Hanging on... Injections take 2 and an IUI?

 After a failed attempt with injections, we are now upping our aggressiveness with injections, trigger shots and an IUI!

Day 3: BW/US- Uterine lining good and lots of tiny follicles, Okay to start injections at 50iu for 6 nights before bw/us monitoring. Asked Doc to up the dosage of injections but because I have so many follicles, he said he didn't feel comfortable doing that.

Injections: Not so bad the beginning of this round. Very little symptoms so far, except for the bloating.

Day 9: BW/US largest follicles 10.4 and 10.1 on left side and in the 9s on the right, continue with injections at 50iu. Estrogen at 63. Will a little click and stick to the trick?

Day 12: BW/US, lining thickening, no follicle growth, estrogen at 75 need to cancel iui because there won't be enough time before I leave for the wedding... bloated and heartbroken. Is there any way to describe how difficult this journey is??

CD 14: BW/US, lining still thickening, no real follicle growth (right ovary- 11.1 10.4 10.3 etc, left ovary- 10.9 10.8 etc) and estrogen level dropped to 40.3. Whoa! Huge, unexplained drop. I know that your estrogen levels are an indicator that the growth of the follicles is going well and can indicate how many follicles are maturing. This level is so, so low especially for this point in the cycle. We went out for pancakes to cheer ourselves up a bit and later that afternoon got a call telling us to up the meds to 75 iu from 50 iu which made us happier to know that we could amp up the aggressiveness a bit more to give this another shot... (literally and figuratively!)

CD 15: This ramp up in follistim is wearing me out. Feel lethargic, nauseous and so, so bloated. I feel like I just ate a huge thanksgiving meal and am constantly waiting to digest it! Yuck! Please let this be worth it.

CD 16: BW/US, lining is now at a good thickness, I have about 47 follicles with the largest at 12.3,  10.7, and  9.3 (so other follies may be backing off) and my estrogen jumped to 99.4. So glad they bumped me to 75 ius! While still not where I need or expected to be, this may be a glimmer of hope that we might not have to cancel the whole cycle after all (but IUI is still out of the question at this point because of the wedding I'm going to this weekend). Feeling insanely bloated. I wish I could push my stomach out of my belly button. Ugh! Going back for monitoring again tomorrow.Wishing and hoping for good news and a big jump!

CD 17: BW/US After one more shot of 75 iu of follistim... Estrogen 96.5, largest follicles measured at 13.2, 9.8. Met with the doctor today and he is trying to figure out a solution to my travels while he still strongly cautioned me that we may have to cancel this cycle. When I asked him about the drop in my estrogen before, he said this can happen as some follicles back off when one or two are taking the lead but that estrogen levels in the 40s or 90s are very low.

He upped my follistim to 112iu tonight with my last chance monitoring tomorrow morning before my flight out. I'm supposing this must have to do with the fact that my estrogen level is not climbing but is down a bit from yesterday... so stressful... I'm going to go do some gardening and then get my hair cut tonight to get my mind off of this...

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. 

Easter and New Beginnings

Had a fun day back from vacation yesterday, including a very special Easter mass. I was teary through the whole mass once the organ began filling the Basilica with beautiful music. Easter is all about new beginnings. As the Monsignor said, we start Lent with ashes and on Easter, we light a new candle, a new fire. Easter is a sign of God's intervention during desperation to bring new joy, new hope. I'm trying to take this homily to heart and to embrace renewed hope this spring. I wish the same for all of you, no matter what journey you are currently taking right now.

HSG Test and Aftermath

From my perspective and experience, here's what they do when you have to get a dreaded HSG test to check to see if your tubes are blocked or if there are any other problems that could be inhibiting fertility. First off, this goes into the TMI category but in the spirit of full disclosure of my experiences, I guess this whole blog is TMI...

HSG Test

1. Arrive with a full bladder, they will make you pee in a cup (not sure why??). Doesn't help to wait while nervous with a full bladder... Read the waiver form in the waiting room. Freak out because it says something about seafood allergies and the iodine being a risk. (Of course, I'm allergic to seafood...)

2. Meet the nurse and pee in a cup. (Nice to meet you!) Pass the test. :) Nurse tells me that I'll be fine with the iodine and that it's an outdated form but she'll let the technician know and she might use a different rinse. Nurse took my height, weight and blood pressure and explained the test procedure. Hands me a Kleenex as I get teary eyed from my nerves listening to the procedure and the googling I did earlier in the week... (The nurse was super friendly, especially for a 7am appointment, and you can really tell she has experience calming the nerves of many, many patients! She is so good at her job.)

3. Go into the xray room and go into the changing room to put on a gown over your sweater and booties on your feet. Recline on "bed."

4. Insert speculum and catheter and then slowly inject dye. Small, round x-ray machine is floating above your abdomen and captures the image in real time as the fluid goes up one tube, into the ovary and then out into the abdomen. Repeat towards the other side. Feels like uncomfortable pressure and general ickiness but not sharp pain at all if they do it correctly (which they did). I heard that it lasts 2-3 minutes but I think they were way faster than that.

HSG results (not mine)

5. Immediate results= all clear! You own doctor/nurse team will follow up with you later in the day.

6. Go to Panera next door to make it all feel better. Go home to stretch and do some yoga before work.

7. Wear a pad, no tampons allowed, as the brownish/orange dye will leak out and you may experience spotting and cramping (I did).

 

Aftermath

I went on the birth control pills after passing my day 3 ultrasound and before the hsg test. The original plan was to discontinue the pills after getting the hsg all clear. Because of my husband's need to get more blood work done (to prove he doesn't have hiv, etc), our timeline got put on hold again. With vacations and wedding festivities for friends, we have to delay further because I need to be in town for monitoring. It just feels sometimes like the roadblocks keep on coming but at the same time, we are so lucky to be living such full lives.

I kept cramping/spotting for almost two weeks after the hsg test which is abnormal. Not only was it uncomfortable for a long period of time, it was also incredibly inconvenient because I was on vacation at the beach. Horrible time to not feel well and not be able to use a tampon...

After a week of bleeding, I contacted my nurse from my vacation spot and after exchanging emails, she recommended that I go to the emergency room to get an ultrasound. I decided not to go because we were out of the country and would be returning to the US in a few days.

Upon returning home, the spotting ceased with just 3 birth control pills left before I will get a period again... but hopefully this time it will lead to something more positive and less stressful.

Ultrasound- Follicles Galore!

I got my period yesterday after taking progesterone (provera). So, I called my nurse and she scheduled my monitoring baseline ultrasound for first thing this morning. (You have to do it between day 2-5.) I got there 30 min before my appointment when the office opened with hopes that I could get in early so I wouldn't be late for work and sure enough, they got me in lickity-split!  Again, everyone at the fertility clinic was so friendly and happy (even though it was really early in the morning) which really put me at ease.

http://weheartit.com/entry/36681830

The tech administered the t/v ultrasound while another doc from the practice sat in to interpret the results on the spot. She said my uterine lining looked good and then when she saw the "pearl necklace" lining the outside of my first ovary, she grew quiet and looked a bit nervous. I said, "I already know I have pcos." To which she sighed in relief saying something about how they look like typical pcos but in a way that made me feel positive about them looking so normally abnormal. (See, everyone is so friendly they make everything sound okay. Talk about rose colored glasses!)

She said to go forward with my plans to get the HSG test on Monday and that they saw nothing there that would hold me up further. ::Sigh of relief::

After about 2 minutes of the ultrasound, I was on my way to pay my 50% and even had enough time to grab a small cup of decaf coffee as a treat for myself during my drive to work!

Fast forward to the end and highlight of my day- Acupuncture Tuesday! I had another great, relaxing, centering session and walked around outside for awhile feeling refreshed and renewed.

After returning home, I found my lost phone and saw that I had a long voice-mail from my nurse. She informed me that they were looking for me to have at most 10 follicles when I, in fact, have 90. Yes, I'm an overachiever... 40 on one side, 50 on the other.  She said they "looked good, really good" with a laugh, so I suppose this is good. I'm patting myself on the back for not googling this... yet.

Lots of long walks planned for this week, start b.c. tomorrow leading up the HSG test Monday and an acupuncture reward on Tuesday!

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. :)

Chinese Medicine- PCOS

For PCOS sufferers, there are often sticky/damp side effects in your body. The stickiness gathers in your ovaries so the eggs don't develop or ovulate properly. In essence, they are stuck. Google "Chinese Medicine: Dampness" and you'll see a whole slew of ways to treat dampness through food, spices and teas.

Here are a few dietary changes my acupuncturist recommended to me: 

1. Drink lots of water. Add lemon or lime to it. Sour flavors = dampness scissors. Because of this, green tea, apple cider vinegar, and grapefruit are also good for you.

2. Limit and avoid sugar, refined carbs and added sweeteners.

3. Eat food that is warmed up or heated. Avoid putting ice in drinks or eating anything cold. Cook your vegetables and fruits instead of eating them raw. If you are going to eat something that is cold, make sure you pair it with a warming food or drink or add spices like cinnamon that have a warming quality to them. This is because your body has to use energy to heat up the food before breaking it down which when treating PCOS is not recommended.

4. Avoid dairy products. Yes, even yogurt...

5. No bananas. :(

6. No peanut butter (or peanut products).

Basically, my favorite foods have been put on the no-no list...

Good luck!

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!