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.

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. 

New Cycle...

Got my period yesterday (unusually fast after ending bcp) which meant rearranging my flight out today for a special wedding so that I could get a baseline ultrasound and blood work completed. The u/s was all clear and I'm just waiting on my blood work this afternoon to get the go ahead to start Clomid 150mg (round 3) on Saturday, day 3. Not at all thrilled about starting the evil Clomid meds during wedding festivities... Of course, my period would come early this time after carefully planning it around vacations and of course, it changes everything- again. Tough to make plans right now.

Just hoping that something positive will come out of round three of Clomid.

Fertility Clinic- New Hope and Next Steps

I called fertility center with hopes that someone would cancel due to the snow. My hunch was right and my husband and I hopped in the car and were seen an hour later for our first appointment- over a month before previously scheduled!

After listening to our journey so far, he said that we have nothing to worry about and he feels confident I will be pregnant within 9-12 months. Yep, you read that correctly. Complete reversal here. I'll now be calling my fertility center doctor, Dr. Hope.

He sat with my husband and I in his office while he outlined a course of action for us. He outlined the success rates for each intervention and took us through the flow of what would come next if one step did not work.

After our consult, I met my amazing nurse who further explained the steps to us, gave us more information and filled out the paperwork with us. A technician drew a lot of my blood so they could run a bunch of blood tests again to check my hormone levels. I also gave blood for genetic testing.

When we finished with our nurse, we met with the financial councilor who gave us all of the pricing for each treatment. Because of the snow day, we had to wait to find out what our insurance covers. (Which is not too much, but surprisingly better than most!)  Everyone we encountered was so nice to both of us and the clinic had a quiet, peaceful and intellectual feel to it!

Once my initial blood work came back, they confirmed again that I did not O. I got the go ahead to take progesterone again for 10 days. After I get my period, I will go in for a baseline t/v ultrasound to check out my follicles on CD3. Then I will go on birth control and get an HSG test to see if I have any tubes blocked.

Once that comes back, Dr. Hope will take me off the b.c. and I will do another round of Clomid at a higher dose (150mg), an injection shot to spark ovulation and ultrasound monitoring all along the way. Because of all the monitoring, I don't need to temp or use OPKs, hurray! If that cycle does not work, then I will switch to a different drug called Femara.  

There is a new plan. There is renewed hope. :)

Three Cheers for Acupuncture!

I started going to acupuncture a few days after finishing my second round of Clomid pills and while I wasn't sure if it would work, I fell in love with it!

It helped to give me a deep sense of calm, focus and mental clearness. My skin cleared up and my hunger was greatly diminished following the Clomid and Metformin side-effects.

My acupuncturist listened to my experiences in great detail during our first meeting. She looked at my tongue, the colors in my face and felt my pulses before deciding where to place the teensy, tiny needles in my legs, feet and stomach. (I did not feel them go in at all.) As she continued her work, she would check my pulses to see if they were becoming more even and added needles accordingly. I felt so peaceful.

Once satisfied with the placement, she left me to relax on a heated bed with soothing music playing and then returned at the end of the session, pleased with my improvements. She added little, tiny gold beads to three pressure points in my legs. I loved being bedazzled and was so excited to go home and show my husband!

My next post will be devoted to the dietary recommendations she made for PCOS. If you haven't tried acupuncture yet, I highly recommend giving it a try! You'll feel soo relaxed and refreshed.

Clomid- Round 2, No O and a Break Up

Round 2: 100mg Clomid, Days 5-9 (While continuing with 1500 mg of Metformin)

After talking with my doctor and confirming that I did not ovulate during round 1 of Clomid through a blood test, we decided to increase the dose to 100mg after another 10 days of Provera to induce my period again. (Two of those little white pills daily for 5 days... scary!)

Even though the first round wasn't terrible, I was incredibly nervous that round 2 at a higher dose would double the side effects. This time, I didn't have an awesome feeling on the second day of Clomid but the side effects were not bad either. I did feel it a bit more than my first round.

I was definitely hot at night this time and used only a sheet but nothing that kept me awake. My skin was broken out and I felt bloated but oh, so hopeful for ovulation this round. (Which didn't happen either...)

I began going to acupuncture and loved how relaxed and comfortable I felt afterwards. It also helped to qualm some of my intense hunger which was a welcome relief. I temped and did OPK tests and got my blood drawn on day 21 of my cycle which came back negative.

I continued acupuncture, temping, doing OPKs from day 13 to day 40 before my doctor told me to stop and that she could not help me any more.

She referred me to a fertility clinic, asked if I had thought about adoption and wished me luck. I felt so defeated, so devastated...

I left the doctor's office determined to go to work and throw myself into a fun Friday, but was heartbroken and teary eyed at every turn. Luckily, I have amazing colleagues who comforted me when I told them what was going on with me after all these months. I couldn't ask for a more supportive group of people and am truly blessed to be surrounded my such great people in every aspect my life. 

After a few days, I started feeling more reassured but it wasn't until I went for acupuncture the following Tuesday that I felt relaxed, truly comforted and ready to tackle anything despite the breakup. Getting that qi (CHEE) following is incredibly powerful! I got some extra needles in my wrists and feel asleep on the heated table. When I awoke, I felt drunk on qi and happy- and even needed some time before I knew I could drive again! Haven't done acupuncture yet? What are you waiting for? It's life changing.

Clomid- Round 1, Not so bad, no ovulation

Here is my review on my first two rounds of Clomid. All and all, I must say, the symptoms for me weren't as bad as I had googled...

Here is a website that I referred to several times that gives a lot of information about Clomid. 

Round 1: 50mg Clomid, Days 5-9 (While continuing with 1500 mg of Metformin)
I was very anxious and nervous about starting Clomid but went forward with it because the Metformin was not making a difference in my cycles. My doctor prescribed me Provera for 10 days to induce my period. Then on CD 5, I began my first round of Clomid convinced it would work on the first try.

Based on internet reviews, I began my first dose at night. The first day, I felt a little bloated and icky, but by the second day, I actually felt better than I had in a long time. The Metformin was tough on my body and I was constantly feeling nauseous and gross. Day 2 of the Clomid, I was feeling great and completely normal again.

I thought that'd I'd beat the Clomid until I woke up on day 3 of Clomid feeling yucky. I had a headache, felt bloated and tired. Day 4 made me more hot than before, but nothing like the dripping, sweaty hot flashes that I have read about others enduring while on Clomid. Who knows if it really was the Clomid or if I was playing more attention to my body temperature throughout the day.

On the last day of Clomid, my stomach was thankful for my comfy yoga pants at home! (The bloating and severe hunger that the Clomid caused lasted the next two weeks.)

My mood at work was just fine but I know that when I came home, I was more easily agitated and emotional. The worst part for me was my skin's reaction. Ugh, my poor skin was so broken out. I felt fat and pimply and not so wonderful, but I knew that the other symptoms I had read about were much worse.

Overall, the Clomid that I psyched myself up over wasn't so bad and I didn't really have much of a physical reaction to it. (But I didn't ovulate from it either...)

Our Fertility Journey

It's been a long one so far with a lot of highs and lows. We are still hoping and wishing for our own little one.

A little about myself: I am now 29 years old, happy and healthy but after about 100 days of amenorrhea (lack of period) following birth control last year, I was diagnosed with PCOS via ultrasound and was put on progesterone to start my period. I switched from my general women's health doctor to a specialized ob/gyn who also confirmed the PCOS through another transvaginal ultrasound. My husband's sperm was tested and he has no diagnosed issues. She started me on progesterone again after a long cycle and I tried one round of Clomid 50mg on which I did not ovulate. I began another round of progesterone and got my period after 50 days. I completed a second round of Clomid at 100mg but again, failed to respond and ovulate. Following the second round's failure, my doctor broke up with me and referred me to a fertility clinic.
 


Feb/March 2013- Preconception Meeting with women's health doctor, given the green light. Began taking prenatal vitamins

May 21, 2013- Take out last NuvaRing

May 24, 2013- NuvaRing induced period

July 29, 2013- Start officially tracking CM on fertility friend

August 17, 2013- CD 86, Start officially temping

August 26, 2013- CD 95 Start Metformin 1000mg, t/v Ultrasound. Blood work (PCOS diagnosis)

August 29, 2013- Metformin 1500mg

August 30, 2013- Bloodwork done

Sept 4, 2013 Horribly sick, stomach pains

Sept 5, 2013 Back down to 1000mg Met for a week, then back to 1500mg

Sept 26, 2013 Switched Drs to specialist, t/v ultrasound confirms pcos, prescribed Provera for 10 days to induce a period.

Oct 5, 2013 Last Provera pill CD 136

Oct 7, 2013 Provera Period #1! (Light, no major cramps or symptoms)

Oct 9- blood test, fsh, progesterone, wbc- not ovulating

Nov 2- Hubby SA- all clear! (rushed to get done because we thought I'd start provera/clomid but dr said to wait two more weeks to see if my period would come first...)

Nov 19- No luck, Provera round 2 (cd 44)

Dec 2- Provera Period #2! (after 56 days, more substantial and longer flow than p#1)

Dec 6- Begin Clomid Round 1 (cd 5-9)
Dec/Jan Test with OPKs and temping, did not detect ovulation. Blood work confirmed this.

Jan 21- Provera Period #3 began after 10 days of Provera round 3. (50 Days...)

Jan 25-29 Clomid increased to 100mg Round 2 (Taken days 5-9)

Feb 4- Begin Acupunture! :)

Feb- More bloodwork confirms that I did not respond to Clomid

March 7- Ob/Gyn breaks up with me, telling me I'm infertile and she can't help me any more, refers me to fertility center and asks if I have considered adoption... obviously devastated

March 17- Was scheduled for a 4/21 appt, but got a new patient appointment at fertility center because of a snow day cancellation and a lot of Irish luck! Dr. Hope says he feels confident he can help us get pregnant! Start Provera round 4!

March 26- Genetic testing is in- I'm a carrier for SMA.:(  DH needs to be tested to see if he's a carrier too. If so, it will reset our plan again. 2ww for results.

March/April ??-Provera Period #4
April 26- Start Clomid (days 3-7), plan to take trigger shot and progesterone if all goes well
May 4th- Day 11 ultrasound and blood work, one follicle at 7.4mm (too small), others tiny, no trigger shot necessary
May 8th- Another u/s and more blood work... failed again
May 13- Day 20, Another u/s and more blood work... failed again, no Clomid response, begin Femara 2.5mg
May 26- Femara failed, began Follistim at 50iu and continue Metformin/Acupunture (estrogen dropped to 25, yikes!)
June 6- Estrogen jumped  to 102 -6 larger follicles, largest at 14.5mm
June/July- Failed injection cycles
August- Successful with follistim and ovidril but ended in chemical pregnancy
September- Again successful, but same result 
October 2014- Started with follistim and converted to IVF
Oct 8- Egg Retrieval- 28 eggs, 22 mature, 18 fertilized!