|This pic was taken just after IUI #4. The wristband was used to help SRM make sure they inseminated me with the correct man's sperm.|
What's interesting to me is that whenever we've done an IUI (intrauterine insemination), things have always looked really good. As far as the doctors can observe, we shouldn't have any issues getting pregnant. I've even been told things looked so perfect that we could easily conceive twins. Optimal conditions for IUI on my part are when there is one follicle or more measuring at least 20mm, the uterine lining is thick and able to support a growing embryo, and when there's plenty of cervical mucus to help the sperm travel from the cervix up through the fallopian tubes. In every ultrasound I've ever had, the technicians have always found great follicles and commented on how thick my lining is. When we go in for the insemination itself, they always remark on how excellent Oscar's sperm counts are and what great cervical mucus I have (that's something I can brag about, right?...). Keep in mind, though, that these are just ideal conditions, not requirements for getting pregnant. Plenty of couples conceive with much smaller follicles and/or less than optimal body fluids. With everything Oscar and I have going for us, we should be breeding like rabbits.
In all but our 4th IUI attempts the doctor prescribed Letrozole for ovarian stimulation. This isn't because I need increased fertility, but simply as a precautionary measure to ensure I produce at least one good follicle. Letrozole is often preferred over other fertility drugs because it helps stimulate the follicles while also lowering the level of estrogen in the body. If the estrogen is too high, the body can hyperstimulate and produce too many follicles, putting you at greater risk of conceiving multiples. But if the estrogen is too low, the uterine lining won't become thick enough to support a growing embryo. Sometimes other fertility medications and injections are used, but it's really only done if the woman isn't responding well to Letrozole. My doctor mentioned this other more invasive form of IUI as an option, but she didn't think it would be particularly helpful for me, so I never chose to do it.
Fortunately I always responded perfectly to Letrozole. In our first three IUIs I built up one follicle that was over 20mm and another that was somewhere between 17 and 19. During our 4th IUI this past August I did not use any fertility medications in order to avoid complications with nursing, but I still produced one very nice follicle measuring 24mm. Tyler had weaned by the time we did our next IUI, so I used the Letrozole again and produced one follicle measuring 22mm and another measuring 14. And in this most recent cycle, I had my best results yet - one measuring at 22mm and one at 21mm. Since I didn't do the trigger until later that evening, they would have been even larger by the time ovulation was induced.
On Oscar's end they've already tested to make sure his sperm are healthy and shaped properly, so in the IUI sample they're really only looking for overall sperm count and if there are enough that can move well enough to get to the egg. These were the results from this past IUI. In pen they have written the minimum number they're looking for after the sperm's been washed. In concentration they wanted at least 15 million; he's at 118 million. In motility they want 40%; he's at 63%. In rapid and linear they want 15%; he's at 44%, and in total motile sperm they want 10 million; he's at 37.2 million. This was after only 36 hours of abstinence as they'd instructed us to have intercourse 36 hours prior to the IUI in order to cover the full period of ovulation. With a longer period of abstinence he's had even higher results. Obviously our inability to conceive cannot be blamed on inadequate sperm.
Because of our past history, we're really not expecting to get pregnant from this IUI, but we'll at least have gained some additional closure in our conception struggles. After 6 failed IUI's where everything look optimal combined with over 7 years of attempting to conceive on our own, it's extraordinarily unlikely that we'll ever conceive without the help of IVF. But at least we'll know we've done everything in our power to conceive, that it's likely my body simply doesn't send fertilized eggs to my uterus, and that conceiving on our own or with IUI would literally require an act of God to make it happen. I think I'm in a good place of acceptance with it, and I'm crazy happy that everyday I get to love a wonderful little boy who's even more adorable than anything I had ever hoped for. The other day when I was saying my prayers I said "God, thank you for this cute little boy. You know how much I longed for a baby. I would have gratefully taken a grumpy, unattractive child and never wanted anything more. But this extra cuteness and sweet disposition is an awesome bonus!"
Update: IUI #6 was also unsuccessful.
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