Another Manic Monday

Okay. So cycle one was a bust. I called my doc’s office Monday morning and let them know I wouldn’t be coming in Tuesday for my lab appointment because Aunt Flo had already arrived and I knew there was no bean. So, they scheduled me for Thursday to come in and start cycle 2. Which was fine…except that Monday at 1:30, the office called and said they had a cancellation and they would really like to get me in that day. I said sure, what time? 2:30…

So, after flying back to the mainland and making it to the office at 2:34 (oops) I got to meet with my doc, who seemed very sincere in his condolences over my failed cycle (he ended my appointment by saying that it was nice to see me again, even though he’d rather he didn’t have to see me because I was off pregnant…but barring that it was nice to see me again, lol).

We did an ultrasound and had a chat.  He said he saw some good things, like no cysts/follicles left behind. He even said starting my period was a good thing because it meant I had ovulated and had responded to both the clomid and the hCG. However, as I said before, he was a little disappointed that I only had 1 follicle mature, even after being on 150mg of clomid. So, what he wanted to do was move me up to 200mg and see if I could get a response and have multiple follicles mature (last cycle he said he was hoping for 2 or 3). Although, he said there was a possibility that he would stair step me up to 250mg if he needed to.

Joy.

As miserable as I was taking the 150mg, I can’t imagine what kind of wonderful is in store for me at 200mg. However, I am most certainly not afraid to try. So, today is Wednesday (cd4) and I get to start my massive dose of clomid tonight. Then, ultrasound on Tuesday to see how things are progressing.

I’m a little nervous that I will have too much of a response and that I’ll have too many follicles mature for it to be safe to try this cycle. But I guess that’s a risk I have to take? This whole medicine tweaking thing kind of blows.

I’m not as excited about this cycle as I was about last cycle. I guess that is to be expected, though. I told my husband that this cycle I want him to back off of all the “just stay positive” crap. It’s not me. I’m cynical and I keep my expectations low to keep from getting hurt. It’s just my way. Staying positive didn’t really do anything last cycle except stress me out that I wasn’t being positive enough for everyone else. Frankly, I don’t particularly care if my husband and my mom think I need to keep a good attitude. Being positive doesn’t make an egg mature. It doesn’t help an egg get fertilized. It most certainly won’t help a fertilized egg stick in my uterus. All it does is set me up for disappointment when the cycle fails.

Maybe that’s the wrong attitude to have, but I don’t really care. I’m not a positive princess. I’m cynical sally.

For now I’m going to take one day at a time, focus on what I need to be doing, and let myself feel whatever it is I am feeling without judgment. If I feel hopeful, then I’m going to be hopeful. If I’m feeling defeated, I’m going to throw myself a pity party and camp out in my bedroom with a book.

Maybe I’m being a little too dramatic. Oh well. I’ll suck it up.

And I’ll probably be keeping my fingers crossed anyway. A friend, colleague and mentor of my once said I always seem to have a unique blend of sarcasm, cynicism and timid hope in my approach to life. I think it probably applies to my approach to fertility as well.

So I guess that’s all I’ve got to hold on to – sarcasm, cynicism, a tiny ribbon of hope. Maybe it will be enough to get me through.

I don’t know if anyone out there even reads this damn blog, but I have to ask (just in case). Anyone know of any success stories at 200mg of clomid with PCOS?

Two Week Wait Over

Aunt Flo arrived on Sunday.

One more week...

So I’ve reached the halfway point of the two week wait and I’m feeling miserable.

Not only do I have a cold, but I’m still getting the rolling nausea that I got after the hCG shot. At first I was only nauseous for the first day or two and had a break. But this weekend it came back full force. I spend Sunday night unable to decide if I should blow my nose or vomit (thankfully I never did throw up) and I got basically no sleep. Monday I woke up still nauseous, but, remembering that eating lunch helped the day of my hCG, I grabbed some cereal to munch on. I felt immediately better, although whenever I had an empty stomach throughout the day the nausea came back. Today (Tuesday) I woke up feeling better, but around lunch time the nausea came back.

Additional side effects of the shot have been sore boobies (especially in the nipple region). I would also say tiredness, but that could just be because I haven’t been sleeping well. Lol. Also, my left ovary was very sore/tender all weekend, and is just now starting to feel better.

One more week. Can’t wait to find out. J

All hail the two week wait

So my last post was on Monday. I said that I’d had some cramping starting the night before and a little nausea after taking the hCG shot and I was hoping that would be the end of it.

Ha.

I should have known nothing ever goes easy for me. Today is Wednesday and I have been nauseous pretty much constantly since then (which let me tell you, makes baby dancing feel like I’m lost at sea with 30 foot waves). My ovaries have been crampy and sore, and any quick movement causes them pain (so, double sucky for the baby dancing…not to mention when we were and I had a big O it was excruciating…worst orgasm of my life). Apparently it is common to “feel like someone kicked you in the ovaries,” as I read on so many blogs and forums, after clomid and especially with the hCG shot.

Joy to me.

Additionally, I had some major bloating (like my pants barely fit kind of bloating) and a general feeling of crap.

However, I woke up this morning with no pain. No ovary pain, no bloating, no crap feeling. I am still a tiny bit nauseous, I imagine from the hCG in my system, but nothing I can’t live with. So, I’m assuming that all of that means my doctor was right, and sometime last night my big beautiful follicle released.

And now we enter that hell period known as the two week wait. For those of you unfamiliar with the term (although I can’t imagine why you’d be neck deep in an infertility blog without knowing what the two week wait is) it is the two week period after you ovulate before you find out if you’re preggers. There’s about shit that can be done during that time because your egg has released and all the baby dancing in the world isn’t going to help.

So, now I’m stuck in limbo. And today is only day 1. For, potentially, the first time ever, I’m 1DPO (day past ovulation). It’s also the first time ever that my husband has felt the very real stress of trying to conceive. Friday night I had a break down (and he was a wonderful shoulder) and finally explained to him how awful the last 3 years has been. How broken I felt, how every month we didn’t get pregnant made me feel more distant and hurt, and how I had started resenting him, myself and our sex life as just a big clusterfuck of infertility. He listened and was sympathetic, but I don’t really think he understood.

This week, though, that changed. My husband has always wanted to be a father, and so now that we are going through fertility treatments, he is finally starting to see the light at the end of the tunnel. However, all of the treatment so far has been for me, as our only infertility factor (that we know of) has been my PCOS. Other than coming to all of my appointments and holding my hand during the worst of it (like my HSG), his biggest involvement was his semen analysis.

But this week things changed. I pumped myself full of drugs, we dropped another $80 on a shot, and I endured yet another vaginal ultrasound which revealed one mature follicle. I had done largely everything I could to get us ready. Now, in his eyes, it was on his shoulders to impregnate me (I tried to explain to him that it wasn’t on his shoulders, but he got all boy-ish and brushed me off). He got very stressed out, to the point that he couldn’t even eat without feeling like he was going to throw up. Then, after dinner he took a shower (I think he was trying to work himself up—he was so worried he would mess everything up). When he got out, I laid down in bed with him and we just listened to music and made fun of R Kelly music videos (a midget? Wtf R Kelly?). I think he almost murdered me, haha. He finally told me that he’d been so stressed all day because the doctor told us we HAD to baby dance exactly 34-36 hours after I took the shot, and he was so worried that something would happen and we wouldn’t make it. So, because he was all in his own head, he couldn’t even think about getting into the mood. I told him that realistically, ovulation occurs 34-40 hours after the shot and that it is best to try and catch it early, but that if we don’t make it exactly in that 2 hour window, it will be okay.

It was like I could see the weight come off of his chest. He held me and we laughed and he calmed down significantly (and, amazingly, once he calmed down we were able to still get our baby dance in during the 34-36 hour period, much to his delight). I think it was the first time that he’s ever felt the stress I’ve been under for the last 3 years. And after we baby danced I explained it again to him, and this time I could see the empathy in his eyes, and I think a little bit of wonder, too. I think that, going forward, he might cut me a little more slack when I get all wound up about this baby making stuff.

It’s been a miserable 48 hours. But, now it’s behind us. Hopefully we’ll get pregnant this round (I hope these aren’t words that I will look back on years from now with amusement at their naivety) and we won’t have to go through this again anytime soon. And, even if we do, at least the two week wait exists as a buffer so we have time to gather ourselves before we go through it again.

Good news? Great news!

Aaaaaand another appointment this morning. My little 17mm follicle, the one I was so worried wouldn’t grow to 20mm by Monday, blossomed to a whopping 26mm this morning! My left ovary is still a mess of underdeveloped follicles, but I have that one, and it looks beautiful.

So, my doctor wrote me a prescription for an HCG shot this morning and told me I needed to take it today then do the baby dancing exactly 34-36 hours after. Well, I guess none of the pharmacies in our area keep it in stock, so I got to take an hour long trip to go pick it up (which kind of sucked). And the damn thing was $200. Luckily, the pharmacy took pity on the fact that insurance wouldn’t cover it, and they let me use an in house coupon for 60% off, so I ended up only paying $80 for it (which is still freaking expensive). I had to do my own injection, but the needle is very small, so I barely even felt it go in.

Oh! Another positive, I don’t have to have any more doctor’s appointments for two whole weeks! Lol. AND, my next appointment is just a lab appointment to see whether or not I’m pregnant. So, I’m done with doctors, ultrasounds and pills for this cycle. And now that my injection is done, all that’s left to do is baby dance and wait.

Cue the music! J

Last night I started having some cramping around my ovaries. Definitely not period cramps, but it is noticeable and a little annoying. I imagine they’ll get worse over the next day or two. *sigh* I haven’t looked into side effects for the HCG shot, but I know that I started feeling nauseous about an hour after taking it. I had some lunch and my tummy settled, so I’m hoping that’s the end of it.

I guess I’ll know soon enough

Keep your fingers crossed for me and send lots and lots of baby dust my way.

Today was a good day!

Finally some good news!

Had another appointment this morning (what does that make this, like the 500^th this cycle, lol). I have ONE (yes one) follicle that has grown! It is at 17mm, so close to the magic number 20. It is the same one on my right ovary that was at 11-12mm on Monday, so it has grown a full 5-6mm in the last 4 days! It is slow growth, and not the 2mm a day my Dr. was hoping for, but it is still growing.

I’m so excited! Even though my Dr. said that he would like to see me have 2-3 follicles that size, one is better than none, and I’m excited that at least now we have a chance. It is such small progress, but I couldn’t be happier after all of the bad news we’ve had over the last 2 weeks.

My left ovary still has about 10 tiny follicles on it, and none of them have developed. Womp womp.

So, basically I have a follow up on Monday. IF everything looks good AND my little 17mm follicle has grown another 3mm over the weekend and hit the magic number, I’m going to get my HCG booster shot! However, my doc said that because I am so far along in my cycle (you know, because of the whole stair step clomid thing) there is a chance I could ovulate prematurely this weekend. SO! We have been prescribed baby dances on Friday and Sunday…just in case. J I’m all smiles today.

It’s so nice to finally have good news instead of bad.

Another (dis)appointment

Today I had my follow up appointment. I can’t really say it went badly, but it also didn’t go well, either.

On the plus side:                                                  

I had one follicle on my right ovary that had grown to over 1cm (I think either 1.1 or 1.2cm) which means I responded to the clomid some.

On the negative side:

My left ovary had about 10 follicles respond. Even though they are all small, my doctor said it means we will not be stair-stepping up to 200mg of clomid like he was planning.

Which means that I’m done taking medicine this cycle. I’m not really sure if that should go in the plus column or not. It’s more a fact than anything.

It also means he doesn’t think I’m going to be a good candidate for continuing clomid, although he let me know, again, that he thought I would be a good candidate for IVF *sigh*

So, I have another appointment on Friday to see if my 11/12mm follicle has grown large enough to possibly work. If not, we’ll talk treatment options again. I’m not very hopefully that my tiny little follicle, which only grew 6ish mm in the 7 days I was on 150mg of clomid, will grow another 8ish mm in the next 4 days. Trying to do that whole “staying positive” thing, but all in all it’s not really helping. I’m feeling really bummed out and discouraged.

To follow up on my increased clomid experience. Blegh. The 150mg of clomid really affected me. I was up in the middle of the night with nausea, my breasts were EXTREMELY tender (so much so that even the pressure of laying on my side hurt them). One night I woke up in the middle of the night very dizzy, like the room was spinning. So, all of that and still no real reaction. *sigh*

I’ll report back in after my Friday (January 10) appointment. I’m not hopeful it will go well.

(this is just for my later reference, ignore the link) http://www.nichd.nih.gov/health/topics/PCOS/conditioninfo/Pages/infertility.aspx

Starting Clomid…again…

So, my New Year’s Eve appointment didn’t go very well.

I had my u/s and my doctor said that my ovaries were not responding to the clomid the way he would like. Basically, I had some follicles that responded, but they were only .5 cm in size, when they needed to be 2 cm.  Then he mentioned that after 5 days on clomid I should have shown more progress.

Hold the phone.

Five days?

The prescription I got (that he wrote) was only for four days. He said it wasn’t likely that not getting the 1 extra day of clomid had any real effect on my follicle size, but he went off to do some research.

When he came back he informed me that we are going to try something called the stair-step protocol for clomid. I don’t think he is very familiar with it, but I appreciate that he is trying to make up for screwing up my prescription (and potentially wasting the $500 that we spent on this cycle). Basically the protocol is as follows: start clomid at 50mg on cycle day 4 or 5. Take for 5 days and have u/s. If there is not a good response, immediately start taking 100mg for 5 days. Have u/s. If there is still not a good response, immediately start taking 150mg for 5 days. Because he started me out on 100mg and I had minimal response, we essentially stated on the 2^nd step so he started me on 150mg per day for the next 5 days. Right now I’m on day 3.

I have to say with the higher dose I’ve noticed more side effects. I’m nauseous a lot and my boobs have been very tender. I take it at night, and I’ve woken up both nights with nausea. So that really blows.

I have a follow up appointment on Monday for another u/s to see if I responded better to the higher dose. He told me that 150mg is the highest dose because after that there is no difference in response rate. Basically, if I don’t respond to the 150mg of clomid, I’m not going to respond to clomid at all.

Which is another thing he told me. Because we started out at the 100mg, he expected to see more of a reaction out of my ovaries, so he thinks there is a good chance I am clomiphene resistant. He then told me that his office’s protocol for clomiphene resistant patients is IVF. That’s it. No intermediary steps, no other treatments. If I go in Monday with follicles that still haven’t responded, this will be my last round on clomid. On the plus side, it means we haven’t spent 3 or 4 cycles (or $1500-2000) on a treatment that didn’t work. On the down side, husband and I decided before we ever got into this business that we were not interested in IVF.

So, if we find out on Monday that I’m clomiphene resistant, we’re basically done trying to conceive.

I have a hard time even writing that sentence. I guess I honestly thought that we’d come in, do a couple of rounds of clomid (because not ovulating was my only problem) and get pregnant. It never really occurred to be that we’d go through fertility treatments and not come out the other side with a pregnancy. I guess it is needless to say I’m not doing very well emotionally right now. At husband’s urging, I’m trying really hard to stay positive. There is still a chance that I will respond to the higher dose of clomid, and if that’s the case we need to be ready. At the same time, I feel like what little hope I had has been ripped away from me. *sigh*

I’ve done some research online about clomiphene resistance, and there are several studies that suggest there are other medications that can be used with clomid for a better effect. However, based on my Tuesday appointment, my doctor doesn’t seem really interested in trying them. So after this cycle we may go get a second opinion somewhere else. Either way, Monday will be a game changer for us.

Keep your fingers crossed for me that Monday goes well.