When an obstacle comes

Today I had a repeat follicle monitoring to check if I had already ovulated and if there was still fluid in the cul-de-sac. The good news was I haven't ovulated yet, but the dominant follicle on my left ovary was nearing its rupture. Also, my uterine lining thickened to its normal size (I'm guessing this is because of the estrogen supplement I took for three days). 

Unfortunately, there was still fluid found in the cul-de-sac and the amount even increased from 24 mL to 28mL. I don't have pain whenever AF comes, so Dr. Jing cancelled out endometriosis. We are still wondering what the cause of this might be. If AF comes next cycle, I would need to have TVU on CD3 to check if there is any cyst that may be causing the fluid. If there is no cyst found and the fluid is still there, Dr. Jing will investigate more through other ways. For now, I have to continue taking Doxin (an antibiotic) for four more days. 

It would have been a perfect timing for the IUI, but we had to forgo this cycle's procedure due to the situation. Because I would most likely ovulate today, Dr. Jing gave me a Pregnyl shot and told us to do BD today and tomorrow, hoping that we would conceive naturally this cycle...crossing fingers now...

Pregnyl (chorionic gonadrophin for injection)

Human chorionic gonadotropin (HCG), a polypeptide hormone produced by the human placenta, is composed of an alpha and a beta sub-unit. The alpha sub-unit is essentially identical to the alpha sub-units of the human pituitary gonadotropins, luteinizing hormone (LH) and follicle-stimulating hormone (FSH), as well as to the alpha sub-unit of human thyroid-stimulating hormone (TSH). The beta sub-units of these hormones differ in amino acid sequence.

(Source: http://www.drugs.com/pro/pregnyl.html)

*BD: baby dancing

Fluid in the Cul-de-sac

I had my follicle monitoring today. Despite the assistance of Clomid, there was only one dominant follicle, which is on the left ovary. Dr. Fernandez was supposed to schedule the IUI within the next two days. Unfortunately, 24mL of fluid was found in the cul-de-sac and it needed to be addressed first. Doing the IUI with the fluid still in the cul-de-sac would only be a waste of money and time because fertilization will not likely occur in this situation. Also, with my second month of using Clomid, my uterine lining has already thinned, which may hinder implantation if not corrected. So Dr. Fernandez prescribed me to take antibiotics (for the cul-de-sac issue) and estrogen (for the uterine lining) for three days. I will be having a repeat follicle monitoring on Monday. If the results are good and the dominant follicle has not ruptured yet by then, we will do the IUI for this cycle. If not, Dr. Fernandez will prescribe me a different fertility pill, instead of Clomid for the next cycle.

Cul-de-sac (Source: http://pcos.about.com/od/glossary/g/Cul-De-Sac.htm)

There are two small pouches close to the uterus, one on either side, called the cul-de-sacs. The anterior cul-de-sac is located between the bladder and the uterus. The posterior cul-de-sac is found between the uterus and the rectum. They are also called the excavatio recto-uterina (posterior) and excavatio vesico-uterina (anterior). Refer to the accompanying photo to see exactly where they are located.

In women undergoing fertility treatment, fluid in the cul-de-sac (as seen on ultrasound) is a common finding in ovarian hyperstimulation syndrome (OHSS). If the doctor suspects that you have this condition, he or she will likely suggest that you have an ultrasound to check for fluid in the cul-de-sac and measure your ovaries (enlarged ovaries are also common in OHSS).

It is frustrating, but what can I do? I just have to keep trying and doing what is needed. I hope my body will respond properly to medicine.

When things don't work out the way you want

Today, this is my shout out on my Facebook wall:

"Unless you have been very, very lucky, you have undoubtedly experienced events in your life that have made you cry. So unless you have been very, very lucky, you know that a good, long session of weeping can often make you feel better, even if your circumstances have not changed one bit." ~Lemony Snicket

I was really sad when AF came yesterday. It was my CD29 (16dpiui). I couldn't help but cry. It has been hard in the last few years every time AF came when we were trying to get pregnant the natural way, but it was even harder that my first IUI didn't work considering that there wasn't any serious problem with our health that could prevent us from conceiving.

We went to Dr. Jing today. The first question I asked was, "What are the factors that could make the IUI not work?" In her explanation she said that we have met all the prerequisites for the IUI and we have avoided an obstacle by helping the spermies get into the uterus easily through IUI. And what happens after that is already beyond our control: 

1. We don't know how much of the spermies went to the right tube or the left tube. I had two dominant follicles, one on each ovary. The mature follicle (ready to burst out) was on the right ovary. If most of the spermies went to the left ovary, spermies might have gotten "tired" to wait longer for the follicle to burst out. According to my readings, washed spermies can live up to 24 hours. If fertilization doesn't happen within this period, they die.

2. If one of the spermies was able to meet the egg after ovulation, we don't know where it went wrong during the process of fertilization. (Image Source: http://www.women-health-info.com/80-Fertilization.html)

3. If fertilization occurred, we don't exactly know why implantation did not succeed.

Dr. Fernandez said that what happens after the IUI process is already up to God and if we can't find a solution to a problem, leave it all to Him. 

We will be having our second round of IUI this cycle. As the Korean expression goes, "Fighting!!!"

*AF: Aunt Flo (menstrual cycle)
*CD: Cycle Day
*IUI: Intra-Uterine Insemination
*DPIUI: days past IUI