Saturday, April 14, 2012

IUI timing with frozen sperm

The new clinic has a completely different protocol for scheduling IUIs than our other one and it's throwing me off a bit.

At the new clinic, I am to call before 8:00 am on the morning that I test positive on an OPK and they will schedule me for the IUI that same afternoon. But doesn't it take anywhere from 24-36 hours to ovulate after testing positive? And doesn't previously frozen sperm die within 6-12 hours? Doesn't that timing sound a bit off? Maybe I'm just used to doing things a certain way. I don't know. I'd be interested to hear from some of you.

The other issue I'm having is that for the last three cycles, I haven't tested positive with OPKs, but instead have gone in for an ultrasound at about day 14, injected a hCG trigger shot at about 10:30 am that day and had the IUI 24 hours after that. 

There is the added trouble that although the new clinic will do the actual inseminations, our old clinic will do all the monitoring of the cycle, so there is a disconnect there too.

So what if I go in for an ultrasound at the old clinic, they tell me I'm ready, give me a prescription for the hCG shot, and I'm not scheduled for my IUI until 4 pm the next day at the new clinic (they only do IUIs in the afternoon, except on weekends)? I'll have missed the boat. But if I go in the same afternoon when the trigger shot is hardly registered within me, the boys will fizzle out and die before the egg is ready.


It's kind of hilarious - in a dark comedy sort of way - how ridiculously small the time window is for getting pregnant. Especially with donor/frozen sperm. We have a peak of 6 hours out of a window of about 72 hours where it could possibly be an optimal time. And to boot, it's $1000 each time to "try". Frustrating as hell, but we have no choice.

And I know the worrying is not making my stress levels, and in turn my chance of pregnancy, any better, but I just want to have a plan. I'm a planner. That's what I do. No-one at either of the clinics can really give me an answer, or at least any reassurance, for how the timing is going to work. My clinic just said to call them, tell them I'm going for a confirmation ultrasound, and do it that day.

All of this will be moot if I actually do test positive on the OPK, so let's just hope for that.

It's day one of Femara and so far no nasty side-effects, though it's only been a few hours. I also want to have an ultrasound to see how I am responding to the meds, and to compare with my response to Clomid (which is generally good follicle count wise, but my lining is shit). I trust everything will work out; I'm just anxious... and anxious to get going.

I got my prolactin levels tested again and it's only 1/3 of what it was when it was high. I went from a level 31 to a level 10. Not sure why they were so vastly different, but I'm not worried about it. Huh, not worried about something. Surprising.


9 comments:

  1. Our doctor had us come in the day we tested positive on the OPK, sometimes the same morning, but we also did back-to-back IUIs, so we had one go-round that morning and one go-round the next... and I can't say that I would have been totally comfortable doing an IUI the second I got the positive OPK, either. I'm not sure you would have missed the boat if you go in a day after the trigger shot, even in the afternoon, but I'm not an RE.

    I've read lots of different things about how long frozen sperm lasts, some saying up to 36 hours, some saying much less (my doctor saying much longer, but I didn't have faith in that, honestly). The other trick is that the OPK does not say exactly when you are ovulating and so you could be catching the middle or end of a surge (and after the first positive, it can be as soon as 12 hours but not necessarily - on our first go-round, it looked like I had ovulated just after I had gotten the positive OPK, which means I probably had that initial surge the night before).

    There is, sadly, no certainty about any of it, which is frustrating at best. I think that clinics and doctors do generally try to do what has worked for them in the past and what they know to be "right," and maybe a different strategy will equal winning combination. I hope so!

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  2. AS a non lesbian doing it the old fashion way many many long years ago we were told to do it every other day for 3 days around the time of ovulation so the sperm must be able to last longer than we think since it was 48 hours between. Men swim faster and die quicker. Girls hang around so if it is a the tale end you get a girl. Since there are more girls born than boys I would assume you can catch it either end. I sort of like the idea of going back to back with IUI as it costs more but your chances I would think would be better. Wow, what a lot to think about. It took me a year the first time to get pregnant at 22 and one month at 24 so who knows and this was 41 years ago. Seems like with all the technology available this should be so much easier than it has been for you Lex. Not necessarily getting pregnant but having all the ducks (sperm) in a row. Let us know if you find out why the big differences and I would guess if you tested positive they would work you in for that afternoon. It is amazing how strict they are with their times of IUI. Maybe afternoon doesn't do it for some eggs :)

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  3. I took Femara and had horrible leg pains - for 4 cycles, til, DUH I figured it out!! Best of luck with all this chaos, I hope it gets sorted out and works!

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  4. I'm glad I found your blog -- it's so honest and relatable. My partner and I are not yet to this point on the road, but I am already anxious about the complexities of the challenges we will have to overcome to experience something many couples take for granted. I will be sending good vibes your way!

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  5. as far as timing with my iuis (all unsuccessful to this point but i had several problems that probably negated all of my efforts) i would go in for daily monitoring with bloods tests and ultrasounds from day 10 on, and they would tell me based on my LH levels whether or not to do the trigger shot. the times that i did the trigger shot, i did the trigger at night, and did an insem (w/ frozen sperm) the following day. if i had already ovulated on the day of the insem (confirmed by an ultrasound) we only did one insem. if i hadn't, they would have me come in the following day as well for another insem. hope that helps. hang in there

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  6. "But doesn't it take anywhere from 24-36 hours to ovulate after testing positive? And doesn't previously frozen sperm die within 6-12 hours"

    Sadly I don't think anyone knows for sure, and it's likely there are some sperm that die quickly and some that last longer (regardless of if they're XX or XY). Personally, it seems based on hearing everything everyone and the research has said, that frozen last between 12 and 24 hours.

    As far as how long it takes to ovulate since a positive OPK, it really depends on your body. As I've stated many times before, for us it was about 12-24 hours after the dark OPK line. For others, I've heard up to 48 hours. For most people, it's 24-36. But you can usually figure this out. Use multiple OPK's throughout the day (you can buy them cheap in bulk online). You should notice the line go from faint to dark to faint again. How quickly it does this can help you know how quickly you ovulate. If it happens all in one day, you ovulate quickly. If it spreads out between two days, you ovulate more slowly/typically. If it spreads out over three days, you ovulate very slowly. Time your insem based on that. For us, we wanted to do the IUI 12 hours after the darkest line appeared because it went quickly.

    You don't have to tell your clinic what you're doing (we didn't). We just told them ovulation happened when they expected, when it truth it was much closer to IUI time than they said it should be.

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  7. I just found your blog and wanted to put my 2 cents in :)
    Having been pregnant 3 times through IUI with frozen sperm (pregnant one the 1st month twice and 2nd month once), I have always found that doing the IUI about 24 hours after a positive test (which is when I ovulate, I can feel it) and it has worked well each time. If your office tells you to trigger in the AM and do the IUI in the PM, then I would find a new office! Good luck!

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  8. as someone who is trying to get the timing *just right* and trying to plan as much as I can (without meds, and so relying on "nature!") this post is invaluable to me. Thank you! (and now I'm off to the blogs of everyone who posted, so I can learn more about what has worked for people.

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