.

When the doctor first mentioned this option to us, we weren't completely sure if we wanted to put it into our "definitely not" pile or keep it in the back of our minds to reconsider later. I think Aaron was more against it than me but we go back and forth with it a lot.

If we chose to do an embryo adoption, we would be given options much like the sperm donor but this time for what we believe are LIVING babies. When couples go in for IVF (which, like I said, I will explain later), there's a pretty good chance you end up with extra embryos. An embryo is what is created when sperm fertilizes an egg which is the act of conception. When this happens, you're given several options about what to do with your embryos and one of those is putting them up for adoption just like you would a child (kinda). The embryos are frozen until a couple, usually struggling with infertility in the form of issues with the female's eggs, decides that they are a good match. When we found our match we would then pay lots of money to have them shipped to our doctor. The doctor would then implant the embryo into my uterus and I would carry and deliver the baby just as if it were my own.

We like this option because we feel like it is much like the form of adoption that most people know about, the child just hasn't been born yet. We would be saving a life from being frozen in a test tube somewhere forever and we'd still get to experience the pregnancy and delivery part of having a baby. It would allow us to give a baby life though it wouldn't be ours biologically.

As I mentioned before, we do go back and forth about this option but I think we've both agreed that it is something we'd like to consider after exhausting all options for having a biological child. This also comes with a pretty hefty price tag, costing about $12,000-$15,000.


As you can tell, neither of these choices are an ideal way to grow our family and we didn't know that these options were even out there until we were practically cornered with them. When something that should come so easy suddenly becomes nearly impossible, you really have to evaluate your beliefs and values.