Blog 3 IUI - is het nu gelukt?

Blog 3: Different hospital, new start...

In my last blog I already indicated that we looked for another hospital, we did not feel that we were not taken seriously at the Bronovo hospital. So we ended up at the St. Antonius hospital in Utrecht. Even though this was quite a drive from The Hague, we were looking forward to a new start.

At the end of March 2018: our first appointment in St. Antonius, we went there full of excitement. What could we expect? What are they going to do? Are we finally going to start treatment?
The doctor had clearly read our file and actually gave us one right away
hopeful message. We are going to start with IUI, after 2 years I don't see why it can't be started, that's what she said. However great the relief was that we got this news, the doctor pointed out that we shouldn't put all our hopes on it. settle.

IUI often requires multiple treatments and indicated that they estimated the chance at 6 treatments. What if no pregnancy resulted after 6 treatments, we thought? The next step would be IVF.

What does IUI entail:
IUI stands for intrauterine insemination. With this treatment, 'processed' sperm is introduced high into the uterus just before ovulation.

A follow-up appointment was soon scheduled, my husband's sperm test. Luckily there was nothing to complain about :)

We can start our IUI adventure.

The doctor explained that she is opting for an IUI treatment with a stimulated cycle. This means that the growth and maturation of my eggs are stimulated by means of hormones. During this phase I have to inject myself with hormones.

This is monitored by ultrasound and the aim is to obtain 2 ripe eggs.

You will of course receive a fertility intake on how to inject and in which places. It also explains exactly how it works once you have finished injecting and have ripe eggs. We had this appointment in mid-April.

After the explanation, I immediately received a prescription to start with the IUI. Because I had just started a new cycle, I couldn't start right away and had to wait until my next period. My cycle is always pretty similar every month so I knew approximately when I could start. This would be early May.

During the IUI
treatments, you are advised not to consume alcohol and to eat as healthily as possible.
So in April I decided to enjoy my wine for a while.
May 17, 2018: 7 days later than normal my new cycle starts, you will always see that you look forward to your period, it does not come, but now that it finally arrived, I had to call the hospital on cycle day 1 for an appointment for the exit echo.
This takes place on cycle day 3.

May 19, 2018: my first ultrasound scan, everything looks good and I can start with hormone injections (Gonal F) once a day. On day 10 there is another ultrasound to see whether my follicles are growing and maturing properly due to the hormone injections. This was also the day that I had to inject myself for the first time. I remember very well how exciting I found this, you have to prick yourself with a needle in your stomach. Anyway, I had this wish, so I talked myself into courage and gave my first injection in the evening.

The first days passed like this and every day I injected the hormone into my stomach. I was given a tip to first cool the area with an ice cube and not to inject on the same side every day, this is possible.
I really recommend it to everyone who is or will be in such a process, because my goodness, your stomach is sore and painful.
Day 10 arrives, time for an ultrasound: Unfortunately my follicles are not growing as fast as they expected and I certainly had to continue for a few more days. They did see many small follicles, but at least 1 follicle of 17 mm must be ripe.

I started on the lowest dose so I was allowed to inject a little more.
Day 14: a new ultrasound: Fortunately, something is starting to grow. 1 follicle continues to grow, I had hoped for 2, but 1 is already a lot and this is only the first IUI. Continue injecting for another 2 days and then another ultrasound.
Day 16: Been injecting for 16 days now and it's becoming sort of normal. Off to the hospital for another ultrasound. 1 follicle large enough for our first attempt. Tonight 1x Gonal and then the next day the ovitrelle.

What is Ovitrelle:
Ovitrelle is another type of injection that artificially induces ovulation.
36 hours after the ovitrelle, it is time for our first IUI. The treatment is at the end of the morning and therefore my husband's sperm must be submitted to the lab early in the morning. They will process the sperm cells in the lab.

Why is sperm processed:
The volume and number of sperm cells are determined. Moving (motile) sperm cells are separated from the lower quality cells.
The number of motile sperm cells (the yield) is counted. If this is less than 1 million/ml, insemination is not useful.
If the yield is sufficient, the sperm cells are placed in a tube for insemination.

Good news, there are enough good sperm cells and the insemination continues.
It is time for our first insemination, the good sperm is injected into me with a long tube. Now 15 long days await me in the hope that my period will not come.

12 days later: menstruation has come through! SHIT!

No matter how well the doctor has emphasized not to have too much hope on the first attempt, I am still sad. I pull myself together and contact the hospital. A new appointment is immediately made for cycle day 3 and then IUI attempt 2 begins.

In the meantime, we are 4 cycles further and therefore 4 IUI attempts further, still no pregnancy.

It's getting tougher, my follicles are growing slowly and so I'm stuck
also at a high dose with injection. My stomach looks like a war zone, I have mood swings and I'm tired. But I don't see a break.
We are now in October 2018 and IUI 5 has started. I have been injecting for 10 days now and it is not making any progress. My follicles really don't want to go this time. On day 14 of injecting I have another ultrasound, suddenly I had spontaneous ovulation and IUI 5 is therefore finished and is considered lost.
How is this possible again?

After this downer, we request a meeting with our head doctor. We have no confidence in the IUI at all and therefore want to ask if we can proceed to a follow-up process sooner. The answer to this was clear, no, unfortunately that is not possible and you must have had at least 6 IUIs. Because attempt 5 is not seen as an attempt, because no insemination has taken place, we still have to do 2 (it's nice that we now have 2 more attempts) but it also makes me very sad and down. Giving up is not an option!

December 2018: we end the year again without pregnancy and still have 1 IUI attempt to go in January.

January 2019: The start of our last IUI attempt, would this be our lucky month? The whole routine starts again, injections, ultrasounds, ovitrelle, insemination.

Our lives have consisted of this for 7 months and I can really say that it is intense. You are constantly working on it, you have to continuously make sure that you plan everything well and take into account that you suddenly have another ultrasound or that the insemination is scheduled. This, in addition to a full-time job and the distance to the hospital, means that I am starting to run out of energy.

The last IUI and I really want it to be a success, we have 2 follicles this time so this should be fine, right?

Unfortunately, 14 days after insemination, my monthly nightmare occurs again...
How can you still have hope after so many attempts? How do I pull myself together for a sequel? Am I ready for that or should I take a break?

It's time for an evaluation with our lead physician.
My question is of course why doesn't it work? What is wrong with me? Unfortunately she has no answer to that, everything looked good every time during the ultrasounds and the sperm was of very good quality every time.

IUI has been completed, we will move on to the next step; IVF.
Do you want to know what exactly IVF treatment is? And/or whether IVF will make our wish to have children come true? I will close the IUI process and continue with IVF. I will share my IVF journey in my next blog.

Love Stephanie

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