Ramp Up Aggressiveness with Follistim

 

Sunday

I left a beach trip early to get Sunday monitoring and received a call in the afternoon saying that my estrogen levels went up to 32 (less than 10 increase) so they wanted me to return again Tuesday to do blood work and u/s again. Seeing as they want to see my estrogen at 180 (estrogen increase signals start of process), I asked to speak with a physician about starting fsh injectables. Of course, the doc called back in the 2 seconds my car was turning on the Bluetooth so I missed the call and because it was the weekend, I could not call back. The voice-mail told me to come in again the next morning to do blood work and u/s again then I could talk to the doc.

Monday

We got up early and drove to the fertility clinic without an appointment prepared to wait for a turn. I wanted to talk to the doc first before messing around with more blood and ultrasounds. After not too long of a wait, we got to talk to the doc! She was amazed by how many follicles I have (80, it was like she never saw so many before) and thought it was very reasonable to move onto FSH injections since I haven't responded to clomid or femara.

She will start me today with a low dose *50iu) of Follistim injectable since I have sooo many follicles and my chance of cancelling the cycle is high if too many follicles respond. They want only one follicle to grow or else it would be a high risk of multiples. (When doing ivf, they give you a lot because they want to mature a lot of eggs for harvesting) So, it will be monitored every few days and my husband will inject me each night with FSH. The doc said usually patients have to do it for 5-7 days, but she has one patient now who has been doing it for 30!

Still have to go through blood and another u/s today and wait on the results (make sure estrogen level didn't jump up or follicle grew 7mm over night) but I have the injectables laying next to a cold pack from the pharmacy below the clinic in my purse now!

Before we left, the nurse showed my husband and I how to use the syringes. Basically, you just pinch an inch of your stomach and inject.

Monday Night Follistim

 After getting blood work back, my estrogen dropped to 25... really low. And no follicles grew. Got the go ahead to start with 50 iu shots for 3 nights. Headed back Thursday for another ultrasound and more blood work. My husband gave me the shot and it wasn't as bad as either of us feared. Felt less than the sting of a mosquito. Injection of hope.  I'd like to think of it that way.

Praying for only one follicle to grow! Just one special little gift.

Fertile Femara?

My fertility doc started me on Femara 2.5mg for 5 days after not responding to my 150mg Clomid without waiting for AF induction (so technically it was cd20). Overall, Femara was almost a breeze for me compared to Clomid. While I didn't have as much difficulty with Clomid as others, I found Femara to be much easier on my body. And my skin thanks me too!

Day 1: Failed Clomid ultrasound and blood work. Lots of tiny follicles...

Days 1-4: I took the pill late at night before bed. I felt fine- a little bloated but nothing much more to note. My skin also began to clear up since the after Clomid effect. Lots of energy and in a good mood. Feel a little hot. This may also be coupled with my new order of Murad skin care products. 

Days 5-6: Felt a bit nauseous and run down, but taking several walks with my husband and watching Netflix in between helped. Day 6, I didn't have to take a pill but I was going through the effects of my evening pill. 

Day 10: Acupuncture- yay!! Feels so good! Lots of energy to begin with, very clear feeling and relaxed afterwards

Day 11: Still in a good mood. (This is definitely not CloMood!)

Day 12 ultrasound and blood work: Failed. Again. Follicle that was 8mm with 150mg of Clomid grew 2mm to a max of 10mm, with still lots of little follicles. Need to go back in a few days to check again and then we discuss next steps.

Kind of anxious to find out what's next. 1. Wait longer? 2. Start higher dose of Femara without AF induction? 3. Induce AF and start again with ...who knows...? 4. IVF? It's hard because I have all of these summer plans and being in town to do all of this monitoring will be more of a struggle. I'm getting really sick of this re-prioritizing and endless waiting game. If it will take several more months to find the magic, that's fine but I'd rather just know. Where's the crystal ball??

Good-bye Clomid, Hello Femara

 

Since I never responded to Clomid, my fertility doc moved me to Femara 2.5mg. On Day 20 of my Clomid cycle, I went in for an t/v ultrasound and blood work to confirm that I had not grown any follicles.  My husband and I also had to sign a release form to take Femara, which is commonly used as a breast cancer drug and is illegal in several countries. Again, I had lots of follicles and they were all too small, proving that Clomid and I were due for a break-up. 

I got a call later that day from my nurse instructing me to start my five days of Femara that evening, treating my actual day 20 as day 3 since my uterine lining was set to go. I was concerned that the dosage of Femara was so low that I wouldn't respond and wondered why I didn't start with what seems like the common 5.0 or 7.5 mg. They explained that it was due to me already being somewhat stimulated by the Clomid this cycle so they did not want to send me into hyper-stimulation which makes sense. Now, I just wait until my next t/v ultrasound and blood work to see if I can use that trigger shot that is just waiting for me in my fridge.

Several friends have announced their pregnancies in the past week or so. We're hoping that we are one step closer to our own gifted little one. 

Stay tuned for my play-by-play on my Femara experience.

3 strikes...

Went again on Thursday (cd 15) for another ultrasound and more blood work. Story of my life now.

My estrogen levels were still incredibly low for this point in my cycle (34.8-cd3, 47.6- cd15, should be in the hundreds or even thousands) so I am not showing any signs of follicle development nor pending ovulation.The ultrasound just showed lots of tiny follicles and 2 larger ones- the largest is 8.6mm which is still very small.Can't believe that I went through all of that and didn't respond...

Clomid Round 3, 3 strikes and you're out. I won't be sad to see you go. If I fail again on Monday, I can finally move directly onto Femara without AF first. Heard that it's less harsh to bodies than Clomid so I'm excited about that and hopefully I will respond to it. Many women who don't respond to Clomid respond to Femara and we're hopeful that this time something will work. Also glad I got permission to go ahead and start Femara without using provera to induce AF. That would have added about 14 days to my wait to cycle again, so I'm thankful for that.

Mother's Day is this weekend. Can't help but feel a bit sad that I'm not in the club this year. So glad to have a new, clear plan in place to keep this process moving along though.

Failed Follies

Went yesterday (Sunday, day 11) to get my ultrasound and blood work done. I didn't respond to my third round of Clomid. I had one follicle measuring 7.4 mm and bunch of little follicles. (You need to find follicles around 20mm to do the trigger shot.)

One of the most depressing things about Sunday monitoring were all of the hopeful couples waiting in the lounge area. They were overflowing with patients but the waiting room was very quiet. Patients and their partners were whisked in and out of the blood work room, the ultrasound rooms and the check-out area. While they were very efficient, cheery and positive, my husband and I both felt a bit sad to see so many struggling people all around us.

One of the good things was that my husband was finally able to see what my PCOS ovaries look like via ultrasound. The radiologist told him that I have a beautiful uterus (um, thanks?) and explained to him that that chocolate chip cookie looking thing was my right ovary (and there is an ovary on each side.)

When the doctor on call came in, he told me to schedule again for Thursday (cd 15) to check again but that I most likely will be advised to try another route since I did not respond to the maximum dose of Clomid they use at the clinic. Still have the trigger shot chilling in the fridge and the progesterone supplements waiting in the drawer in case something changes, but it's not likely. While I didn't expect the Clomid to work this time due to my lack of response before, it still hurts to have gone through all of the yuckiness just to have to undergo more yuckiness and uncertainty...

Clomid Round 3 Report

Here's how the third round of Clomid at a higher dosage (150mg, days 3-7) went for me. With how many terrible, horrible, terrifying experiences are posted in blogs and forums, I feel it is important to share how for me, Clomid has not been so, so evil.

CD 3- Took it during a wedding, not the best time for the stomach cramps and general icky feeling that followed. My skin is seriously angry at me. 

CD 4- Nausea sets in, feel like I'm hung over (but I'm not...), Emotional (also had to cancel fun travel plans for next weekend due to treatment and my early period), Sweaty at night

CD 5- Moments of strong nausea.Starting to feel sick (headache, body aches, sinus pressure).  Not sure if it's the Clomid or seasonal allergies. Really bad night sweat! Oye!

CD 6- My skin is still screaming for relief from the hormones. Feeling more sick today and wanted to cancel acupuncture because I felt congested, yucky and all I want was to take a nap! So glad I went though!! 

Let me elaborate: She stuck those glorious needs in my nose and between my eyebrows which opened my nostrils up and cleared my headache. Also got needs in my legs and stomach for fertility. 

Went to bed early, slept amazingly and no night sweats!

CD 7- Felt great! Quite amazing, really! My head felt clear and my symptoms magically cleared. Hurray for acupuncture. So worth it. 

Now let's see if I respond to Clomid this time. Monitoring appointment this weekend.