Tag: vaginal ultrasound

You might be upside down, but you’re gorgeous to me dear Uterus

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I have been told by several doctors that I have a beautiful cervix, and today I discovered that my uterus is just as “gorgeous”.  Well these were the exact words of my Reproductive Endocrinologist (RE)!!!

Today was my hydrosonogram (also known as a Saline Infusion Sonogram).  This procedure was the final test I required prior to our IVF treatment.  The hydrosonogram is a procedure where the doctor inserts a catheter into the uterus and injects saline into the uterine cavity whilst performing a transvaginal ultrasound.  The water shows up as dark black on the ultrasound against the white endometrial lining.  This allows the doctor to look for smooth edges of the uterine cavity.  If the ultrasound shows an edge that is not smooth then these rough and lumpy edges maybe polyps, fibroids or scar tissue which could be a possible problem for embryo implantation.

The procedure in itself was an interesting experience.  Greedily, I had three doctors in the room as well as the nurse! The three doctors were: my RE, the doctor whose name I can’t pronounce and performed two of my IUIs, and one of the male student doctors Chris conversed with at our last IUI.  I wasn’t quite sure if my RE was overseeing the procedure, or she had called in the other doctor because she was more familiar with my cervix and therefore inserting the catheter.  Either way, there were a lot of people clambering around my vagina in this one tiny examination room.  It was rather amusing.

First the doctor with the unpronounceable name inserted the speculum, and then peered up from between my legs and showed me the ‘flexible’ catheter and said, “remember this?  Was it this one we used before?”. Ummmm….. “I think so??!!!” I replied.  How am I supposed to know these things???! When she inserted the catheter I could hardly feel it at all.  The speculum was removed with the catheter still in, and then she inserted the vaginal ultrasound ‘wand’.  We could see the catheter on the screen, there was a lot of excitement amongst the doctors.  The nurse was tying to hold something in whilst the two female doctors discussed tactics of why it wasn’t distending with the saline, perhaps the catheter was up against something, my uterus wall…or perhaps it was bent somehow.  Either way, when they removed the magic wand, the catheter came out.  They apologised and said they would try again.  So back in the speculum went (this was only the painful part, no different to a pap smear), the catheter went back in, speculum was removed, magic wand went back in.  And there was a gaggle of excitement as this time it had clearly succeeded; the saline filled the uterine cavity and I could quickly see there was a nice oval shape, with no rough edges on the screen.  My RE told me my uterus was “gorgeous!”.  She took a few shots on the screen, and showed me in 3D my uterus.  With this image it actually looked more like a normal shaped uterus that you see in biology books rather than what I saw on the screen during my HSG x-ray.  You can see from the image from my HSG below that it was upside down.  Today’s ultrasound, it was the right way round and looked almost perfect.  Text book.

My HSG X-ray with my retroverted uterus (it's hard to see because it's hiding behind the catheter)

My HSG X-ray with my retroverted uterus (it’s hard to see because it’s hiding behind the catheter)

I don’t have a copy of images from my ultrasound from today, but I have found a link that shows the difference between a normal and abnormal result from a hydrosonogram.

After all the excitement and the nurse had cleared everything up, suddenly my RE exclaimed! “Wait!  I need to see her ovaries so I can calculate her dosages!” So back in the stirrups I went and the nurse re-prepared everything for another peek inside using the magic wand.  We had a very quick look at my ovaries to count the number of follicles.  As today is Cycle Day 7 I had about 5 or 6 follicles in the right ovary and then a dominant one in my left.  She seemed pleased with this. I mentioned that I knew it was going to ovulate from the left his month because I could feel it.  I can always feel pain in my ovary on the left side when I’m ovulating from this side.  I’m not sure why.  The doctor who’s name I cannot pronounce seemed very interested in this fact. I left wondering why.

All in all, I left with a sense of relief.  But my feelings were mixed.  I was relieved that we can still proceed with IVF and there was nothing seriously wrong that would require surgery, but I had the feeling of frustration. In the back of my mind, we still don’t have an explanation for why we have not been successful in conceiving so far.  Unexplained infertility can really niggle away at your mind.

On a side note, today I have experienced two more pregnancy ‘announcements’.  One whilst I was at the fertility clinic, a lady found out she was being released from the fertility clinic to her OB/GYN.  She kept asking the nurse if she was sure, then she cried a lot (tears of happiness of course) which made pretty much everyone else around cry too.  Including myself.  And secondly another of my colleagues who recently married is pregnant.  Soooo all I’m thinking is – who is the third?  They usually come in threes, right??!

The $$$ lowdown

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I have created a new page on my site that sums up all the costs of our infertility journey so far.  I will keep this up to date as much as possible…I have copied the text from it and pasted it below (or here is the link to the page)

We are very lucky that our medical insurance includes coverage for the treatment of infertility, including IUI and IVF.

We are being open and honest about these costs because it is important for people to understand the difference having insurance coverage can make.  Only 15 states in the US make it mandatory for insurance providers to cover infertility treatment, and even some of those are extremely limited.  There is much debate on whether infertility should be covered as an essential health benefit.  There are many campaigns ongoing to change state law in this regard (www.resolve.org)

There is definitely a lot to be said about the psychology and stress to infertile couples over spending this vast amount of money if they do not have insurance coverage for infertility.  Chris and I find this process stressful enough as it is without the added burden of the actual cost.  I cannot even begin to imagine what it would be like without coverage.  At each stage of our journey we have had to get approval from our insurance company and with having an ‘unexplained’ diagnosis we have always been nervous that they will not cover us.  However, we have been fortunate so far. Fingers crossed they will cover our IVF too.

Item Full cost Insurance covered? Final cost to us
Ovulation Kit (pack of 20) x3 $70.00 No $70.00
Pregnancy Tests (various types) x4 $85.00 No $85.00
Basal Thermometer x1 $13.00 No $13.00
Pre-seed Lubricant x1 $24.00 No $24.00
Chris blood tests $572.00 Yes $10.25
Dani blood tests $560.00 Yes $14.43
Reproductive Endocrinologist Consulting Fees (Doctor visits) x3 $340.00 Yes $5.85
Ultrasounds x4 $900.00 Yes $71.72
Anti-biotics for HSG $15.97 Yes $1.60
Sperm Analysis $110.00 Yes $1.53
HSG $835.00 Yes $29.18
Letrozole x3 $8.53 Yes $0.86
Ovidrel x3 $371.16 Yes $37.11
IUI x3 $765.00 Yes $36.81
Sperm Wash x3 $320.00 Yes $16.80
Progesterone suppositories x3 $147.00 No $147.00
Running Total* $5,136.66   $565.14

A note about our healthcare insurance.  We pay a 10% co-pay for each bill of the ‘in-network’ cost, not necessarily 10% of the whole cost.  Our current infertility clinic (or ‘provider’ as it is also called) is ‘in-network’ so we get extremely preferable rates; for example our new doctor visit it was $190.00, our insurance paid $0, so we paid $0.  This is because our insurance company has negotiated these types of ‘bulk’ discounts in advance with our provider.

Choosing an ‘out of network’ provider can increase overall costs.  There is one other fertility clinic in our area we could have chosen, but is out of network.  It was something we considered, but we went on recommendation and did not think too much about this at the beginning.

Currently my insurance premium is ~$500 a month, plus my employer contributes ~$1100 a month, this covers both Chris and I for all medical expenses including dental and optical.

*As of 10th May 2015

Don’t panic Mr Mainwaring!

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You know how I said third time round means I must be expert on IUI and I felt at ease with this round of treatment?  Well today is Cycle Day 11, everything had been going to plan so far…..But this morning I had my CD11 Ultrasound to check how my follicles are doing.  (By the way, you know you are in serious business when they send my actual doctor to do the ultrasound – they were obviously sending in the big guns for round 3!  It was good to see her.)  Back to my follicles, they are looking good.  I have two maturing, one in the left ovary and other in the right.  Both are 22mm – perfectly sized!  My doctor commented on how good my uterine lining was – 7mm.  She pondered on why the eggs hadn’t wanted to make a home in this nice uterus already!  She knows all the right things to say 🙂 I told her that I thought I was about to ovulate in the next 24hrs because this morning I had a 0.53 degree drop in my body basal temperature and my Ovulation Predictor Kit came up with an almost positive line.  She thinks I will probably surge on my own, but I should take the Ovidrel shot, just in case.  But this would mean I would have to take the shot now for an IUI procedure tomorrow pm (Weds).  OK….sounded good! Just one problem – I’ve got to go home, get the shot out of the fridge to bring back to room temperature – and I’m going to have to do this thing alone! Oh and I’m supposed to be back at work too. Cue panic attack.

I furiously attempt to call Chris to see if he can come home to give the shot, because I really don’t want to have to give myself a shot for the first time under pressure.  Chris must be busy. So here I am, sat here with my Ovidrel shot warming up next to me, whilst I wait for Chris to call me back. I’m freaking now because it’s either do it myself or nothing. And nothing is not a valid option.  You’d have thought stabbing myself with a needle is a very small price to pay to have this chance of having a baby and my logic would take over my fear.  But no logic does not dictate in this case.  Come on Chris!  Call me back!!!!!

For those of you who have not heard of the ‘saying/quote’ “Don’t Panic Mr Mainwaring”, here is a little video excerpt….

On Being Pregnant in a War Zone Pt 2

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Spring 2007 continued

Finally, two days after discovering I was pregnant, I received my ‘Call Forward’ to fly to a US Military Hospital in Kuwait.  By this point, I had made my excuses to colleagues (An Ovarian Cyst that probably needed surgery), eaten just two crackers, hid under my bed from another five rocket attacks, slept a lot, caught up on several episodes of 24 and thoroughly read up on pregnancy and ectopic pregnancies.  I was exhausted and feeling weak.  I could barely pick up my daypack, body armour and rifle; the bag was packed for only 2 nights – that officially made me pathetically weak.

I waited for my ride to Kuwait in the helicopter departures lounge.  I was the only one there waiting.  A crew member called my name and asked me to follow him, he took my bag from me (he probably thought I was actually a real medevac patient).  My pre-deployment training was running through my head.  How to get on and off a helicopter, depending on the type of helicopter, depends on where you can and can’t load/unload.  This helicopter, a lynx, had its engine off anyway, so it didn’t matter.  There was no chance of getting my head chopped off or sucked into the intakes.  The crew member showed me to my seat, he was overly jolly considering it was 0130 AM.    It looked like I was getting the helicopter all to myself.  The crew member turned out to be the door gunner.  The two pilots arrived shortly after and introduced themselves.  They were HILARIOUS, typical Army Air Corps pilots.  I was given a headset so I could listen in to all their intercom chatter.

As the engines started, I began to feel nervous.  Last time I flew into Iraq, we got shot at and rocketed.  A nice welcome from the Insurgents.  But suddenly my nerves were overtaken by pain.  Pain in my shoulder.  I read about this in ectopic pregnancies.  Just as I started to worry and think the worst, the gunner handed me some night vision goggles.  He pointed out the window.  I looked through the goggles and I could see the shimmering lights of Basrah City, and the oil fields.  It was magical.  It was bitter-sweet.

As soon as we crossed the border into Kuwait, the gunner closed the door and removed his body armour, indicating to me I should do the same.  The comedy pilots debated where they should land in the US base.  Is this not something you would know before taking off??!  We flew over at least 25 parked up black hawks.  Do we even have this many helicopters in the British Forces??  After a few laps of the base we found somewhere to land.  No one was there to greet us. Well it was 0230AM, I wasn’t too surprised at this!  Whilst I received a comedy show, one of the pilots managed to call through to the hospital.  We were at the wrong helipad.  No shit Sherlock!  Of course, this base was big enough to have two helipads.  We were told to wait there and a nurse would come pick me up.  I could have been sleepwalking at this point, the next hour was a blur.

Somehow, I woke up lying down on a hospital bed, trying to answer the doctor’s questions.  I was immediately put on an IV drip as I was severely dehydrated.  Wow, I felt almost instantly better, but it was temporary.  Next was the vaginal ultrasound.  The whole reason I was in Kuwait.  I had no clue what to expect, no one really explained what was going to happen and that the nurse would be male.  The nurse told me I was about 6 weeks pregnant, and he printed out a picture of the ‘blob’.  Because that is all it was, I wasn’t really experienced in ultrasound photos at this stage of pregnancy.  He reassured me that everything looked just fine.  No ectopic pregnancy.  Phew!!!  So what now?

Well I had a few more hours with the IV drip, and I was ‘quizzed’ by one of the nurses – what was I going to call my baby?  Had I thought of names?  Would I name the baby after him?  Would I email him to let me know how the baby was? He was genuinely excited for me.  Bless him, because he seemed to be the only one.  I was given a prescription for the nausea (no idea what the drug was called), some folic acid and vitamin D and told I HAD to eat, for the sake of my baby.

I was taken to a temporary bunk where there was one other British female who was recovering from surgery from Appendicitis.  She was an Officer so I kept myself to myself.  The next day, I was driven to the ‘weekend spa resort’.  This is where battle weary soldiers were sent to from Iraq at least once in their 6 month tour to get a break.  It had a makeshift Jacuzzi (more like a paddling pool), sunbed loungers, massages, decent internet, volleyball, and computer games.  Lots of computer games.  Everyone was in civvies (civilian attire), I had not packed any civilian clothes, so I walked around in my pyjama shorts and a T-shirt.  I felt free!  No, body armour, rifle or rocket attacks.  I still felt nauseous so I didn’t even get to enjoy one of the ‘two cans of beer’ we were allowed.  I tried to eat, I really wanted to, so I took one of the tablets I was prescribed.  That seemed to do the job, and I managed to get half a plate of food down me.  The nurse would be proud of me.  Despite the ‘spa’ environment, it was lonely and I tried to get on the earliest flight back to Iraq, I missed my squadron, I missed my friends and I knew I was letting them down right now.  After one more night in Kuwait and I was back in Iraq, feeling a little better, but the pains were still coming.  This sucked.

Back in Basrah, I had an appointment at the medical center to discuss what next.  I had a completely different doctor, so had to start my story from the very beginning.  I think this doctor was the first to show any compassion.  He also told me that I was lucky to get the prescription for the nausea because it was not allowed in the UK, it was up to me if I wanted to keep taking it.  To date I still have no idea what this drug was because I threw it in the bin after the British Doctor told me this.  Of course the next step was to ‘medevac’ me back to the UK because I was not allowed to be in the theatre of operations anymore, it was too dangerous for my unborn baby.

A total of seven days had passed since I discovered I was pregnant.  The only person who knew I was pregnant was my boyfriend (and of course the doctors and nurses I had met).  As I sat in the hospital’s morale, welfare and recreational area waiting for my pre-flight checkup, I read many letters from random people wishing our soldiers well.  It’s amazing so many people care to take time out of their day to write to ‘unknown soldiers’.  Although the letters were clearly not aimed at pregnant female soldiers, their words were comforting.  But this comfort slowly turned back to guilt.  And the biggest guilt was yet to come.  As I boarded the C-17 aircraft to fly home with the other 20 ‘Medevacs’, I sat down amongst people who had broken arms, missing legs, wounds and scars to their face.  Then there were the two bed patients, one of whom was in a controlled coma so that he could fly back and be with his family.  He was probably not going to live for much longer.

I hadn’t told anyone I was flying back to the UK, I couldn’t; I was shamed, confused and exhausted.  I just needed some time on my own to figure out what was going on.  My life was never going to be the same again.

On Being Pregnant in a War Zone Pt 1

On being pregnant in a war zone Pt 1

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Spring 2007

I winced as the doctor examined my stomach.  The pain was excruciating.  As he prodded, he said “feel here…see?”  I felt my own stomach where he indicated – it was hard, not squishy like normal.  I continued to wince as he poked around my tummy.  “This is your poo.  You are constipated.  We will get you some laxatives and you should be better in a few……”.  The piercing alarm sounded.  We both looked at each other and quickly dived on to the floor.  My body armour and helmet were in the waiting room, no chance of me grabbing hold of it in time.  I leopard crawled under the table, it probably wouldn’t offer me much protection. The doctor grabbed his own body armour and helmet just as there was a loud thud and the ground shaked.  As he put his body armour on and quickly threw on his helmet, he mumbled “Here we go again!”  I wasn’t sure if he was trying to make conversation or if he had genuine grievance by the incoming rockets.  The way I was feeling about these rockets I felt it was probably the latter.  After a few minutes of what was probably the last rocket (usually 2-3 at a time), the doctor quickly stood up and said, “I’ve got to go, I’m on call for the crash emergency team.  Wait here until the all clear, someone will be with you soon.”  And he ran out of his office.

As I lay there on the dusty floor waiting for the all clear siren to sound, I felt stupid.  I felt stupid and embarrassed that all I had was constipation. I wondered how it had happened.  For the last 8 days I had hardly eaten a thing, I felt nauseous and I had horrific stomach pains.  These pains were sharp and short, sort of like my IBS pains, but twice as painful as usual. But this didn’t seem like IBS.  I promised myself I would go to the doctor after 7 days of feeling like this.

The all clear siren sounded. I got up and left the office to speak to the corporal at the reception desk. I explained what had happened, she told me to take a seat in the waiting room and another Doctor would see me shortly. I waited for half an hour. All I could think about was that someone must have been injured by the rocket attack, otherwise my doctor would be back by now. This made me very sad.

I was called into the very same office I had been in just 30 minutes ago, but this doctor was different. I explained that the previous doctor was just about to prescribe me something for constipation. He asked me to tell him from the beginning what the problem was and the symptoms I was suffering. He wasn’t going to sign anything until he made his own diagnosis.

He asked me all sorts of questions about my IBS, what I had been eating, how often etc…it all made sense to me. New environment, crappy food, stress from rockets. Usually my IBS presents with horrific diarrhea, but now my IBS was giving me constipation. Not uncommon, right? But this doctor asked me (like the other doctor) “Is there a chance you could be pregnant?” I laughed and said “No, very unlikely!”, he said, “Well let’s be sure, I want you to take a pregnancy test before I prescribe you anything”. “Sure….” I said, but muttered to myself “…if you want to waste our time”. The doctor called in the nurse and explained I was to take a pregnancy test. I dutifully peed in the cup and together we sat down and waited for the results. The nurse tried to make small talk about the recent rocket attack. She proceeded to tell me that a lot of girls try to get pregnant on purpose to avoid deploying or wanting to be sent home. But then her words slowly slurred to a halt, she paused and exclaimed with a look of unexpected shock “errrr you are………pregnant! Ummm, congratulations?!?”.

I could feel the blood drain from my face in disbelief. I haven’t had a period in years after my depo provera issues, how was this possible? What is going to happen now? I’m not ready for this. I’m not one of these girls who purposefully gets pregnant just to be sent home. I volunteered to deploy to Iraq! I volunteered to be with the rest of my unit. Despite the shit getting real with the rockets, I wanted to be there, to do my job, to serve my country.

I could hear in the distant background, the nurse asking me all sorts of questions about if this is what I wanted? Was I excited? Did I need anything? But I was in too much shock to answer her questions other than mumble a no.

The doctor who made me take the test called me back into his office and said “Well, now we can explain the constipation and nausea. But this doesn’t explain your pain. We need to make sure you are not having an ectopic pregnancy. Let’s get you to the Emergency Hospital for a checkup by the specialist. I was hurried out of the doctor’s office, into the back of an ambulance to drive the half mile to the emergency hospital. This was the most embarrassing thing of it all. Being driven into the ER entrance. Pregnant. Not shot, wounded or even sick. Just pregnant.

I had no idea what an ectopic pregnancy really meant. I was prodded and poked all over again by several nurses and doctors. They even checked my constipation and try to help it along, but there was nothing in there. There was no poo. After all, I had barely eaten for the last 7 days. I hadn’t pooed in 4 days.

Finally, my boyfriend arrived at the hospital (yes we were deployed together, we got it together during pre-deployment training). He had no idea why I was in the hospital, he had left me at the doctors only 2 hours ago! He looked panicked. I looked at him and tried to get the words out, but I just started crying. It was the first time I cried since finding out my news. Eventually he got it out of me, and we both cried. We cried conspicuously together as we were not really sure how else to do it, this crying thing.

The hospital facilities on our camp did not have a vaginal ultrasound machine. The closest one was in another country – Kuwait at a US Airforce base. They wanted to check if the pregnancy was ectopic as the symptoms matched. I was put on the medevac waiting list and told to go back to my room and rest until I was called to fly.

I went back to my room, cried a lot, read up on ectopic pregnancy, and asked myself a lot of questions. How will I explain this to my unit, to my boss? Will my boss know already? What are the rules on medical confidentiality? Will they send me home? Will I be discharged from the Army? What if I have an ectopic pregnancy? Should I tell my family? When will I be able to eat again? When will this pain go away? So many questions as I lay in my room, sometimes in bed, sometimes on the floor under my bed as the rockets kept coming throughout the day and night. Get some rest? Ha. No rest for me….

TBC.

IUI #2 off to a better start than #1

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Intrauterine Insemination (IUI) round 2 is off to a better start than the first one – we think anyway.

A matter of timing

The first round of IUI was, of course, all new to us.  I had taken an ultrasound on the Friday (Cycle Day 11), took an Ovidrel Shot to stimulate ovulation on Saturday evening, and had IUI on Monday (CD 14).  At the time we wondered whether the IUI procedure too late because my clinic are not open on Sundays we could not do IUI that day, the Doctor had indicated that I needed the IUI procedure early on Monday, rather than later as my follicles were rather large.  I had a positive result from my ovulation predictor kit on the Sunday morning, the day BEFORE the IUI.  I simply thought that this was the Ovidrel in action, and the doctor had everything timed well.  But now we are suspicious that all this meant is that the IUI was too late….

THIS time around for cycle 2 it was a slightly different story.  I had my ultrasound on the Thursday (Cycle Day 11) and I had slightly smaller follicles, but big enough to go ahead with the IUI.  I took the Ovidrel shot on the Thursday evening, and had IUI on Saturday (CD 13).  This time, I got a positive result from my ovulation predictor kit on the morning of the IUI, Saturday morning.  This makes me believe that we were too late last time around as it seems that the Ovidrel doesn’t interfere with ovulation predictor kits.  This cycle I decided to monitor my Basal Body Temperature (BBT) for the first time ever.  Today, Sunday (CD 14) I got a spike in my temperature confirming my suspicions that I most likely ovulated yesterday.  Woohooooo!  This cycle, it feels that the IUI procedure was better timed.  I was also having horrible ovulation pains on the way to the clinic and all day yesterday.  A good sign?

The sperm stats low down

Another excellent sperm sample Mr C!

  • semen volume: 1.2mL
  • Sperm Concentration: 129 million per mL
  • Percent motile: 51.9%
  • Number of motile sperm: 80.3 million
  • After washing (centrifugation)
  • Number of motile sperm in vial: 72.5 million
  • Motility:  86.8%
  • volume of vial: 5mL
  • recovery rate for processes sample: 90.2%

The IUI procedure

As we were a bit more knowledgeable about the whole procedure this time around so the whole appointment took about 20 minutes, of which 15 minutes I was laying down on my back resting whilst the sperm figure out which direction they need to swim in. Chris joked we knew that about 15% of the sperm were just swimming around in circles, confused, not knowing what to do with themselves.

The doctor was a new one for me – a sweet lady who seemed very happy for an early Saturday morning!  I asked Chris later if I had just been treated for the first time by someone younger than me.  Eeeek we are getting old! But he believed she was actually in her mid thirties, so not much older than us.  The doctor was very kind and kept apologizing for any pain she might cause.  She told me she would use the smallest speculum and the smallest catheter possible so it wouldn’t hurt.  This made me wonder whether all this time other doctors purposefully use big speculums and catheters out of choice!  She was good at explaining everything she was doing.  She put the (smallest!) speculum into my vagina (No lubricant because this kills sperm).  She told me she was going to open the speculum up and I might feel some pressure.  Which I did, but it did not hurt.  After this she inserted the catheter into my uterus via the cervix and the sperm was injected via the catheter directly into my uterus. I barely felt a thing and it was over with in less than 2 minutes.  I had no cramping until later in the day.

Here is a short 2 minute 3D animation of how IUI works.

The nurse set a 15 minute timer and I lay down on the bed feeling a bit surreal. This time the 15 minutes went much quicker than last time because we spent it talking about our next holiday – a road trip to the West (Las Vegas, Grand Canyon, Bryce Canyon, Santa Fe etc).  We have been planning on going in October, but have been waiting for the last 4 months to see if we were pregnant before we book anything.  This will be the last cycle we wait before we book it.  No more holding off!

Naughty Gift – no not that kind of naughty

The morning of the IUI I decided to give Chris a gift I bought him a few weeks ago.  I have declared before that I believe it is unlucky to buy baby name books, pregnancy books, baby clothes etc before actually conceiving.  But seeing as we have been unlucky so far I thought we cant possibly have any more bad luck so what the hell, I bought a pregnancy book for men.  It’s a slightly funny book with interesting facts about pregnancy.  I couldn’t resist!  But I won’t buy anything else.  I just wanted to get him something we can share together along this journey.

My naughty gift to Chris

My naughty gift to Chris

2 Week Wait and greasy progesterone suppositories here we come!

Cycle Day 11 Ultrasound – its’s go go go for IUI #2

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Today I went in for my Cycle Day 11 Ultrasound to check my uterine lining and follicle maturation.  The doctor was a little more smiley today than the last time she performed the ultrasound.  I felt a little more at ease this time around.

So here are the results from my ultrasound:

8mm Uterine lining – that’s apparently very good

3 follicles in total: 2 in the left ovary, 23mm & 16mm in size and 1 in the right ovary, 25mm.  All three looked good.  So more of a chance of multiples than last time :-s, but it is a risk we agreed to take.

Chris asked the doctor about the last cycle where two of my follicles were a bit bigger, were we too late and missed our chance?  But the doctor said that with letrozole, follicle size can be up to 28mm.

Tonight we get to do the ovidrel injection and then IUI is scheduled for 0800 Saturday morning. Woohoo!!! (but not woohoo to the injection though, that stuff is just mean).

French women don’t get fat, even the pregnant ones

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There is a saying that you won’t find a fat woman in Paris. In my two day work trip to Paris, it’s something I observed to be absolutely true. Even the pregnant ones are slim; they just have a big round protruding tummy, doing what it should do, providing a cosy home for a baby to grow and develop in – but not an ounce of fat to be seen. I want to know their secrets. I need to know their secrets! This got me thinking about jealousy and pregnant women.

The past week has been one of those weeks where I have met three pregnant women. It’s kind of like buses in London – you never just get one bus at a time, three always arrive together after you have been waiting an hour. I like talking to pregnant women about their experiences and how they feel because I like to hear it from the horse’s mouth what this pregnancy thing is going to be like! I can read all about it, but it’s so much more interesting listening to my pregnant friends and family. Sure, there is a part of me that feels a teeny bit sad that I’m not pregnant right now, but my feelings are far more consumed with excitement and nervousness about what is to come. If it is a close friend or family member who is pregnant, my excitement for them is a gazillion times more because at the end of their pregnancy a beautiful baby is born waiting to be loved and I want to share that love with them, I look forward to falling in love with them.

I read an interesting blog article about being a ‘child-full’ couple rather than a ‘child-less’ couple; parts of the article I related to for how I feel when I find out my close friends and family are pregnant. Whatever happens in the future, I want us to be a ‘child-full’ couple. But there is one difficulty I have when it comes to being around pregnant women. When it is an acquaintance or colleague who is pregnant I feel less inclined to be excited for them, and I find them hard to talk about their pregnancy.  My jealousy far outweighs my interest in their pregnancy and their baby. Wow, how mean does that sound? But it is the truth and this is how I honestly feel right now.

This week I found out a friend of ours was 22 weeks pregnant, we had not seen her since before Christmas, and she had not announced it officially, so it came as a surprise when she visited our house for dinner with a big bump!! When she pulled up in our drive in her new car, I joked that she must have some exciting news to tell us because she has bought a brand new ‘soccer mom car’. Quickly our other friend who was unaware that we did not know our friend was pregnant quickly updated us that she was having twins! And wham bam without any digestion of this awesome new news our friend walked in with a huge bump! Last time we saw her before Christmas she was pregnant, but not noticeably and obviously not sharing the news because it was her first trimester. I had a lot of happiness for her because we had talked before Christmas about her plans to expand their family (I must not have been reading the ‘I’m pregnant’ subtle signals back then!!!). Our friend explained her recent shock of discovering at 20 weeks that she was having twins, there had been no indication at her 10 week scan. What a big surprise!! I had a variety of feelings for her when she talked about her pregnancy so far – nervousness for her, twins are a risky business – excitement that she will have two adorable babies to love – fearful for her sanity and how she will manage if her husband is posted the other side of the country, – general happiness that her family plan as going, well, to plan! So this pregnant lady was news where my excitement far outweighed any jealousy I might have.

Later in that week my husband and I went for dinner round his friend’s house. I have met this couple only once before, they are more my husband’s friends than mine; I hear a lot about them and what they are up to, but personally I don’t really know them. They are currently 28 weeks pregnant with their second child. As we were driving to their house for dinner, Chris mentioned that he hadn’t told his friends about our fertility treatment, and he asked if I would be happy talking about it if it came up. I agreed that it was OK to talk about it if the conversation flowed to it. The evening was lovely, and as usual I took my opportunity to quiz them about their pregnancy experiences so far (I hope I didn’t come across as annoying asking questions!). Their 2 year old daughter spent most of her time in either Chris’s or my lap, wanting to play with us or just cuddle, she was an adorable friendly girl, a little cutie indeed. We had a fun evening, some interesting topics of conversation, lots of laughter and good food. But despite this, throughout the evening I realized that I still did not know this couple well enough to talk about any fertility treatment we were having – I thought it would be awkward, for me mostly, just because they are pregnant. So any topic that headed towards our plans of trying to conceive were vehemently steered away from (well I consciously did anyway, I haven’t spoken to Chris about that yet), it just didn’t feel right. However, as my second meeting with a pregnant lady in one week, with this pregnant lady I felt a little more jealousy brewing inside of me and I am not really sure why.

Travelling for work to Europe has its ups and downs

Travelling for work to Europe has its ups and downs

The third pregnant lady I met this week in Paris was my new colleague. A couple of days ago I wrote about how I had a dilemma about what to tell my new team (who I will be working with over the next 1.5 years) regarding my departure one day earlier than planned. My plans were amended after I found out my Cycle Day 11 ultrasound would be on the day of my return from Paris. After I wrote my blog, I spent the morning travelling from Charles De Gaul airport into Paris city centre plucking up the courage to be more bold and open about why I was going to leave a day early. My new team (a virtual team) were all relatively new acquaintances, so I was nervous, but had pretty much committed myself to being open. I had little to lose. But all of that went out the window when I arrived to discover that one of my new team members was pregnant. As I did not know the lady very well I did not want to create any awkward feelings within the team. Maybe it wouldn’t have been awkward, but I didn’t want to risk that with our new team going through the forming and storming stages of working together. I made my excuses and told the leader that I was very sorry to have to leave early for an unavoidable doctor’s appointment. He didn’t ask any more questions, thankfully, and all went well. With this pregnant lady I felt immense jealousy. When we went for lunch and sushi was suggested there was that moment when everyone cared and realized their error in suggesting sushi to a pregnant lady. I wanted that to be me. When she turned down wine at dinner. I wanted that to be me. When the next meeting was discussed to meet again in 6 months’ time. I wanted that to be me, saying I probably wouldn’t be able to make it because I would be busy with my new born baby. And it wasn’t me. Despite this jealousy, I do hope that someday soon I can share those moments and experiences with my new colleague because she is very nice and we have a lot in common. So I was not jealous of her, I just wanted it to be me, and I saw that this could be me in the not so far future. And that was kind of cool.

So let’s get this TTC show on the road, IUI #2 – tomorrow I get to find out how many follicles I have grown this cycle – and the best part is that Chris will be there this time at the ultrasound, I‘m very excited!

Ps.  If you ever go to Paris – the skinny women, the free flowing good wine, flaky, buttery pastries and creamy, chocolatey tartes, rich creamy sauces – this is no place for a lady on a diet (I’m not actually on a diet, but after the last couple of days I think I’m going to need to go on one!)

My what big follicles you have – all the better for inseminating with!

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Today is Cycle Day 11 and I attended the first ultrasound for my first ever Intrauterine Insemination (IUI).  The clinic were very efficient today, I was in and out within 15 minutes.  I sat waiting in the examination room for the doctor to arrive, and there on the wall was a poster explaining the differences between fraternal twins and identical twins – A handy guide or perhaps more of a handy reminder of the increased risk for multiples with IUI.  Today, the doctor had a student shadowing her, I had no problem with this, but I think he looked a bit awkward throughout – bless his cotton socks.

The doctor showed the student my good uterine lining – apparently three lines is good.  This is all new to me, so I appreciated her explaining everything.  I had two follicles in the right ovary (as I had predicted) one 20mm and the other 28mm.  I also had a teeny tiny one in the left ovary, only 6mm, but she said it might be nothing.  So I am ready to go.  They don’t open on a Sunday, so my appointment is on Monday 16th Feb.  As a romantic Valentines day gift, I get an injection of Ovidrel at 1130pm.  Not looking forward to this given my phobia of needles.  I am undecided yet whether I will do it myself or get Chris to poke me in the abdomen.

This is all assuming my medication arrives tomorrow as freedom fertility pharmacy have promised me.  Today I called them to check the status of my order with regard to my insurance approval.  They had the approval for the Ovidrel, but not yet negotiated the progesterone.  I don’t understand how this system works in the background, but from what I understand, it is crazy.  So I said I would go ahead and pay full price for them rather than wait for the insurance company to do its thing.  If it is covered, then I can just try to claim it back later….but I needed my meds ASAP!

The progesterone was $49 and the Ovidrel was $123 full price, with the insurance agreeing to pay up, my 10% copay made it only $12.30.  Not too bad.

Cost of this IUI cycle, full price:

  • Meds inc. letrozole, ovidrel & progesterone: $311
  • Ultrasound: $225
  • Sperm Wash:$140
  • Insemination:$225

Total: $901

Expensive stuff!! Chances of success? Our doctor told us our chances were about 20%.  Advanced Fertility.com breaks down the success rates even further depending on age, sperm mobility and treatment options. Apparently there is a 7.6% chance of success with one follicle, and an increase chance to 26% with two follicles. Wooohooo!  But those numbers are still pretty small. there is almost a 4 in 5 chance that we won’t conceive.  Putting it like brings you back down to earth.

Fingers crossed for a Valentines baby (Just like Chris is!).  Happy Valentine’s day everyone!

Freedom Fertility Pharmacy Fail

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My nurse recommended freedom fertility pharmacy rather than my usual pharmacist, Walgreens, because the ovidrel trigger shots and progesterone suppositories are much cheaper if my insurance does not cover it.  Sounds great, I said, let’s do it!

So once my prescription was ready freedom fertility pharmacy dutifully called me via a robot, who then proceeded to tell me there were no free reps available at that time, please call back later.  Unfortunately, every time I tried to call them back their lines were busy and I was put on hold for aaaaaages.  Usually I don’t mind waiting if I can leave my phone on speaker and wait for a representative to pick up.  Unfortunately freedom fertility put in ads and notices over the music.  Something I don’t really want my colleagues around me listening to.  So I gave up.  Then there was the snow storm and they were closed.  Eventually when I did get through to them several days after they called me, I arranged delivery of my meds for 11th Feb (Cycle Day 9).

Later that day I had a missed call from freedom fertility.  I thought it was probably the robot that kept calling me to say I had to call them, so I ignored this.  If it wasn’t the robot I’d get another call.  And I did not get another call, so I wrongly assumed all was well.  This was until yesterday when I came home expecting my meds to have been delivered.  Nothing, nudda had been delivered.  I had no missed calls asking me where my house was (a frequent occurrence from delivery people) and no email saying delivery had failed.  So first thing this morning I called them up.

‘Oh’, the representative said, ‘your order was cancelled because your insurance card expired.’

My insurance card doesn’t expire! And no one bothered to check with me????!??!?!?!?!?! BAHHHHHHHH!!!!!!

So I re-confirmed the insurance details, which went through correctly this time (why couldn’t the other lady have done that when I was on the phone last time??).  I said I needed the delivery ASAP because I will probably need to do the trigger shot this weekend.  ‘No problem’, the lady said ‘we will get it to you tomorrow, stay with your phone today in case we need anything else from you’.

As I am driving home this evening I had another missed call from freedom fertility.  So I call them back as soon as I could….

‘we are sorry, we are currently experiencing a high caller volume, please hold’ DOUBLE BAHHHHHHHHHHHH!!! Luckily for them someone answered within three rings.

The representative said ‘we have to have authorisation first’….Okaaaaaay….I said ‘sure you have my authorisation!’ I thought this was for payment as I had previously set a limit on my card.  Then there was this awkward silence.

‘So we can put the meds on hold then?’ the lady on the phone said.  ‘Ummmmmm, wait, what? No?  I don’t understand, we may have our wires crossed’ I asked thoroughly confused.

The lady realised she was talking to a bit of an insurance process idiot and explained that the Ovidrel shot required prior authorisation from my insurance company first.  I thought to myself, isn’t that what I checked with my insurance company the other day?  No – apparently the insurance company have to check with the doctors about something, they will do that within 24 hours. So you are telling me that even though a doctor has prescribed me some medication, they still have to check with them?  I am sooooo confused.

So let’s hope that my follicles aren’t quite big enough at tomorrow’s ultrasound and I can wait another day.  I am sure the clinic will help me figure it out tomorrow if I do need the shot sooner.

Eeeeeeeeeeek!  Why is it all so confusing???!?!