I’m in the middle of my third IUI treatment and just got back from the doctor’s office. Today’s visit was to check my uterine lining, follicle growth, and estrogen levels in preparation for the IUI procedure next week. With my first round I was hopeful, second round I was expectant, and this third time I’m just feeling like this better happen.
Difference between IUI and IVF
Let’s start here.
IUI is a non-invasive procedure recommended to women who have mild or ‘unexplained’ fertility issues, and have been trying to conceive for 6 months+. For an IUI, your cycle is closely tracked and, when you’re about to ovulate, they take your partner’s sample and inject it directly into the uterus. It’s done in-office and takes just about 5 minutes. After that, nature takes its course.
IVF is a more involved procedure typically recommended for people who haven’t had success with less invasive options like IUI, or who have more complex fertility challenges (like blocked fallopian tubes, low sperm count, or advanced maternal age). The process starts with hormone injections to stimulate the ovaries to produce multiple eggs. Once the eggs are mature, they’re retrieved in a short outpatient procedure. The eggs are then fertilized with sperm in a lab, and after a few days of development, one or more embryos are transferred directly into the uterus. It’s a multi-step process that takes a few weeks start to finish, but it's one of the most effective paths to pregnancy.
My first IUI pregnancy
I had been trying to get pregnant for about two years. Is that long? Yes. I admit that I romanticized conceiving until I accepted the reality that I definitely needed intervention.
I was referred to a fertility clinic and the testing began. My periods were irregular but consistent in length. I had a high follicle count (which I now know was indicative of PCOS). My husband’s sperm quality was all good. I had a partial closure on my left fallopian tube. Everything else was pretty normal.
[Sidebar] The test that is necessary to determine whether or not your fallopian tubes are blocked is absolute torture. It’s called a Hysterosalpingogram and I wish I had been put under for it. They put a catheter into your cervix that’s full of contrast dye and is injected quickly while the x-ray tracks if it flows freely into the abdominal cavity or if it stops or backs up. It’s not painful immediately after - I was cramping a bit but was able to get dressed and make it to the lobby. BUT THEN…I had the most painful cramps I’ve ever felt. Worse pain than when I had appendicitis and nearly comparable to labor. Hunched back on the benches in front of the hospital, I called my husband to come get me and contemplated asking them to admit me. It was that bad. I should add I have a relatively high pain tolerance but this was no joke. They say take tylenol before. Tylenol my ass. It went away about 30 minutes later but it was a trash experience.
Back to my first IUI The IUI process takes about 4 weeks and the medications are different depending on the people. Here’s a visual timeline of each of the steps:
This story is a short and rare one. I got pregnant from my first IUI. I won’t expand on this because I understand how annoying this could be compared to most fertility journeys. I was grateful. Let’s move on.
My Second IUI
We waited until our daughter was about 2 to start trying again. There’s no way we’re strong enough for 2 under 2. After 3 months with no positive pregnancy test and an impatient me, I made the appointment to go back to my the same fertility doctor. She redid some light testing - my bloodwork and my husband’s sperm. She asked us to keep trying naturally for another 3 months as I guess 6 months is due diligence?
Welp, that didn’t work either so we started the first round for the second time. We followed the exact same steps as my first IUI and I was optimistic. I wasn’t drinking, I was feeling a bit ‘off’ when it made sense to, and up until the fourth week, I was feeling pretty good. I have access to all of my lab results and I’m a freak so naturally, I made a spreadsheet where I could compare the lab results against the first successful IUI. My progesterone levels were a bit low at 11.6ng/ml compared to 22.2ng/ml with the first IUI. The doctor said it was fine but I got my period the next week. I wasn’t too fussed over it. Only 14% of women get pregnant with the first IUI procedure.
My second round was tough. I had to do two rounds of letrozole because my follicles weren’t growing at the rate they needed to which added stress and anxiety. Post IUI my progesterone came back at just over 5ng/ml so I was put on supplements which rocked me for a bit - 2 suppositories daily, fatigue, hot flashes, irritability, it sucked. I ended up having a chemical pregnancy and ultimately my period. I had a long convo with my doctor afterwards and we game planned the next round.
It’s currently day 11 of my third round. I had my follicular check-in this morning and things are looking alright. I’ll go in again in two days to check the growth and either get another round of letrozole or not (hopefully not).
My fingers and toes are crossed. If it doesn’t take this time, IVF is likely next.
If you’re thinking of or currently going through the IUI process, I hope this helps and would love to hear your story.
You're amazing for sharing this! I didn't even know there was something in between no intervention and IVF!