Nine

I’ve had a really good feeling about this cycle for the past two weeks. I’m not really sure why – maybe because in the end, the timing of ovulation seemed so perfect. Or perhaps I felt that after two BFNs it was about time for another pregnancy, or that the ordeal with the six catheters practically guaranteed a good outcome. Who knows? I could visualise our embryo inside me, I secretly thought of myself as pregnant and I kept having to remind myself how depressing the statistics for IUI are.

On Sunday, though, I started to worry. It was 10 dpiui (days post IUI) and in my last cycle, I got my period on day 11. I was scared of the same thing happening again, of all our hopes and dreams literally going down the toilet before I’d even had a chance to test. So I was devastated when, late that night, I had some red spotting. It’s happening again, I thought. My luteal phase is getting shorter and shorter. There’s barely time for an embryo to implant. I should never have asked for another natural cycle. I went to bed and cried and prayed and fell asleep in OH’s arms. The next day, I made sure we left my in-laws’ house early because I wanted to be safely home before I began to bleed.

It wasn’t until late that afternoon that I started to understand the situation differently. Not only had my period not come (normally, it would be within a few hours of any spotting), but I was starting to feel nauseous. On Tuesday the nausea remained and my breasts were killing me. I know most women don’t get these symptoms until later on in pregnancy, but I had them from 9 dpiui last time and they were so strong, I knew it was for real. There was no doubt whatsoever in my mind that I had had an implantation bleed and was pregnant. The only question was, would it stick?

Today I went to the clinic for a blood test and it showed I have an hCG (pregnancy hormone) level of 9. The nurse basically told me the pregnancy isn’t viable and that they’ll follow it up in a week. I haven’t had a bleed, but apart from that, it seems to be a similar situation to my last miscarriage.

And yet…

Everything I’ve read about hCG levels says that you can’t tell whether a pregnancy is viable or not from one number. That they vary enormously and what’s important is how much they rise between one test and the next. That anything between 5 and 25 is an “equivocal” result and should be followed up with another test a couple of days later. I’ve read forum posts by women whose first level was 9 and who went on to have healthy pregnancies (as well as by women who miscarried) and I’ve learned that according to the American Pregnancy Association, hCG levels in women who are four weeks pregnant can range anywhere between 5 and 426. Maybe there’s less room for variation in mine since we know roughly when I ovulated, but what if the embryo just implanted late?

I know 9 isn’t a great result, and there’s probably a reason why the clinic’s outlook is so pessimistic, but it seems to me that there’s still hope. And I don’t want to wait a week to find out whether that hope is misplaced or not. I can’t repeat the test in 48 hours because the lab is closed at weekends, but I’m going to ring the clinic tomorrow and ask whether I can go back in on Monday. I’m not ready to write this baby off just yet.

How to Make a Baby

Ingredients:

  • 2 lesbians (one ovulating)
  • 1 vial of IUI-quality sperm, defrosted
  • 2 nurses
  • 6 catheters of a variety of types
  • 1 glass of orange juice

1. Position the ovulating lesbian on a theatre table with her legs in stirrups, and have the other lesbian hold her hand. Keep the sperm warm.

2. Have nurse #1 try to insert the first catheter, without success. Repeat with catheters two, three and four.

3. Change to nurse #2. Try to insert catheter five, without success. Finally, insert catheter six and inject sperm in catheter.

4. Take lesbian onto the ward and give her orange juice until she stops shaking.

5. Allow sperm and egg to marinate in the womb for two weeks. A pregnancy test will then indicate whether the recipe has been successful.

* * *

I hope this hasn’t put anyone off IUI. It’s not usually that traumatic (honest!) and my retroverted uterus can make things trickier than usual.

On the plus side, after all my worries yesterday, I’m now pretty certain I ovulated today, so fingers crossed for a successful outcome!

The Fear of Ovulation

OH and I have been practically living at the fertility clinic this week. On the whole, it’s been good news: we’re going ahead with IUI #4 tomorrow, and if it doesn’t work, everything is in place to start superovulation in July. We’ve also been told that as things stand, we’ll still be eligible for IVF on the NHS after six unsuccessful cycles of IUI – my miscarriage, the extra natural cycle and the recent overhaul of the NHS don’t change that – and there is no waiting list. 🙂 Our budget is suddenly looking a lot healthier, and I feel reassured by having a long-term plan in place. I can’t know when (or if) I will conceive, but having a clear road map helps a lot.

However, there’s one dark cloud hanging over me: ovulation. I am terrified I’ll ovulate too soon. With natural cycle IUI, there is no way to prevent this from happening. The clinic monitor my follicles until one is deemed mature (greater than 15 mm), then line up treatment for the next day, and I inject myself with Ovitrelle or Pregnyl to make sure I don’t ovulate too late – but that’s all we can control for. An unfertilised egg only lives for 12-24 hours after it’s released, and there are typically about 29 hours between my last scan and the IUI. It’s so hard during this period not to overanalyse every little twinge in my ovaries, and the words ‘egg white’ take on a whole new significance (if you don’t know why, you probably don’t want to).

This month I’m worrying because my follicle was just under 15 mm yesterday, and a whopping 18 mm today. And also, I suppose, I feel like there’s been a subtle change in my ‘status’ as a patient. I’ve gone from being the girl who got pregnant first time (and would surely conceive again soon) to the woman who is expected to need superovulation and is even making IVF plans. Part of that is my doing – I chose to have all the superovulation appointments now because I didn’t want to risk any more delays if this cycle doesn’t work, and I chose to ask about IVF – but I do seem to have generated a little confusion by opting for a fourth natural cycle. A couple of members of staff thought I had doubts about trying a more invasive treatment, until I explained. I guess it’s not ‘normal’ to choose a treatment that’s less likely to succeed just because you can have it sooner – but I have no doubt in my mind that it was the right thing to do for my emotional health. The turmoil of treatment is easier for me to cope with than the limbo of waiting. Still, I’m aware that I’m now deviating a little from the treatment pathway the clinic would recommend.

However, I’m cautiously optimistic. This could work. It worked the first time, after all. And although there’s always the risk I will ovulate too soon, I have to trust that the clinic know what they’re doing and that their protocol will maximise our chances of success.

May's tulips with my Pregnyl

May’s tulips with my Pregnyl.