IUI Cycle #6: The Results are In...

... Time to move to IVF. My 6th BFN. It's weird, I didn't cry this time - almost like I knew it was coming. My heart just feels heavy with the news, but not emotional. I think since fail #5, I had a feeling IVF would be inevitable since I knew the % chances go way down after IUI try #4. I feel so resigned about the whole thing. 

Beta Test

When I got my blood drawn for the Beta Test to confirm, I was a bit teary eyed when I told her that I'm expecting it to come back negative. But the sadness I feel is a little less because I'm trying to focus on positive things and figuring that: 1) I'm doing all I can do to have Baby C and 2) Maybe it's not the right timing. 

Looking back on my life, situations that seemed dire or didn't go as planned, I stressed about and worried about excessively. Yet, everything worked out as it should, which I realized after I had some perspective. I'm trying to look at this the same way. Everything will turn out as it should... even if it's not how I imagined it originally. 

IVF 

So, there's absolutely NO guarantee that IVF is going to work for me. I am going into it realizing that. I don't want to get my hopes up. IVF will be my last shot at making Baby C a reality... I'm absolutely hoping for the best, but I don't want to have unrealistic expectations about the entire situation. I've read too many blogs and have been on too many forums to realize that IVF doesn't work for everyone. With that said, it's my best and only chance at having a baby at this point... Which means I have to give it a try. Because as I mentioned, I want to do all that I can do. I almost feel like this is my "Hail Mary" of a try. Depending how things turn out, I'll have to reevaluate and determine next steps. For now, IVF is the next road to venture down. 

Next Steps: 

• Call Insurance & get infertility approval. I will get assigned an infertility contact person at my insurance company to help me through the process. 
• Wait for AF & schedule CD 3 ultrasound to check for cysts. 
• IVF consult 11/9 @ 4pm. Hopefully will get IVF calendar & go over all costs. Get a better idea of how it's all going to work during the follicle stimulation, Egg Retrieval, and Egg Transfer. 
• I need to get my IVF questions ready. I have an entire list that was on the SMC forum, very thorough list! Questions I never thought to ask. I just need to funnel through it, edit, and add some of my own. I will post my Q&A list when it's complete. 

IUI Cycle #6: Two Week Wait

Here I am... My last IUI Cycle #6 and my 6th TWW. Let me tell you, the TWW doesn't get easier the more cycles you go through.

• After the IUI, I was bloated again and a bit uncomfortable for the rest of the day. 
• 24 hours after the IUI, all I could think is: "If it is going to happen, it's happening now." The first 24 hours after an IUI is when things should happen. But you still have to wait the full two weeks to figure out if it did. Wish there was some way to know sooner. 
• When I started the Progesterone, had all the same symptoms as previous TWW's, unfortunately! Not that I was expecting something different, but it would've been nice to have less symptoms. Going to sleep at 8pm is not that productive! 
• Being so tired on Progesterone and then having to do feedings at night for my new foster son, Munchkin -- was a bit exhausting! I'm tired. I could sleep for a whole day straight if I had the opportunity! Maybe I'll have the boys go to a babysitter for a day so I can rest. Hmm... 
• Still getting hot flashes. I hate those things...! 
• I always have the most vivid dreams during the TWW. This can be good and bad! They just seem so real. 
• During the second week stretch of the TWW, I was anxiously excited to find out if this cycle works. It's like so much is riding on how this cycle turns out. Either I'm preparing to welcome Baby C in 9 months or I'm preparing for IVF... Which both directions would be uncharted territory. 
• As I get closer to testing if this cycle worked or not... I am a bit nervous. I don't want it not to work... So it's a bit nerve wrecking. Right now, there's nothing I can do. It either worked or it didn't, it's just a matter of waiting and finding out what the next steps are. 
• Started getting AF cramps, so thinking this cycle is a bust. Scared to do a HPT... 

Thoughts On IVF 

I've gone back and forth on whether I REALLY want to start IVF right away. Most of me wants to wait, take a few months off, lose some weight, get back into shape, get re-connected with myself, save some money. However, the truth is that it's a money issue. 

If I do IVF in 2015, then almost everything is covered. This is what it'll look like: 

• I've already met my deductible of $500 
• Insurance will cover 80/20 of costs up to my out of pocket fees of $2000 
• I have about $500 left to reach the out of pocket fees of $2000
• Then, insurance will cover 100%
• Total Cost (not including donor sperm) = $500 

If I wait until 2016, then it'll look like this: 

• Meet Deductible $500 
• Insurance will then cover 80/20 of costs until I meet out of cost fees of $2000. 
• Then, insurance will cover 100% 
• Total Cost (not including donor sperm) = $2500 

That's a huge difference, right? I might as well just jump right in. I have to keep in mind that insurance doesn't cover donor sperm (of course) and doesn't cover genetic testing or any extra things (i.e. assisted hatching). So, if I want those things done - even if I do them in 2015 - these things will be out of pocket. There is a potential for more costs in 2015 if I go that route. 

Anyways, it's been playing with me. I've gone back and forth on -- WAIT till 2016. Then, NO let's do it in 2015. 

Another factor that's playing into my decision on moving forward with IVF is that I'll be on adoption leave for all of December. Which makes it easy to do the Egg Retrieval and Egg Transfer, without having to take time off of work. 

Ugh. Choices, decisions, $$, time. Let's hope that I don't even have to go there and that this cycle #6 worked. Only a few more days until I find out. 

Next Step: Beta Test 10/27/15 @ 8:00 a.m.

IUI Cycle #6: HCG Trigger + Last IUI

I forgot to add an entry when I did my Trigger Shot! Had my trigger on Sunday @ 10:30 p.m. It wasn't too bad. I stayed up and watching the premier of season 6 for the Walking Dead and then did my trigger. Good excuse to stay up late! Same trigger shot, Pregnyl 10,000 iu. I must be getting so used to doing shots, I didn't even have to read the instructions and the mixing/injection went smoothly. No pain or burn. 

Last IUI - #6 

I had my last IUI this morning. I do feel optimistic about this cycle. However, I'm also planning for IVF if this cycle doesn't work. Even though I'm planning for contingency purposes, I am still feeling extremely hopeful this cycle will lead to a BFP.

Sperm Analysis: 38.7 million Motile Sperm, 43% Motility with a Progressive Motility of 4.

The IUI procedure was the smoothest I've had in all 6 tries. My RE's office has 2 RE's. The RE that is not my *main* RE did my IUI's #1-4. The nurse did my IUI #5. This is the first time my main RE did my IUI. Which is nice because it was the least painful of all of them! The speculum went in really easy - no pain. I didn't even feel the tickle of the catheter going in. He went slower than the other two, wasn't rushed. When he was done he said, "The sperm stayed in the uterus." LOL. Kind of funny. Then he wished me luck.

Hoping Donor #3 is the lucky one and hoping #6 IUI is also very lucky. Here's to hoping the TWW doesn't go by too slowly and that at the end of the two weeks I'll have good news to share. 

Next Steps: 

1. Starting Tomorrow: Progesterone Suppositories 
2. 10/27/15 @ 8:00 a.m.: Beta Test 

IUI Cycle #6: Follicle Stimulation and Mid-Cycle Ultrasound

I have hope that this cycle will be successful. Maybe lucky #6? I remember when I had my first consult with my RE, when I was still deciding between medicated vs unmediated IUI's. In hindsight, I'm glad I opted for medicated from the beginning. With having such a hard time getting pregnant, I would've wasted those cycles. 

At the initial consult, we briefly discussed insurance not covering fertility treatments until 6 failed medicated tries (for >35). He then said that maybe the insurance companies know what they're talking about because he had a patient that got pregnant on her 6th IUI. Strange to think that I'm here on my 6th IUI now. I remember thinking that it wouldn't take me that many cycles to get pregnant... Oh the naivety and optimism I had early on thinking that it would be "easy" to get pregnant. Tsk tsk.  

Hopes for this Cycle 

Here's what I'm hoping for from the mid-cycle ultrasound: 4 mature follicles >17mm and lining >7mm. 

CD 3-7, Clomid 150 mg 

This is my 6th and final cycle of Clomid and my highest dose. I have to say, the hot flashes were more like being overheated. All. The. Time. Oh the joy of Clomid.  I was like a walking inferno. Blah. Clomid is no joke. It was also harder for me to swallow these pills this go around. Not sure why, they just felt dry and would get stuck in the back of my throat. Yuck. I normally don't have a problem with taking pills. Maybe it's a mental thing? 

I was really emotional on the Clomid as well. Quick to cry over any thoughts about the upcoming Adoption of Little Guy :) 

CD 8-10, FSH Injectable Gonal-F 75iu

This is my second cycle on Gonal-F. As it turns out, the pharmacy never told me I had to refrigerate the Gonal-F! So, last cycle I didn't refrigerate it. Ugh. I don't think it made a difference, as far as follicle stimulation goes, as I still had 3 follicles in Cycle 5. But it would've been good to know! This cycle, it's sitting in the refrigerator.

The first injection is always the hardest. I don't know what it is about the 1st injection, but I always hesitate. I let the Gonal-F sit outside the refrigerator for about 20 minutes, so that it wasn't too cold. Then, I mixed and injected. Same burning sensation when the medicine went in and the plunger was hard to push in. Other than the normal "giving myself injection" thing, it went relatively quickly.

Second and third injections went much more quicker and I didn't hesitate as much. 

Mid-Cycle Ultrasound Results

I had my mid-cycle Ultrasound today.

I wasn't that happy with the results of the ultrasound. But at the time of the ultrasound, I still had one final Gonal-F injection and the follicles still have a few days to grow (they grow 1-2 mm a day).

• Right ovary: 16mm, 12mm. The 12 is a "potential" one. If it grows 1-2 mm a day, it can get to maturity and release with the other ones. 
• Left ovary: 16mm, 9mm. The 9 is probably not going to catch up. 
• Uterine Lining: 6.49 mm. Should be >7. The lining should continue to get thicker until IUI day, so nothing to worry about that it's under 7. 

So, even with the increase in the Clomid to 150mg, I still had the same reaction to the meds -- 3 follicles. Which was disappointing. I was hoping for the stimulation to result in a better reaction. But, as I've learned in the process - there's really nothing I can do about it at this juncture. Just have to roll with it and hope for the best. 

IVF Preparation 

It's weird "prepping" for IVF when I'm in the middle of an IUI cycle. But surprisingly, it's a good thing that I am or else I probably would've had to wait until 2016 to do one cycle. We discussed jumping right into IVF if IUI #6 doesn't work. If I get a negative this cycle, this is how it would go down: 

• I need to call on CD#1 and schedule a CD#3 ultrasound. They'll check for cysts and then put me on Birth Control. 
• I'll need to call my insurance and get the approval codes for infertility coverage... 
• IVF Consult to go over procedure / costs / etc. 
• Take meds. 
• Egg retrieval week of Dec 7
• Egg transfer week of Dec 14. 

Let's see how things go down. I'm really hoping #6 is successful and I can cancel all the IVF appointments. I've been really worried about doing IVF. Now... I'm not as nervous. I feel OK about it. I think it's actually better because if #6 doesn't work, I will at least have better % chances of IVF working. Plus, knowing if the egg fertilized would be nice... There's also other options of testing the embryos (PGD testing). Not sure I'm going to do the PGD testing, will have to get costs (I don't think insurance covers that). 

Either way, I'm feeling optimistic about try #6 and I'm feeling content with moving towards IVF if #6 doesn't work. After all is said and done, I'll figure out next steps. Right now this is the game plan.

I also told my RE about my upcoming adoption of Little Guy :) I've spoken about Little Guy before, so he knew that it was possible I could adopt him. I shared the good news about adopting on National Adoption Day. I also told him about Munchkin coming to live with us. It was kind of weird talking to my RE about my kids when I'm trying hard to have one. I wonder if he's thinking, "Why do you want a baby if you already have 2 kids?"

Well, with foster care you never know what's going to happen with the case. Little Guy is my #7 foster child and he's my first adoption. Munchkin is my #9 foster child and it's too early to see how his case is going to go. I've mentioned it before, but I want to give Little Guy a sibling... I've also always wanted to get pregnant and have a birth child - just as much as I've always wanted to be a foster parent and how I've always wanted to adopt :) All are equally important and precious to me.

I'm extremely blessed to be adopting my Little Guy and I feel grateful to have Munchkin with us (for as long as he stays). I would've moved forward with TTC Baby C either way, once I turned 35. I always planned to take this path eventually. I'm glad I'm trying... I don't know if I would've been happy with my life if I haven't at least tried to have Baby C. I have no clue how this will all end... If I'll have a baby at the end of this... or if I won't. But, I'm glad I'm doing all I can do - so that I'll have no regrets at the end of all this. 

Fingers crossed that things work out this cycle. If you have any baby dust to spare, I would appreciate you sending some my way! :) 

Next Steps:

1. Trigger Shot: 10/11/15 @ 10:30 p.m.
2. IUI: 10/13/15 @ 10:30 a.m. 
3. Beta Test: 10/27/15 
4. IVF Consult: 11/9/15 @ 4:00 p.m. 

Choosing Donor #3

Well, when I ordered Donor Sperm last month, I decided to order only 1 vial - to try to save money. As it turns out, Cycle #5 was a bust and I'm not pregnant. So, here I am ordering Donor Sperm again. Initially when I ordered Donor #2 last month, he had a bunch of vials available for purchase (20+). I was sure Donor #2 would be available again if I needed to purchase for Cycle #6. As it turns out, Donor #2 is sold out!!! Very popular it seems.

Luckily I'm not too attached to Donor #2 since Cycle #5 didn't work, so now it's moving onto Donor #3.

Picking Donor #3 was relatively easy. Originally, I thought I would go with my second choice from my search last month. But something just made me not want to choose him. I did so much research on donors last month, that I just reevaluated a few of my top choices and chose one from there.

Easiest donor choice I've made thus far!

One vial has been purchased. If Cycle #6 doesn't work, I'll have to figure out what type of vials to purchase for IVF. As I'm not sure how many vials they'll want and if they prefer ART vials vs. regular IUI vials. But that's a bridge to go over when/if it comes to that.

Will see if I stick with the same donor if I move to IVF... I have my "Top 5" that I'm OK going with. Good medical history, nice interviews, etc.

Lucky (hopefully) Donor #3 vial of baby-making goods should arrive next week.

IUI Cycle #6: Back to the Starting Line... Again. Baseline Ultrasound 6.0 Style

When parking at the RE's office, I had this feeling of dread... Never felt that before during any of my cycles. I even said to myself, "I don't want to do this" and tears filled my eyes. This journey is so much harder than I ever anticipated. I was thinking how easy it would be to just stop, to not move forward with this, how it wouldn't impact anyone really -- just me. <sigh> The momentary thought stayed with me, but I went through with the appointment.

Here we are, my last IUI attempt -- #6... or so I think. I decided to go ahead and get my blood work done, so that if #6 doesn't work, I can get approval from my insurance to move forward with IVF. When I was discussing with the billing expert about possible next steps with IVF, she told me she's going to confirm with my insurance that IVF will get approved. I'm now really worried it won't get approved! I'll find out Monday. She said there might be a loop hole where I may need to do another 6 medicated cycles under the insurance, prior to IVF getting approved. All I could think was WTF. I didn't even think of this as an option. I thought it was a "for sure" thing that coverage would kick in after 6 medicated cycles. She's going to confirm Monday and get back to me. So now I will be stewing all weekend on whether or not IVF is even a possibility. Ugh. If it's not... I'm done trying for now. I can't afford IVF out of pocket and I'm not going to waste more money on IUI's when the percentage of success is so low after 6 tries.

My RE said that last cycle looked great on paper. They're not sure why I'm not getting pregnant. My last few cycles have looked excellent... I have to start really believing it has to be egg quality. Or just bad luck...? Who knows.

Baseline Ultrasound

Here's my starting point for this cycle:

• Right Ovary: 5-6 follicles 
• Left Ovary: 6 follicles 
• Uterine Lining: 4.57 mm

We are sticking with the mini stimulation cycle and just upping my Clomid to 150 mg. RE said he probably wouldn't cancel the cycle if I had a lot of follicles because my past cycles were unsuccessful. Normally, if I had more than 3 - the cycle would get cancelled. My last 3 cycles I've had 3 follicles and have not gotten pregnant. So, if I have more than 3 this round - he said he wouldn't cancel it. 

Medication Protocol:

• Clomid CD 3-7, 150 mg 
• FSH Gonal-F CD 8-10, 75 iu 
• Baby Aspirin 81mg 
• Trigger HCG Pregnyl 10,000 iu 

How do I feel?

I don't really know how I should feel... Frustrated. Nervous. Anxious. Worried. Just to name a few. I really want this cycle to "be it" - as IVF is the next logical step... If insurance truly kicks in that is... So much is in the air, I just hate it. I want to be positive and optimistic... but at the same time, I think it may be time to take a break if Cycle #6 doesn't work...

Next Steps:

1. Purchase Donor Sperm  
2. Clomid for CD 3-7 
3. FSH Gonal-F CD 8-10 
4. Mid-Cycle Ultrasound on 10/9/15 @ 2:15 pm