Waiting

Just took my last “active” birth control pill. Now I just wait for AF, I have never been so excited to get my period. So until then it is just a waiting game. The plan is this: on day 1 I call my nurse and let her know I have started a new cycle (I think this will be on Friday). Then, on day 3 (or day 4 if day 3 ends up being on Sunday) I go in for bloodwork (including a re-check on my thyroid levels) and an ultrasound and I get to start taking Clomid! I take the Clomid for 5 days (day 3-7) and then go in for an HSG trigger shot on day 12 and an IUI on day 14. So here is how everything is supposed to work: Since I have PCOS my problem is that I don’t ovulate, in fact, my ovaries don’t even mature eggs that are developed enough to ovulate. Apparently, the only reason I even get a period at all is because my body just gives up. Normally a woman’s estrogen levels increase until she ovulates and then the hormones change and the estrogen levels drop. With me my estrogen levels keep climbing until my body says it had had enough and this is why I normally have cycles about 52 days long but that have gone up to 81 days. What the Clomid supposedly will do is make my ovaries act normal and produce mature eggs ready for ovulation. Once the eggs are developed enough (they will be checking their development by frequent, possibly daily, ultrasounds) I will have a HCG trigger shot to tell my body to release the egg(s) to actually ovulate. Two days later I will go in for an IUI (Intra-Uterine Insemination). This is where I go in with my husband’s swimmers and they do an IUI wash to his sperm (not sure what this entails but you come out with a concentrated sample of only the best and strongest sperm), then they will insert the washed sperm directly to my uterus through a catheter to (hopefully) meet up with a developed egg. After they do the IUI I have to stay lying down in the office for 30 minutes and then take it easy for a day or so. I think I will probably not want to move for the next 2 weeks until I am able to take a pregnancy test at the doctor’s office. With all of this timing and assistance part of me (and basically all of my hubby) thinks that this has got to work – how could it not? but the other, more cautious and rational part of me knows that people do this all the time and it doesn’t work – I wish I knew the reasons it doesn’t work. I’ve got so many mixed emotions running through my mind. I haven’t even considered the side effects of the Clomid, which I have read can be pretty brutal, but some people report absolutely no side effects. Whatever it is I really don’t care, at this point I am willing to put up with just about anything. I expect the most difficult part will be the two week wait after the IUI. I can’t even cheat and take a home pregnancy test because the HCG trigger shot I will take to make me ovulate will make any test I take come out positive (since HSG is the hormone that the home pregnancy tests test for). That would seriously be the worst, to take a test and (finally) see it come up positive just to find out later that it was a false positive. I am not a very patient person, especially when it comes to something like this that I want more than anything but I guess I will just have to be. I am hoping that by this time next month I will be pregnant. I know I shouldn’t get my hopes up too much but it is a possibility. So for now I have a whole bunch of countdowns for exciting stuff going on with my body. Countdown to AF, countdown to Clomid, countdown to HCG shot (never in my life have I wanted a shot so bad), countdown to IUI, countdown to beta test!

Pregnant Women...

It seems like, lately, everywhere I go I see pregnant women or new babies. I see them at the grocery store, at the pharmacy, at church…it feels like literally everywhere I go. It must be that I’ve just got babies on the brain so I notice these things more often but I honestly wish I didn’t. Every time I see a pregnant woman or a brand new little baby I get a twinge deep in my gut. It reminds me all too much of what I currently do not have and plays on my emotions making me worry that it might not ever happen for me. I know I am getting WAY ahead of myself as I have not even started real treatments yet but whatever; this is how my brain works, how my anxieties can take over. And this is the feeling I get seeing complete strangers. Unfortunately when it comes to people actually in my life it is even worse. I know I shouldn’t feel this way and I am not angry about other people being pregnant at all or jealous of them (ok maybe a little jealous of their situation) but knowing others are pregnant or are mothers just reminds me that I am not. In the past week or so I have found out that two friends are pregnant (each with their third child). Each time I cried. I am glad my husband told me and I didn’t have to find out initially from those people themselves because my reactions were less than appropriate (actually any normal person would probably be appalled by my reactions – who cries when they find out a friend is pregnant?) and I would not want that to happen in front of my friends, who, deep down I am truly happy for. Right now it just hurts, a lot, so much more than anything has hurt me before. Hopefully all this pain will be worth it for the feeling of being able to hold my own child in my arms someday (please someday soon!). When I feel sad, angry or frustrated with this whole infertility business I have to hold on to the faith and hope that God will give me the child He knows I desire with all my heart and He will give me this child in His perfect timing.

Can't Focus/Update from my Nurse

For me one of the hardest things about all this is trying to stay focused on non-infertility stuff aka my real life...It seems like fertility (or my lack thereof) is the only topic on my mind lately and the only thing I can talk about with others. I know they say the two week wait (after insemination or egg transfer but before you can take a pregnancy test)is the worst part about the whole process but for me (since I have yet to get to that step yet) I feel like I have been in a two week wait that has lasted 4 months. I don't know what I thought when I started going to the RE but I definitely wasn't prepared for such a long time of testing. And while I get that not everyone has to wait as long to start and that my testing time was drawn out significantly due to my re-scheduled surgery, it seems like things have been taking forever which means that all my anxiety and energy has been focused on this for a long time. I find it extremely hard to focus, especially now when I am expecting to (finally) start clomid in about 10 days. At work, which I know I should use as a distraction, instead I am constantly checking calendars or my personal email, waiting for an email from my nurse. Especially on days like today when I am expecting a call from my nurse. I did not leave my desk, afraid that I would miss her call (she didn't get to call until just now, 4:30). I know I am a little (or a lot) high strung/tightly wound/crazy about all of this but going with the flow has never been my thing.

When I spoke with my nurse I almost had a freak out because initially she was thinking that I wouldn't be able to do treatment this cycle. I have been working with the nutritionist to loose weight since they have a BMI cut-off and they won't do treatments if you are above the limit. Thankfully I know I am below it (and have been since I started going there) and am still working hard to keep loosing weight and to be healthier to make a happy space for a baby to grow. Maybe that's what I need to focus on more...Nurse said hubby's semen analysis (SA) was ok but on the low side of parameters for volume, concentration and motility but that since it is such a pain for us to get the SA done (since hubby goes to a VA Dr. and has to get special permission to do out of VA network stuff) and since all that really matters is an after IUI wash look at his swimmers that they can proceed with out hubby going for another! This made me happy. Very happy, even though the numbers are low. So on we go...only 7 more active pills! My nurse also told me that if cycle day 3 (the day to start the Clomid) falls on a weekend (which I think it will) to email her on Day 1 and let her know and that I can come in the following Monday which, even though it delays things a day or two, I am happy about because it means I can go upstate with my sister-in-law and mother-in-law like I had planned to pick some fruit and poke around the cute vintage shops up there. I think that would be a lovely way to (try) and relax before starting treatment. We'll see.

History of my infertility

From the day I was diagnosed with PCOS when I was 17 I was told it was going to be difficult, if not impossible to become a mother. This diagnosis lingered in the back of my mind, without any real acknowledgement all through my young-adult life. I always knew I wanted to be a mother but definitely not then and I didn't really worry about it until Shawn and I got married and we started thinking about starting a family of our own. Shawn knew I had PCOS and it was going to be difficult to become pregnant so we started trying right away because I also knew that most specialists won't even see you if you are under 35 until you have been trying for a year on your own. So we tried for a year and nothing. In March 2010 I went to see my OB/GYN who suggested that I not waste time with her and go directly to see a Reproductive Endocrinologist (RE). Funny thing is that she referred me to the same RE that a friend had suggested 6 months before. To catch up quick here is a timeline of what we have done so far to get us to the point we are at now:

3/26/10 - First appointment with my RE Dr. R, finally getting things started! Because of my PCOS he suggests that we first do all the testing and then move to Clomid with a trigger shot and an IUI. He is hopeful that I will get pregnant and I am excited to finally have some answers and a glimmer of hope for the future of my family
4/3/10 - Initial bloodwork (and lots of it) including a 2hr glucose and insulin test (not fun)
4/5/10 - Increase medications, Synthroid to 112 and Metformin to 1000
4/10/10 - First appointment with nutritionist
4/12/10 - Increase Metformin to 1500/day
4/13/10 - Hystosalpingogram (HSG) found that my left tube was blocked
4/20/10 - More bloodwork and an ultrasound FSH 6.6 (I was told this level was good)
4/26/10 - Second appointment with nutritionist (down 5 lbs!)
4/30/10 - Appointment with RE to go over HSG results. My RE said that it looked like I have a Hydrosalpinx in my left tube and that the end near the ovary was blocked by adhesions. He said that the best course of action is to have a laprascopic surgery to determine if they should interrupt or remove the tube (either way I will loose it and it is not doing me any good anyways) and then, instead of Clomid/trigger/IUI we should move right to IVF. Not the greatest news but ok.
5/10/10 - Third appointment with nutritionist
5/13/10 - Pre-op appointment and bloodwork for lap surgery
5/17/10 - Get a call from my RE nurse, something was wrong with my bloodwork and I need to come re-do it, in for more bloodwork
5/18/10 - Liver enzymes are high and I need to get clearance for surgery from my PCP
5/19/10 - Appointment with my PCP to see if she will clear me for surgery - not so much instead I have more bloodwork and go to to have a liver ultrasound
5/20/10 - My surgery was supposed to be today, but it is not
5/27/10 - Appointment with a gastroenterologist to go over my liver bloodwork and ultrasound. He say that he thinks I may have Autoimmune Hepatitis but that I can still have surgery and this is something I will have to periodically monitor.
6/16/10 - Appointment with nutritionist
6/19/10 - Nutrition seminar and first fertile yoga class (love this)
6/24/10 - Pre-op appointment (take two) and bloodwork (hope it goes better than last time)
6/26/10 - Fertile yoga
6/28/10 - surgery diet
6/29/10 - surgery diet
6/30/10 - only clear liquids (I'm getting really hungry)
7/1/10 - Surgery, turns out my tubes are beautiful and Dr. R. didn't have to do anything but take a peek, I'm kind of fuzzy about what exactly went on and can't wait to talk to the Dr. about it and what we do next. I was supposed to have three incisions but I only have two - they still hurt a lot though and it is really difficult for me to move or get up and down.
7/4/10 - went to a family BBQ, probably shouldn't have, still in pain and groggy
7/7/10 - Hubby finally does his semen analysis at Yale
7/8/10 - Post-op appointment. RE says I am healing better than he expected and that because my tubes are fine we can go back to the original plan for Clomid/trigger shot/IUI. I am very excited about this! I am still in a bit of pain from the surgery but definitely much better than before. RE puts me on a round of BC pills and the plan is to call my nurse on day 1 of my period and then come in on day 3 for an ultrasound and to start clomid! Seriously counting down the days.
7/17/10 - Fertile yoga

Hopefully this blog will be more than just about my infertility struggles but right now it seems to be what is consuming my life. Approximately 11 more days until I can start clomid and get on with things. I feel like I have been in testing limbo since March and really can't wait to finally be in treatment. I'm excited and nervous all at the same time. What if it doesn't work? What if it does?