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A Tale of Two Inseminations

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People are so different. I love it! There was one time when in the same week, I performed intrauterine insemination procedures in my office on two different patients of extreme attitudes with regards to the level of emotional involvement in the process.


“Mrs. Total Experience” requested the room lights be dimmed. She brought a CD player and headphones to play meditation music. She wanted to bring aromatherapy candles, which I said was probably OK, although if it were an IVF procedure with delicate air-particle-sensitive embryos involved instead of an IUI with just hearty sperm involved, I would have said no. She wound up not bringing it anyway. I’m glad, because I had an afterthought that it might violate some fire code in our office. After I placed the speculum and gently threaded the catheter into her cervix, she had pre-requested that I let her husband depress the plunger on the syringe. He did so with his left hand while he held her hand with his right. It was actually kind of touching. Having husbands inject the syringe is not uncommon, but this entire ritual was definitely the most elaborate I’ve seen.


In contrast, “Mrs. All-Business” was already waiting in stirrups and fully ready when my assistant and I came into the room. She was on her cell phone having a heated business conversation and I politely waited for her to finish. Instead, without the slightest pause in her conversation, she waved her hand in a “go right ahead” motion followed by the curved index-finger-touching-thumb gesture, which I immediately understood from my scuba diving days to indicate “A-OK.” So while she smilingly continued her conversation, I had to use some sign language myself. Waving both my gloved hands, I signaled “scoot down along the table a little.” Then “let your knees go apart a little.” Each time, I had to stand up from my exam stool so she could see me. I then held up the speculum for her to see and pointed towards the area where I would soon insert it. She nodded, all the while focusing on her conversation, which I couldn’t help but overhear. It apparently involved a transaction of more money than I would ever see in my lifetime. I did the insemination and stood up.


Most other RE’s save time by not doing an ultrasound right after an insemination, but I do for several practical reasons. I confirmed that the sperm was in her uterine cavity. I was able to get a bonus image of her cavity to confirm the absence of polyps, sort of a no-cost poor-man’s saline-contrast ultrasound using the insemination fluid as distension medium. I also verified that her follicles had all ovulated. I adjusted our power exam table so that the patient was tilted head down at a fifteen degree angle. She motioned for my assistant to give her her handbag which she had left on the chair on the other side of the room. As she pulled what looked like a small appointment book out her purse to write in, she smiled and casually waved to me as I left the room. I wondered if this superwoman will bring her laptop to work on while she is in labor pushing out her baby eight months from now.


I really enjoy my job. The day that I stop seeing things that surprise me is the day I will finally retire. I have a strong feeling that it won’t be any time soon.

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