Plan B

Well, the Easter bunny's eggs didn't take. Luckily we have a Plan B (and C and D and E...).

The first 3 tries at intrauterine insemination, we did a cycle with ovulation induced by Clomid. Then I did ovulation predictors, and when it indicated ovulation, we scheduled insemination for the next day.

Plan B is different because now we are adding injectible hormones. So, days 5-9 of my cycle, I take the Clomid. Then, starting day 7, I begin injecting myself with follicle stimulating hormone (FSH) gonadotropins. This helps me produce several eggs and to control when they are produced.

After several days of the FSH shots, I will inject myself with human chorionic gonadotropin (hCG), which tells my ovaries to release the mature eggs into my fallopian tubes. If one of those ripe eggs meets up with a healthy sperm on its way to my uterus, we just might conceive.

When I went for my appointment on Tuesday, I had no idea what to expect. First, they took some blood to get a "baseline" of my hormonal status. Next, they did a trans-vaginal ultrasound (always fun when you're having your period) so they can get a good look at my ovaries as a baseline, too. Basically, they want to see what everything looks like now, before I start the hormone injections so that they can see any differences as they monitor my cycle.

Finally, a nurse sat down with me and showed my how to give myself the shots. I got a little kit with a Follistim (the brand of the medication) "pen." They really make this easy - you load the vial of medication into the pen, close the pen, screw on a needle, dial a dose, and then inject it into your fatty tissue (luckily I have plenty!).

The nurse ordered the hormones from a pharmacy, and I had to give my credit card. The hormone vials were delivered to my work because they needed to be refrigerated and I would be at work later. So, almost $700 later, my well-packaged little hormone vials were in a brown paper bag in my work refrigerator.

After 3 days on the FSH injections, I will go back to the doctor to be monitored with a trans-vaginal ultrasound and blood tests. I will continue to be monitored until the tests indicate that my eggs are mature. Then I'll give myself an hCG injection, which will hopefully cause me to ovulate 24-36 hours later. I will then be scheduled for intrauterine insemination in the next 24-36 hours.

Once again, we will give this process 3 tries before moving on to the next "plan" which would probably be in-vitro fertilization - which is something we'll really have to think about before we go there.

There is a 10-40% chance of my conceiving twins or more with these fertility drugs. While this would normally be an exciting blessing, multiple pregnancies for me would not be a good thing since I have incompetent cervix and I am at risk for miscarriage, premature birth, and other complications with even one baby, let alone more than one. I had to sign a waiver that I would consider selective reduction of the pregnancies if it becomes necessary for my health or the health of the baby(ies).

Success rates are between 20 and 60 percent. This is good since the cost for the whole process, with drugs, tests, and office visits is between $2,000 and $5,000 per cycle. Of course, none of this is covered by insurance.

I start the injections tomorrow, and since I'm currently involved in our board meetings, it should be an exciting emotional roller-coaster of a weekend!