My Journey into Motherhood: Super Ovulation + IUI

We laid off Clomid in June for the HSG procedure and we were a little hopeful to conceive naturally after that as we've read reports that the rate of conception increased in the 3 months after HSG.

However, that's not God's plan for us at that moment.

So we took the next step.

My gynae gave us some options regarding IUI which is essentially a procedure where sperm is inserted via a tube into the cervix so that the little guys are nearer the eggs. We felt this was the most natural procedure versus ICSI and IVF which requires the eggs to be extracted and some form of artificial fertilisation process. At this moment, we are not inclined to consider the other 2 options not just because it is CRAZY EXPENSIVE (at approximately US$12,000 per try) but because we just felt it was meddling too much with God's ways.

The 3 IUI options given are:

1. Natural IUI - to ovulate naturally whereby only 1 egg will be released, coupled with IUI
2. Clomid + IUI - to ovulate with the help of Clomid whereby 1-2 eggs will be released, coupled with IUI
3. Super Ovulation + IUI: to ovulate with the help of Clomid and 2 Gonal F injections whereby 2-3 eggs will be released, coupled with IUI

Weighing all things, we decided to go for the 3rd option as the chance of conception is the highest

I started my 5 day course of 50mg Clomid on Day 3 of my cycle and on Day 8, I had to go in to the clinic and check on the number & size of the follicles. I had 3 follicles in my left ovary and all was going according to plan :)

Next up:

This is basically to encourage the growth of the follicles to 18mm & above. The first jab was self administered at the clinic under the watchful eyes of the nurse. It hurt just a little when the needle went into the abdomen about an inch below the belly button. It hurt a little more when the solution was injected. Overall, it took less than 5 minutes for the injection.

I injected the 2nd dose myself in my bathroom on Day 10 of my cycle. Because of some fear, I felt the pain more intensely this time round.

I was supposed to go for a scan on Day 12 but as it fell on a Sunday, I went the following day. My 3 follicles were doing well and measured 16mm,18mm and 24mm. The gynae felt it was timely to perform the IUI the following day so he injected me with Pregnyl (5000IU) as my LH test was still negative that morning.

Day 14: IUI Day

Sperm sample was collected in the morning for washing.

About an hour later, the sample is ready to be inserted.

During the insertion, my gynae noticed that my cervix was too small and because of that the catheter could not be inserted inside the cervix so he just placed the sperm just outside my cervix. He advised that if we were not successful this time, he would have to do a cervix dilation the following month so that he could do a proper IUI.

The entire procedure was over in less than 10 minutes but I was told to rest there for as long as I wanted. In the end, I rested for a little over an hour before leaving the clinic.

Breakdown of the total cost:
Clomid (5 tabs): $14
2 Gonal F injections: US$166
Consultation:US$48
Pregnyl: US$70
Ultrasound:US$48
IUI: US$170
Total: US$516 (excluding the washing of sperm which was less than US$50)

After all is said & done, we put our hopes not on the procedure but on our unchanging Jesus.

For this is God, Our God forever and ever; He will be our guide Even to death.

Psalm 48:14

My Journey into Motherhood: HSG

We decided to go for the HSG test after 4 courses of Clomid as recommmended by the gynae.

HSG is short for Hysterosalpingogram and is "an x-ray of the uterus and fallopian tubes performed after the injection of a contrast material". According to the brochure, it is used to examine women who have trouble becoming pregnant. The procedure is usually performed during the "lull" period  after menses and before ovulation.

My HSG test was scheduled on 22 June morning (which was Day 10 of my cycle) and I was taken off Clomid for the month which according to my gynae, is bacause it is not safe to conceive in the same month as the procedure. I was told to take 2 panadols in the morning of the procedure just in case it was "a little painful".

While the brochure provided explained the procedure, unfortunately, it didn't explain the amount of pain and discomfort :(

The overall experience the radiologist was not what I expected.

First of all, when I got to the x-ray department and told them I'm on Day 10 of my cycle, the nurse said she had to check with the radiologist if I could still go ahead with the procedure as they normally do the test no later than Day 8 of a cycle. Ok, I understand that my gynaecologist & radiologist are not from the same clinic and unlikely to have a long drawn discussion about my case but I was not going to lose one whole month just because of a technicality!!! I assured the nurse that we have not tried for the month so it was very unlikely that I was pregnant. She went back to the radiologist with this information and I was given the go ahead!

I was put in a hospital gown and brought to an x-ray room. Then, I was made to lie down on a operating bed(??) and then... the nurses started having a discussion as to whether my blood pressure should be taken before & after the procedure or throughout the procedure. The senior nurse was very indignant and insisted "No, I'm very sure it is throughout the procedure. You weren't at the briefing this morning!".

After everything has been set up, the radiologist came in and was immediately impatient with the nurses and scolded them for attempting to measure my blood pressure throughout! He was very short with them and kept verbally abusing them whilst I was lying there.

For the first 10 minutes, he tried to insert the catheter up my cervix but had some difficulty as he realised that my cervix was too small. He then asked for a smaller catheter whilst biting the nurses' heads off.

Although he was seriously nasty to the nurses, he explained the above to me in a very nice doctor-ly manner. But all I can think of is "get the freaking speculum off me!!!".

So the nurse came back in 5 minutes with the smaller catheter and thank God it was successfully inserted this time!

And then the toture begins... he slowly inserted the water-soluble contrast material into my cervix and here, I cannot explain the immense discomfort except that it's not just painful but truly one of the worst things I ever felt. I can literally feel the liquid bloating me up inside and all the while I was so tired from lifting my legs up (there were no leg holders so I held up my legs for the whole time). I think I was close to fainting at this point.

The only good thing about a HSG is that the results are immediate. In fact, as I was lying there about to pass out, the good radiologist said "look at the screen... you can see the entire left ovary but the right ovary is missing". So I explained that it's not missing, it was removed when I had a growth on it when I was about 12. He made me turn to the left and right a few times to take the images but this part was relatively fast.

And then it was over! I was told to put on my clothes and take a rest in the waiting area and come back an hour later for the x-ray so I could bring it to my gynae. Immediately after the HSG, I had some slight spotting and then for the rest of the day, it was just some clear discharge which was probably the dye coming out.

The HSG procedure costs around US$210 which included the fees of the radiologist and the cost of the catheter.

My gynae took a look at the x-ray and declared that all was well and there are no blockages in my left ovary! YAY!

After lunch, I went home to take a nap but there was still some pain on the right side of my stomach so I tool 2 panadol, cried a little (not from the pain but from self-pity which was pain induced) and fell asleep. During dinner, there was still some mild discomfort so I went to bed early. Thankfully, I was back to normal the next day and the bleeding stopped :)

AFTER the procedure, I read a little about HSG and some websites claim that it boosts fertility for a few months as the "debris" collected over the years are "flushed out" by the contrast material. Some people claimed that they got pregnant within the same month or the following month after the procedure. I don't think there are any scientifically proven claims and if it proves the same for me, I'll post a blog about it!

I'm grateful that the HSG result is positive and that we can proceed to the next step - IUI.

Call to Me, and I will answer you, and show you great and mighty things, which you do not know.

Jeremiah 33:3