Wednesday, September 21, 2016

Fertility Journey | Femara & IUI

Disclaimer: Female anatomy. Blah blah blah. You get it by now.
Here we go! The next step in our fertility process. If you are just starting out reading about our journey, you can find the rest of my posts below.
The Beginning 
First Visit with Fertility Doc
Round of Clomid

Again, I wrote these posts back when we were actually going through this and I wrote a little something on almost every day. That way you can see what was going on back then, before I was ready to share everything.

March 11-April 9

As I shared last month, Richard and I started out with a round of clomid just to see if it would work for us. Since we did not get pregnant, the next step was to move on to an IUI, which stands for intrauterine insemination, aka artificial insemination. This is when they they take sperm and inject it directly into the uterus at the exact time that an egg is also passing through. This way the sperm does not actually need to travel, it is already there and the idea is that it is easier to conceive.

Cycle Day 1: After seeing spotting and knowing my period was on its way, I was not surprised to get it shortly after stopping my estrogen supplement. This is probably TMI, but what isn't these days? My cycle was significantly lighter than normal, like normally I feel like I am dying and this time I hardly even noticed it. I think it must be because my lining was so thin.

Cycle Day 3: I get a call from Walgreens on a Sunday afternoon telling me that my prescription is ready. I haven't even gone into the doctor yet so I was confused on how I had received a prescription already. Since I was curious, I decided to go to Walgreens and see what was there. Sure enough, I had fertility medication waiting for me, but it was not Clomid like I did last month, it was Femara. My doctor had made a comment last cycle that the thin lining was a side effect of Clomid so she might want to try Femara next month. I had not heard anything since so it seems that she decided to do that this month. So new month, new drug. I then spent the rest of the evening doing research on this new drug and there is a lot less information about it than Clomid.

Cycle Day 4 (Femara Day 1): Since the first day of my cycle landed on a Friday, that would make my typical day three ultrasound be on a Sunday. So I had to do a day four ultrasound instead. This is just the initial check to make sure that the lining of my uterus is thin like it should be for this point in my cycle. They also take some blood to make sure my estrogen levels have dropped enough to continue on with the next round of fertility medication. Everything was reported back to me as normal so I was given the green light to start my fertility medication. I was told to take 5.0 mg of Femara for the next five nights. Exactly like last month, just a different drug.

Cycle Day 6 (Femara Day 3): I feel completely normal and have not really noticed many side effects from the drugs. The one thing I have noticed, is that for the last three days I have had a terrible headache. Today, I felt like my brain was literally going to explode from all the pain. Since I had not even started the medication on the first day of the headache, I was thinking that maybe it was just pain related to my injuries from the car accident (in March) so I did not really think much of it. I just dealt with the pain since advil never helps me with headaches because my pain comes from tight muscles. Today though, my head hurt so bad I had to try to see if advil would work. And it worked wonders. I think since my headache went away with taking pain meds that it means that the pain was a side effect of the medicine. Whatever it means, I was relieved to not have to feel that pain anymore.

Cycle Day 8 (Femara Day 5): Today was the last day of the medicine and I am happy to say that I have had zero symptoms other than the headache. So far so good.

Cycle Day 12: They wanted me to come in on Day 11 for an ultrasound, but I was out of town so I couldn't. I went in for an ultrasound today so that they could check on the size of my follicles (follicles usually contain an egg) to see if they were big enough to release an egg. The ideal size is larger than 18mm. They found one big follicle for me in my right ovary that was measuring just under 18mm. There were a few others that were smaller, but most likely they will not be released because they are too small. Since my follicle was just a little too small, my doctor wanted to see if we could wait another day to trigger ovulation. She had a nurse draw blood to check that my LH levels were not too high. If the LH levels are high, this signifies that my body was going to ovulate on its own since that is the hormone that triggers ovulation. The results came back and the levels were low enough that my doctor felt comfortable waiting a day to trigger ovulation, in hopes that my follicle would get just a little bit bigger and be the right size.

Cycle Day 13: I was given instructions by the doctor to give myself the trigger shot at exactly 9 pm because it takes 36 hours from the time of the trigger shot for the egg to be released and in the tubes ready to be fertilized. Since I have an IUI scheduled for 9 am, 36 hours after the time of my trigger shot. I was writing the first part of this blog post when I was about to type that I need to time my trigger shot when I realized that it was 8:55 pm and I hadn't prepared my shot yet, so I had to quickly run inside since I was sitting on the front porch and get it together. I have to mix water with powder and then fill the needle, change the gauge of the needle and have Richard give me the shot since I am too chicken to give it to myself. We did a lot better this time than last month and it hurt less while Richard was giving me the actual shot. There is redness and itching again surround the injection site. We will see if I get a bruise.
Cycle Day 14: No bruise! I actually can't even tell we gave me a shot this morning so we are definitely learning how to do this!

Cycle Day 15: Time for an IUI! Richard had an appointment at 8am to umm, "collect" and then the lab will prepare the sperm for the actual IUI which was scheduled for 9am. Richard wanted me to come with him to the procedure and sit in the waiting room. He said he did not want to go to a fertility specialist alone. Hmm, alright. I wanted Richard to come with me to my appointment because if I actually do get pregnant, it would be weird for me to have done that without him even in the room. Ha, fertility treatments. They really change this whole pregnany process. After Richard's appointment, we headed out to get a donut because we had time to waste. Unfortunately, Richard could not eat a donut with me because he had to fast for his annual physical he had scheduled for later that day. Sad for him. We then went back to the office. They called us back and we went to a procedure room, which is much different from the normal rooms where I usually go. The nurse then brings in the "specimen" along with a report of the quality. She then informs us that they shoot for more than 10 million sperm, and they have collected 38.5 million. I would say we exceeded that goal and Richard got an ego boost. We waited a while longer and then my doctor came in. She took a syringe and filled it up. She then used a catheter to place the sperm inside the uterus. The procedure was somewhat painful, but it was again quick so nothing too bad. I was then required to lay on the table slightly elevated for 15 minutes before I was released to go. The rest of the day at work I had minor cramping on and off, but nothing crazy. I just tried to take it somewhat easy throughout the day.

Cycle Days 18-22: I have felt like crap with a cold for the last few days which is never fun. It is also the week before my birthday, but I am really not excited about it. I used to always say that I wanted to have kids at 25 and now I am turning 26 and am still waiting to get pregnant. It is just another reminder for me of how long this process is taking.

Cycle Day 25: I can't explain why, but I don't have a whole lot of hope for this cycle. I know I should be more hopeful, but I just have a feeling it is not going to work. Maybe if I knew somebody that had a success with an IUI I would feel more optimistic, but I don't. I should find out in less than 5 days whether or not we were actually successful.

Cycle Day 28: I had to go to the office to get blood drawn to check for a pregnancy test. As I was on the way to the doctor I realized I was not all that excited about the results of the test. I had to get myself in a better mood before the results came back. The visit itself was pretty standard where they quickly drew blood and I was on my way, bandaid and all. I even treated myself to a donut. I went to work knowing they would call me later that day. I was hoping they would call me on my lunch and by the end of my lunch I was really hopeful. I had not even started spotting yet which usually happens for me two days prior to my cycle actually coming. So I was thinking that maybe it actually worked and I started to get my hopes up. Since I am not allowed to have my phone on me at work, I ended up taking a bathroom break to check my phone. I had a message from my fertility doctor that told me I was unfortunately not pregnant yet again. You would think that after all these months I would be used to it, but it never gets any easier. At least this time I did not obsess about it for the whole two week wait. I was also told by my doctor that I needed to make an appointment with her to discuss what our next steps will be. Who knows what that means, but I will find out next week. I had to make an appointment at a bad time because it was the only time they had available. It is in the middle of the afternoon on a day when Richard will be out of town for SIOP. So I will be going alone which is a big huge bummer. But, if we waited until he gets home we might end up having to skip next month which is something I did not want to do. We will see what the doctor says.
So another month gone and another treatment that did not work for us. We will just have to keep trucking along and continue to hope for the best.

Costs:
Ultrasound: $116.97 each. We had two this month.
Femara Medication: $2.91
Blood Test for Estrogen Levels: $23.96
Trigger Shot: $138.99 cash. We chose to pay for this without insurance because it was twice as much
                                              with insurance, and even though that would have counted toward our
                                              deductible, we saved money in the long run.
IUI Procedure: $200.32
Progesterone Blood Test: $18.65
Pregnancy Blood Test: $9.55

Total for Femara & IUI: $628.32

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