The IUI before the IVF, part II: Dr. Yours Truly
Shoutout to my spreadsheets and inability to take no for an answer.
Last week on Monday, I went to the doctor for a routine bloodwork and ultrasound post letrozole1. On day 16 of my cycle to be exact. We were looking for early follicle development. This is for my third IUI procedure in hopes to have a second baby. I wrote up a bit about it 2 weeks ago: The IUI before the IVF.
My regular doctor was on vacation and so the doctor who performed my ultrasound was a man who I’d seen around the office but never 1:1. While doing my ultrasound, he showed me that there were more follicles growing on my left side (which is the side that’s partially blocked) than my right. After some light conversation, he says, ‘I’m not too keen on this cycle’ and walks out. I remember sitting there, about to get up and get dressed, thinking to myself ‘was that weird and abrupt or is it just me?’
I head to the nurse’s desk to hear next steps, like I always do. The nurse looks at me and tells me that the doctor has determined this cycle is a no-go since my follicles were growing on the side where I had the blockage. Excuse me?! My regular doctor has performed IUI’s when the follicles were growing on this same side. My daughter is the result of a successful IUI where my follicles were growing on this same side.
Several feelings and thoughts came over me - it was like I couldn’t grasp at one long enough to understand it without another one interrupting it in order to generate a response. Why was the nurse telling me this and not him? The thought of taking my hoops off and going all it’s-not-clocking-to-you-right-now definitely crossed my mind but I rose above it. Then I remembered, thanks to the spreadsheet I made to track all of my bloodwork and ultrasounds for my 4 prior IUIs, that this could actually still work.
‘Even though that’s the same side my follicles were on when I got pregnant with my first daughter in this same office?’ I said calmly. In fact I knew how many follicles were on that side and each of their sizes. She told me it was the doctor’s call. The doctor, who seems ill prepared and ill informed and whom I’ve never met before. I asked if my regular doctor could be reached and was told they can’t reach her while she’s out. I felt deflated and not even mad, just disappointed.
And obviously a little mad, I was lying. Obviously.
I think I was also more hurt because I’ve built a relationship with the nurses and my doctor over the years. I’ve seen them almost twice a week for the last 4 months. These are my medical homies and to be told that my treatment would stop by some doctor who’s never seen me and the nurses just had to listen to him was kind of heartbreaking.
So I said I couldn’t accept that and would like to move forward should the bloodwork be in range given the stage I’m in. She was kind and sympathetically made a follow up appointment for Wednesday to check on the progress of the follicles. Later that day the bloodwork came back right on track.
At my next appointment, my bloodwork was gorgeous and my lining had grown to perfection. My follicles, however, were not growing at the rate they needed to. Letrozole sometimes causes a bit of temporary stagnancy in growth so I wasn’t tripping. There was still hope. It’s worth noting that same doctor was in an entirely different mood today. Not sure who spoke to him or if me dropping facts about my history made him change his tune but I’m glad he did. The nerve! Anyways, given that the follicles had only grown to 12-14mm (18-22mm is maturation size in order to administer the trigger shot and perform the IUI), he recommended I come back on Monday, or in 5 days, to check the growth. I thought that was a bit long to wait but I was grateful for another appointment.
Cut to today, Monday, when I go in and guess what? My lead follicle is 21mm on the right ovary which is the one that’s completely open. This means that although my follicles started to grow on the left side in the beginning, the follicles on my right side surged and outpaced them. Bloodwork and lining are all measuring positively for the IUI procedure tomorrow. My doctor still isn’t back so it might be this guy performing the IUI. He’s been in a much better mood though so I’m chopping up last week Monday’s experience to a bad day. We all have them.
I’m hopeful, of course, but even more so, I’m feeling validated for understanding my medical history, advocating for myself, and keeping records. I would encourage anyone going through a fertility journey to keep track of their symptoms and test results throughout. You never know when you’ll need them.
Imagine if I just said ok last week? Sometimes it pays to be a psycho with built in Latin rage.
Anyways, I came home and gave myself the trigger shot. Tomorrow’s the IUI. Then I have the fun 2 week wait. Wish me luck!
Sidebar: Anytime I’m being seen by this male doctor, there is always a nurse in the room who acts like a supervisor. I’m grateful but it also makes me wonder if it was a legal requirement. I learned that there’s no law in New York preventing a male doctor from being alone with a female patient, but strict rules exist around consent, especially for intimate exams, and chaperone rights. Patients must be informed of their right to a chaperone during sensitive procedures, and their decision must be documented. Interesting huh?
Letrozole is the medication that the doctor prescribes you in order to stimulate follicle growth.