The Infertility Process

Struggling with IUI’s

After my blood sugars were on a steady track, my first cycle with the new clinic was scheduled in June 2016.  We went for our baseline ultrasound thinking we would go straight into an IUI treatment; however, they talked us into doing a follicle stimulating hormone, no trigger shot and timed intercourse.  I was not happy with this decision (because I can be impatient) but thought I’d try it their way the first time around. Unfortunately, it did not work and with the next cycle, I insisted we add the trigger shot and IUI.

The second cycle was moving along but when I had my second ultrasound to check the progression of my follicles, we realized that my body was not responding like we wanted so they decided to change my stimulating hormone in the third cycle to an injectable, Menopur.  My body was then almost too responsive and so by the fourth cycle we found the sweet spot, a full dose of Letrozole and a little Menopur then the trigger shot.

Since we had such good luck with our first IUI, we didn’t expect the disappointment of going so long without a pregnancy.  The waiting was brutal. First, there is the waiting for the cycle to start. Then, there’s the wait for the baseline keeping your fingers crossed there are no cysts or other problems.  THEN, there is the wait for the follicle check hoping too many follicles weren’t stimulated. At least during that time, you’re kept busy with medications. Once given the ok to move to trigger shot and scheduling the IUI, things move pretty fast.  After the IUI, though, there is the worst waiting of all: waiting to see if it work?

Because we used Hcg to trigger ovulation, I had to wait a full 14 days to test.  This time period allows the medication to clear out of my system so that an elevated Hcg test on a  pregnancy test (or a positive home pregnancy test) is an accurate result. I don’t ever remember 2 weeks moving more slowly.  Inevitably, I would think surely we are at Day 10 but it would only be Day 5. (Women who go through infertility treatments only have to say “the wait” and everyone else in their shoes knows that this phrase means this wait to see if their treatment worked.)

Towards the end of 2016, I started experiencing the disappointment of canceled cycles – and not from the Perinatal Diabetic Clinic (more on that story here).  I started having large cysts on my ovaries which are no fun and can be super painful. They can’t give me follicle stimulating hormones when I have a large cysts because the medications can cause the cyst to rupture – so instead, they put me on birth control because it helps dissolve the cyst.  

During what should have been the December cycle, we decided to use the time on birth control as a break for the holidays.  The thought was take it for 7 weeks with the idea of starting back up in January.

At some point in 2016, I was told about a reproductive immunologist in New York, Dr. Braverman.  I will devote a whole post on my experience with him but I will explain this one thing. I had made a phone appointment with him at the beginning of January 2017.  During the initial consult, he explained to me that he would run a bunch of tests, which he did, but explained for the simple fact that I have PCOS, I should be on a medication called metformin.  Metformin is used to treat Type II diabetes but in women with PCOS, studies have shown a significant decrease in inflammatory markers and a decrease in miscarriages. This was the first we’ve heard of it.

We made an appointment with one of the fertility doctors at our clinic to discuss the plan we made with Dr. Braverman and the metformin.  The doctor told us to be cautious about reproductive immunology because it’s a fairly new field and there has been few studies to show it’s significance in the infertility world.  He did agree, however, that metformin might help with my PCOS.

I don’t think I have ever seen Andrew so mad.  We were frustrated because we went through 5 cycles at their clinic and no one ever mentioned anything about metformin or it’s benefits in women with PCOS.  The doctor stated one of the reasons he didn’t mention it was because of the side effects: diarrhea, nausea, headache. But what I don’t understand is why wasn’t I given the option to try?

So, we decided to extend our break even longer to have my case looked over by Dr. Braverman and his office.  We figured there was no point in keep trying IUI’s when there was possibly something else wrong. Plus, it’s recommended limiting IUI’s to 6 in a lifetime – we had already had 5.  

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