Fertility Story: Part 3 – The Second IUI

This is the third installment of six about our struggles with infertility. Read parts one and two. This is our story, nothing more, but we share it to add another voice to this often unspoken struggle.

They say athletes should have short-term memories. To continue after a setback, you must forget the failure. You can learn from it, but do not let it taint the path forward. Marathon runners are experts at this, especially after a particularly painful race. They train for months, but then race day doesn’t go accordingly to plan. They shuffle and scoot forward, in physical and mental anguish, for hours. They finish tired and defeated, swearing that they will never do this again. The next day, though, they are browsing races and planning their next marathon. (As a marathoner, I have lived out that exact scenario.)

This selective amnesia also exists in the fertility world and accurately explained my transition from the failure of the first cycle to the hope of the second.

My husband and I went to that party while I tried to keep it together, draining beer after beer, and then I broke down when I got home into shaking sobs. I didn’t sleep much that night, and I cried on my way to work the next day when I saw women pushing strollers on the sidewalk. It felt so cruel for all of my hopes and big dreams to be ripped away. For two weeks, I had been thinking about that Monday pregnancy test and how I would pass the time until the nurse called with the results. If positive, I had planned to go out and get a sweet treat to surprise my husband. I cried and cried for having just that piece of my dream ripped away.

However, instead, when Monday came, I was frantically calling the clinic, hoping to speak to a nurse before my appointment so I could change it from just bloodwork to a baseline ultrasound and bloodwork. I wanted to move right into the next cycle. The nurse agreed, and then asked if we would continue with an unmedicated cycle. While that was the original plan, things were changing. My husband and I were planning to leave the city in the next month or two (timeline and location still TBD), and we wanted to put more effort behind this cycle. She suggested that we meet with our doctor to revise our plan. We met with him Tuesday, virtually, and after explaining our situation, he agreed that we should try a medication that would stimulate more follicles for ovulation, releasing more eggs, and increasing our chances of conceiving. This could also increase the probability of twins, which was a risk we were willing to take.

Suddenly, we had hope again. It was unlikely that the first cycle would work, anyway. It was a practice round. We just needed a practice round. 

I started with five days of Clomid, dosages twice a day, to stimulate my follicles. I also started on another medication that seemed to be for women in menopause. My doctor never explained why I was on it, but I also didn’t question it and took that twice a day as well. Dr. Google says that a patient will be ready for ovulation about five to 10 days after finishing the medication. Three days after I stopped the Clomid, I had a monitoring appointment. At this point, I’ve had all of the ultrasound techs at the clinic, and yes, I do have a favorite. She is in her 50s and has an accent that I can’t place but assume belongs somewhere in Eastern Europe. Part of the reason she is my favorite is that she has a bathroom attached to her room, so I can empty my bladder, change, and then hop on to the table. On this day, I was randomly assigned my favorite tech and she led me into her spacious room. With the probe inside, she started looking for enlarged follicles, with the ultrasound monitor pointed towards me so I could look with her. On the left side, we saw a few measuring at 10 to 12mm. Those are decent, but I now know that I would only be ready for ovulation once they are greater than 18. We moved to the right side, and a big black blob appeared. We both gasped. The tech recorded it at 21mm. “That’s your baby,” she said.

My fertility clinic typically calls between 2:30 and 4 p.m. to discuss that day’s appointment. I had to go to at my retail jo work, but I kept my phone with me on the sales floor, waiting for that call. I had assumed we would be doing another round of IUI over the weekend or that I would need to come in again the next day, but I wasn’t entirely sure. At 4:00 p.m., I still hadn’t received a call from the clinic. I was worried and didn’t want to wait another day, so I went to the patient portal to send my nurses a message and saw an unread waiting for me. Don’t worry, it said. We haven’t forgotten about you. We will be calling soon.

Finally, at 4:30, the nurse called. It was time. She instructed me to take my trigger shot that evening and then schedule the IUI for Saturday morning. This round seemed to move so much quicker than the other, which it did. In the first cycle, we waited for my body to be ready to ovulate. This time, though, the medications dictated the cycle.

That night, I pulled the trigger shot out of the fridge. I had bought it for our first cycle (at $200 a pop) but did not use it. Luckily, it was there waiting for me. Like most people, I had never given myself a shot before, however, poking yourself with needles is just another part of the fertility world. I watched the demo video that my doctor sent a couple of times, and then followed the instructions, my hands shaking with nerves. My husband wasn’t home, but he isn’t good with needles and would have been useless. I cleaned the insertion area. Tapped the air bubbles out of the test tube. Grabbed a piece of flesh from my abdomen. Inserted the needle at a 45-degree angle. Pushed the clear liquid into my body.

Another prescription of the IUI process is sex. With instructions of what medications to take and when, the doctor also indicates what days we should, as the fertility forums call it, “baby dance.” It seems a bit silly, but it is actually very stressful and removes the intimacy and romance. We felt pressured to do this now, and that if we fail, it will be on us. Sometimes my husband doesn’t get home from work until 10:30 or 11, and by that time, we are both tired and not in the mood. Or, we are stressed about other things. With fertility, sex becomes forced and a means to an end, and for most couples, this is a damning part of their relationship. Honestly, scheduled sex is not that much fun, and it’s hard not to get in your head. There are times when we can follow the doctor’s recommendations, other times it just isn’t going to happen. That’s a really sucky feeling.

This second round of IUI came on a weekend when family had decided to visit us. While everyone was still sleeping Saturday morning, my husband and I snuck off to the clinic. I fell asleep in the car while I waited for him. When it was my turn, I went into the clinic expecting to be called within a few minutes, like last time. However, 10, 15 minutes passed, and I was getting anxious. Some of the other waiting patients started to annoy me, including one woman who was very upset that her nurse did not tell her that she needed a full bladder. I watched other women get called before me, and I couldn’t help but think I was being denied something. It had been nearly three hours since my husband produced his specimen, which is when sperm outside the body start to die, and I panicked. Surely, it was stress and anxiety speaking, but each minute passed felt like an opportunity slipping through my fingers.

Eventually, it was my turn.

The procedure was similar to the first time. I verified mine and my husband’s info. A probe and catheter were inserted. It was all over within a few minutes, and then I waited 10 minutes. The worst part of all of this is the full bladder, which is required because it makes the cervix easier to access. However, I am worried about losing my restraint as I sit there for those 10 minutes (and honestly, in the waiting room beforehand) and forget about cramping from an irritated uterus.

After, we went sightseeing with our visitors. I was in pain much of the day, and often had to take breaks and sit, which put a slight damper on the day. Also, I couldn’t enjoy cocktails with my brother and sister-in-law and ended up insisting they drink all the booze in my house, hoping that I wouldn’t be able to anyway. By the next day, I still had slight cramping but was better.

In addition to booze, I gave up running during this cycle. My doctor confirmed that I shouldn’t get my heartrate above 130 and that the bouncing up and down motion of running is not good for implantation. I’ve been a runner most of my life and very consistent with my mileage in the last few years. It was hard to take a step back, specifically after I had already reduced my running due to finishing my master’s degree and studying for my licensure exams. Had I not been desperately trying to get pregnant, I would have probably been training for a fall marathon, excited like all runners to have in-person races back. Now, I was not running at all. Thankfully, a few of my running friends invited me out on walks, giving me an excuse to be outside and social. Still, I missed running, and it was now another item on the list of things I’ve had to sacrifice for fertility treatments.

During this two week wait, I decided to stay off the fertility forums. They gave me false hope and no amount of Googling could predict if I was pregnant or not. I did fairly good with this refrain up until the final days. As I got to 10, 11, and 12 DPIUI (days past IUI), I wanted to know what symptoms to look for and tried to gleam any information that could indicated pregnancy without taking a test.

Around 10 DPIUI, I thought I could feel my period coming. I was crampy in a different way and my breasts were sore, as they usually are before my period. My menstrual cycle was to begin in three days, and I cried that night, thinking it was all over.

I was expecting spotting in the morning, but there was none. Same with the next day and the day after. Maybe it wasn’t my period after all. Maybe I was really pregnant.

When the day of my expected period came and went, my hopes started to rise. It’s been 13 days. No period. I was tired and crampy at times but mostly fine. All things were pointed in my favor. There was one small shred of doubt, though. The progestogen that I take is known to delay periods, and it can be inconsistent at times. Meaning, because it did not delay my period last month, doesn’t mean that it would prevent it this month.

There was only one way to know for sure: take a pregnancy test.

My bloodwork, or beta test, wasn’t until Monday, but my husband and I agreed that it wouldn’t hurt to take a pregnancy test two days before. We were visiting family in another state, and I had packed one. Up until that point, I had only ever used “cheapie” tests purchased on the internet, and this was a Clear Blue test, which could predict more accurate results. I had bought this many months ago (not yet expired), and I wanted to save it for when I knew I could get a positive. This seemed like that day.

I woke up before anyone else, hoping to get that early morning urine when the HCG (human chorionic gonadotropin) levels are the highest. I pulled out the stick and went into the bathroom. After the test was activated, I stared at it. Waiting, finally, for two lines to show up. I kept my eyes fixed on it. Several minutes passed, and still only one line. Negative.

The desolate white that is next to the control line on a pregnancy test is one of the most heartbreaking colors.

I didn’t want most of my family to know that I had taken the test. I had gone out to the living room to hang out with my early-rising nephew who was busy snacking on toast and playing with cars. Other family members woke up and joined us. When my husband came into the room, I shook my head and held back tears.

Infertility brings out an irrational side, such as going back to the test hours later, hoping it had magically changed. Or, Googling stories of women who received negative tests at 14 DPIUI but then got a positive a day or two later through bloodwork. Or, researching to find out that First Response tests are actually more accurate than Clear Blue. Infertility drives you to attach on to hope, even when there is not much. But I found that hope, and I prayed that the negative test was an error, that my bloodwork would bring me different results.

When I went into for my appointment, I still did not have my period. I needed a miracle at this point, but a small piece of me knew that the miracle was a possibility. Unlikely but still. I went to the appointment, watched as they searched for my minuscule veins before deciding to go in my hand for bloodwork, and then tried to figure out how to spend the rest of my day. I did some grocery shopping and went on a walk with a friend. I was napping when the nurse called.

“You HCG was zero,” she said with a flat tone. “So, the test was negative.”

Before the phone call, I had received an email about an online fertility support group. There is a lot of ways for one to connect with others in the infertility world via social media. However, I couldn’t feel at home in those places. I followed infertility Instagram accounts and listened to other women’s stories, but I did not see myself in them. In sharing my own story a few months ago on social media, many people—from friends to former colleagues to acquaintances—had reached out about their own struggles. While their encouragement and support embraced me like a warm hug, I still felt like I was missing something. Someone had suggested a RESOLVE group, and I found one in Chicago that was conducting online meetings. I hadn’t been able to make the previous sessions, but on the Monday of that negative test, I received an email for tonight’s meeting. The timing was kismet.

The RESOLVE group was very similar to AA meetings. All members were invited, but not required, to share their progress and what had been going on with them. Each member had their own struggle, from several rounds of IVF to exploring surrogacy. I shared my story, how I had learned that day that my second IUI had failed. I explained our long journey and how if we do another IUI and it fails, I do not know what’s next. I expressed grief for missing running. I even told them that the first thought I had when I saw that negative was about how many people I know who have good jobs and are financially stable get pregnant on the first try while we are already financially limited and yet we are pouring more and more money into these treatments.

These strangers on a screen listened. They nodded their heads in acknowledgement. They understood. We were all at different points in the journey, but we held the same pain. They couldn’t tell me that everything would work out, and they could not point to babies as notes of perseverance. Yet, together, we quietly encouraged each other to keep going. It’s the only thing we could do.

I stopped the progesterone, and my period came a few days later. Then, I went to the clinic to prepare for our third round of IUI.

Published by The Running Therapist

A runner, writer, and therapist in training.

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