I went in for my first day 11 ultrasound this morning and the first thing my RE did was check my lining. It was very thin (despite taking estrace twice a day for the past few days), but it did have a "triple lining" which is a good sign. He then took a closer look at my right ovary. "There's nothing!" he exclaimed. Then he looked at my left. "Still nothing!". Great. Just my luck. He pointed out some very very tiny follicles, but there was nothing to measure. The ultrasounds was done in less than two minutes.
I was expecting to have small follicles, because I know I don't get "full" and ovulate until day 22, but I wasn't expecting "nothing". He wasn't either. He immediately said that I should stop my estrace today and begin to take another round of clomid for the next five days, then resume the estrace. I'll have another ultrasound next Tuesday, the 27th, on day 19. Apparently, it's better to take more clomid in this cycle than waiting until the next one (I asked). But I'm worried about being overstimulated. And annoyed that I must spend even more money.
250mg/clomid a day for five days. The most I've ever taken is 150mg/day, so this seems like a lot to me. Plus the fact that I took 150mg for five days last week, so it will be doubling up. Yikes. Let's hope I get some nice large follicles, but not too many.
The only upside is that we can relax during our Thanksgiving vacation and don't need to meticulously plan alone time together. At least there's that.
Monday, November 19, 2012
Sunday, November 18, 2012
Ultrasound Tomorrow
Today is cycle day 11. My "natural cycle" last month ended up the same as usual - no pregnancy. But luckily I did get a period, so I did not need to take medroxyprogesterone to induce one.
Now I am starting my first medicated cycle with a fertility clinic. I took 150mg of clomid days 3-7, and days 8-12 I am taking estrace twice a day. Tomorrow, I will have an ultrasound with my Reproductive Endocrinologist. He will be measuring my folicles to determine when one or more will reach the 20mm size needed for ovulation (for instance if the follicle is at 14mm tomorrow, with an expected growth rate of 1.7mm a day, I would reach 20mm 4 days later). Once I'm at 20mm I will take a shot to induce ovulation. The goal is to shorten my cycle so that my body doesn't wait until day 22 or after to ovulate.
I have to admit, I'm pretty nervous about the ultrasound tomorrow. I'm not sure what to expect. Will my follicles be at a good growth spot? Or will they be non-existent and only grow later in my cycle? I'm worried they will be unhealthy in some way. Hopefully all will go smoothly.
I'm trying not to think too much about future planning and ovulation until we get an estimate of when I might get to 20mm. The problem may be timing with Thanksgiving coming up! Actually, we'll almost certainly be staying at my husband's family's house when we have to give the shot and try to time everything correctly with intercourse. Not the greatest scenario, but it's not possible to time these kinds of things. I'm just crossing my fingers that it all works out - especially acquiring my shot away from home. I'd rather not have to bring it through TSA with a doctor's note and then have to store/hide it in the shared fridge until it's time.
Besides the ultrasound, in the morning I will also be testing my AMH with a blood test. I hope this also comes back with good results! My husband will be taking a second semen analysis. His first came back in the "normal" range, but at the low end. The doctor would like to know if this first test is a representative sample, because if it's his "best" day then there might be problems if the new sample comes back below 20 million.
Now I am starting my first medicated cycle with a fertility clinic. I took 150mg of clomid days 3-7, and days 8-12 I am taking estrace twice a day. Tomorrow, I will have an ultrasound with my Reproductive Endocrinologist. He will be measuring my folicles to determine when one or more will reach the 20mm size needed for ovulation (for instance if the follicle is at 14mm tomorrow, with an expected growth rate of 1.7mm a day, I would reach 20mm 4 days later). Once I'm at 20mm I will take a shot to induce ovulation. The goal is to shorten my cycle so that my body doesn't wait until day 22 or after to ovulate.
I have to admit, I'm pretty nervous about the ultrasound tomorrow. I'm not sure what to expect. Will my follicles be at a good growth spot? Or will they be non-existent and only grow later in my cycle? I'm worried they will be unhealthy in some way. Hopefully all will go smoothly.
I'm trying not to think too much about future planning and ovulation until we get an estimate of when I might get to 20mm. The problem may be timing with Thanksgiving coming up! Actually, we'll almost certainly be staying at my husband's family's house when we have to give the shot and try to time everything correctly with intercourse. Not the greatest scenario, but it's not possible to time these kinds of things. I'm just crossing my fingers that it all works out - especially acquiring my shot away from home. I'd rather not have to bring it through TSA with a doctor's note and then have to store/hide it in the shared fridge until it's time.
Besides the ultrasound, in the morning I will also be testing my AMH with a blood test. I hope this also comes back with good results! My husband will be taking a second semen analysis. His first came back in the "normal" range, but at the low end. The doctor would like to know if this first test is a representative sample, because if it's his "best" day then there might be problems if the new sample comes back below 20 million.
Friday, September 14, 2012
A New Chapter
I got my period on September 1st, which means it's easy to remember Day 1 for this cycle. I took 150mg of clomiphene citrate (clomid) on days 4-8, just like I have been for months. But I do not have high hopes for this cycle.
I do have high hopes for upcoming cycles though! On Tuesday my husband and I went to a fertility clinic talk. There are two fertility clinics in my city and we had visited the other one (which is attached to the local university) a few weeks before. The university-affiliated clinic is fairly new, and their information talk was pretty generic. In a some ways, the talk was a bit like what we imagined a timeshare selling meeting would be like. We both walked out of there feeling a bit weird about it. But at the other clinic, the one we visited on Tuesday, we had a better experience. When we pulled into the parking lot at 5:58pm there was only one other car, which was strange. Then we walked in and were welcomed by the founding doctor of the private clinic, who then informed us that we happened to be the only couple who had RSVPed (which is unusual because the month before their informational clinic had been packed). Luckily, this meant he would give us a one on one fertility consultation in his office instead of the planned powerpoint. What a score for us! Usually the first consulation is $250-$300 so this in my mind was like winning a generous prize.
We sat down and told him a little bit about our history (PCOS. Trying to conceive for 5 years, the past 2.5 of which I've been on clomid with good ovulation - according to my testing with LH strips and basal body temperature charting. I've never had any tests done, and haven't been monitored while on clomid. We got pregnant on our first clomid cycle and had a miscarriage at 9 weeks. Since then we've had no luck, and have tired metformin for 3 months with no ovulation, and femara/letrozole once, which was a terrible experience). He then gave us a short but informative information about how a typical cycle works and all the components (FHS, GnRH, estrogen, LH, progesterone, HCG, etc.) which was a good refresher.
Next, we went over the typical evaluation of infertile couples and talked about testing and research studies (we really liked that he has a long history in academia and was very up to date on scientific research and studies). One thing he mentioned that was good to hear is that if the total motile sperm count is over 20 million then things are OK, according to some studies. Also, he told us that clomid, unlike femara/letrozole, is a drug that stays in your system for a long while (about 60 days), so if you don't take breaks in between cycles it may build up. This was news to me. There was a lot of information given, which was great!
The main takeaway that I came out of the meeting with is that we have a good chance of becoming pregnant again, and there are some fairly easy next steps for us to take, even before we would go down the IUI/IVF road. Next steps include:
I do have high hopes for upcoming cycles though! On Tuesday my husband and I went to a fertility clinic talk. There are two fertility clinics in my city and we had visited the other one (which is attached to the local university) a few weeks before. The university-affiliated clinic is fairly new, and their information talk was pretty generic. In a some ways, the talk was a bit like what we imagined a timeshare selling meeting would be like. We both walked out of there feeling a bit weird about it. But at the other clinic, the one we visited on Tuesday, we had a better experience. When we pulled into the parking lot at 5:58pm there was only one other car, which was strange. Then we walked in and were welcomed by the founding doctor of the private clinic, who then informed us that we happened to be the only couple who had RSVPed (which is unusual because the month before their informational clinic had been packed). Luckily, this meant he would give us a one on one fertility consultation in his office instead of the planned powerpoint. What a score for us! Usually the first consulation is $250-$300 so this in my mind was like winning a generous prize.
We sat down and told him a little bit about our history (PCOS. Trying to conceive for 5 years, the past 2.5 of which I've been on clomid with good ovulation - according to my testing with LH strips and basal body temperature charting. I've never had any tests done, and haven't been monitored while on clomid. We got pregnant on our first clomid cycle and had a miscarriage at 9 weeks. Since then we've had no luck, and have tired metformin for 3 months with no ovulation, and femara/letrozole once, which was a terrible experience). He then gave us a short but informative information about how a typical cycle works and all the components (FHS, GnRH, estrogen, LH, progesterone, HCG, etc.) which was a good refresher.
Next, we went over the typical evaluation of infertile couples and talked about testing and research studies (we really liked that he has a long history in academia and was very up to date on scientific research and studies). One thing he mentioned that was good to hear is that if the total motile sperm count is over 20 million then things are OK, according to some studies. Also, he told us that clomid, unlike femara/letrozole, is a drug that stays in your system for a long while (about 60 days), so if you don't take breaks in between cycles it may build up. This was news to me. There was a lot of information given, which was great!
The main takeaway that I came out of the meeting with is that we have a good chance of becoming pregnant again, and there are some fairly easy next steps for us to take, even before we would go down the IUI/IVF road. Next steps include:
- Testing!
- AMH to determine my ovarian reserve (I am extremely curious about this!). This test is $75 and not covered by insurance
- HSG testing, done during cycle days 5-12 to look at internal reproductive organs and make sure everything looks OK. He wants to make sure that nothing is in my uteris that is acting like an IUD (cysts, part of a miscarriage, etc.). This test can be done as an xray or ultrasound, is $1100, and not covered by insurance, so I will pay out of pocket.
- TSH testing for my thyroid. I've had this done in the past, but not in the last two years, so I'm going to get this done at soon at my yearly physical. This should be covered by insurance, so I will save $100.
- Prolactin testing. I've had this done in the past, but not since 2008, so I'm going to get this done at soon at my yearly physical. This should be covered by insurance, so I will save $100.
- Pre-diabetes testing, for glucose, taken while fasting. I've also had this done in the past, but I'll get an updated test at my yearly physical. This should be covered by insurance, so I will save $40.
- New cycle procedure!
- I'll continue on clomid, but my dose may be changed (safe use is from 50mg to 250mg a day), taken on cycle days 3 through 7. $11.25 at Costco, out of pocket.
- Estrace will be taken on cycle days 8 through 12 at 4mg a day ($7.85 at Costco, out of pocket). This will help produce a nice uterine lining.
- Then I'll have an ultrasound to monitor how the cycle is going. They'll look at my lining, to make sure it it thick enough for an egg to implant, my follicle count, and the size of my follicles (generally follicles grow at 2mm a day and are good to go at 19 or 20mm. The ultrasound will be $250, out of pocket.
- Ovidrel will then be taken (an HCG boost) to promote the follicle release. Intercourse should be had at the time ovidrel is taken, as well as 38 hours later, when the egg has been released. This medicine is $85 at Costco, out of pocket.
Tuesday, August 28, 2012
Waiting
We're now in the two week wait (TWW) period of my cycle. Some women find this part the most excruciating, but for me that would be the pre-ovulation cycle days. My cycle is usually pretty long, and the 21+ days before ovulation is the worst. Even though my body is getting ready and preparing for ovulation it feels like nothing is happening and wasted time.
During the TWW there is hope and anticipation that this cycle will be the one. I feel in tune with my body during this time - feeling every single movement and cramp and hoping that something is happening down there. I am praying that the timing of everything worked, but I'm not holding my breath. I've been through this many times before: feeling bloated and "full", small cramps, sore breasts, tiredness, then getting OH SO EXCITED that I've reached day 16 or 17 days post-ovulation, and then....my period.
During the TWW there is hope and anticipation that this cycle will be the one. I feel in tune with my body during this time - feeling every single movement and cramp and hoping that something is happening down there. I am praying that the timing of everything worked, but I'm not holding my breath. I've been through this many times before: feeling bloated and "full", small cramps, sore breasts, tiredness, then getting OH SO EXCITED that I've reached day 16 or 17 days post-ovulation, and then....my period.
Sunday, May 13, 2012
Mother's Day
It's Mother's Day. A day I love and hate.
I want a child so badly, and have been hoping, praying, charting, and actively trying to become pregnant for several years now. Mother's Day is hard because it reminds me of what I'm missing. And the ache to be a mom becomes deeper. But there is also some hope. At some point in the future I will celebrate Mother's Day as a mother, whether I'm a mother biologically or through adoption. I just want it sooner rather than later.
It also doesn't help that two years ago I was pregnant on Mother's Day. My first pregnancy, my first cycle on clomid, it was all so seemingly simple then. It hurts to remember: the pain of finding out that no heartbeat was present at nine and a half weeks, and the waiting....six weeks later....until the miscarriage.
I'm creating this blog as a record of my thoughts and feelings as I process and try to understand my infertility. I've been reading a handful of blogs in recent weeks and it has been helpful to read the experiences of other women who also have been going through heartbreak in order to create a family. Hopefully, by sharing my story, I can help others.
Today I acknowledge the wide continuum of mothering:
I want a child so badly, and have been hoping, praying, charting, and actively trying to become pregnant for several years now. Mother's Day is hard because it reminds me of what I'm missing. And the ache to be a mom becomes deeper. But there is also some hope. At some point in the future I will celebrate Mother's Day as a mother, whether I'm a mother biologically or through adoption. I just want it sooner rather than later.
It also doesn't help that two years ago I was pregnant on Mother's Day. My first pregnancy, my first cycle on clomid, it was all so seemingly simple then. It hurts to remember: the pain of finding out that no heartbeat was present at nine and a half weeks, and the waiting....six weeks later....until the miscarriage.
I'm creating this blog as a record of my thoughts and feelings as I process and try to understand my infertility. I've been reading a handful of blogs in recent weeks and it has been helpful to read the experiences of other women who also have been going through heartbreak in order to create a family. Hopefully, by sharing my story, I can help others.
Today I acknowledge the wide continuum of mothering:
To those who gave birth this year to their first child—we celebrate with you
To those who lost a child this year – we mourn with you
To those who are in the trenches with little ones every day and wear the badge of food stains – we appreciate you
To those who experienced loss this year through miscarriage, failed adoptions, or running away—we mourn with you
To those who walk the hard path of infertility, fraught with pokes, prods, tears, and disappointment – we walk with you. Forgive us when we say foolish things. We don’t mean to make this harder than it is.
To those who are foster moms, mentor moms, and spiritual moms – we need you
To those who have warm and close relationships with your children – we celebrate with you
To those who have disappointment, heart ache, and distance with your children – we sit with you
To those who lost their mothers this year – we grieve with you
To those who experienced abuse at the hands of your own mother – we acknowledge your experience
To those who lived through driving tests, medical tests, and the overall testing of motherhood – we are better for having you in our midst
To those who will have emptier nests in the upcoming year – we grieve and rejoice with you
And to those who are pregnant with new life, both expected and surprising –we anticipate with you
This Mother’s Day, we walk with you. Mothering is not for the faint of heart and we have real warriors in our midst. We remember you.
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