hCG Levels: What Do They Tell Us, and Why Should We Care

If you are doing infertility treatments, chances are your doctor will have you test your human chorionic gonadotropin (hCG) hormone levels about 12 days after your procedure to determine if you are pregnant. hCG can be detected in one’s urine or blood, but a home pregnancy test will not show you the amount of this hormone, only whether you have enough of it to be considered pregnant. Knowing the actual level on a given date, however, is important if you want to be sure that the pregnancy is going well in its early stages.

What Doctors Don't Tell You About Fertility Medications

Before you started your first intrauterine insemination (IUI) or in vitro fertilization (IVF) cycle, did you know that you would most likely end up injecting yourself with hormones several times a day for as many as three months? I didn’t. Possibly so as not to discourage potential patients, reproductive endocrinologists do not go into detail regarding your medication schedule until you are already emotionally involved and committed to complete the treatment.

IVF Cost

The first thought that comes to mind when most people consider in vitro fertilization (IVF) is not about its complexity or even its success rate. It’s about cost. Undeniably, IVF costs significantly more per attempt than alternative approaches such as intrauterine insemination (IUI) or a Clomid cycle with timed intercourse. However, although it may seem like a good idea to keep expenses low, one needs to consider the cumulative cost of having to repeat a low-cost procedure multiple times due to its lower success rates compared with IVF. (See my post “IUI vs. IVF: Cost Factor Revisited.”)

My IUI Medications

Intrauterine insemination (IUI), like most other fertility treatments, typically relies on medications to stimulate the production and release of eggs. Usually, Clomid (or its generic version clomiphene citrate) is the first drug prescribed to women who do not ovulate regularly. It is inexpensive and often effective. However, not everyone responds to it or can tolerate its side effects. In such cases, Clomid can be replaced with injectable medications to encourage the formation and ovulation of eggs.

Lessons Learned After Four IUIs

Within the span of one year, I underwent four intrauterine inseminations (IUIs) in an attempt to become pregnant. The reproductive endocrinologist who treated me had all the right credentials, plus a high success rate in making many couples happy. More importantly, my uterus appeared healthy, and so did my ovaries. The only thing I had going against me was my age. I was in my late 30s, and the quality of my eggs proved to be the one unknown that made all the difference.

IUI #4: Final Attempt

With two almost successful pregnancies, I knew that intrauterine insemination (IUI) could work for me. The question was how many more attempts would I need before I managed to have a truly successful pregnancy. Since my insurance covered most of the cost of my IUIs, I decided to give the procedure another chance.

IUI #3: Chemical Pregnancy

Even though my second intrauterine insemination (IUI) attempt did not make me a mother, it did prove that I was able to get pregnant and stay pregnant during the most critical months. To the reproductive endocrinologist who treated my infertility, this was encouraging; the aneuploidy was merely bad luck. Surely, my age had a lot to do with the unfortunate diagnosis, but since the chances of having another fetus with trisomy 13 were close to nil, I was eager to try to get pregnant again, hoping that the odds would now be in my favor.

IUI #2: Quasi Success

Seventeen days after my unsuccessful first intrauterine insemination (IUI), I began preparing for my next attempt. Since I had experienced rare but severe adverse reaction to Clomid, this time I had to order an injectable medication (Menopur), which was significantly more expensive but presumably had milder side effects. At this point, the cost didn’t matter. I just wanted results.

IUI #1: The Clomid Experience

I was 38 when I first heard about reproductive endocrinologists and how they could help me. After nearly a decade of unsuccessful attempts to conceive, I was relieved to learn that I no longer had to resort to regular OB/GYN doctors, whose experiments with birth control pills never did make me fertile. I was also surprised to find out that both OB/GYN doctors and reproductive endocrinologists like to start a patient’s treatment conservatively—with a pill.

What Is IUI?

Intrauterine insemination (IUI) is an assisted reproduction method that improves a woman’s chance to achieve pregnancy by placing sperm directly inside her uterine cavity. Albeit simple, this concept can be an effective way of circumventing male fertility problems such impotence, premature ejaculation, or low sperm count or motility. It is also widely used in cases of unexplained infertility, polycystic ovary syndrome (PCOS), anovulation, or absence of a male partner.

IUI Cost

Many couples who choose to pursue assisted reproduction opt for intrauterine insemination (IUI) first. Their physicians have informed them that the procedure is relatively simple and fast and would require lower doses of medication (if any). These are undeniably true statements, but they are typically followed by a much fuzzier claim regarding IUI cost. Here are some points to consider.

Care to Compare?

I have been trying to conceive since I was 30 years old. Eight years had quickly rolled by with no result before I finally decided to consult a reproductive endocrinologist and seek alternative methods. In the span of a year, I underwent four intrauterine insemination (IUI) procedures. Two resulted in pregnancy, neither of which lasted. I am now in the process of attempting my first in vitro fertilization (IVF).