Since we are not millionaires, we were very upfront with the RE (Dr. M) about not having insurance coverage for infertility or testing. At first I thought he was being really nice by offering to do a natural-cycle IUI before moving on to clomid cycles. He said a natural cycle would save us a lot of money on medications. In retrospect I find this really funny because I recently filled a prescription for Clomid and it costs about twenty bucks. We were already paying for the Ovidrel and the Prochieve during this supposedly "natural" cycle so I don't think another twenty bucks would have killed us. I'm pretty sure we got hosed and I'll explain why later on.
In the meantime, here's another reason why I loathe Dr. M. Let me warn you in advance that this is going to be graphic and a little icky. I realize that a rectal exam is supposed to be a normal part of a pelvic exam and I have had a doctor or two in the past that did them. I do not enjoy them but I have always managed to be pretty stoic about that sort of stuff as long as I know its coming at least 5 seconds in advance. Dr. M apparently thinks that rectal exams are better when they are a complete and total surprise. He actually laughed a little at the expression on my face and said something about it "being better not to warn people in advance." I'll bet its "better" you sadistic bastard!
In all seriousness, that was a truly horrible experience - not because it was painful or uncomfortable (and it was) but because it left me without a shred of dignity. I walked around in a daze for the rest of the afternoon and for several days I kept replaying it over and over and over and feeling sick. I even had some nightmares. I don't know why it bothered me so much because at this point I'm used to whole teams of people poking around down there. I think it was just the way he laughed about it that made me think that this guy was definitely not trustworthy.
So about the IUI. Yeah, it was a pain in the ass getting probed up the hoo-ha and stuck in the arm with a needle every morning for $250 a pop. But I don't dare complain because I know that IVF is much, much worse and I am pretty sure we're headed there at some point. The IUI failed but it was interesting for a couple of reasons:
1. We learned that I have several small cysts on my ovaries. I wish I could tell you what they are and why they are there but I have no idea.
2. DH may not have a morphology problem after all. On the big day, DH managed to whip up a sample with 400 million swimmers. I'm not sure if the nurse who did the IUI understood our question thoroughly but she did say that they were all "good ones." My new Ob/Gyn seems to think they would have had to be all good ones to make it through the sperm washing but I don't know who to trust these days.
Here's why I wonder if we were hosed from the get go. All the books I've read seem to think that you're supposed to get inseminated at least twice after you have the hCG shot. We only had it once. I've also heard there are supposed to be plugs put over your cervix to keep the sperm inside your uterus - they told me its a one-way valve which I find VERY hard to believe considering how well I tolerated the catheter. I don't think my cervix is that tight. Most importantly - it seems like other women's IUI's are performed only after they get a positive OPK. They told me the hCG shot would work in the next 24-48 hours. My IUI was at exactly 24 hours post-hCG shot. If washed sperm only lives 6 hours and eggs only live 1 hour and I didn't ovulate till 45 hours - well, you catch my drift... If anybody out there reads this and knows something about this please (please!) write to me.
In short - I think our RE figured that the longer he put off doing any real testing and the longer he put off doing any real medication, the longer he could charge us lots and lots of money for ultrasounds and IUI's that probably wouldn't work. We would have seen him again in three months after three more failed (and very expensive) IUI's and he would have looked really surprised and really sorry that it didn't work. And then maybe at that point he would taken his finger out of his own ass and gotten down to figuring out why we can't get pregnant.