Intrauterine Insemination (IUI)

Tomorrow is another appointment to discuss our options. Before the cruise, the doctor returned our call and basically told us that we would have to utilize IUI in order to become pregnant. We could still try normally, but the IUI is a very successful alternative for us. I know in several posts that I have mentioned IUI. In this post though, I would like to actually provide information on exactly what it is. I used the Attain website: http://attainfertility.com/ . I hope you all find this information very helpful. I thank Attain for providing this information on their website. Our doctor's office at REACH handed out an Attain IVF pamphlet that helped me to discover this website.

According to the Attain website:
http://attainfertility.com/article/iui-procedure

Are you considering the intrauterine insemination (IUI) procedure? The IUI procedure may help you get pregnant and take home a baby, particularly if you are dealing with infertility.

How the IUI procedure works

When you undergo the IUI procedure, you can expect to go through the following three steps:

1. You may begin taking fertility drugs and your ovulation cycle will be monitored.
2. Your partner will provide a sperm sample (or you will obtain donor sperm) that will be specially washed and prepared for the insemination.
3. Your doctor will inject the prepared sperm into your uterus.

Getting ready for the IUI procedure

Before the intrauterine insemination procedure, you will need to visit a fertility specialist and have a pre-IUI workup. With this workup, your doctor will check to see if you are in good health. The doctor will assess your hormone levels to see if they are in the normal range and check to see if your uterus can support a pregnancy.
Prior to the IUI procedure, your doctor may start you on ovulation drugs, while closely monitoring you with ultrasound and/or blood testing. This monitoring will confirm that you are producing healthy eggs. It will also help your doctor determine the best timing for the injection of the sperm.
You may also take another test that tells you when ovulation is about to happen. Right before ovulation, there is a surge in luteinizing hormone (LH). Ovulation occurs within 1-2 days after the LH surge. Your doctor will inject the sperm into your uterus at the optimal time for conception.

Preparing sperm for IUI

Your partner will give a sperm sample, which will be washed and prepared for the IUI procedure. This washing can remove potentially toxic chemicals possibly present in the sperm that your body may negatively react to.
These chemicals can sometimes cause an allergic reaction in women, which could hinder pregnancy. Washing the sperm may also minimize the cramping that sometimes occurs after the IUI procedure.
This washing and preparation process also concentrates the sperm into a high volume. This high concentration helps the healthiest, most mobile sperm to reach the egg. This helps to increase IUI success rates.

Inserting sperm during IUI

Injecting the prepared sperm into your uterus is quick and virtually painless. This part of the IUI procedure takes 1-2 hours at the most. Here is what to expect:

1. You will lie down on the exam table as you normally do for a pelvic exam. 
2. Your doctor will insert a very small, thin and flexible catheter into your cervix. 
3. The washed sperm sample is injected right into your uterus.

Since you will be lying down for awhile after the IUI procedure, you may want to bring a friend, your partner or a good book to read while you are waiting in the exam room. Having support may help you to stay calm during the process.
Some doctors perform two inseminations with the intrauterine insemination procedure. These are done within a day of each other.
Following the IUI procedureAbout a week after ovulation your doctor may have you come back to the office to check your progesterone levels. Your doctor will observe your uterine lining with an ultrasound at this time. By checking your uterine lining to see how thick it is, your doctor may have some clues as to whether the IUI procedure was effective.



The IUI procedure for male infertility

If male factor infertility issues are suspected before IUI, your partner will need a full male fertility evaluation, including a sperm analysis (SA), before you undergo the IUI procedure.
During this evaluation, a doctor will check your partner’s semen for sperm count and motility. If he has low sperm count, the doctor may ask him to give several semen samples that can be used during the IUI procedure. Having several samples will increase the number of sperm available and may improve your chances of IUI success.
Before giving a sperm sample, your partner will want to abstain from ejaculation for 2-3 days. This 2-3 day wait will maximize his sperm count, and help ensure that his sperm are healthy and mobile.

Get healthy before IUI

Practice healthy lifestyle habits when trying to conceive. To optimize your chances of a healthy pregnancy, get to a healthy weight and stop drinking, smoking and using other drugs.
Talk to your doctor to see if you should take a multivitamin, or make any other healthy lifestyle changes before starting the IUI procedure. 

Trying to be a Statistic

Who thinks in statistically terms? I never thought that I would want to be a statistic but in this case I do. The word statistic possesses a negative connotation. Everyone always reports the statistics of crimes, illiteracy, poverty, joblessness, teen pregnancies, murders, divorces, bankruptcy, etc.... How often are the statistics of becoming pregnant after trying so hard reported? I ask this because I want to be one of those numbers/ people factored into that statistic. I want to be a part of that reported number so desperately.

In the time since I wrote, I have been researching the success rates of IUI. Our appointment is so close (tomorrow) and I want to know what we are up against. I know that we will only be discussing how to precede next and what all that needs to be done. There will be no cycles, medicines, or anything. At this point, I am so impatient. We know the problem and we now have a solution. I just want to jump right in head first. The wiser we are though, the better we will be prepared especially for the worst. Soo, let me share some information with you all that I have discovered:

Success Rates
http://attainfertility.com/article/iui-success-rates

According to the Attain website:

IUI success rates by number of cycles

• 86% chance of pregnancy with multiple IUI cycles
• 10 to 20% chance of pregnancy with one IUI cycle 
• rate similar to, or slightly lower than, pregnancy rates of fertile couples that become pregnant on their own.

IUI success rates by age

• Under 35: 10 to 20 % chance of IUI pregnancy success
• Between 35 and 40: 10 % chance of IUI pregnancy success
• Women 40 and above: 5 % chance of IUI pregnancy success

Breaking down IUI success rates

• Age affects IUI success rates
• Fertility drugs improve IUI success
• Healthy sperm boost IUI statistics

Side Effects
http://attainfertility.com/article/iui-side-effects

According to the Attain website:

Most women find that IUI side effects are minimal. Here are some quick facts about IUI side effects:

• Most women experience little to no pain during IUI.
• Some women may experience mild cramping with IUI.
• Severe side effects, like infections, can occur following IUI, but these are very rare.

Most IUI side effects are caused by the fertility drugs taken during the IUI cycle, not the IUI procedure itself. 

IUI side effects caused by fertility drugs are often mild and disappear once the medication is stopped.

The risk of multiples (becoming pregnant with twins, triplets, or more children) with IUI is fairly small, but it is a side effect of taking fertility drugs taken with IUI. About 10 percent of women that take ovulation-inducing drugs and 30 percent of women that take gonadotropins will become pregnant with multiples.


I hope that this information was very helpful to many of you all.
~Until Next Time

When the Time is Right

First and foremost, I would like to say that I am so happy that I am back!!! We got back from our cruise on Friday the 20th around 1:00am. I missed everyone!

The cruise was amazing! I got to explore beautiful new places and stuff myself until I could not eat another bite! We had an amazing anni-moon with my family. I can not explain how content I was! This vacation was exactly what we needed to relax! Here are some pictures from our cruise!

Grand Cayman Islands

Captain's Formal Dinner

Jamaica
 

 

Now an update:
Before we left, the nurse had given us a call about our results and wanted us to come in on Dec. 31st in order to discuss them. I was in the middle of studying for my final and said ok sure. After my final and the final countdown to the cruise, I knew that I could not wait that long to hear back from them. I called and left a message. We were desperate. We wanted a small hint, a small insight to what we would encounter when we returned from our glorious vacation. I did not want to worry the entire time, so I was at ease with the decision to receive the news via phone call. A couple hours passed until our doctor eventually returned our call. The call was nerve racking. I was pacing in our tiny kitchen, stuttering, and holding my breath. He broke down the results into multiple categories that rocked my world. It was more fertility lingo in combination with a doubled edged sword. Unfortunately, he could not deliver the good without delivering the bad.  (My husband would not like me to reveal the specifics. I respect his request for a small amount of privacy.) So all in all, there were some complications.We are able to have children, though we would have to have them via IUI. This news had me so excited. I wanted to cry tears of joy! I am so happy that we will not have to spend our life savings, our retirement money, and nonexistent, future lottery winnings in order to have children through IVF. These results and this news are something that we can work with. I thank God that we have this small chance at starting a family.

The problem now is where do we go from here? We have a chance to decide when we want to have children. We can choose when to begin the process, but the money has to be right too. How much does IUI cost in the Charlotte, NC area? Are there drugs that has to be taken in conjunction with the procedure? Will I have to miss work and school? What are the success rates? Are there any guarantees? I have to research this procedure and speak to my doctor so I look forward to the 31st. Though the news is partially bad, there is still this amazing hope that I thought would never be attainable. I know that more answers will come. Eventually, when the time is indeed right, we can start a family! I am so overwhelmed with joy. I hope that we will continually be able to share our baby journey with you all!

~Until Next Time

One Among Many

Today is another big day, but before I start that discussion let me update you all.

Tuesday the 10th, we had an appointment scheduled in order to have a semen analysis done. We traveled to REACH, checked in, and was immediately able to go to the lab. Here, we were taken to a small area off the sitting room to sign some documents, where my husband had to initial his labels for the sample to be collected. These labels were applied to our forms and also to our cup. We were then able to pick a room and get started. This was the most awkward moment I have had in my entire life! How are you suppose to feel while trying to get your husband off in a very tiny, small room with 1980's pornos and Playboy magazines that absolutely suck?! The atmosphere did not exactly put either of us in the mood so we had to tough it out. Pretending this task was one of our dying wishes or fantasies was the only way to trudge through this debacle. So instead of going to medical school for the PA program, I instantly became a sexy MD and worked as a "doctor" for a day! : ) Knowing the importance of the sample urged us forward too. Hmmm, I am wondering could this already be counted as a sacrifice for our children? Ha ha ha! This experience was very interesting and one that I will never forget!

Yesterday around 4 pm, I received a call from REACH about our results. One of our nurses, Mary, wanted to schedule us an appointment for this Friday to talk about the results. Once again my heart stopped and I could not breathe. I hate receiving calls like this and getting no hint or indications on whether the discussion will be good or bad. Her tone conveyed that perhaps the news will be bad news. Since we are going on our cruise, we had to schedule the appointment on the 31st, which is a whole 19 days away!! Ah the anticipation is going to kill me. I will worry, worry, and worry some more on our vacation. I almost wish I had not answered that call. I wish I had ignored it, but I know that would not have gotten us anywhere. It is so ironic that I can be a warrior at one moment and a scared little girl the next. I guess it is true, I am a jelly bean just like my husband likes to call me. I am hard on the outside, but once my shell is penetrated I am so soft on the inside. Yes, we will have to wait unfortunately to get the results, but when we do receive them, I will make sure I share!

Anyways, on a more exciting note, this day is one among many! A very special day where new adventures begin. Today we will head to Miami, FL for our cruise that sails on Saturday the 14th (our 2 year wedding anniversary yay!). I can not tell you all how excited, happy, joyous, anxious that I am. Though I love to travel, it seems like I rarely take vacations, so I am looking forward to this much needed retreat full of relaxation.  I can not wait to see the ocean. I love the ocean and water in general. I am your average swimmer, but I love the sights of huge bodies of water. They seem edgeless, limitless, are mysterious, and full of wonder. I could not imagine myself going deep into the ocean because of the heavy, deep darkness, but I love seeing the images of deep sea diving. I also look forward to exploring Miami and seeing what all this city has to offer. On the cruise ship, I look forward to the food the most. I love to eat!! I can not wait to play bingo and explore Ocho Rios, Jamaica and the Grand Cayman Islands with my family. Overall, I know this trip and these days will be one among many joyous days. Surrounding yourself with love, family, and good times helps you to keep going. I plan to do that and much more!

~Until next time

Prepare, prepare, prepare

Prepare, prepare, prepare! It seems like all I have been doing lately is preparing.

I am struggling so very hard to prepare for my finals at school. I attend York Tech here in Rock Hill, SC. I am taking one of the last few classes needed as prerequisites for my admission into the Physician Assistant program at MUSC in Charleston, SC. I hope that by the next application cycle (Early Oct. 2014) I will be fully ready! Currently, I am also seeking a shadowing or volunteering position to observe a PA working. In other words, I am extremely busy preparing for my future career!

In five days, our two year wedding anniversary will be here! I am so excited! We are finally taking a much needed trip that could be technically considered our honeymoon. Hmmm so could I call this vacation our anni-moon? Anyways, the trip we are taking is a cruise! Thursday night we will be leaving to travel to Miami, Fl. We will spend a day in Miami and then on Saturday the 14th (exactly our two year wedding anniversary), we will set sail on the Carnival Victory for five days. Our cruise destinations are Ocho Rios, Jamaica and the Grand Cayman Islands. I can not express how excited I feel, yet I can express how saddened I feel.

I can not help but feel saddened. With the dawning of our two year anniversary, it also almost marks the two year anniversary of us deciding to try to conceive. It feels like so much longer, but we are only two years into our dreadful infertility war. Who knows maybe history might be repeated and this will turn into a seven year or ten year war, except exchanging the bloodshed and bodies for tears and failed attempts. Indeed I have been preparing. I have been preparing for yet another disappointment in our infertility journey. I am waiting, waiting, and impatiently waiting some more for the unwanted, bad results we are bound to receive.

After our first, initial doctor's appointment, I received a call on Friday, December 6th. Since I was at work, the call went to my voicemail. It was a call from one of the nurses on our infertility team at REACH. She wanted to discuss some results from my blood test. OMG! Terror had gripped my insides and for a moment I could not breathe. My body stopped functioning and I panicked! I had never received  a call pertaining to results from a blood test. I always received my other blood results in the mail, so I thought the worse. I feared that this was it, I would find the answer to our infertility problems: my malfunctioning body. I debated forever whether I would return the call. My husband, Willie, urged me to call, but I did not want to know especially if the results would be devastating. Once home, I returned the call and left a voicemail for my infertility team. Then I was off to shop with my favorite Canadian, Samantha, for a formal dress for the captain's dinner to be held on our cruise. While I was trying to unsuccessfully squeeze into a small, one shoulder white dress with gold designs trailing the arm, I received the return call. There in the dressing room, with my head halfway through the dress, my breasts smashed flat, and my arm dangling through the top of the dress, I received the results with bated breath. My nurse was relaying the results from the AMH (Anti-Mullerian Hormone) test. For those of you who are new to the world of infertility and its jargon (like me) the site, createhealth.org, describes AMH as the following:

Anti-Mullerian Hormone (AMH) is a protein hormone produced by granulosa cells (cells lining the egg sacs or follicles) within the ovary.  AMH can be measured in the blood at any time in the menstrual cycle as it is stable throughout the cycle.  It is a marker for ovarian (egg) reserve.

Ovarian reserve testing, as defined by the American Society of Reproductive Society is:

Ovarian Reserve Testing: When attempting to test for a woman’s ovarian reserve, the clinician is trying to predict whether she can produce an egg or eggs of good quality and how well her ovaries are responding to the hormonal signals from her brain.

Another take on these two topics from thebump.com is:

AMH, or by its full name, Anti-Mullerian Hormone, is a hormone that’s produced by small follicles in the ovaries. It’s not something you’d tend to spend a lot of time thinking about, unless you’re debating trying IVF, in which case AMH’s importance goes up substantially. Fertility doctors use a blood test to measure your levels of AMH as a way to help determine your ovarian reserve -- or approximately how many eggs you have to work with. The higher your AMH level, the more follicles you have, and therefore the higher your potential remaining egg supply. And an AMH test is an indicator of the quantity of your eggs, not the quality.

The foreign results, a number given to me and coined "very good", was either a 42 or 43 (at the moment I can not remember). I was ecstatic that this was good results even if I did not understand what it truly meant. At the conclusion of my shopping trip, I researched the results and createhealth.org provided this:

Interpretation of AMH results (As per TDL Laboratories, London)

Ovarian fertility potential	Values per 2nd generation assay (TDL)
Optimal fertility	40.04-67.9pmol/l
Satisfactory fertility	21.98-40.03pmol/l
Low fertility	3.08-21.97pmol/l
Very low/undetectable	0.0-3.07pmol/l

This description of the AMH results does indeed show that my score of either 42 or 43 is "very good" or featured in the "optimal fertility" category. This newfound information was a huge relief for me. It helped to clarify my results and put me at ease, if only for a little while.

Lately I have prepared, prepared, and prepared, but I realize that some things in my life I can not prepare for. I knew that these results would be horrible, yet was pleasantly surprised. I guess you can not foresee the small blessings in life. Many times I am so optimistic, while other times I am surely counting down for the dawning of judgment day and the end of my world. From now on though, I think I will prepare myself for brighter outcomes because sometimes you have to have a little faith.

~Until next time....

A Letter to Support

Thanksgiving was four days ago and I am still so overjoyed because of the wonderful experiences I had. My family was amazing, the food was to die for, and the memories will last for eternity. I could type for days describing the wonderful week I had, but I would rather write a letter to support.

My letter to support is for everyone out there that has played a vital role in supporting not only me, but Willie too. The support has come in huge, visible ways and also small, yet still so meaningful ways. The support has come from strangers, from friends, from foes, and most importantly from family. Everyone I have encountered has a shared belief that no one should experience this type of hardship. Especially since it is a fact that this is what we are born to do. Reproduction is in our DNA and one of the sole purposes in life.

I want to thank everyone, especially my readers too. This blog would be meaningless without my readers. These words would feel empty and weightless. Every search, click, and view of my blog spurs me on. I want to believe that I am helping someone other than myself. I want to know that with every heartbreaking word, thought, feeling, and emotion that I type, someone benefits from my pain. I like to give and sometimes take, but giving is what gives me life. With every word that I give, I hope that understanding dawns, empathy is born, and knowledge is gained. I hope that these conveyed words are useful to my readers or even to someone they know that are experiencing this or a similar situation. Support is the greatest gift to give to someone who suffers from infertility. I do not need for everyone to understand, but simply accept it. Support me as I cry, discover, and move forward. The greatest gift is to simply be there as a shoulder to cry on or a wall of unwavering support. I become stronger every time I have someone to read or listen to my troubles. Thank you to each and every one of you who has done all the things I listed and so much more. You all are very appreciated and important in our lives.

Until next time