The Infertility Guidebook
Stage 5: Intrauterine Insemination (IUI)
*The procedure itself is anywhere from $500-800, depending on your clinic. The total range here includes the injectables and office visits, so again, cost will vary depending on the dosage you need.
Meds: FSH (Gonal F / Follistim), Trigger shot (HCG)
You’re ready for an IUI! This one is exciting. For me, this protocol felt like the first real fertility treatment. Artificial insemination – the ol’ turkey baster method – like you hear about in movies and TV shows all the time, right? Sort of.
You’ll build up your follicles using injectables (or sometimes using Clomid or Femara, depending on your situation), checking in with ultrasounds every few days to measure your follicles and adjust your dosage, and use a trigger shot to force your ovulation when they’ve matured.
Then, a day or two later, your hubby will go into “the room” (any man who’s gone through this process is well-acquainted with the room), and provide his bizness. The lab will then take his, er, specimen (sorry, I’m still immature apparently, so this part is really gross to actually type out), and wash it so you’re left with just the good stuff.
Warning: It’s pink when it’s all said and done. I don’t know why, but it’s weird, and you may end up impregnated with a cartoon character of some sort, but would you really even care at this point?
Anyway, once the sample is ready, your RE will insert a catheter into your uterus, and just shoot it up in there, so it’s ready and waiting to greet your eggs once they arrive. It’s like a big ol’ swingers party happening right there in your uterus! (Too far? Meh.)
You’ll round out your cycle with the two-week wait and some glorious progesterone supplements which, as a cruel joke, cause every pregnancy symptom in the book.
What to Expect:
- The easiest shots ever – seriously, these do not hurt even a tiny bit. It’s the world’s smallest needle, and you inject it into the fattiest part of your tummy. YOU GOT THIS. 💪🏻
- The scariest shot ever – I had to jump to the full intramuscular HCG for IUIs, and that needle is NO JOKE, my friends. First of all, you mix it up yourself like a damn chemist. Second, the needle is like 42″ long. Third, the instructions say to “insert it in a swift, dart-like motion” so it goes into the muscle. It goes in the booty, so my husband had to do this one for me, and I think it was the scariest moment of both ours lives the first time he did. (The second and third times he got a little too much pleasure from.) But it’s only one shot, and then it’s done. Remember in Stage 1, when I said it was time to get over your fear of needles? Do that now, if you haven’t yet.
- Cramping – you’re really going to feel your ovaries throughout this process. Your follicles may contain knives instead of eggs.
- Mood swings – hormones, man.
- Bloating – Think of it as pre-pregnancy puff.
- Cysts – After every cycle using injectables, I had monster cysts on both ovaries. This meant, if it didn’t work, I had to take a month off so they could go away. I would take anywhere from two weeks to a full month of birth control pills (because this process has a way of kicking you when you’re down like that), then wait for another period, and go back for another ultrasound in hopes they were gone.
Fun fact: I just learned that Kate Gosselin got pregnant with her sextuplets doing IUI with four mature follicles, so everyone who says IUIs don’t work (like me) can shut their traps.
Yes, if I’m being honest, I’ve always been skeptical of IUIs. They’re a lot of money, they don’t increase your chances that much compared to timed intercourse (success rates for IUI are around 25-30%, I believe, and 20-25% with timed intercourse), and some REs will let you do 6 or more before encouraging you to move on. If you add up all that money, you basically could’ve done a round of IVF.
BUT, I do think they’re good for prepping you for IVF. It gives your RE a chance to see how your body is going to respond to injectables, and it gives you a chance to get comfortable with stabbing yourself daily. It also emotionally gets you ready to take another big leap. And hey, if it gets you pregnant in the meantime – hooray! But if it doesn’t, at least you’re primed and in a great position to jump to IVF when you’re ready.
We did two rounds of IUIs (with cyst breaks before and after each one), before we all agreed it was time to move on to IVF. We could’ve kept doing IUIs, and it’s very likely that it would’ve worked eventually, but my husband and I emotionally could not handle another failed cycle after nearly two years of this.
It was one of the hardest decisions we made throughout the infertility process, but we were both at our breaking point. We knew we needed to put everything we could towards this dream, and then just move on with our lives if it wasn’t going to happen.
So onto IVF we went! Check out Stage 6: IVF for more on that process.
*This should go without saying, but this is the internet and therefore it doesn’t: I’m not a doctor, and you need to consult your doctor about any kind of medical treatment.