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SearchDonatelocation: Transition > Becoming a Parent > Insemination Process > Gonadotropin-assisted IUI
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The following outlines our experience with Gonadotropin-assisted intrauterine insemination (IUI) - starting with try #7. After two tries with Clomid-assisted intrauterine insemination through our local fertility center, we moved out of state; therefore, we had to find a fertility center near our new residence. We had consultations with two facilities and enrolled with one just in time to start a new cycle (though we missed one cycle during the move). Our new doctor offered us the options of continuing Clomid-assisted cycles, taking the next step and trying gonadotropin-assisted cycles, or jumping to in vitro fertilization (IVF). Before moving out of state, we had discussed doing three Clomid cycles before moving on to gonadotropins, because the best chance of becoming pregnant is within the first three cycles of using Clomid. However, we chose to begin the gonadotropin-assisted cycles with our new doctor, because we were ready to move on and gonadotropin-assisted IUI has higher success rates for unexplained infertility than Clomid-assisted IUI. Gonadotropin-assisted IUI is also easier to adjust the dose according to response than Clomid-assisted IUI. Using injectable gonadotropins also comes with intense monitoring with ultrasounds and estrogen levels due to the risk of Ovarian Hyperstimulation Syndrome. We also used Ovidrel, similar to the Clomid-assisted cycles, to induce ovulation. Gonadotropins The gonadotropin drug we used is Gonal-F (follitropin alfa), which is an injectable drug that is administered by subcutaneous injection beginning on cycle day 2 or 3 for a period of 7-12 days, depending on the individual response. Gonal-F is recombinant follicle stimulating hormone (FSH). FSH is primarily responsible for the development of follicles in the ovary (each follicle should contain one egg). Because Gonal-F acts like the body's own FSH, it causes multiple follicles to develop on the ovary. The risk of multiple-order pregnancy using gonadotropins is about 30% - two-thirds of these are twins, one-third are triplets or more. Ovidrel We used Ovidrel to stimulate ovulation once the follicles were mature to better time the IUI. Ovidrel (choriogonadotropin alfa) is a subcutaneous injection that can be given at home, and ovulation occurs about 36 hours after the injection. Ovidrel is a recombinant human Chorionic Gonadotropin (r-hCG) and it acts as the body's natural hormone would to cause ovulation. Insemination is typically performed about 36 hours after the subcutaneous injection is given if doing one insemination, or about 24 hours and 48 hours after the injection if doing two inseminations. Ultrasound Monitoring and Estrogen Level Testing Ultrasound monitoring and estrogen level testing is very important when using gonadotropins, because there is a risk of Ovarian Hyperstimulation Syndrome (OHS), which if severe can result in hospitalization. An example of schedule of ultrasound monitoring and estrogen level testing is below. NOTE: This is only and example and the actual days are determined by the individual's response to the drugs.
AI Visits The insemination visits for the Gonadotropin-assisted IUI are much the same as the visits for Clomid-assisted IUI and natural IUI visits. The new fertility center requires lying down for 10 minutes after the visit. They also do two inseminations per cycle (24 and 48 hours after Ovidrel injection) instead of one insemination per cycle. Pregnancy Testing Part of the monitoring with using fertiltiy drugs involves a blood pregnancy test approximately two weeks after insemination. Ovidrel can cause a false positive urine pregnancy test so we just waited with patience the two weeks between the insemination and the test, hoping for the best. |