IUI is not for Me Him Me

I had a difficult time last week reconciling Trump's Tuesday night win with my Wednesday fertility appointment. They aren't directly connected, of course, but then again, maybe they are. Isn't everything? This is what I wrote then ...  

... I cannot get past the juxtaposition that I am headed in to the fertility clinic where I can freely access healthcare and medical intervention to support a desire to grow a family, but our country just voted for President of the United States a man who vowed to eliminate much of women's healthcare access/reproductive rights. So what you are saying is that Trump wants to either grab women by - or legislatively rule over - pussy? 

 

 

In a nutshell, I'm pissed that I can get medical intervention to get pregnant again in an already overpopulated and environmentally-wrecked world, but my sister from a darker mister might not be able to get that abortion she needs in order to continue supporting her family as a single working mom. Or the teen who grew up in a religious home and was, sadly, never educated about the going-ones her own body, let alone sex or birth control. Or the college student who was wasted and was kinda-sorta-maybe-probably date raped and discovers she's pregnant with some predatory frat boy's baby. Or the mature, independent woman who tragically learns at 22 weeks that her baby has anencephaly and she can't imagine carrying to term. Or the married woman who becomes pregnant with her third child just before learning that her husband is having an affair and intends to leave her for a younger woman. Diverse and very personal scenarios like these, and so many more.   By way of a recap, Alex and I have been dealing with unexplained secondary infertility issues for 2.5 years now. Until recently, I have been very reluctant to pursue any medical intervention. I did finally complete all the required testing, and late this summer I started taking Clomid, a medication aimed to improve fertility by stimulating an increase in the hormones responsible for the growth and release of an egg. Last month my period was a week late and I wasted some $30 on pregnancy tests because the only times I've ever been late were when I had an eating disorder in high school and then that time I was pregnant in 2011. Turns out - thanks a lot for the thorough info, Kaiser! - Clomid can extend the length of your cycle. Would have been nice to know, just saying. I have now completed three cycles without successful pregnancy, let alone even a positive ovulation predictor. Kaiser recommends pursuit of IUI, or intrauterine insemination, as the next course of action. Essentially, IUI is the process of spinning semen in some kind of fancy centrifuge so that only the best and brightest sperm are selected with the hopes of impregnating me with something resembling a turkey baster. They use the fancy contraption to blast the Super Jiz past the Circle of Death (as I have come to call that part of the cervix that is the most "hostile" to sperm) to wait patiently at the opening of my Fallopian tube to fertilize the egg (god hope it's not two eggs).   As hot as all this centrifuge and Circle of Death sounds, don't be too jealous because there are some drawbacks. For one, it costs money. But not really that much. As an educated, healthy, and knowingly privileged white 34-year old woman with excellent health insurance, these procedures and their associated medical charges will cost us just $100-200 per month/cycle/attempt. Secondly, it costs me time. And really, my sanity. Now, I'm someone at risk of losing my mind after just a few back and forth texts or missed phone calls attempting to coordinate with friends. So imagine how distressed I might be at the prospect of having to anticipate and manage SO MANY variables in order to ensure my best chance at a successful pregnancy with IUI. WHich, for the record, is a mere 10% per cycle. Because I'm not getting any positive results indicating ovulation (although I have had several Day 21 labs  that "are indicative of ovulation), I would need to get follicle scans to determine the timing of ovulation. So sexy time would now look something like this:   - Day 1: call the fertility clinic/imaging to schedule a follicle scan for Day 12 - Day 6ish: start OPK anyway - Day 12: get follicle scan (an ultrasound) - IF I do miraculously get a positive OPK, call to schedule IUI for the following day -Day 12-14: depending on the follicle scan, give myself a "trigger injection" of something called Ovadril (which can cause ovarian hyper stimulation, whatever that is) - Days 13-16: schedule IUI for within 36 hours of trigger injection - Plan for "specimen collection" no greater than 45 minutes before the IUI appointment time; this can be done at home and then kept warm in my coat pocket or something, or done in some special clinic room where, explicitly, "only one person at a time is permitted" - Plan to wait at least 1 hour while the sperm is spun; wearing my best panties, I take them off in favor of a gown and they inject just a half-cc of sperm directly into my uterus; I lay flat for about 10 minutes and am then free to "go about my day," although I can't imagine how that would be possible after such an arousing and satisfying attempt to get knocked up, possibly without my Baby Daddy/husband even in the room - And then, fingers crossed, I wait about two more weeks to determine if I'm statistically fortunate, or simply in the 90% of women who do not get pregnant with each IUI attempt; of note, the average rate of pregnancy success in the typical female population is 14% per cycle; the average couple completes 4-6 IUI cycles to become pregnant - speaking of stats, now is a great time to remind you, my dear loyal 14 readers, that my risk of conceiving twins associated with Clomid is 10% - also, the clinic requires both Alex and I complete blood/urine labs for STDs YET AGAIN   Needless to say, nothing about this process appeals to me. Even the end result, at this point, is of little interest. Walking out of the appointment, my detailed notes for Alex in hand, I check in with myself to see what I might be feeling. Stress. Overwhelm. Maybe a touch of resentment? And I decide, before even discussing this all with the other half of this equation, that in my heart of hearts this IUI business is not something I want to endure. I'm already exhausted by the appointments I currently manage - with my therapist, for acupuncture, in the fertility clinic - adding to that sounds like a fulltime job. And that's all just to get pregnant. Never mind the work it requires to exist as a pregnant person, and then feed and nurture the new life, let alone care for the one I already successfully conceived, carried, and birthed. Fortunately, Alex is supportive when I tell him all of this, and he more or less concurs that it doesn't exactly sound worth our time or the money. We agree that we're not closing the door on a Family of Four, but that we'll keep at it the natural way for a bit longer, and see what the world may or may not have in store for us. Cynically, part of me doesn't even want to usher in a new Close in the Trump era.   Maybe it is simply a factor of my own on-again-off-again battle with ambivalence about reproducing again, but I feel particularly conflicted about the freedom I am granted to make certain choices about my own body and my own family. And on the very day our great nation has elected a misogynistic demagogue - one who has bragged about sexually assaulting women, insulted women's bodies, thinks that pregnancy is inconvenient to employers, has fathered several children with three different women - how is it that this man will be the leader of the free world, and also very nearly the boss of my body?!? In the meantime, I'll be proud to make my own difficult decisions about my fertility and family planning - and it won't be via IUI - and will keep in mind my privilege to do so while pledging to do what I can to defend the same reproductive rights for all women.