Thinking of having IUI?
42 Replies
Ann - August 2

Hi Lena, It went well again today. They want me to wait and take a blood test in two weeks, but I doubt I'll be able to hold out that long to test! I had two follicles on Friday. But only one was going to be ready. It was 16mm and I got the shot on Sunday, two days later. So it should have been at least 18mm. I had some pain yesterday afternoon through last night. And only a little this morining. Now I have none. So I am guessing that it worked ok. Does you Dr. take an ultrasound the day you go in for IUI? Is this how they tell how many eggs you ovulated? When can you test?

 

Lena - August 2

Glad to hear day #2 went well. Yes, my doctor U/S me the day before IUI, and both days of IUI. Its not his standard practise too do so, but I've asked him to do so. I do this with the horses and my IUI success rate with the horses blows his IUI success rate in the dust so he does it for me. For example this cycle, my u/s on IUI day showed no significant growth on two of the follicles when compared to the day before, so I elected to wait one more day before starting my IUIs. Hopefully it worked! When you ovulate, the round follicle will appear as a star-shaped structure. This is the CL.

 

Beth - August 2

Hi I'm so glad to see there are others out there having IUI this week. I just had my second IUI today. I'm taking Femara and did the HCG injection yesterday. The one follicle I had was 24mm and my uterine lining was 10mm yesterday. My doctor did not do an u/s today do you think I should have had him do one? What kind of changes would you be looking for at this point seeing as though the follicle was of good size yesterday? Any info would help. Baby Dust to all!

 

Ann - August 2

Welcome Beth! It sounds like your follicle was a good size. Good luck this month. I'd love to share symptoms as we continue. We should be right around the same time frame for AF. As far as what to look for, I don't know I'm new to this and Lena has very generously shared her guidance. I am wondering if I should ask for an u/s next time(if this doesn't work). My timing was over a weekend when the u/s person wasn't in. I guess there is nothing I can do now but wait this month. Also, I am supposed to start progesterone on thursday. Has either of you taken progesterone?

 

Ann - August 2

Lena, I'm a little nervous to sound ignorant here, but what did you mean by "with the horses". I am trying to educate myself as much as possible. I feel my Dr.'s are competent, but I still think that knowledge is by best friend during this process. Thanks.

 

Lena - August 3

I meant "with the horse" because half of the year I manage the breeding program of a large horse farm using IUI and embryo transfer. The other half of the year I work in research on horse IVF & ICSI. I was just commenting that my conception rate using IUI with frozen semen was much higher than my doctors. The repro-sound horses I breed become pregnant 75% of the time on their first cycle. (The sciene has been around much longer and more wide spread for horses than humans) My doctor averages 15% with his human clients. The national average for humans is 10%. So I give my doctor a hard time about this.

 

Beth - August 3

Ann, I have not used progesterone before. When I was on Clomid my progesterone levels were always very high, in the 80's, so my doctor doesn't think they'll be any lower on Femara. Did anyone monitor BBT after IUI? I did last month and right on target my BBT shot up a lot. This month my BBT was actually lower today than yesterday when I had the IUI. Do you think this might mean I haven't ovulated yet?

 

Ann - August 3

Hi Beth, I don't chart my BBT, but I have been reading about it this week and think I will start next month, if I need to. I wasn't sure if the HCG shot interfered with your temps.?? So I don't know if the drop you had means you didn't o. Have you had any pains or noticeable cm changes? Maybe you could get a progesterone test to check that you did indeed ovulate.

 

Ann - August 3

Lena, what an interesting field of work! I was going to ask how you became so knowledgeable about these reproductive issues. I grew up around horses because my sister has ridden since a she was a child. They are amazing animals. I can't believe the discrepancy between success figures in horses and humans. I wonder if sometimes we are so emotional that it plays a part in our being able to conceive? Or, like you said, the science has just been around longer for the horses. If you don't mind my asking, how long have you been ttc?

 

Lena - August 4

Stress can definitely play a big role in conception. A study was published just two weeks ago about this. I also remember reading another study that suggested stress can influence the sex of the child. If the mom is more stressed, then the baby will be a boy. If the dad is stressed, then it will be a girl. I don't really buy into this, but thought the study was interesting all the same. So horse's have a higher conception rate than humans for a few reasons. (1) Horses have been selectively bred for fertility for hundreds of year, obviously humans haven't, (2) Fertility sciences are "invented" in cattle but refined in horses because humans and horses have very similiar hormonal and immunilogical reactions, (3) Breeding manager are paid on their conception rate because mare owners have little tolerance for a non preg mare. When I started IUI for myself, I was amazed at how little management is done for our cycles. We even went to another RE clinic thinking the first one was bad. With horses we u/s daily. On the day of ovulation we u/s 2 - 3 times and inseminate immediately upon O. We use straws instead of ampules for the semen storage because straws (which are thinner) evenly freeze the semen more quickly and thaw more evenly. The IUI is peformed IMMEDIATELY upon thaw. We work in a dark room and don't let any air come in contact with the specimem. For my first IUI cycles they u/s me 2-3 days prior to O, so O was an estimate at best, and I wasn't called into the IUI room until after my specimen had been thawed. I don't know about humans, but in horses thawed semen only has minutes to live if its not kept at a consistent temperature in a dark environ. (4) Thawed semen inside a mare will last 24 hrs. My husband had an unsuccessful vasovasectomy 39 months and we've done 10 rounds of IUI (5 w/clomid).

 

Ann - August 4

Lena, thanks for elaborating. From the points you mentioned, I could see how there is higher success rate in horses. You seem to follow them closer than our Dr.'s follow us. I think one thing that bothers me is what you mentioned about the u/s's. I got mine three days before my IUI also. So even though they induced ovulation, the size of the follicle was a guess. It was probably 20mm when I ovulated, but I don't really know. Does an egg ovulate if it isn't ready, but is induced? When I go to my Dr. I often feel like she is too relaxed about this whole process. She has a very flat affect and I tend to be emotional, so I think I might scare her a bit. I have not seen a specialist yet, and I am thinking that it should probably be my next step. I teach, so the summer has been a good time to start this. But I am completely open to taking days off as needed. Unfortunately, I won't be able to do IUI again next cycle because it would fall in the first couple of days of school. I think it would be unfair to leave the kids that soon. Also, talk about not relaxing! I'd be so worried about my class that I don't think it would work anyway. I am not feeling very positive about this round. Last time I got pg, my chest was sore the night after we conceived. Everything I read says you wouldn't see signs that early. Believe me I didn't imagine it. It was so painful that I could not sleep on my stomach. I have no such signs this time. But since it ended last time in a m/c I am thinking that maybe that wasn't a good sign?? This will be month four for us post m/c. It took us seven months the first time and only got pregnant after they checked my tubes. I am wondering if I should request that again. Keep me posted on how you are doing. It is nice to share my feelings with people who are going through this too. Sorry this post is so long!!

 

Lena - August 5

When I first started going to my RE I was intimidated. I figured he's a human DR and I just have a masters in horses so he has to know this a whole lot better than me. I asked a lot of questions and then always qualified that I did it differently with the horses. (For example using the semen immediately upon thawing). It wasn't until I had an u/s w/ a nurse practioner and she saw an irregular shaped "follicle" on my ovary. She had to get the RE and they looked at it for a long time while I kept saying, "Hey that's a CL. That what a follicle looks like within 6 hrs of ovulation." When I got home I looked it up in a radiology book and sure enough the CL in the book looked just like mine. That finally gave me the confidence and credibility to insist on procedures that made me more comfortable. This is the first cycle where I really felt positive that we were optimizing my chances and this is the first cycle where I actually think I might be pregnant. AF's due tomorrow, so we'll see. So regarding your question about ovulation of a mature egg: The follicle will only release a mature egg. Should you have a 14mm follicle when you were given hCG, then most likely it would regress. hCG can do some tricky things though. With horses its possible for them to have 30mm and a 20mm (equivlaent of a 20mm and 14mm in humans) and the larger follicle regresses while the smaller one hastily grows and ovulates 5 days later. The next cycle would then start 5 days late because this smaller follicle would actually be the one producing progesterone. With horses this happens about 50% of the time. I'm not sure how often this occurs in people.

 

isa - August 5

check this website for faq's on iui's it looks like a really good site.
http://www.fertilityplus.org/faq/iui.html

 

Ann - August 5

Lena, I can understand feeling intimidated with your RE in the beginning. I think we all feel like they are the expert. But then things happen like seeing the CL and it makes you wonder. When first seeing my Dr. about infertility testing I mentioned that my dh took a home sperm count test. She didn't even know that they existed. Also, the last Dr. I saw (who did the IUI) asked me if I had started taking my progesterone. This threw me because if you take it too early you will not o. I think we were misunderstanding each other, but it still made me worry a bit. I do ask a lot of questions and as I am learning more I will continue to ask and begin to request things like more u/s's. I am at the point where I feel like they need to be more attentive. Like I said though, I think I will be ready soon to move on if my IUI's are not successful in the next few months, or if I feel they are not providing the service I feel I need. Thanks for the info. about the eggs. I was hoping that if it wasn't ready I wouldn't O. But I think the timing was ok. Anyway, I am so excited for you. I really hope this is the month! Are you going to test tomorrow? Let me know how it works out. You will be in my prayers.

 

Ann - August 5

Isa, thanks for the website!

 

Lena - August 6

I tested about 45 minutes ago and it was POSITIVE!!! I can't stop looking at it. We are trying to not get excited about it tonight until after we do the hCG test.

 

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