After diagnosing us with unexplained infertility, our reproductive medicine doctor went over our options with us. The first two things she recommended were intrauterine insemination (IUI) and in-vitro fertilization. She said that in-vitro fertilization (IVF) had a much higher success rate on the first try, but it was also much more expensive than intrauterine insemination. In fact, the difference in price was staggering. IVF costs approximately $16,000 for one try. Intrauterine insemination, on the other hand, only costs about $750 for one try. Of course, intrauterine insemination only has a 10 percent chance of working on the first try compared to 40 percent for IVF. If neither worked for us, there were other options we could explore. However, due to cost and not knowing why we weren't conceiving, we decided to try intrauterine insemination first.
Intrauterine insemination is a relatively simple process. It's kind of like having sex without having sex. Sperm gets into your uterus through a catheter rather than through your husband or boyfriend. The vaginal canal is really treacherous for sperm. It's a very acidic environment and sperm often don't survive the journey into the uterus. Those that make it to the uterus have to be right where the egg comes out of the fallopian tube at exactly the right time to fertilize it. When you think about the odds of all of those things coming together at once, it seems like a miracle anyone ever gets pregnant at all. Intrauterine insemination is supposed to take the guesswork out of conception and eliminate the hazards of the vaginal canal by bypassing it entirely.
I had to control the timing of my ovulation to do this. The doctor had to know exactly when to expect the egg to enter the uterus and to make sure sperm was there when it did. I also had to produce multiple eggs to increase my chances of conception. You normally only produce one mature egg per cycle. My doctor put me on a week's worth of Clomid to stimulate more eggs to maturity. Clomid is an old, well-known fertility drug, and it's pretty safe. After a week of taking it, I went back to the doctor for a sonogram. The sonogram showed I had six mature eggs in one ovary that were ready to be released. We just had to control exactly when they were released.
To control the release of the eggs, I had to go home and inject myself in the stomach with a drug that is meant to stimulate ovulation. I'd given myself injections before (such as blood thinners after my two knee surgeries and for alternative health treatments), so that wasn't a problem. The injection didn't even hurt, so that was good. The next day, my husband and I had to be back at the doctor. He had to provide another sperm sample, which he did with much complaining about having to do this humiliating thing again.
We went to lunch while the lab techs washed the sperm. This is a process where they remove the seminal fluid and any sub-standard sperm and concentrate the best sperm. When we came back, I undressed, got up on the table, put my feet in the stirrups, and the doctor inserted a catheter into my vagina that went up into my uterus. She then poured the concentrated sperm through the catheter.
Once the catheter was removed, I had to lay there for 15 minutes to give the sperm time to find the eggs and fertilize one or more of them. Yet I couldn't shake the feeling that the timing was off. I was sure I'd ovulated as soon as I did the injection and the timing was too late. But I tried to remain confident. I had six mature eggs, after all. Surely one of them would get fertilized and I'd get pregnant.
I tried not to think about it for the next two weeks until I could take a pregnancy test. We even went on vacation so we would have something different to do. When the time came to take the pregnancy test, I was pretty excited. Despite my initial reservations, I just knew this would work. How could it not? That's why I was simply stunned when the test came back negative. I wasn't pregnant. I couldn't believe it. With so many things in our favor to achieve conception it still hadn't occurred. Why? And, if I couldn't get pregnant with fertility drugs, controlled ovulation, and concentrated sperm put right where the eggs should be, could I get pregnant at all?