Wednesday, August 29, 2007
Background
Hi everyone,
I have finally come to realize that this journey is not a short one and I need a space to update all of you supportive friends and family. At times it becomes exhausting to talk about all the pokes and prods and lack of forward movement, or even the seemingly rare uplifting moments. So I thought it appropriate that my first 'blog' (I hate that word) would give you the background on what we've been through so far.
We started TTC (trying to conceive) in March 2006 (during our trip to Mexico for Jessica and Jeff's wedding, sorry TMI but I want to dispel the idea that all we need to do is 'go on vacation and we'll be pregnant'). We were not watching for ovulation or any of that fun stuff that was to come, but nothing happened.
We started using ovulation predictor kits in October 2006 and also went on a vacation to Europe (yep, still not pregnant after a VACATION). Through the ovulation kits I noticed my ovulation was late in the month cycle day (CD) 20 or so. I also had skipped several periods while training for the 2006 Twin Cities Marathon which I had just finished. I went to the doctor in November to discuss this. She gave me medication to induce a period and didn't seemed concerned at all. She said "You're young, just have fun! " Yeah right, lady! I was concerned. I had skipped periods in the past and started to think there was a real problem. After four or five more months with no pregnancy, I decided to get serious.
In March/April we went to another OB/GYN to get a second opinion. He took it seriously and began testing. Everything came back okay, my blood work was a tiny bit off, but nothing to be worried about. Mark's analysis was okay too. It looked like we were fertile...just not SUPER fertile. I was relieved, but didn't totally buy it. Call me cynical, but I knew something was wrong.
With the OB/GYN we began medications to help our fertility. I started with 100mg of Clomid to create egg follicles and injectible Gonal-F, 150 IU to grow the follicles. My cycle was ultimately cancelled because of over reaction...my ovaries were acting PCO (polycystic=multiple cysts on ovaries). We were told to not touch each other for the remainder of the month...WTF?? We are trying to conceive and we can't touch each other? The drama continues...
I thought, well this is a good opportunity to take care of myself and seek other avenues. I started getting acupuncture for fertility as well as regular chiropractic adjustments. A generally healthy body can't hurt!
Over a month later I still hadn't gotten my period (the story of my life, my cycles can range from 34 to 43 days unless they decide to not come at all). The doctor gave me medication to induce a period, thus starting cycle #2 with 'help'.
My baseline ultra sound showed that my ovaries were 'quiet'. A baseline is done on the third day of your cycle (CD3), to check the status of your ovaries.
If you have seen "Knocked Up", the movie, there is a scene where the doctor is holding an uncomfortably sized wand that he is about to use on Katherine Heigl (I don't know her character's name). He smiles at the dad and says "Your next.". It's a funny scene, until they stare you in the face and tell you that is how they are going to do your ultrasound! What...I thought you did that on top of my belly...not with that...up there! Anyways, by now that is old news and the wand and I have actually become quite close friends...to the point where Mark is maybe feeling a little jealous! :)
We started my second cycle with 75 IU of Bravelle. Bravelle is an injectible medication that I mixed myself. All of you scientists would have been proud of the makeshift lab I created out of our bathroom. I definitely was feeling under qualified for this job...but somebody had to do it! I even tapped the needle and squirt it a bit to get out air bubbles...just like in the movies!
All seemed well with this cycle, my follicles were looking good (as seen through repeated ultrasounds) and my estradiol level was good (they measure this via blood draw to make sure your hormone levels match what they are seeing on the ultrasound). The nurse practitioner even went as far as to say my uterine lining was beautiful. I know, you are all jealous! :) All seemed fine, great actually, until my CD10 ultrasound.
My follicles looked great, but my estradiol had dropped significantly. So significantly, in fact, that the doctor thought there was a lab screw up. The follow up ultrasound three days later proved devastating, we were cancelling this cycle as well and were instructed not to touch each other for the second month in a row. They didn't want to risk multiples in case all of those small eggs dropped.
And I digress...you may be thinking at this point that even if the ultrasound wasn't positive, this is really just your second month of trying with help so how could it be truly devastating? Isn't that a strong word? This journey has reared emotions as well as human sounds (while sobbing) that I did not know existed...so yes, at that point it was devastating.
They also called back to say that they were referring me to a specialist. My response was "Do you think the specialist can help get the right dosage of medications to make this work?" The nurse practitioner said a bunch of things like, "Well, I don't know, your ovaries haven't reacted the way they should...", all I finally heard was, "The response we are getting from your ovaries are ideal for IVF (invitro fertilization)". WTF!!?!?!?? Who said anything about that? We've tried for two months and you morons can't get the dosages right! I'm not going to jump on what is the $15,000 per cycle IVF train yet! If you thought devastating was a strong word...you have not begun to imagine how I felt after this conversation. My strong, optimistic husband lost it a bit at this point as well. We were a 24 hour wreck, so I made the appointment to see the Reproductive Endocrinologist (RE aka Specialist) immediately. His schedule was two weeks out, so we were able to see him August 14.
Oh, I forgot to mention that as if infertility wasn't enough to make a girl crazy...I'm on all sorts of hormone altering drugs. They made me bloated and insane, gave me hot flashes and night sweats and generally made me a complete basket case. Welcome to my current life. If you've wondered why I've seemed a little 'off', that explains it.
August 14, was one of our rare happy days. We met with our RE, he had reviewed our file and he did an ultrasound on me. He goes to my right ovary first, "Yep, classic PCOS (polycystic ovarian syndrome).". I smiled, because even though my blood work had come back ok, I always thought I had this. He moved to my left ovary, "Oh...you've ovulated on this side (something that PCOSers don't do), you could be pregnant." So he didn't really think I was pregnant, but I actually ovulated which is rare for people with PCOS to do on their own. A side note, my chiropractor had thought I was quite tight on my left side so she had been concentrating her acupuncture on that side. I credit that for my ovulation.
We sat down with the RE after the ultrasound to discuss our plan. He said I have a mild case of PCOS because I have kept my weight down through diet and exercise. People with PCOS are typically obese and are more prone to things like type 2 diabetes, heart problems, et cetera. I have finally found out that it is not in my head that it takes me a lot more to lose weight and maintain my weight than others. He gave us three options:
1. Least expensive/Least invasive/First-line approach - Metformin (for insulin resistence), Clomid (for egg follicle production), a trigger shot(to trigger ovulation) and an IUI (intrauterine insemination, to take the guess work out of finding the cervix for the sperm)
2. More expensive/More Raging Hormones - injectibles, trigger, IUI
3. Most invasive - Ovarian drilling (yes, the name says it all)
We chose the first option, to see how my bod reacts. The RE was SUPER optimistic for us and said 97% of the people that come to him with PCOS conceive. He's been an RE since 1980 (the pioneer days of infertility) and has basically seen it all. He might as well have given me speed, because I was high! We had finally found the one that would make it all better! We just had to get the piece of the file that was missing, Mark's lab results, and we could start at my next period.
Again my period, aunt flow as we like to call her in the infertility (IF) world, wasn't coming. So the doctor's office gave me all sorts of false hope and made me go in for a beta HCG (blood pregnancy test). It was negative, of course. I wasn't too sad, because that is what I had expected but I was excited to get started with the drugs! I got my period a few days later.
I called the office to get my drugs and have a baseline ultrasound. They said that they had received Mark's analysis, and the RE wanted to put me on Metformin and the birth control pill, and wanted to retest Mark to be sure nothing had changed and that the prior results were representative. WHAT!?!?! We are trying to have a baby. I mean, I'm no doctor, but I assume it is increasingly more difficult to conceive on the birth control pill (unless you are a teenager or had a one night stand, or are basically anyone but me). They told me that it takes a month for the metformin to really start working and that the birth control will help restart my system and get rid of cysts/prevent new cysts.
So that is where we stand. I take my little, pink birth control pill every morning like a good little girl that doesn't want to conceive. I'm continuing with my acupuncture and chiropractic adjustments and I'm adding massage specially geared for fertility. I'm doing yoga every week on top of my cardio and lifting and I'm eating well. If I have to be on hold, I'm determined that my body will be the better for it when we finally get to try.
So, after three months of 'help' we officially have gotten to try ZERO times. During this time we would have had better luck trying on our own...but, I'm positive there is good ahead.
The funny thing is that since Mark and I got engaged, I've felt like getting pregnant was not something that would come easily. I've always felt, however, that it would happen. I truly believe everything happens for a reason. Mark and I have become even closer through this process. I've matured both personally and in my faith. I feel like I may regress and have angry/jealous/resentful feelings toward people who I don't feel should be pregnant or have children over me, but I ultimately come to peace every time those feelings overwhelm me. God has a place for each of us, He is just showing me where mine is right now.
I have finally come to realize that this journey is not a short one and I need a space to update all of you supportive friends and family. At times it becomes exhausting to talk about all the pokes and prods and lack of forward movement, or even the seemingly rare uplifting moments. So I thought it appropriate that my first 'blog' (I hate that word) would give you the background on what we've been through so far.
We started TTC (trying to conceive) in March 2006 (during our trip to Mexico for Jessica and Jeff's wedding, sorry TMI but I want to dispel the idea that all we need to do is 'go on vacation and we'll be pregnant'). We were not watching for ovulation or any of that fun stuff that was to come, but nothing happened.
We started using ovulation predictor kits in October 2006 and also went on a vacation to Europe (yep, still not pregnant after a VACATION). Through the ovulation kits I noticed my ovulation was late in the month cycle day (CD) 20 or so. I also had skipped several periods while training for the 2006 Twin Cities Marathon which I had just finished. I went to the doctor in November to discuss this. She gave me medication to induce a period and didn't seemed concerned at all. She said "You're young, just have fun! " Yeah right, lady! I was concerned. I had skipped periods in the past and started to think there was a real problem. After four or five more months with no pregnancy, I decided to get serious.
In March/April we went to another OB/GYN to get a second opinion. He took it seriously and began testing. Everything came back okay, my blood work was a tiny bit off, but nothing to be worried about. Mark's analysis was okay too. It looked like we were fertile...just not SUPER fertile. I was relieved, but didn't totally buy it. Call me cynical, but I knew something was wrong.
With the OB/GYN we began medications to help our fertility. I started with 100mg of Clomid to create egg follicles and injectible Gonal-F, 150 IU to grow the follicles. My cycle was ultimately cancelled because of over reaction...my ovaries were acting PCO (polycystic=multiple cysts on ovaries). We were told to not touch each other for the remainder of the month...WTF?? We are trying to conceive and we can't touch each other? The drama continues...
I thought, well this is a good opportunity to take care of myself and seek other avenues. I started getting acupuncture for fertility as well as regular chiropractic adjustments. A generally healthy body can't hurt!
Over a month later I still hadn't gotten my period (the story of my life, my cycles can range from 34 to 43 days unless they decide to not come at all). The doctor gave me medication to induce a period, thus starting cycle #2 with 'help'.
My baseline ultra sound showed that my ovaries were 'quiet'. A baseline is done on the third day of your cycle (CD3), to check the status of your ovaries.
If you have seen "Knocked Up", the movie, there is a scene where the doctor is holding an uncomfortably sized wand that he is about to use on Katherine Heigl (I don't know her character's name). He smiles at the dad and says "Your next.". It's a funny scene, until they stare you in the face and tell you that is how they are going to do your ultrasound! What...I thought you did that on top of my belly...not with that...up there! Anyways, by now that is old news and the wand and I have actually become quite close friends...to the point where Mark is maybe feeling a little jealous! :)
We started my second cycle with 75 IU of Bravelle. Bravelle is an injectible medication that I mixed myself. All of you scientists would have been proud of the makeshift lab I created out of our bathroom. I definitely was feeling under qualified for this job...but somebody had to do it! I even tapped the needle and squirt it a bit to get out air bubbles...just like in the movies!
All seemed well with this cycle, my follicles were looking good (as seen through repeated ultrasounds) and my estradiol level was good (they measure this via blood draw to make sure your hormone levels match what they are seeing on the ultrasound). The nurse practitioner even went as far as to say my uterine lining was beautiful. I know, you are all jealous! :) All seemed fine, great actually, until my CD10 ultrasound.
My follicles looked great, but my estradiol had dropped significantly. So significantly, in fact, that the doctor thought there was a lab screw up. The follow up ultrasound three days later proved devastating, we were cancelling this cycle as well and were instructed not to touch each other for the second month in a row. They didn't want to risk multiples in case all of those small eggs dropped.
And I digress...you may be thinking at this point that even if the ultrasound wasn't positive, this is really just your second month of trying with help so how could it be truly devastating? Isn't that a strong word? This journey has reared emotions as well as human sounds (while sobbing) that I did not know existed...so yes, at that point it was devastating.
They also called back to say that they were referring me to a specialist. My response was "Do you think the specialist can help get the right dosage of medications to make this work?" The nurse practitioner said a bunch of things like, "Well, I don't know, your ovaries haven't reacted the way they should...", all I finally heard was, "The response we are getting from your ovaries are ideal for IVF (invitro fertilization)". WTF!!?!?!?? Who said anything about that? We've tried for two months and you morons can't get the dosages right! I'm not going to jump on what is the $15,000 per cycle IVF train yet! If you thought devastating was a strong word...you have not begun to imagine how I felt after this conversation. My strong, optimistic husband lost it a bit at this point as well. We were a 24 hour wreck, so I made the appointment to see the Reproductive Endocrinologist (RE aka Specialist) immediately. His schedule was two weeks out, so we were able to see him August 14.
Oh, I forgot to mention that as if infertility wasn't enough to make a girl crazy...I'm on all sorts of hormone altering drugs. They made me bloated and insane, gave me hot flashes and night sweats and generally made me a complete basket case. Welcome to my current life. If you've wondered why I've seemed a little 'off', that explains it.
August 14, was one of our rare happy days. We met with our RE, he had reviewed our file and he did an ultrasound on me. He goes to my right ovary first, "Yep, classic PCOS (polycystic ovarian syndrome).". I smiled, because even though my blood work had come back ok, I always thought I had this. He moved to my left ovary, "Oh...you've ovulated on this side (something that PCOSers don't do), you could be pregnant." So he didn't really think I was pregnant, but I actually ovulated which is rare for people with PCOS to do on their own. A side note, my chiropractor had thought I was quite tight on my left side so she had been concentrating her acupuncture on that side. I credit that for my ovulation.
We sat down with the RE after the ultrasound to discuss our plan. He said I have a mild case of PCOS because I have kept my weight down through diet and exercise. People with PCOS are typically obese and are more prone to things like type 2 diabetes, heart problems, et cetera. I have finally found out that it is not in my head that it takes me a lot more to lose weight and maintain my weight than others. He gave us three options:
1. Least expensive/Least invasive/First-line approach - Metformin (for insulin resistence), Clomid (for egg follicle production), a trigger shot(to trigger ovulation) and an IUI (intrauterine insemination, to take the guess work out of finding the cervix for the sperm)
2. More expensive/More Raging Hormones - injectibles, trigger, IUI
3. Most invasive - Ovarian drilling (yes, the name says it all)
We chose the first option, to see how my bod reacts. The RE was SUPER optimistic for us and said 97% of the people that come to him with PCOS conceive. He's been an RE since 1980 (the pioneer days of infertility) and has basically seen it all. He might as well have given me speed, because I was high! We had finally found the one that would make it all better! We just had to get the piece of the file that was missing, Mark's lab results, and we could start at my next period.
Again my period, aunt flow as we like to call her in the infertility (IF) world, wasn't coming. So the doctor's office gave me all sorts of false hope and made me go in for a beta HCG (blood pregnancy test). It was negative, of course. I wasn't too sad, because that is what I had expected but I was excited to get started with the drugs! I got my period a few days later.
I called the office to get my drugs and have a baseline ultrasound. They said that they had received Mark's analysis, and the RE wanted to put me on Metformin and the birth control pill, and wanted to retest Mark to be sure nothing had changed and that the prior results were representative. WHAT!?!?! We are trying to have a baby. I mean, I'm no doctor, but I assume it is increasingly more difficult to conceive on the birth control pill (unless you are a teenager or had a one night stand, or are basically anyone but me). They told me that it takes a month for the metformin to really start working and that the birth control will help restart my system and get rid of cysts/prevent new cysts.
So that is where we stand. I take my little, pink birth control pill every morning like a good little girl that doesn't want to conceive. I'm continuing with my acupuncture and chiropractic adjustments and I'm adding massage specially geared for fertility. I'm doing yoga every week on top of my cardio and lifting and I'm eating well. If I have to be on hold, I'm determined that my body will be the better for it when we finally get to try.
So, after three months of 'help' we officially have gotten to try ZERO times. During this time we would have had better luck trying on our own...but, I'm positive there is good ahead.
The funny thing is that since Mark and I got engaged, I've felt like getting pregnant was not something that would come easily. I've always felt, however, that it would happen. I truly believe everything happens for a reason. Mark and I have become even closer through this process. I've matured both personally and in my faith. I feel like I may regress and have angry/jealous/resentful feelings toward people who I don't feel should be pregnant or have children over me, but I ultimately come to peace every time those feelings overwhelm me. God has a place for each of us, He is just showing me where mine is right now.
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