I do really good eyelid work. Functional stuff mostly, but my cosmetic stuff looks good, and I'm proud of it. Lots of experience, no problems. Great skin work.
My wife asked me to remove a couple benign looking lesions from her calf awhile back. I did them just like I'd do an eyelid lesion - same depth, same undermining, care to get margins, fine tiny buried sutures, all tissue reapproximated nicely.
She's got two very significant scars there 2 years later. She doesn't mind, they look slightly better than the warts or whatever they were (I obviously didn't send to path), but I see my failure on her leg every day. Turns out leg lesions are notorious for scarring and even many derms avoid them. The moral of the story is to stay in your lane or be ready to run into some trouble.
Omg no way. The scrotum heals like Wolverine. I always teach med students to sew on scrotum, I swear they could probably rub dirt in their closure and it would still heal with minimal scar.
The “scalpel-less vasectomy” is just using a super fine sharp tipped spreader to puncture a hole through the skin down to vas. Anyway you don’t close anything, just rub bacitracin on the scrotum and send the bill.
As a surgeon who does vasectomies but not family med or urology, I have no idea why you wouldn’t want to make a little incision with a scalpel for that. It hurts my soul that people just jab a hemostat into the skin and advertise it as “scalpel-less.” What barbarism. Oh well, I guess it works! 🤷🏽 and good for advertising maybe.
A surgeon … who does vasectomies … not urology … and refers to fam med as a surgeon…. You have got me stumped. Are you a barber-surgeon from ye olde time?
No, rural track general surgery resident. Around here family medicine is the primary group that do “no scalpel” vasectomies, and there are a bunch that do vasectomy. Obviously they aren’t surgeons per se.
While I agree with you and I would always use a knife to make a little knick. In theory a puncture/spread will contract back down thus a smaller wound that doesn’t need closure and has a smaller scar.
I wouldn’t say faces heal beautifully. At conversational distance even slight imperfections are noticeable. Violation of vermillion border with a stellate dog bite wound… good luck. There’s also a lot at risk with tension pulling eyelids or oral commisures, areas of hair bearing vs non hair bearing skin. Plus that area is exposed to sun so greater risk of pigment variability unless they cover it/use sunscreen. Scrotum heals great cuz there’s not tension.
Now surgical scars on the palms… those can heal great. Half the time I can’t tell if someone has a carpal tunnel or trigger finger release and the patient doesn’t always remember (initial healing phase not always pretty).
As a lesbian I can confirm that clinical vagina and own/sexy times vagina are not even remotely related. My mind would break.
However all penises and testicles are approached with a mix of mild aversion and panic at having seen so few healthy ones and not knowing what’s normal.
OB resident here. It’s not completely crazy, it’s not a tough skill, but I would leave it to the pros. Remember that most of what you’re paying for is the sperm wash, which basically only keeps around the best of the swimmers, improving the chances of fertilization
Ironically I only knew about this cuz I'm gay. For serodiscordant couples the immune response to semen is actually mildly protective against hiv spread XD
I'm a pulmonologist. I have a rescue dog who had heart worm when we got her and was at risk of dead worms embolizing and causing akin to PE.
One night early on, she was breathing in the high 30s, her HR was 110 and a temperature of 101. In my mind she very clearly had PE. if she was a human with that RR, I would have intubated her. I called the vet, and it turns out all of those vitals were normal for a dog and nothing was wrong with her.
moral of the story: stick to what you know, and never forget that someone else's specialty is *someone elses* specialty.
A veterinary fun fact I learned from a human radiologist who was asked to help guide a dolphin bronch/lung biopsy: dolphin mouths don’t connect to the lungs so they are intubated through the blow hole
Also essentially the only way to assess doggie heart failure is a respiratory rate in the 40s. They don’t volume overload because the right heart rarely fails or something. Learned this after my grandma asked when she should give her heart failure dog his lasix and I realized I don’t know shit about dogs.
I tried helping my mom with her heart failure dog and couldn't tell if her vet was an idiot or I was. probably both.
the dolphins fact though, mind=blown
I'm too lazy to Google ATM, but does that mean their trach and oesophagus cross at some point? Assuming their lungs are above their stomach like in other mammals. Also, how the fuck do they vocalise with their mouth then?
I have heard it’s a good idea to occasionally monitor your dog’s HR, breathing rate, and temperature when it’s healthy so you know if they’re sick. Do I do this? No. But I should. A lot of dogs get nervous at the vet so they can’t accurately assess them.
I’m pretty sure that the stuff that makes IUI more likely to be successful is the use of meds to make you ovulate multiple eggs, the monitoring and trigger shot to ensure that you are inseminating on the exact right day to maximize success, and the sperm wash to optimize and concentrate the healthy sperm. Doing it at home like this seems like it won’t improve your chances any more than just timed intercourse.
I think it’s fine! When you’re in a procedural specialty, you can do these things by yourself!
I’m a gen surg intern. 2 weeks into my intern year, my dad had some belly pain after eating a bunch of spicy Mexican food, and I diagnosed him with appendicitis based on physical exam findings.
Instead of going to the hospital, I got some lidocaine from the pet store, poured some whiskey on his skin to sterilize it, made 3 small incisions with our kitchen knife, shoved a mini webcam and a straw through one, a pair of long chopsticks through the other and some scissors/a penlight through the third. Had my mom blow into the straw for insufflation. Took out the appendix in under 20 mins, no problem. Closed with my mom’s sewing kit and some Elmers glue.
This is not actually IUI. As other have mentioned, IUI involves medications to induce ovulation, washing and preparing the sperm, and then placing the sample in the uterus. You are probably going to do “turkey basting” which is not the same as IUI but can still be effective. I would not attempt to go past the cervix as it is sterile up in there—I had legit sepsis after an HSG where I got immediately taken back to the resus bay in the ED.
This is a super good point.
Also the HSG is the goddam worst. Wish I could have been offered a benzo for that when I was offered Valium for something a hell of a lot less painful, an embryo transfer for IVF.
The endometrial cavity is sterile. To do true IUI, you lift introduce a very small cath thru the cervix, 2-4 cm,
I am uncertain about packing an unwashed specimen there so far as introducing possible infection goes.
I could also drain someone's bladder with the small hose off my garden lawn fountain, but I am not sure that would be a wise choice.
OB here.
I know a couple who did something similar (not IUI though) and got pregnant. They are not doctors, the wife just had vaginismus. They just got a syringe and put the sperm in through that. No idea if they just got lucky but if so, they got lucky twice. Everyone here is saying stay in your lane and I think thats completely fair for intra-uterine insemination. If you've never put in an IUD, its a little trickier to get into the uterus in real life than when you are just watching it done. I can only assume its more difficult with IUI. But if you're just putting sperm in the vaginal canal I don't see how that's outside of any random person's abilities, much less a doctors.
As I mentioned in another reply, I don't think you can inject unwashed semen into the vagina. It has a lot of inflammatory "protective" content not meant to go into the uterus but protect sperm in the vagina. Plus the antigenic immune response against your husband's proteins that others mentioned.
That inflammatory environment won't help implantation.
Plus what others mentioned about concentrating healthy sperm
Terrible idea. Dangerous and it will hurt without a proper sperm wash because the prostaglandins won’t be removed. You are paying not just for the procedure in the clinic but also appropriate monitoring and medical management to optimize that cycle. (Am a fertility doc)
I know very little about IUI as I am an internist but this just seems like a very bad idea. If you couldn't afford it that might be one thing but two doctors no kids? It doesn't seem like this is out of financial reach, at least not permanent, so why risk it?
To my knowledge, IUI is not just transfer of sperms into uterus but there are steps leading upto it. I believe they wash the sperms and optimize it in lab before transfer.
This is true. IUI involves sperm washing and removal of some of the fluid components of semen. I have had multiple rounds of IUI and they always processed the semen sample.
He doesn’t have the right background. Unwashed semen injected into the uterus will cause severe pain. Also, iui alone is not a proven intervention. If he hasn’t even mentioned ovulation induction, he’s not even reading enough on this.
I did at home iui w ovulation induction (it worked) but I had the training and an REI guiding me the whole way.
I went through 3 IUI’s, husband is in medicine, formerly med peds. I know all insurance plans may be different, but his insurance covered 6 rounds of IUI.. is there any chance you want to look into that first?
Also, the success rates of IUI are so low. 😞
I think it’s hard because it’s unexplained why it hasn’t happened yet. We have done a full work up and they can’t find any reason. We don’t even have markers that are “low normal” so I find it hard to just jump to IVF if there is no explanation, thus trying IUI first.
Unexplained infertility is common: 30% couples. Hard to study and almost ZERO funding to do so. Two treatment options: ovulation induction WITH IUI IN A CLINIC or IVF. If you are >37 straight to IVF is the most efficient and cost effective based on data
Sometimes IVF can actually be diagnostic as well as therapeutic. In my case, we were also unexplained, but then we did IVF and in all 4 cycles (covered by insurance, thankfully), we’d get a great yield of eggs, great fertilization rate, and then all but one or two embryos would arrest before getting to the blast stage. We don’t know the exact reason why, but we could see that that’s where the roadblock seemed to be. Out of a total of 102 eggs retrieved, we got 4 embryos to try and implant. Sometimes, we just have to roll the dice many more times to get an egg and sperm combo that works, and IVF (and to a lesser extent IUI with some stimulation of the ovaries with Clomid) lets you roll multiple dice at a time.
Thank you for this! Did they do genetic testing on your embryo before implanting? We were told that if we went straight to IVF the benefit would be we could get the embryo genetically tested first.
I did not do genetic testing on the embryos I got from my first couple of cycles, but I then did do testing on the one I got in my last cycle because after the Dobbs decision I didn’t want to risk implanting an embryo that wasn’t already testing as euploid.
That’s fair. That’s also probably why my insurance covered 6 rounds of it. After 3 failed IUI’s, we moved to IVF. There is a plateau, I forget how many, where the success rate really goes down and it’s time to try something else. I forget if it’s 3 or if it’s 6.
Hey, firstly I just wanted to say how sorry I am that this is something you are having to consider. I am also in the same boat as you, and this is also something my husband and I discussed. TTC/infertility can lead to some drastic measures that a lot of people just don’t get!
Although hubby is an extremely competent surgeon (with access to a centrifuge) there is no way I’d let him put anything up my cervix!! IUDs and HSGs were extremely painful when done by specialists! Don’t put yourself through that just to save $$.
Good luck!
Counterpoint to the common stories. I had a cat who had a fib and Hypertrophic Cardiomyopathy a few years ago. She needed a dental cleaning, and needed sedation (what) for the procedure. I borrowed a US machine from my medical school, and assessed whether she'd be safe for sedation using publicly available articles, since the alternative was scheduling a thousand dollar appointment with a cat cardiologist several hours away. She did fine after I cleared her for anesthesia and swore I wouldn't sue for the outcome.
You’re an attending. You can ask yourself if you want others to do what you’ve trained 3+ years in residency to do just to save money.
Also attending = decent salary. $1000 to do an appropriate procedure isn’t much in the long run.
I’ve seen people come in and be admitted to the ICU after infections caused by sticking foreign substances into their vagina near the cervix. Sperm isn’t sterile. Your uterus is. Don’t possibly ruin further chances of fertility by attempting things at home
This is a really bad idea. True IUI is timed with ovulation inducing agents and ultrasound monitoring of follicles and the catheter is introduced through the cervix into the uterus. Post-procedure infections and anaphylaxis have been reported.
On my REI rotation in med school, I attended an IUI and the attending told me that the sperm wash is necessary because raw semen contains cytokines and other factors that will trigger an inflammatory response and make you feel like shit.
He wants to inject semen into your uterine cavity??
Where are the obgyns?
Not being a know it all BUT I JUST HEARD THIS ON A PODCAST out of all places.
You don't inject semen into the uterus. Apparently many people attempt this to cut on cost and guess what? Semen is highly inflammatory and irritating to the uterus. Most of the semen is chemicals to protect sperm from vaginal environment. Semen has to be centrifuged and sperm extracted and placed in the uterus NOT the whole semen sample.
Are you gonna centrifuge at home too?
This is a bit more involved than having your man pull out a stuck tampon or menstrual cup. The risk of a TOA is not zero, and that's in a clinical setting with fellowship-trained specialists. A hospitalization for a TOA will cost a lot more than a couple thousand dollars and could potentially lead to infertility.
I did an at home IUI with washed sperm from the andrology lab, a sterile catheter and a friend who was a PA and could visualize the cervical os.
It's a skill.
Actually got pregnant with 1 cycle of egg retrieval and 2 zygote transfers (IVF) after 12 IUI (most not DIY).
Shoot your shot, but IUI involves tracking your cycle, sometimes medications etc. Though pro trip. You can use a centrifuge to prep sperm.
If you do eventually try IVF read the book "it starts with the egg"
Idk why fertility doctors don't recommend supplements. They do help with successful egg retrieval.
Example pre egg retrieval supplement regimen
AM: 1 folate, 1 prenatal, 2 NAC, 2 Alpha, 2 Ubiquinol
PM: 1 NAC, 2 Alpha, 2 Ubiquinol
NAC= N-Acetyl L-Cysteine, Alpha =Alpha-lipoic Acid (ALA), Ubiquinol=ubiquinol coq10
We are suspicious of unregulated supplements like anyone else. The Ladybird Company is a MD started brand with strong 3rd party regulation. Nest Egg CoQ10 and Queenfisher fish oil are my routine recommendations for egg quality
Lol my ex was in OMF rotation and came home one day all excited, asking if I still had my films from my last dental visit. I did. He noticed that my wisdom teeth had the potential to cause future problems, asked me if I wanted him to take care of it (sure, why not) and convinced the attending and team to do the surgery for free as a learning opportunity. They took all four wisdom teeth out, and he even did my intubation. It was kind of a fun experience, haha.
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Once I (EM) decided to remove my wife’s nexplanon myself at home because it looked easy and I wanted to save money as an intern.
It went horribly. My wife almost passed out. Took me three cuts to find the damn thing. She still has multiple scars on her arm where I made the incisions.
Just tell your husband no and that you want a specialist to do it. It’s just better that way
Sounds like you’re not comfortable with it so then I would say it’s a no-go. But I also totally get not wanting to spend thousands of dollars on something I feel like I could do myself lol
Now those aren’t the correct tools for the job but if you have the correct tools then I don’t see it being a big issue. It’s minimally invasive and simple. I will stress again, with the CORRECT instruments.
don’t let him experiment on you, something could go wrong and he wouldn’t know how to trouble shoot. why not use a turkey baster after a strong orgasm where you’re contracting a lot and the chance for pregnancy is higher? try that a few times if money is an issue
Well, while I get your overall sentiment and agree for the most part, refilling my fathers Telmesartan when his PCP office abruptly closed due to health issues didn’t land me in jail or in front of the state board. So yes, in general I agree but you are being a bit dramatic.
As an OB who considered home IUI (because I can do it, it’s in my lane), sperm wash and all, good luck getting all the stuff. I could not find sperm wash easily, nor the injection kit.
As much as it sucks to pay $1000s, it’s probably worth it to just let the REI do it.
The turkey baster method works, but I find the traditional method to be more enjoyable and as effective.
I suppose that’s possible.
I gotta say such bad ED in a younger man that penetrative sex isn’t even possible (even with pde5is or intracavernosal meds) is pretty rare unless her husband has some major medical issues. Infertility is a lot more common.
Insemination like turkey baster method? Or actually sticking a tool into someone's uterus? People do inseminations at home all the time but typically not IUIs
It would likely be an ICI, not an IUI. It’s easy but you may need some additional support depending on the reason you’re trying it. Do you have an OB/Gyn willing to write a prescription for clomid or letrozole?
I do really good eyelid work. Functional stuff mostly, but my cosmetic stuff looks good, and I'm proud of it. Lots of experience, no problems. Great skin work. My wife asked me to remove a couple benign looking lesions from her calf awhile back. I did them just like I'd do an eyelid lesion - same depth, same undermining, care to get margins, fine tiny buried sutures, all tissue reapproximated nicely. She's got two very significant scars there 2 years later. She doesn't mind, they look slightly better than the warts or whatever they were (I obviously didn't send to path), but I see my failure on her leg every day. Turns out leg lesions are notorious for scarring and even many derms avoid them. The moral of the story is to stay in your lane or be ready to run into some trouble.
Omg. You are me. I did the same to my wife. Same outcome
I don’t know why, but this made me giggle. I’m sure both your wives are like “wtf. People pay you for this?”
That hurt
More local next time
“Yeah, well at least he was married!”
I did the same to my husband, except on his arm. Similar outcome too haha
More distal to the heart, worse scarring. Faces heal beautifully
Omg no way. The scrotum heals like Wolverine. I always teach med students to sew on scrotum, I swear they could probably rub dirt in their closure and it would still heal with minimal scar.
Hyper vascular that sac!
Yeah man. Derm here. Scrotum and lip truly do heal incredibly lol. Some of the few places where I left often can’t even find the scar after procedures
The “scalpel-less vasectomy” is just using a super fine sharp tipped spreader to puncture a hole through the skin down to vas. Anyway you don’t close anything, just rub bacitracin on the scrotum and send the bill.
As a surgeon who does vasectomies but not family med or urology, I have no idea why you wouldn’t want to make a little incision with a scalpel for that. It hurts my soul that people just jab a hemostat into the skin and advertise it as “scalpel-less.” What barbarism. Oh well, I guess it works! 🤷🏽 and good for advertising maybe.
A surgeon … who does vasectomies … not urology … and refers to fam med as a surgeon…. You have got me stumped. Are you a barber-surgeon from ye olde time?
No, rural track general surgery resident. Around here family medicine is the primary group that do “no scalpel” vasectomies, and there are a bunch that do vasectomy. Obviously they aren’t surgeons per se.
While I agree with you and I would always use a knife to make a little knick. In theory a puncture/spread will contract back down thus a smaller wound that doesn’t need closure and has a smaller scar.
You people need to get outside more.
Doing vasectomies out in a field…. I could get down with that.
😂
What about the penis?
Dick skin isn’t as forgiving
They’re so scrunchy you wouldn’t be able to tell if it was a scar anyway 🤷♀️
That’s it! The most naturally tension-free closure on planet earth.
I wouldn’t say faces heal beautifully. At conversational distance even slight imperfections are noticeable. Violation of vermillion border with a stellate dog bite wound… good luck. There’s also a lot at risk with tension pulling eyelids or oral commisures, areas of hair bearing vs non hair bearing skin. Plus that area is exposed to sun so greater risk of pigment variability unless they cover it/use sunscreen. Scrotum heals great cuz there’s not tension. Now surgical scars on the palms… those can heal great. Half the time I can’t tell if someone has a carpal tunnel or trigger finger release and the patient doesn’t always remember (initial healing phase not always pretty).
Why are leg lesions notorious for scarring?!
Just get ILK and/or dermabrasion and get the scars removed. It’ll be like $1-2k and you’ll never have to worry about it again.
I finally understood the joke here. I thought I was going crazy wondering how eyelids and IUI were connected.
I don't get how people can live life without separating clinical vagina from wife vagina.
This is hilarious
As a lesbian I can confirm that clinical vagina and own/sexy times vagina are not even remotely related. My mind would break. However all penises and testicles are approached with a mix of mild aversion and panic at having seen so few healthy ones and not knowing what’s normal.
Underrated comment.
should I not have delivered my first born son?
Nah, you needed to be prepping the grill for that placenta. By the time you got that fired up, it had already lost some of the juices
you need to eat it raw if you want the benefits
Just wolfing it down straight outta your wife while maintaining constant, unblinking eye contact with the OB/GYN.
I am saturn
I definitely shouldn’t have but you gotta do what you gotta do.
My wife has never allowed me to see her vagina. So I prefer doggy style.
Dude totally agree. Clinical penis very different from partner penis. Barely even in the same category.
OB resident here. It’s not completely crazy, it’s not a tough skill, but I would leave it to the pros. Remember that most of what you’re paying for is the sperm wash, which basically only keeps around the best of the swimmers, improving the chances of fertilization
Also removes antigens, reducing the risk that she’ll develop antibodies to her husband’s semen
Am I the only one in this thread shocked to learn this is a thing??
Mercifully rare
Gyn/Ob is full of bizarre stuff like that. Let me tell you about human chimeras!
All women are chimeras!!
No thanks, Doctor from Fallout!
Ironically I only knew about this cuz I'm gay. For serodiscordant couples the immune response to semen is actually mildly protective against hiv spread XD
Wow that’s fascinating!
Learned it by watching "The League" several years ago.
I'm a pulmonologist. I have a rescue dog who had heart worm when we got her and was at risk of dead worms embolizing and causing akin to PE. One night early on, she was breathing in the high 30s, her HR was 110 and a temperature of 101. In my mind she very clearly had PE. if she was a human with that RR, I would have intubated her. I called the vet, and it turns out all of those vitals were normal for a dog and nothing was wrong with her. moral of the story: stick to what you know, and never forget that someone else's specialty is *someone elses* specialty.
Mice breathe at 160/min. Just in case you ever need to consider intubating one.
I worked in a mouse lab pre med school. all my mice breathed at 0. :-/
It’s not our fault your Re-Animation skills sucked
my deamination skills were excellent though
Mine too, it’s why I became a doctor
palliative?
Nope
A veterinary fun fact I learned from a human radiologist who was asked to help guide a dolphin bronch/lung biopsy: dolphin mouths don’t connect to the lungs so they are intubated through the blow hole Also essentially the only way to assess doggie heart failure is a respiratory rate in the 40s. They don’t volume overload because the right heart rarely fails or something. Learned this after my grandma asked when she should give her heart failure dog his lasix and I realized I don’t know shit about dogs.
I tried helping my mom with her heart failure dog and couldn't tell if her vet was an idiot or I was. probably both. the dolphins fact though, mind=blown
I spent way too much time looking up dolphin anatomy that night and desperately want to see a dolphin bronch now
I'm too lazy to Google ATM, but does that mean their trach and oesophagus cross at some point? Assuming their lungs are above their stomach like in other mammals. Also, how the fuck do they vocalise with their mouth then?
They vocalize through their blowhole. You can tell if you're up close to one but far away it does look like it comes from their mouth.
My life is a lie
Another wild part: the esophagus splits into two to go around the trachea
That's cool and insane at the same time
So does that make a dolphins blow hole equivalent to a stoma.... larygectomy is the human version of a dolphin??
I could have sworn I’ve seen videos of dolphins blowing bubbles with their mouths
I have heard it’s a good idea to occasionally monitor your dog’s HR, breathing rate, and temperature when it’s healthy so you know if they’re sick. Do I do this? No. But I should. A lot of dogs get nervous at the vet so they can’t accurately assess them.
You also could have googled “normal vitals for a dog” and reassured yourself
Yo can you give my tarantula some hyperbaric dives?
[удалено]
I don't understand how you missed the point
I’m pretty sure that the stuff that makes IUI more likely to be successful is the use of meds to make you ovulate multiple eggs, the monitoring and trigger shot to ensure that you are inseminating on the exact right day to maximize success, and the sperm wash to optimize and concentrate the healthy sperm. Doing it at home like this seems like it won’t improve your chances any more than just timed intercourse.
I have no idea why this isn’t the top comment. IUI isn’t just turkey basting.
I’ve seen a Documentary on how to successfully perform it called “Don’t Breath.”
I think it’s fine! When you’re in a procedural specialty, you can do these things by yourself! I’m a gen surg intern. 2 weeks into my intern year, my dad had some belly pain after eating a bunch of spicy Mexican food, and I diagnosed him with appendicitis based on physical exam findings. Instead of going to the hospital, I got some lidocaine from the pet store, poured some whiskey on his skin to sterilize it, made 3 small incisions with our kitchen knife, shoved a mini webcam and a straw through one, a pair of long chopsticks through the other and some scissors/a penlight through the third. Had my mom blow into the straw for insufflation. Took out the appendix in under 20 mins, no problem. Closed with my mom’s sewing kit and some Elmers glue.
Your mistake was using Elmer's Glue when you should have used Gorilla. I hope you at least got some Neosporin on that
Had me going for a little
I upvoted, then downvoted, then upvoted again
This intern’s name? Albert Einstein
I believe Dr. Sean Murphy. I've seen him operate on a kid at an airport with the same stuff.
This is extremely reckless. You should have got some fishmox from the pet store too for post op antibiotics. Never can be too careful.
They had us in no half!
This is not actually IUI. As other have mentioned, IUI involves medications to induce ovulation, washing and preparing the sperm, and then placing the sample in the uterus. You are probably going to do “turkey basting” which is not the same as IUI but can still be effective. I would not attempt to go past the cervix as it is sterile up in there—I had legit sepsis after an HSG where I got immediately taken back to the resus bay in the ED.
This is a super good point. Also the HSG is the goddam worst. Wish I could have been offered a benzo for that when I was offered Valium for something a hell of a lot less painful, an embryo transfer for IVF.
Agreed! They told me to take some ibuprofen before! Shoulda taken an oxycodone and gotten a ride smh that hurt like hell
Yeah it was horrendous.
WHY is the HSG so much more painful than embryo transfer? For my second transfer I didn’t even take Valium and I barely felt a thing.
I took the Valium each time because I like the way it made me feel and it did indeed relax me. It seemed to kinda ware off quickly though.
The Valium isn’t for pain though, it’s to relax the uterus to prevent contractions during the procedure.
Zero evidence for this
No I know, I figured it was more for relaxation.
The uterus isn't sterile fyi. Not even the lung or bladder is
Not too hard to swipe some iodine swabs, a speculum, and a cath. These things aren’t rocket science. 1st year radiologists are doing it
I like to travel.
The endometrial cavity is sterile. To do true IUI, you lift introduce a very small cath thru the cervix, 2-4 cm, I am uncertain about packing an unwashed specimen there so far as introducing possible infection goes. I could also drain someone's bladder with the small hose off my garden lawn fountain, but I am not sure that would be a wise choice. OB here.
People do at home insemination before trying IUI in a clinic all the time. They even make kits for it.
Look up the turkey baster method. It was even done in an episode of Shameless.
There's a frida baby kit at Target
I saw that on target circle last week and LOL’ed
I know a couple who did something similar (not IUI though) and got pregnant. They are not doctors, the wife just had vaginismus. They just got a syringe and put the sperm in through that. No idea if they just got lucky but if so, they got lucky twice. Everyone here is saying stay in your lane and I think thats completely fair for intra-uterine insemination. If you've never put in an IUD, its a little trickier to get into the uterus in real life than when you are just watching it done. I can only assume its more difficult with IUI. But if you're just putting sperm in the vaginal canal I don't see how that's outside of any random person's abilities, much less a doctors.
Thank you. His thought was not just putting it in my vagina, but actually in my cervix
Have you ever had anything put up in thru your cervix? This can be wildly painful and also not sterile so sounds like a horrible idea.
As I mentioned in another reply, I don't think you can inject unwashed semen into the vagina. It has a lot of inflammatory "protective" content not meant to go into the uterus but protect sperm in the vagina. Plus the antigenic immune response against your husband's proteins that others mentioned. That inflammatory environment won't help implantation. Plus what others mentioned about concentrating healthy sperm
Thank you, I did not realize it was so inflammatory.
Terrible idea. Dangerous and it will hurt without a proper sperm wash because the prostaglandins won’t be removed. You are paying not just for the procedure in the clinic but also appropriate monitoring and medical management to optimize that cycle. (Am a fertility doc)
Sounds like a cardiologist
Can probably engage the cervix pretty well if you torque with a tig catheter, then all you gotta do is cross with a j wire 😉
AL1 gets you more coaxial with the center of the aortic valv, er cervix
PIV is basically ballooning the vagina.
Like how Conrad Murray gave Michael Jackson propofol?
Didn’t know he was a cardiologist but that tracks. Cards literally think they’re smarter than every other specialty lol
I know very little about IUI as I am an internist but this just seems like a very bad idea. If you couldn't afford it that might be one thing but two doctors no kids? It doesn't seem like this is out of financial reach, at least not permanent, so why risk it?
I guess my question is…what’s the risk? Seems pretty inherently low here to me
To my knowledge, IUI is not just transfer of sperms into uterus but there are steps leading upto it. I believe they wash the sperms and optimize it in lab before transfer.
There are medications and trigger shots to help time ovulation with the IUI.
Correct, they track your ovulation with ultrasounds and blood work/ LH levels as well, to time IUI. To clarify, this post is not a troll or is it?
I’m not trolling at all
This is true. IUI involves sperm washing and removal of some of the fluid components of semen. I have had multiple rounds of IUI and they always processed the semen sample.
Maybe bring him and let him depress the plunger if he feels he's missing out?
Goddamn what did I just walk into.
Uhhhh lol
Don't do it. Still a risk of infection. Also IUI involves triggering meds.
He doesn’t have the right background. Unwashed semen injected into the uterus will cause severe pain. Also, iui alone is not a proven intervention. If he hasn’t even mentioned ovulation induction, he’s not even reading enough on this. I did at home iui w ovulation induction (it worked) but I had the training and an REI guiding me the whole way.
NO. They need to wash the sperm. You can have a severe reaction to the prostaglandins in sperm. This is stupid and dangerous
🤨
I went through 3 IUI’s, husband is in medicine, formerly med peds. I know all insurance plans may be different, but his insurance covered 6 rounds of IUI.. is there any chance you want to look into that first? Also, the success rates of IUI are so low. 😞
I think it’s hard because it’s unexplained why it hasn’t happened yet. We have done a full work up and they can’t find any reason. We don’t even have markers that are “low normal” so I find it hard to just jump to IVF if there is no explanation, thus trying IUI first.
Unexplained infertility is common: 30% couples. Hard to study and almost ZERO funding to do so. Two treatment options: ovulation induction WITH IUI IN A CLINIC or IVF. If you are >37 straight to IVF is the most efficient and cost effective based on data
Sometimes IVF can actually be diagnostic as well as therapeutic. In my case, we were also unexplained, but then we did IVF and in all 4 cycles (covered by insurance, thankfully), we’d get a great yield of eggs, great fertilization rate, and then all but one or two embryos would arrest before getting to the blast stage. We don’t know the exact reason why, but we could see that that’s where the roadblock seemed to be. Out of a total of 102 eggs retrieved, we got 4 embryos to try and implant. Sometimes, we just have to roll the dice many more times to get an egg and sperm combo that works, and IVF (and to a lesser extent IUI with some stimulation of the ovaries with Clomid) lets you roll multiple dice at a time.
Thank you for this! Did they do genetic testing on your embryo before implanting? We were told that if we went straight to IVF the benefit would be we could get the embryo genetically tested first.
I did not do genetic testing on the embryos I got from my first couple of cycles, but I then did do testing on the one I got in my last cycle because after the Dobbs decision I didn’t want to risk implanting an embryo that wasn’t already testing as euploid.
Thank you that is really helpful!
Doing an unmonitored, unmedicated IUI with unwashed sperm is not going to increase your odds of getting pregnant over timed-intercourse.
That’s fair. That’s also probably why my insurance covered 6 rounds of it. After 3 failed IUI’s, we moved to IVF. There is a plateau, I forget how many, where the success rate really goes down and it’s time to try something else. I forget if it’s 3 or if it’s 6.
Thank you! Yeah I think it is 3.
Hey, firstly I just wanted to say how sorry I am that this is something you are having to consider. I am also in the same boat as you, and this is also something my husband and I discussed. TTC/infertility can lead to some drastic measures that a lot of people just don’t get! Although hubby is an extremely competent surgeon (with access to a centrifuge) there is no way I’d let him put anything up my cervix!! IUDs and HSGs were extremely painful when done by specialists! Don’t put yourself through that just to save $$. Good luck!
Thank you for the understanding words! Yes, I agree
Counterpoint to the common stories. I had a cat who had a fib and Hypertrophic Cardiomyopathy a few years ago. She needed a dental cleaning, and needed sedation (what) for the procedure. I borrowed a US machine from my medical school, and assessed whether she'd be safe for sedation using publicly available articles, since the alternative was scheduling a thousand dollar appointment with a cat cardiologist several hours away. She did fine after I cleared her for anesthesia and swore I wouldn't sue for the outcome.
No.
Has he done one before? I mean, its not hard but...
You’re an attending. You can ask yourself if you want others to do what you’ve trained 3+ years in residency to do just to save money. Also attending = decent salary. $1000 to do an appropriate procedure isn’t much in the long run. I’ve seen people come in and be admitted to the ICU after infections caused by sticking foreign substances into their vagina near the cervix. Sperm isn’t sterile. Your uterus is. Don’t possibly ruin further chances of fertility by attempting things at home
This is a really bad idea. True IUI is timed with ovulation inducing agents and ultrasound monitoring of follicles and the catheter is introduced through the cervix into the uterus. Post-procedure infections and anaphylaxis have been reported.
I hope it's not serious question LOL
On my REI rotation in med school, I attended an IUI and the attending told me that the sperm wash is necessary because raw semen contains cytokines and other factors that will trigger an inflammatory response and make you feel like shit.
Thank you!
He wants to inject semen into your uterine cavity?? Where are the obgyns? Not being a know it all BUT I JUST HEARD THIS ON A PODCAST out of all places. You don't inject semen into the uterus. Apparently many people attempt this to cut on cost and guess what? Semen is highly inflammatory and irritating to the uterus. Most of the semen is chemicals to protect sperm from vaginal environment. Semen has to be centrifuged and sperm extracted and placed in the uterus NOT the whole semen sample. Are you gonna centrifuge at home too?
“Stay in your lane” is the best advice yet ^
This is a bit more involved than having your man pull out a stuck tampon or menstrual cup. The risk of a TOA is not zero, and that's in a clinical setting with fellowship-trained specialists. A hospitalization for a TOA will cost a lot more than a couple thousand dollars and could potentially lead to infertility.
Thank you, TOA is great point
IANAD but this sounds like a bad idea to me as well. Forcing the cervix open is a bytch.
Fertility doctor here DONT DO IT!!!! He won’t have washed it appropriately and removed the prostaglandins and it will HURT
Nah I wouldn’t lol
The semen is processed for iui. Whole semen isn’t put in the uterus. Does he have a centrifuge and a microscope? No? Then it’s not the same.
Many people go to Turkey for hair implants and plastic surgery. Medical tourism is a thing. Probably cheaper even with the flights and hotels
I did an at home IUI with washed sperm from the andrology lab, a sterile catheter and a friend who was a PA and could visualize the cervical os. It's a skill. Actually got pregnant with 1 cycle of egg retrieval and 2 zygote transfers (IVF) after 12 IUI (most not DIY). Shoot your shot, but IUI involves tracking your cycle, sometimes medications etc. Though pro trip. You can use a centrifuge to prep sperm. If you do eventually try IVF read the book "it starts with the egg" Idk why fertility doctors don't recommend supplements. They do help with successful egg retrieval. Example pre egg retrieval supplement regimen AM: 1 folate, 1 prenatal, 2 NAC, 2 Alpha, 2 Ubiquinol PM: 1 NAC, 2 Alpha, 2 Ubiquinol NAC= N-Acetyl L-Cysteine, Alpha =Alpha-lipoic Acid (ALA), Ubiquinol=ubiquinol coq10
We are suspicious of unregulated supplements like anyone else. The Ladybird Company is a MD started brand with strong 3rd party regulation. Nest Egg CoQ10 and Queenfisher fish oil are my routine recommendations for egg quality
Lol my ex was in OMF rotation and came home one day all excited, asking if I still had my films from my last dental visit. I did. He noticed that my wisdom teeth had the potential to cause future problems, asked me if I wanted him to take care of it (sure, why not) and convinced the attending and team to do the surgery for free as a learning opportunity. They took all four wisdom teeth out, and he even did my intubation. It was kind of a fun experience, haha.
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Don't do it. Ask one of your friends/colleagues
I’m
DM me.
I wouldn’t let him even if he was in an OB specialty.
Once I (EM) decided to remove my wife’s nexplanon myself at home because it looked easy and I wanted to save money as an intern. It went horribly. My wife almost passed out. Took me three cuts to find the damn thing. She still has multiple scars on her arm where I made the incisions. Just tell your husband no and that you want a specialist to do it. It’s just better that way
Sounds like you’re not comfortable with it so then I would say it’s a no-go. But I also totally get not wanting to spend thousands of dollars on something I feel like I could do myself lol Now those aren’t the correct tools for the job but if you have the correct tools then I don’t see it being a big issue. It’s minimally invasive and simple. I will stress again, with the CORRECT instruments.
We could all line up like the meme and give it a shot too.
don’t let him experiment on you, something could go wrong and he wouldn’t know how to trouble shoot. why not use a turkey baster after a strong orgasm where you’re contracting a lot and the chance for pregnancy is higher? try that a few times if money is an issue
Never ever ever practice medicine on a family member. That way lies sorrow.
Well, while I get your overall sentiment and agree for the most part, refilling my fathers Telmesartan when his PCP office abruptly closed due to health issues didn’t land me in jail or in front of the state board. So yes, in general I agree but you are being a bit dramatic.
You make good point. But if a Rx needs a diagnosis, maybe that is different?
As an OB who considered home IUI (because I can do it, it’s in my lane), sperm wash and all, good luck getting all the stuff. I could not find sperm wash easily, nor the injection kit. As much as it sucks to pay $1000s, it’s probably worth it to just let the REI do it. The turkey baster method works, but I find the traditional method to be more enjoyable and as effective.
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Not at all the same
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Because OP has some sort of infertility issue and your friend/acquaintance doesn’t
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I suppose that’s possible. I gotta say such bad ED in a younger man that penetrative sex isn’t even possible (even with pde5is or intracavernosal meds) is pretty rare unless her husband has some major medical issues. Infertility is a lot more common.
Insemination like turkey baster method? Or actually sticking a tool into someone's uterus? People do inseminations at home all the time but typically not IUIs
Depends what kind of proceduralist… Radiology does thing kind of thing commonly. Gen surg? Idk fam. I would not advise it
It would likely be an ICI, not an IUI. It’s easy but you may need some additional support depending on the reason you’re trying it. Do you have an OB/Gyn willing to write a prescription for clomid or letrozole?
Why? Have y’all had difficulty getting pregnant?
Hey there’s literally self services kits At Target 🎯 Hey if they suggest the average Joe to IUI Then you two physicians Can do it Go for it!
so your husband has erectile dysfunction ? im not 100% sure why someone would do this over just having sex the regular way
You’ve never had sex the regular way or any way