(The reason we have done so many is because it took 7 cycles (2 IUIs per cycle) to conceive our second baby. We were unaware at the time that I am probably one of the rare women who cannot get pregnant while breastfeeding. So we tried 6 cycles without success and after weaning my first daughter, we conceived the 7th try.)
Also, please take note that this blog post is intended to journal our experiences with infertility and at home IUI's and is in no way giving medical advice. I hope this is helpful for others who find themselves in similar situations, but please do your own research and don't rely solely on my experiences!
Most people are probably unfamiliar with the term IUI or why we choose this option, so I'll explain from the beginning. After a year of trying to get pregnant on our own, we went to a fertility specialist called a Reproductive Endocrinologist (RE). He said everything looked good with me but Ryan's sperm count was very low. He saw a urologist who also did some genetic testing to figure out if that's why his count was so low and we found out that he inherited this condition from his father. So now our options were: IVF, adoption, or donor sperm.
After much thought, prayer, and therapy we decided to go with donor sperm. I have personal ethical concerns with IVF and did not feel good about the drugs used and invasive nature of the procedure. Plus it is very expensive. Adoption is also extremely expensive, you run the risk of the birth mother changing her mind, which would be very traumatic for me, and I would not get to experience pregnancy and birth. I felt a very strong calling to experience pregnancy and birth which I realize may seem selfish. But perhaps I felt that calling for a reason. After researching our options, including trying to figure out how we could finance IVF or adoption, we decided to use donor sperm.
The RE charged a lot of money for insemination and we didn't feel that it was necessary for us to go through a medical professional for a simple vaginal insemination. So I researched online to find a cryobank that would ship to any residence rather than requiring the client to use a medical provider as most others do. Together we went through the list of donors and one stuck out immediately to both of us. It was important that the donor was open to contact from the child in the future, rather than remaining anonymous. We also choose a donor based on some of Ryan's physical characteristics and personality. We were able to see general information about that, 2 childhood photos, and some open ended questions they answered, but no identifying information. Lastly, it was important to me that other clients using the donor had been able to have a successful pregnancy (meaning a live, term baby) because we didn't want to take any chances on that. Luckily it was pretty easy for us to agree on the same donor.
Our first cycle was an ICI (intracervical insemination. Basically it's like a vaginal insemination) and was unsuccessful. On the scond cycle the donor did not have any more ICI vials available (rookie mistake: only buying enough vials for one cycle!) but he did have IUI vials. IUI stands for intrauterine insemination, where the semen is washed so only sperm remains. The sperm is placed directly into the uterus with a catheter and syringe.
So after more
Fast forward about 3 years and we decide we're ready for another baby! So I do lots of things to prepare my body and we try IUI's at home for 6 months with no success. See here to read more details.
While taking a break from TTC (trying to conceive) for a few months, I went to see a highly recommended naturopath who did muscle testing and determined that I had mild hyperthyroidism which was throwing off all my hormones. She was not surprised I wasn't able to conceive. I did some supplements and dietary changes for a month to address this issue. (I know I know, this is another "weird" alternative voodoo thing, but she was able to tell a lot about me just from the muscle testing, such as my blood type and that I had a mold problem in my house. Combined with my friend's experiences and my getting pregnant after following the personalized regimen for a month, I am a believer! Here is the link to her website with more info.)
I also decided I needed to wean Audrey because although I was ovulating it was delayed and I had a short luteal phase. Luteal phase is the time between ovulation and menstruation and if it's too short an embryo may not be able to implant into the uterine wall. Delayed ovulation and short luteal phase is common during the gradual transition to full fertility after exclusive breastfeeding but in most women it isn't as long as I experienced.
So a few weeks after weaning Audrey and implementing the changes suggested by the naturopath we decide kind of on a whim to try a month earlier than originally planned. Partly because Ryan started an intense internship for his master's program in December and he wanted to have some time with the baby before being really busy for 6 months.
First of all, it's very important that I know my typical cycle very, very well. I had been charting my temperature, checking my cervix, and doing OPKs for almost a year at this point, and in total I have charted over 40 cycles in my life. That's a lot, but I would really only need to chart and check all my fertility signs for about least 3 months. I read Taking Charge of Your Fertility did the tutorials on the fertilityfriend app to learn about fertility charting when we were TTC the first time. Once I've charted a few cycles I can look back and see when I typically ovulate. I can start to predict ovulation based on my body's signs - high, open, soft cervix and fertile cervical mucus.
Knowing my cycle and my body is really important for doing an IUI at home because washed sperm doesn't live as long as semen from sex or from an ICI vial . So timing is everything! When I got pregnant the second time I was ovulating very soon after I got a positive OPK - about 12 hours (I took these 3 times a day, not just once as the box says. Your LH surge can happen anytime of the day and along with the shorter life span of washed sperm your window of actual fertility is pretty short). I also had ovulation pain. So that made timing pretty easy for us to figure out, although my cycles before my first pregnancy I didn't have any ovulation pain. The timing issue is why we do two vials every cycle. This way we can extend the amount of time my uterus/fallopian tubes have live sperm in it. We do two vials about 12 hours apart.
All right, here comes the best part of this post: the pictures! No, not pictures of us doing the IUI or anyone's body parts but pictures of the dewar the vials are shipped in and the process of preparing to do the IUI.
My firstborn helping with the dewar! (She was not present during the actual IUI)
Opening the box. The paperwork is on top.
The dewar! There's liquid nitrogen inside which keeps the sperm very frozen until I open and thaw the vials. The dewar is guaranteed to keep frozen for a week from when I receive it.
The cryobank takes their dewars very seriously! This letter says if I lose or damage it I owe them $800 to replace.
Paperwork verifying the donor number and all the testing they do on the sperm.
Written and illustrated instructions on how to remove and thaw the vials. Don't remove the dewar from the box!
Opening the dewar and removing a vial on insemination day! Yes, gloves are essential because we're working with liquid nitrogen. You can see two canisters in the middle of the tube which are holding the vials. They are set firmly in there and I have to kind of pry them off.
First the vial sits by itself for 3-4 minutes until all the frost is gone.
Next I hold the vial in my hand for 10-15 minutes until it has come to body temperature.
Here are the supplies needed for an IUI: speculum, catheter, syringe, and missing is a flashlight or headlamp. We sterilize the speculum after each use but we could also buy one-time-use plastic ones. The catheter and syringe are one-time-use. They are called TomCat IUI catheters and are 4.5 inches long, 3.5 fr with an open end. I like the catheter and syringes from here
(Before I do this, I need to make sure I have scrubbed and scrubbed my hands very clean! Or I could use sterile gloves. Sanitation is super important when doing IUIs because we are bypassing my body's natural filter, the cervix). Here I am aspirating the sperm out of the vial and into the syringe. After the sperm is in the syringe I will put the catheter on it. I open the vial very slowly and very carefully because there will be some pressure built up like a can of pop. (Yep, pop. Guess where I live based on that term!)
Now we come to the actual IUI of which there are no pictures. Basically, I lie down on an elevated surface with my legs butterflied and the speculum is placed. This can take some practice and patience so we practice beforehand. Oh, and Ryan has scrubbed and scrubbed and scrubbed his hands because he is the one actually doing the IUI.
He puts the flashlight in his mouth (this is where a headlamp would be especially useful) and gently positions the speculum to where he can see my cervix. Now this is the part where knowing my body really well (feeling my cervix during my cycle) can come in handy if Ryan has trouble locating it. Sometimes he can't see my cervix at all and he takes the speculum out and tries again. Since I've had a vaginal birth my cervix is always open a little but even when we conceived the first time we had no problems with this. I've read online accounts of IUI's done by medical professionals where the cervix was closed tightly shut and needed to be opened manually (painful!), but if one is inseminating at the peak of the fertile phase, the cervix should be at least slightly open. Then Ryan very carefully and slowly inserts the catheter into my cervix until it meets resistance, which is usually about 4 inches or so. Next he carefully and slowly pushes the plunger on the syringe until it's emptied, then carefully and slowly pulls the catheter out. I stay lying down for about a half hour after this to ensure the sperm is headed up where they need to go. There is usually some leakage, which is likely from cervical mucus rather than sperm coming back out.
And that's it! We're onto the two week wait! Pretty simple, actually. The main things are: getting our timing right, going slowly and having patience, and taking proper sanitary precautions. We've done a total of at 21 home IUI's (usually two IUI's per cycle) and I've never had any bleeding, pain, or infections. 4 of those cycles have resulted in pregnancy! (Except for when I was breastfeeding and unable to conceive, most times it has only taken us 1 or 2 cycles to achieve pregnancy. So 12 of the IUIs were done while I was breastfeeding and likely unable to conceive. Most women can get pregnant while breastfeeding but I seem to be the rare woman who cannot.)
And that's it! We're onto the two week wait! Pretty simple, actually. The main things are: getting our timing right, going slowly and having patience, and taking proper sanitary precautions. We've done a total of at 21 home IUI's (usually two IUI's per cycle) and I've never had any bleeding, pain, or infections. 4 of those cycles have resulted in pregnancy! (Except for when I was breastfeeding and unable to conceive, most times it has only taken us 1 or 2 cycles to achieve pregnancy. So 12 of the IUIs were done while I was breastfeeding and likely unable to conceive. Most women can get pregnant while breastfeeding but I seem to be the rare woman who cannot.)
