Lost in the three letter word - IVF

One ectopic pregnancy resulting in a blocked left tube and history of mild pcos and two years of trying our best to conceive since the ectopic has brought us to a point where our only option might be IVF. We did two cycles of IUI (ovulation induced using Femara) and both the cycles I did have a good follicle (22mm (first IUI)and 19mm (second IUI)) on my right ovary. The right tube is supposed to be clear and open based on our recent HSG last month but things just don’t happen!!!

My RE feels that my right tube might not be functioning too well and chances of that happening is quite high because of previous ectopic in my left tube. These tubes are made up of the same kind of tissue (with those hair like structures - cilia) and if one tube has destroyed cilia or scarring then chances are that the other tube will be of the same type and material. Unfortunately HSG does not reveal microscopic defects in the tube.

He thinks IVF would be our best bet now. It didn't come as a total big surprise to me as I knew it was our only option if this IUI failed.

We were tired after the last IUI and with all the things going on at work we wanted a break so we decided to take a break this cycle. That would give us some time to read up on IVF and look at our finances as well. It looks like we will have insurance coverage for one-two IVF max, third cycle onwards we will need to pay for it. The thought of injections and medications scares me even though I am trying to be very positive. I was speaking to my mom on the weekend and she cried when I explained things to her. Both of our parents are 8500 miles away from us in my home country and we see each other once in 3-4 years....the thought of us going through these pains them more....and it was hard for me to see her cry.

Our plan is to start IVF two months from now which means my next cycle will be the organization cycle when we will have the orientation, injection classes and will be taking Lupron etc. My mom-in-law is visiting my sis-in-law this month helping her to take care of her 10 month old baby before they leave her at the day-care. Mom-in-law is going to visit us in June and will be here for a month. We thought thats the best time to do IVF as we will have some help around. And I think thats the best time because she is more than a mom to me and I would love her to be around!  I just wish I could give her the most awaited moment when she is here in June!

So now I need to get organized for the upcoming IVF cycle. We did discuss about injectables+IUI with my RE and he thinks it might not be very favorable with my tubal condition and thinks IVF might be a better option.....

Before we left the RE's office last week they gave us this big IVF packet which has all the forms and checklists. I had to work last weekend so I had no time to go over it. I am planning to read all of that this week and enquire about our coverage with my insurance. It is very true that infertility makes us stronger day by day but the pain of each failed cycle is just immeasurable!!

Living life two weeks @ a time

16th cycle charting

9th monitored cycle

5th medicated cycle

2nd IUI cycle

22nd cycle since my ectopic pregnancy

HSG done on CD8. The results were the same as the last one two years back but this doctor did it very well. The pain and discomfort was way lesser than last time. After he completed the procedure, he explained the images to me which the other doctor never did. The image showed good spillage on the right and nothing on the left. It was as if there was no tube on the left, the dye never left the uterus on the left side. After I dressed up, the nurse gave me a CD that had my images! I really like that. I could show the images to my hubby :)

As per plan I had my follicle ultrasound on CD12 and to my BIG BIG surprise I had a good follicle on the right measuring 19mm. Thank God! There were no big ones on the left, the maximum was 11mm which does not qualify. They gave me the HCG shot at 8.45 am on CD12. The plan was to have two IUIs done this cycle. We drove in early on CD13 and had the first IUI. I felt O pains around 8 pm on that day and I think I ovulated because there was a slight increase in temp the next day (0.2 deg). We did the second IUI the next day, CD 14. The doctor mentioned that my hubby's samples looked pretty good and he did not see any issues. The three days were very tiresome for us. The two hour back and forth drive from the clinic against NY traffic and the 3 hour wait at the clinic and then getting back to work with the sponge stuck inside me! It was all totally worth it!

Like he said on my last appointment, if it doesnt happen this cycle, then my right tube is something we can't take for granted. He said there could be issues in the tube at the microscopic level and might not help in the smooth transport of the egg. A similar situation could have happened two years back that caused ectopic pregnancy in my left tube. According to him, HSGs do not reveal microscopic defects of the tube and it just shows that the tube is open and we never know if the tube is actually functional...and I do agree to what he says because sadly I see no reason why it can't be true.

Today I am on 6 DPO and I have my progesterone blood work scheduled for tomorrow. For some reason, my temperatures are not that high this cycle and I am quite disappointed. It could be because I just had one egg that popped this cycle and the last few cycles I had 2 eggs....well we will find out tomorrow after the blood work.

I am kind of lost as to what will happen if this cycle does not work. I mean we have done all that we could this cycle to get a BFP. We did HSG (which I believe increases fertility), right tube was open, we got a right side egg, we did two IUIs...not sure what more is needed! The unknown fear is what happens next if this cycle does not work. My RE is leaning towards IVF as he says we should discuss that next cycle. I am not quite sure...we did only 2 IUI cycles so far (3 if we count this cycle as 2 IUIs) ..is that enough to determine that IVF is our only choice? or should we try more IUI cycles? I have been reading on acupuncture and I am thinking of doing at least 1 IUI+acupuncture cycle and 1 IUI+injectables cycle before we head to IVF. And we need 2-3 months break to save a little bit for IVF (based on our coverage we will end up spending a lot out of pocket).

Fingers crossed!!

Back to square one :(

Today is CD7, March 21. Our first 'very hopeful' IUI cycle ended last Thursday when I got my period :( and it was the most disappointing day for us.

We are on our second IUI cycle with the same Femara dose (3 x 2.5 mg). The plan is to have two IUIs this cycle to increase chances. But all these again depend on whether my right ovary produces good follicles. If we end up having bigger follicles on my left then we will have to cancel this cycle. My RE is kind of leaning towards talking about IVF as he thinks my right tube might not be functioning too well. The real problem is that I have a dominant left ovary and most of the time we had multiple eggs from left ovary(normal and clomid cycles). I really hope that my 'right' starts working up and getting up to speed. Before we have our IUI, we are doing a HSG to know the status of my tubes. I had my last HSG two years back (after my ectopic) and I thought it would be good to have another one now. At least it would increase our chances for the next few cycles. With a LOT of HOPE we are marching towards this cycle praying GOD won’t let us down this time!