I feel so completely scattered and unfocused. I can't seem to decide what I would like to do next, treatment-wise. In my mind my options are:
1. another round of fsh & iui
2. another round of fsh, but no iui
4. stop treatment (either temporarily, or for good & move on to adoption)
And, just to complicate things a bit more, option 5: either 1, 2, or 3 at a different clinic.
I am not convinced of the value of iui, statistically. I have been reading through a lot of abstracts online (and yes, as a person who has some experience in empirical research, I know the danger of relying on abstracts) and nothing has convinced me that iui's are going to be of enormous benefit to us, beyond the benefit of the fsh. On the other hand, they might be of slight benefit and at this point I wonder if we shouldn't grasp at every straw.
My personal experience of the iui was not entirely positive. First of all, we were in the office for three hours. Three hours. Obviously, this is a huge inconvenience. We were lucky that it fell on a day that Jack and I both were off of work. For a procedure of dubious benefit, this is a legitimate strike against it, since I only have so much sick/personal time and I am already devoting a good bit of it to monitoring appointments.
But my much greater concern with the timeline is that the length of time between obtaining the semen and performing the iui is negatively correlated with pregnancy rates. And the vast majority of our wait was between those two events, not waiting for them to call Jack in to do his part. I wish I could remember what time he was called back. I do know the exact time we first arrived in the office (I wrote it on the sign-in form) and the exact time of the iui (the nurse told me to wait 10 minutes afterwards before I got up, so Jack looked at his watch) and that those two times were three hours apart. I do know that the iui took place one hour and twenty minutes past the time it was scheduled to occur. I do know that we watched every single other patient in the waiting room come and go while we waited. Can you detect a little bitterness?
Honestly, it is not the inconvenience of the wait (though that was not fun) it is the fact that the wait may have substantially reduced the chances of the iui being successful. And not only reduced the chances of the iui being successful, but reduced our chances of getting pregnant (since we abstained for 36 hours prior to the iui). Which makes me doubt everything else about the way I am being treated by this clinic.
Third argument against iui is the cost. This is not covered, so we pay out of pocket. The cost of the iui is equivalent to our cost for a 300 cartridge of f-stim. Unfortunately, money is a limiting factor for us, so why spend it on iui (dubious benefit) rather than more rounds of injections (proven benefit)?
Finally, and I would not make a treatment decision based on this, but emotionally the iui just didn't feel good to me. It felt as foreign and invasive as anything else on this long journey has. And this is despite the fact that the nurse who performed it was as nice as she could be, and actually let Jack be the one to push the plunger and send his swimmers on their way (he gave me a card later that afternoon that said "thanks for letting me inseminate you").
So, to summarize, I am not convinced that iui is of much benefit to us beyond the benefit of the injections. The way my iui was performed (timed) may have diminished that already questionable benefit. Does what's left, in terms of the advantages of an iui, outweigh the disadvantages (time off work, expense)? That is the question, and I am having trouble finding an answer that feels right to me.
As for option 3 (way up there at the beginning of this post), I don't really think that we would move directly on to ivf from here. I haven't even discussed it with my doctor. But it's looming on my mental horizon. It's the obvious next step, assuming another failed iui or two (and right now I am having trouble imagining a successful iui). Frankly, we can't afford it. Which is exactly why I am thinking of it now. Why spend the money on two more doomed iui cycles, instead of starting our ivf fund with that money? (Here is where I start to feel crazy and scatterd and completely lose the ability to think rationally - because my next treatment cycle, whether iui or just injectables, isn't doomed. But I'm having trouble believing that.)
Then there is option 4. Option 4 is appealing to me right now. A nice, long break sounds good. I am starting to think more and more about adoption, too (which I used to think about all the time, but forcibly put out of my mind since we decided to actively pursue treatment). Thing about adoption is, it costs money too. I wish we could pursue adoption and treatment at the same time, but we can't. And when we reach the point of making a decision about ivf, it will probably be either/or, the big "how do we build our family" question.
And just thinking about that, my brain is so mushy that I can't even contemplate option 5. Which is probably the one I should be putting all my mental energy towards.
Sorry for this extremely lengthy post. I just needed to get this all out of my head.