First off I have to mention I am not a medical doctor. If I was chances are I wouldn't be writing this post! I do however have a PhD in molecular biology, have studied developmental genetics and generally do a lot of research into things. So I decided to write this post to answer a lot of the questions I have had and that many people seem to have about the IUI process (and the difference with IVF). I also want people to know how hard this process is emotionally and physically. It takes a real toll on you mind and body.
So far I have had 5 IUI's and 2 pregnancies - so I have had a 40% success rate. Most IUI clinics have lower rates - on average they give you a 20% chance on every cycle. You need to do at least 3-4 cycles before throwing in the towel and moving onto IVF - because of these statistics. And you need to remember these statistics come from couples who are having problems conceiving, so they will be lower. My son was conceived after 3 IUI's, and my angel baby after 2. I am praying my next baby works after one - so I can have a 50% success rate. Now that would be awesome!
There are a variety of different ways you can do IUI.
1. Natural cycle - no medications taken, you wait until you have your surge (when your egg will be released) and go into the clinic and have your insemination.
2. Clomid cycle - you will be on a tablet - where they may or may not monitor you closely. Again they will wait till you surge (or give you a shot to make you surge) and you will go in for an insemination.
3. Injectable cycle (what I did) - you inject yourself daily with medications and will be monitored closely. They will give you a shot to make you surge/ovulate and you will go in for an insemination. I will be discussing this process below.
What happens before the process:
Each clinic is different. But most will do something along these lines. Please check with your clinic on how they will treat you. They will do blood tests on you and your partner to check you have no infections or underlying problems. They will also do a sperm analysis to see if your partners sperm is high enough and motile enough to get pregnant without IVF. They will also do some sort of internal check - normally a day procedure - to check for scarring, blocked tubes and endometriosis (and maybe some other things never mentioned to me!). They will then let you know if you are suitable for IUI. You then wait for AF (Aunt Flo - your period) and call the clinic when it arrives.
Day 3 of your cycle:
You will go in and they will check that you are not pregnant and that you have no cysts on your ovary. If you have cysts they will cancel your cycle - and may put you on birth control pills. If all is okay they will tell you how much medication to inject yourself. This is a hormone which helps ripen up those eggs! The first cycle you do is always hit or miss. Due to them not knowing how your body will respond to the medications, they need to monitor you and see how you go. They may up your meds if you don't respond, or cancel your cycle if you over respond (more on that later).
Day 3-14 of your cycle:
At some point you will go back in and they will check you to see how many and how big your follicles are. You may then be asked to come back in, or be told to give yourself your hcg/ovidrel shot (pregnancy hormone which will make you surge and release your egg (ovulate)). They will then do your insemination.
Day of IUI:
Your partner will need to give a sample that morning (unless they have a frozen sample), which they will clean and prepare. You will go in a few hours later where hey will insert a catheter into your uterus and inject you partners sperm into you. You may find you bleed and cramp a little after. That is normal!
About 3 days post IUI :
They will test your progesterone levels. This tells them if you ovulated. It tells nothing more. I have great progesterone levels, but still need progesterone support as my hormone levels drop off too early for my to sustain a pregnancy. I also have had sky high levels without being pregnant. Lesson : Don't read into it!!
About 14-16 days after IUI:
If AF has not arrived you can go in for a blood test to find out if you are pregnant (if you haven't tested already).
So that is the nuts and bolts of it.
The fine print :
The whole process is torturous. The first part of your cycle you are constantly worried if you will be over stimulated. What does that mean? Well it means you produce too many follicles. They will cancel a cycle if you have over 3 follicles where I live - and I highly recommend you don't go ahead. I have just read a story of a woman - desperate for twins - who had 10 follicles, and went ahead and now has a suspected quintuplet (yes 5) pregnancy. She is at high risk of losing all the babies, needing a reduction or losing her own life. As much as we want a pregnancy, be aware that lots of follicles can result in a high multiple pregnancy. And that is ten times worse than a cancelled cycle. I don't envy this woman or the choices she will have to make.
The hormones make you Crazy! With a capital C! I cried, I screamed, I wanted to throw my husband out of the house. Just some of the fun of the party.
The two week wait is horrible. Dr. Google is NOT your friend. You will find out soon enough, just try and have faith!
Can I do a pregnancy test with a home kit? Yes you can - but be aware the trigger has pregnancy hormone. On average a 10,000 unit injection of ovidrel will take about 10 days to get out of your system (1,000U a day), but changes with different people due to your metabolism. So if you test too early you may have a false positive. I tended to test at home at 12/13dpiui (12/13 days post IUI).
What if it doesn't work? You can jump straight into another cycle as long as they are happy you have no cysts (or large cysts). I had a baby one when I went in for my third cycle and got my son :)
Find a support group. Some great support sites are around with women going through what you are going through - have a look for them.
IUI is great if you end up pregnant as you are so closely monitored! Lots of blood tests, scans and a hopefully supportive doctor to help you through your first trimester.
So what about IVF?
The big difference is you are on a lot more drugs on IVF. They want lots of eggs - so you are on much higher doses of the same drugs, as well as drugs to stop you from surging and releasing eggs early. You then go in for surgery where they will aspirate (collect) your eggs as they are starting to be released (once they are released they can't collect them). The eggs and sperm are mixed together, monitored and then some are put back into you. It is a much harder process than IUI physically, and the mental challenges are still there.
Final disclaimer:
Each clinic has it's own protocol. I have written about my experience and what I have learnt. Please contact your clinic if you feel something is wrong, or you have more questions. This can be an expensive process, depending on where you live - and you need to feel comfortable in what you are being offered.
This is not medical advice or guidance. Contact your clinic for more advice.
Any other hints or tips out there on how it went for you?
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