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.

Starting Clomid!!!

Okay, so I guess I need to apologize for not updating sooner. But, this week was Christmas and all, so hopefully you’ll cut me some slack. J

I took my last provera pill on Tuesday, December 17. The side effects I talked about during my last post continued through the end. I didn’t take too much notice of when they stopped because I almost immediately started cramping. For me, it isn’t unusual to start cramping 1-2 weeks before I even start my period, so I thought I was in for a long wait.

But, to my surprise, I started spotting on Friday and Saturday (December 20 and 21). Aunt Flo arrived for real on Sunday (December 22) and I met with my doctor on Monday (December 23). He gave me a prescription for clomiphene (Clomid) and told me to stat them on cycle day 4…which was CHRISTMAS! Woohoo! Lol Merry Christmas to dear husband and me!

So anyway. The plan is that I take Clomid (100mg) for 4 days (cycle days 4, 5, 6, and 7). I have a follow up appointment on Tuesday (cycle day 10 / December 31…New year’s eve!). I’m going to get another vaginal ultrasound (yeah, I had to have one on CD 2 when I went in for my appointment which was a little gross, so there was that…luckily it was over quickly and I appreciated that they checked for cysts before we started) to make sure my ovaries aren’t being overstimulated, and as long as that one looks okay, I’ll get an HSG booster shot (I believe that’s what it is called). Then I’ll have to come in for another u/s on Friday

Whew. So, basically I’m going to be living in my doctor’s office over the next two weeks. I’m glad I’m off all of those days (except for the Friday appointment, but oh well, I’ll make it work).

I’m SO SO SO excited. Starting to feel hopeful again (although I also hope that doesn’t come back to bite me in the ass…lol).  

 

Provera Day 4

Alright, so moving on to Day 5 of Provera. I’ve taken 4 pills so far (will take #5 tonight), and have started noticing some side effects. Well, mostly the ringing in my ears continues and my boobies have started getting sore. Last night and the night before it was only at night, so at first I thought I was imagining it. However, this morning I woke up and they are still pretty sore, so now I’m less inclined to believe it is a fluke. However, no nausea or vomiting or headaches or anything.

So far, nothing I can’t live with…as long as AF arrives on schedule, lol.

Day 2 of Provera

So, Provera Day 2 is in the books. I’m taking it at night (you’re supposed to take it the same time every day) so technically I’m on day 3, even though I’ve only taken two pills so far.

I’m still not feeling any real side effects, although I am starting to feel the tiniest bit crampy this morning…like those a-couple-days-before-real-cramps-hit kind of cramps. Anyway. I’ve also noticed that my ears keep ringing, which is unusual for me. Could just be coincidence.

Other than that, though, no nausea, tender boobies, or anything major.

I would have to say so far so good. I’m keeping my fingers crossed. I know in the past I’ve always responded quickly to BCPs, so I’m hoping that Provera will be more of the same on that front and I’ll start my period pretty quickly once I’m off of it.

I think this is the only time in my life I've ever been eager to see AF. Lol

Starting Provera

If you’re following along at home, you know that in my last post one of my concerns was that I wouldn’t be seeing my dear Aunt Flo for a while. Also that my doc gave me 3 missed periods before we started a medical intervention.

Aaaaand here we are.

I’ve officially missed 3, so after a quick pregnancy test (negative, of course) my doctor prescribed me Provera aka medroxyprogesterone. I’m on 10mg tablets once a day for 10 days. Then I am supposed to get my period within 2 weeks. THEN hopefully I’ll be able to start clomid (finally!!!!) It’s looking like if everything goes the way it is supposed to and my medically induced aunt flo stops by for a visit on schedule, I should be ttc the week of Christmas! I’m pretty excited.

As of now I’ve only taken my first Provera tablet. I’ve read online that people suffer some pretty bad side effects with it (severe cramps starting as early as halfway through the pack, very sore/tender breasts, spotting and breakthrough bleeding, severe nausea etc). I’m hoping I don’t get any of those, yuck, but so far I’m feeling fine. I did fine with BCP for all those years, where as my roommate would get extreme morning sickness and other weird pregnancy symptoms in lieu of PMS. So, it is important to remember that when dealing with hormone medicines, they affect everyone very differently.

I’ll keep you posted on how things are going onward.

1 month past HSG

Hello my poor little neglected blog. No, I haven't forgotten about you. I just haven't had anything good to report. As I said in my last post, I had just had my HSG. To follow up, I was gassy and bloated for about 3 more days after the HSG, then it all subsided and I was right as rain again.

Apparently there was some miscommunication between my nurse and I, and *I* was supposed to call them and schedule a follow up, not the other way around (in other words, they forgot about me, lmao). I went in Monday to look at all of my results and make a plan. I found out that my husband's SA came out well -- good counts and all that jazz. Now we are just waiting for my period to start so we can start our first round of Clomid.

There are only 2 problems with that (neither are major). The first is, as I have discussed, that I have really irregular cycles. Even though my LMP was August 30, I still haven't started. My doctor said to give it a little while, and if I miss 3, he'll put me on some medicine to make me have a period. So, that kind of sucks because it means we might be waiting until as late as December or January to start clomid.

The other problem is that we have reached the end of insurance-covered medical care. My doctor told me that my insurance plan covers all testing and fact-finding related visits, but once we make and plan and move forward with the medical side of TTC, then we're on our own. My next visit is going to cost me $500 out of pocket. Which I know is NOTHING compared to what it will cost if we have to go to IVF, but I still have a bit of sticker shock.

My Dr. told me and hubs that we only have about a 20% chance of conceiving with Clomid, and that if we go through 4 rounds without conceiving, he would recommend we try IVF. *deep sigh* I don't think I'll ever not be nervous about all of this. The waiting, the back and forth, the fear. It weighs on me pretty heavily sometimes. I know that, for us, this is what it is going to take to get pregnant which makes it easier. But some days the weight of our reality hits me hard. I know anyone else out there who is going through all of this understands -- some days are just harder than others.

So, dead readers, wish me luck that my AF comes soon so we can start our clomid. 3 years TTC is a long time.

One day post HSG

And the saga continues.

Yesterday was my HSG (technically called Hysterosalpingogram, but don’t worry about knowing that, it won’t be on the test).  As I said in my last post, my doctor warned me it was going to be “unpleasant” and he encouraged my husband to be there in case I needed someone to drive me home.

Now, you may have gathered by now that I’m one of those people who likes to have ALL of the information I can up front, so I spent last week googling the procedure and what to expect. I read a lot of negative stuff (it was the most excruciating pain of my life, etc) and a lot of information from professionals that say it really isn’t that bad.

Regardless, I learned what the procedure was and what to expect, which helped me feel a little better.

I also read some horror stories about mean nurses, husbands not allowed in the room, and uncompassionate doctors. Let me tell you, this was in NO way my experience!

We arrived at the clinic and I had to give a urine sample for a pregnancy test (which we won’t go in to…suffice it to say that I have an extremely shy bladder, lmao).

We were then walked over to radiology (or, as they called it at the clinic, Advanced Imaging…my husband made some lame joke about how we were in the “advance” imaging group and that we skipped right on over basic imaging. So lame, I know, but he always knows how to break my tension and make me feel a little more at ease).

Anyway. We waited for about 5 minutes (enough time to get really invested in some crazy episode of Dr. Phil and NOT get to hear the conclusion!) before we were taken to the back. And I do mean WE. The nurse or tech (I was a little too nervous to mentally record what exactly her job title was) called

my husband the hand-holder, and made sure to get him fitted with a lead vest while I changed into my oh-so-comfortable hospital gown. And let me tell you, he looked ravishing in his purple lead vest with little kittens printed all over it (and yes, he made a joke about being a “kitty” magnet. *sigh*)

There was only one chair in the room, and me being so nervous at this point I was about to faint, got the chair while my wonderful husband stood. We had only been in there about 1 minute, when the nurse/tech lady comes back with another chair and said something like “Well, the Doctor is going to be a few more minutes, and I thought you might like another chair.” I thought that was SO sweet of her. I know it is a small gesture, but it was very thoughtful.

However, in my experience when they bring you another chair and essentially tell you to get comfortable because the doctor is going to be late, it usually means you’re going to be sitting there for an hour. Except that we didn’t. When she said a few more minutes, she meant less than 5. She also stayed in the room and chatted with us the entire time. She made me feel like I was an important patient, and she really made me feel at ease. She talked me through the equipment and a little bit about the procedure.

Then the doctor came in and introduced himself. He was very warm and friendly and honest (all of my favorite qualities in a doctor). He told me the procedure was going to suck (not in those words, of course) and then walked me through EACH step, telling me what I would feel at each point.

He asked if I was ready and walked me over to the table, which, by the way, had a tempurpedic pillow top on it. Had I not been about to have someone digging around in my who-ha, I might have been table to take a nap. It was pretty damn comfortable.

The worst part, I think, about the whole experience was that the table had no stirrups, so I had to hold me legs open the entire time. That kind of sucked.

Anyway. As soon as I was settled on the table, they moved the table into position and told my husband where he could stand (right at my side so that he was leaned over and his face was right there in front of mine the entire time) and he immediately grabbed my hand. He really was the best hand-holder.

The first part was very similar to a well-woman exam. Speculum and all that business, which sucks but is nothing worse than awkward. Then they “cleanse” the cervix, which I mostly didn’t feel. They swabbed the thing down with some gauze to finish the “cleanse” and that was the end of the “fun” part.

Next they inserted the catheter through my cervix. I felt some pressure, but no pain. Then I think they blew some air into my uterus (I can’t tell you exactly, I just know this was the part that hurt a bit). Mostly, it just felt like mild period cramps. Nothing I wasn’t used to, but also not something I would ask to have done to me.

Then they injected the dye. I had heard over and over again that this was the worst part. That it was very painful and that this was “the worst pain of my life.” Let me tell you, it sucked, but it was by no means the worst pain I’ve ever experienced. It just felt like a slightly more intense menstrual cramp. It hurt for less than a second as the dye went in, and that was it. Immediately the little shock of pain subsided. It didn’t even hurt badly enough for me to flinch or cringe.

Within another second, the doctor said “picture” and I got to see the still frame image of my uterus and fallopian tubes, both patent (or open!!!!!)

I was so happy I almost started crying on the table. The doctor removed the catheter (which I didn’t even feel) told me that everything looked great, explained what everything was in the image, told me once again that my tubes are open, shook my husband’s hand, told me to have a great day and left.

The nurse/tech lady stayed there with me and helped me get up off of the table and chatted with my husband and me for a few minutes, answering my husband’s questions about different things in the image (all of which were embarrassing, lol).

In the bathroom where I changed, the nurse had laid out some towels and a pad for me (I brought my own). I thought it was very thoughtful of her. She told me to expect a little bleeding (which I had, just some very light spotting basically) and that the dye would be gross if it dried on me (which I didn’t let happen lol).

As I told the nurse, I wouldn’t schedule one for fun on the weekend, but all in all not the awful experience I was expecting. I even drove myself home afterwards (much to my husband’s chagrin as he took the day off because he was told he would need to drive me home after – not that I think I could have done it without him there holding my hand).

Around bed time last night I started experiencing some bloating, which was pretty uncomfortable. I was having gas-like cramps whenever I moved too quickly. And, as a stomach sleeper, I had a little trouble finding a comfortable position to sleep in. This morning I am less bloated, but definitely still bloated. The gas cramps have subsided, but my lower abdomen is sore. I read one person described it as it being the day after an ab workout feeling, and I would agree with that. However, nothing too awful, and definitely not anything I can’t handle.

So, where are we now? I’m waiting on a call from my doctor so we can schedule a follow up to discuss all of our results (the only thing I’m still waiting to hear back about is my husband’s SA, every other test has been great!) and develop a plan of action. I’m excited and hopeful that, because all of our tests so far have come back positive, treatment is going to work.

I’m keeping my fingers (and my toes and my eyes and anything else I can think of) crossed, and wishing for lots and lots of baby dust. J