Infertility is something so many women struggle with, so it is an essential topic for me to discuss as I struggled with it for so many years. Many women always question when it is the right time to see a specialist and how long they should wait before consulting with one. When I wanted to start a family, I went to a Reproductive Endocrinologist right away because I have PCOS (Polycystic Ovary Syndrome) and knew it would be harder to get pregnant. I will cover more Q&As on PCOS in another post since many women also suffer from this condition. I think infertility awareness is a great topic to cover in its entirety.
What is infertility?
Infertility is not being able to get pregnant after one year of trying unprotected sex. Is infertility genetic? As infertility awareness facts, It has been estimated that nearly 50% of infertility cases are due to genetic defects.
What are the first steps you should take if you feel you are struggling to get pregnant?
Do your research. I cannot stress to you how important it is to research doctors before booking a consultation. You can save a lot of time and a lot of money by reading about a doctor before you go to see them. After you feel you have found the right doctor(s), make your first appointment for a consult.
What to expect from your first appointment?
Usually, the first appointment can take about an hour or two. Every doctor is different so the time can vary. The doctor will evaluate you. They will also discuss your medical history and most likely do some blood work and even a pelvic exam. They may have your partner come in for a male reproductive evaluation if they feel necessary.
What to expect from the next follow-up appointment?
The doctor will discuss the results from your pelvic exam and your blood work. Depending on your exam findings, the doctor will determine the next treatment steps, whether you/they want to start aggressive or less aggressive.
What types of fertility treatments are the most popular choice among people?
Some of the most popular treatments to undergo infertility are In Vitro Fertilization, Intrauterine Insemination, and ovulation stimulation using infertility drugs.
What is IVF, in simple terms?
IVF is the process in which a doctor takes the female matures eggs and male sperm and fertilizes them outside of the body in a petri dish at a lab, and then inserts the fertilized egg or eggs back in the woman or a surrogate’s uterus.
What is IUI, in simple terms?
IUI is also known as artificial insemination, when the sperm is placed inside a woman’s uterus closer to the egg. Placing the sperm closer to the egg helps the sperm skip the step of traveling to the egg. Usually, doctors will also have the patient take ovulating drugs to help with ovulation, so the sperm fertilizes the egg.
Which route did I use when undergoing infertility treatments?
With all my pregnancies, I did ovulation stimulation using infertility drugs. I also combined that with timed intercourse. Timed intercourse is when the doctor monitors your ovulation cycle by doing ultrasounds then timing when you should have intercourse during your most fertile period. My doctor suggested I start less aggressively before deciding to do IVF. My case was slightly different because I got pregnant before on my own, so he felt my body could do it again. If the drugs did not work for me, I would have eventually moved on to doing IVF.
What types of fertility drugs are most popular to help with ovulation? And what fertility drug did I use?
The most common fertility drug prescribed is Letrozole, Clomid, Metformin, and Gonadotropins. Women can use other types of medicines for treatment, but this was the most popular during my experience. My doctor’s drug choice was Clomid during my first pregnancy, but I switched to Letrozole with my last pregnancy.
Was it expensive?
The simple answer is yes. Fertility treatments can be costly. The average cost for IVF is around $20,000. This is also the cost of one treatment. Most women will go through more than one treatment before getting pregnant. If you go with the less aggressive treatment, it still can become pricey. Most medical insurance does not cover infertility treatments. My insurance company did not cover infertility treatments, so I had to pay out of pocket for everything. Some of the costs you’ll most likely cover out of pocket would be the initial consultation, exams, ultrasounds, medication, and treatments. I did not do IVF, but it ended up costing around the same. I know some insurance companies will cover a portion, but it is best to find out before starting if money is a factor.
Is the process stressful?
Going through infertility treatment can be very stressful. It all depends on the person and how well they manage stress, the route of infertility treatments you take, and its success rate. For me, the process was not as bad as some stories I have heard. I was lucky enough to get pregnant on my first and second try with my girls. I also was able to do less invasive treatments. My husband was also at every appointment with me and helped me through the process. Having a solid support system, whether it be your partner or family, is so important. Also, ask as many questions as possible. When you understand the process more and know what to expect, it takes a lot of guessing out of the way. Nothing is worse than going through such a fragile, expensive, and lengthy process and not fully understanding it.
How did I get pregnant?
I documented my journey with fertility treatments with my last-born child. As I mentioned before, I did ovulation stimulating medication with timed intercourse. It worked for me on my second round. That may not be the case for everyone. If you are interested in what I did and want to suggest to your doctor this option, I will provide my step-by-step process. Below you will see the steps my doctor took on pinpointing my ovulation, the medicine I took, and when he suggested it was my most fertile time of the month to get pregnant.
It’s essential to jot down when your period starts. If you have irregular cycles as I do, the doctor can give you Provera to help jump-start your period within 3-7 days from taking a 10-day course of the pill.
My period started- July 31st
Can cyst cause infertility? The majority of ovarian cysts do not result in infertility. Once your period comes, it’s vital to call your doctor right away so they can schedule a baseline ultrasound. This ultrasound rules out any signs of cysts on the ovaries, and it is done between 1-5 days after your period starts. I did mine the next day.
Ultrasound- August 1st
The doctor will begin you on an ovulation-stimulating drug. I used Clomid in the past, but the doctor suggested I use Letrozole this time around. Letrozole is a drug used for women with breast cancer, but research has shown that it has also had great success with getting women pregnant. I began Letrozole at 5mg for five days on the third day of my cycle. The doctor will prescribe anywhere between 2.5 and 7.5mg.
Letrozole 5mg started- August 2nd
My period ended- August 5th
Letrozole 5mg ended- August 7th
The doctor will perform a 2nd ultrasound once you finish taking the drugs. The doctor will measure the follicles’ size, how many are present, and how thick the uterine lining is. Just FYI, a follicle’s most crucial role in getting pregnant is the storage and release of an egg to be fertilized. Each follicle contains one egg.
2nd Ultrasound- August 8th (follicle measured 9mm)
My follicles did not grow enough, so my doctor suggested another round of Letrozole at a higher dosage for the same amount of days. A follicle is considered ready to release a mature egg once it reaches around 15-22mm. My follicles were measuring approximately 9mm at the time of my 2nd ultrasound.
Letrozole 7.5mg started- August 8th
Letrozole 7.5 ended- August 12th
I went in for my 3rd ultrasound two days after finishing the second round of Letrozole. My I went in for my 3rd ultrasound two days after finishing the second round of Letrozole. I had three follicles that measured at 14mm and one follicle at 13mm. My follicles got more significant this time around but were still just under the 15-22mm mark. So, he scheduled me to come back in 3 days to see what their progress would be.
3rd Ultrasound- August 14th (3 follicles at 14mm and 1 follicle at 13mm)
I went for my 4th ultrasound three days later. All 4 of my follicles grew to over 15mm. I had two in my left ovary, one at 21mm and one at 22mm, and two in my right ovary, one at 16.5mm and one at 19.5mm. That meant that all 4 of my eggs were mature and ready to be released for fertilization. Having too many mature eggs is the only downside of taking the drugs at a higher dosage because of the possibility of all the follicles maturing, giving you a higher chance of multiple babies. I was a little nervous after signing a release form saying I was aware that I could become pregnant with more than one baby. The doctor said my chances of having three kids were 2% and two kids 10%.
4th Ultrasound- August 17th Follicles left side (22mm) (21mm) right side (16.5mm) (19.5mm)
After my 4th ultrasound and the good news of not just 1 but 4 eggs ready to be released, my doctor scheduled me to take a trigger shot. A trigger shot contains hormones that help speed up an egg’s maturing process and release it for its chance to be fertilized. I picked up my trigger shot from the pharmacy and had to administer it to myself that night at 6:50 pm. You must follow all your doctor’s specific instructions to avoid messing up and having to start the whole process all over again.
(HCG) Trigger Shot- Saturday at 6:00 pm on August 17th
After taking the trigger shot, you must follow your doctor’s exact timeline for time intercourse to increase your chances of getting pregnant during your most fertile window. Usually, your doctor will tell you to have intercourse the same day the shot is administered, but he scheduled me the following day. Below is the chart I had to follow.
1st Intercourse- Sunday morning (18th) 8:30 am
2nd Intercourse- Monday morning (19th) 9:30 am
3rd Intercourse- Monday night (19th) 10:30 pm
I took an ovulation test 2 days after the shot, first thing in the morning. I got a positive ovulation test precisely 39 hours after taking the trigger shot. You will most likely ovulate anywhere between 24-40 hours after taking the shot. For me, I ovulated right around 39 hours. I took a test after 24 hours, and it said negative. So, it shows how fast the ovulation period occurs.
Aug 18th Sun at 7:00 pm- Negative (24 hours after trigger shot)
Aug 19th Mon at 10:00 am- Positive (39 hours after trigger shot)
Your doctor will have you take a home pregnancy test two weeks after your positive ovulation test and timed intercourse. My doctor suggested I take a test on September 2nd. Because I was so anxious to know and wanted to see any sign of being pregnant, I took my first pregnancy test on August 26th, a week early. That test showed up with a very faint positive result.
When going through infertility treatments, I suggest that you purchase a pack of pregnancy tests off Amazon, as those are more cost-efficient. Clearblue and First Response are also good but cost a lot when you have to test all of the time. I think the Dollar Store and Amazon ones work better, in my opinion. They gave me a positive result a week before I should have tested.
Positive Pregnancy Test Urine- One-week early August 26th instead of September 2nd (the doctor’s suggested testing date)
I was so excited to see a positive test even though the line was faint, so I made an appointment with my OBGYN to get a blood test done since a blood test can tell you that you are pregnant sooner than a urine test can. I got my blood test back two days later, and the results came back as indeterminate. It was too early to tell whether I was or was not. I was super frustrated because blood should have shown before urine, but it was even too early for that. So, in my opinion, for anyone who is deciding to do this, DO NOT test early. It will only cause you to be super anxious for no reason.
Indeterminate Pregnancy Test Blood- August 28th
I went in for a blood test at my Endocrinologist’s office at my 2-week mark. They took blood from me, and my results came back that I was pregnant. MY HCG levels were already at 864HCG. Typically, 6-24HCG is iffy, but once you reach 25HCG, they consider that positive. If your number falls below 5HCG, then that would be considered not pregnant. They scheduled me to come back two days later to make sure my numbers had doubled. In the early weeks of pregnancy, your HCG numbers should double every 2-3 days. My HCG numbers doubled, so my doctor scheduled me for an ultrasound in two weeks to look for a sac, heartbeat and see how many of the four mature eggs got fertilized. It was too early to determine that during my blood work.
Blood Test September 3rd- HCG 864
Blood Test September 5th- HCG 1797
I went in for my ultrasound at 6.6 weeks pregnant, just shy of 7 weeks. During my ultrasound, the doctor found a viable sac and heartbeat. My husband and I were anticipating hearing how many possible babies we could have. We were praying for just one and not four since we already have a 5-year-old. The doctor found one baby with a healthy heart rate of 124. During this time of your pregnancy, your baby’s heartbeat should be around 120-160bpm.
First Ultrasound September 20th- 6.6 weeks 124 heart rate
Second Ultrasound September 27th- 7.6 weeks 170 heart rate
If you need any help with anything related to infertility, feel free to contact me!
* I am not a medical professional. All medical information is solely for informational purposes and based on my personal experience. The content is not intended to be a substitute for professional medical advice. Always seek the advice of a physician or other qualified health provider with any questions you may have.*