September 28, 2004
Ultrasound
After a very sleepless night, I had an ultrasound this morning to check follicle growth. I think he said I had two follicles growing, but they were small. I go back Friday to check again. I was supposed to be going to a conference for work that day, but once again infertility ruins the best laid plans. My panic attacks are still an issue. I tried one medication, but it made them worse. I'm having trouble getting my doctor to understand what I need. I'm also having a hard time finding a counselor. I called 3 places yesterday. One never called me back. One only sees patients once a week and didn't have any openings for 2 weeks. The last one called me back, but I missed the call and left him another message and am waiting to hear back. I'm so frustrated, angry, sad, and scared.
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September 23, 2004
Clomid begins
I started the Clomid on Tuesday. So far I haven't had any side effects. Last time I was overly emotional and had horrible hot flashes. Next Tuesday we go for our first ultrasound to check my follicles. (Mature follicles release eggs) We'll probably have to go to the doctor every other day until I ovulate. I'm really tired of living at the doctor's office. I want my life back, but I want that life to include a child, so we keep trying.
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September 19, 2004
Miscarriage
I started miscarrying on Friday at 4 and half weeks. The RE said we didn't have to wait to start trying again. I'll start taking the Clomid (at twice the dosage I was taking before) on Tuesday.
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September 15, 2004
Results are in
Well my HCG levels are negative now. I have to sit back and wait for my body to realize it isn't pregnant anymore. Whenever I start my next cycle we get to repeat everything all over again. I'm just so tired of this. So many people have it happen easily. Starting a family is supposed to a fun, happy time. This just sucks. At least I get to stop taking the progesterone suppositories now. They are so messy and gross. I wake up during the night because I feel like I peed myself when it's just the suppository melting.
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What we've been through so far
Dave set this journal up for me to detail our adventures in infertility. We both feel it's important to put our experiences out there for a couple of reasons. It's not something a lot of people talk about, but 1 in 6 couples experience infertility. If we can help one person feel less alone in the journey, we've done something positive with it. Also, it's consuming our lives.
So here's where our adventures began. About a year ago we decided we would be wanting children soon. I have PCOS (Polycystic Ovarian Syndrome) so we knew it may be a bit more difficult than normal. PCOS causes mulitple tiny cysts on the ovary each month instead of one good follicle. It makes ovulation irregular or absent and can cause long irregular cycles and insulin resistance. Other equally pleasant effects of PCOS are weight gain around the abdomen, acne, and hirsutism (excess hair, oh boy!). It also puts you at risk for endometrial hyperplasia, endometrial cancer, diabetes, high blood pressure, high cholesterol, and heart disease. A good FAQ site for it is http://www.inciid.org/faq/pcos.html A few years ago I also had a cyst around one of my fallopian tubes, so we also weren't sure if my tube had any damage to it.
I started with my regular GYN. She suggested I see an endocrinologist for my PCOS and a perinatologist (a doctor that follows high risk pregnancies) since I have high blood pressure and a stong family history of diabetes putting me at risk for eclampsia and gestational diabetes. The endocrinologist started me on Glucophage (also called Metformin, I use the two names interchangeably). This was in hope of regulating my insulin levels and hopefully regulate ovulation. She also tested me for insulin resistance, which I have. The perinatologist changed my blood pressure medication to ones I could take while pregnant and put me on a prenatal vitamin (PNV) with extra folic acid. This was all in October 2003.
Towards the end of November 2003 my blood pressure was stable on the new medicine. I was tolerating the Glucophage and had been taking the vitamin for awhile. Everything was fine, the doctor's gave us the go ahead when we were ready. Right before Thanksgiving my uncle died of liver cancer. He also left behind three small girls. It made us realize how short life was and how much we wanted to start our family. I stopped taking my birth control pills then. My first cycle off them was a fairly normal length. When that cycle ended unsuccessfully, I started charting my basal body temperature (BBT). I do this online at Fertility Friend. My chart is there if anyone is interested. It showed that I was ovulating, just irregularly and later than most people. This means I have a chance to get pregnant less frequently than most people.
In April 2004 with still no success it was time to see if there where some other problems going on. Dave had a semen analysis done. He said there was actually a sign in the "collection room" that asked him not to take the videos or they will be unable to continue to provide that service. I guess this must have been a problem in the past or they wouldn't have that sign up. :) I also had an hysterosalpingogram (HSG). This is a test where they inject dye into my uterus and watch to see if it spills out the fallopian tubes. It checks the shape of the uterus and the patency of the tubes. At first my right tube (the one that had the cyst) was blocked, but the radiologist was able to open it up by forcing some extra dye in. Then she told me everything looked fine and that for the next three months my tubes would be wide open and to practice, practice, practice.
I called my GYN to get the results of Dave's semen analysis (SA). He passed with flying colors. Then she told me that my HSG wasn't as good as I thought. The tubes were ok, but it showed that I had a bicornuate uterus. The uterus should like kinda like an upside down triangle. Mine looked like a Y. The top half was split. From what I was told then I would have trouble carrying a pregnancy to term because the uterus would run out of room before the baby was finished growing. I was referred to an RE (reproductive endocrinologist).
In May 2004 I saw the first RE. He said that the bicornuate uterus was not that bad and I shouldn't worry about it. He did a pelvic exam and let Dave have an upclose and personal view. I was not to happy about that. Very embarrassing. Basically he wanted told us to wait another 3 months before coming back for treatment of any kind. He also wanted to see my previous medical records. While I was getting them together I noticed an ultrasound report from around the time I had the tubal cyst. The ultrasound showed a septated uterus. This is similar to a bicornuate uterus, but on the outside the uterus will look normal. On the inside though the uterus is divided down the middle which again puts me at high risk for miscarriage and preterm labor. I called the RE to let him know about this, and was told that he was sure it was fine but to get a second opinion if I wanted.
In July 2004 we went to a different fertility clinic for a second opinion. There we saw another RE who was wonderful. She developed a treatment plan to start on my next cycle. The plan was to start Clomid. Clomid is an oral medication to stimulate ovulation. The hope was that it would make me ovulate earlier in my cycle and give me more opportunities to get pregnant. She also said that if the current cycle went on too long to call and they would give me a medication to jump start it.
On 08/02/04 I got tired of waiting and called for the medication. Before they will prescribe it they have to do a pregnancy test and check progestrone levels. My pregnancy test was negative and my progesterone was 0.5 which showed I hadn't ovulated yet. I started taking Provera. It was one of the worst medications I've ever taken. It made me feel stupid, like I was trying to think with a head full of cotton. It also majorly upset my GI tract. From feeling so sick I started having panic attacks and felt like I couldn't breathe. This led to a trip to Patient First. I stopped taking the Provera after seven days even though I was supposed to take it for ten days. Four days after I stopped the next cycle started.
On 08/13/04 I started cycle #8, 10 months of trying desperately to have a baby and 10 months of heartwrenching disappointment. I didn't realize how much time and emotional effort was going to be needed for our first treatment cycle. They assign "homework" (which is their way of saying sex) on certain days. Here's what happened this cycle:
08/13/04: Called in the RE office to let them know the cycle started
08/16/04: Went in for blood work at 7am. Called back at 1pm for results and instructions. They called in a prescription for Clomid after my blood work looked ok
08/17/04-08/21/04: Took the Clomid. It made me overly emotional and have the worst hot flashes. I think the term hot flash is a misnomer. Flash implies something over and done with quickly. These lasted for days. I was always hot.
08/24/04: Had to go in for a transvaginal ultrasound to check to see if I was developing follicles. When follicles are mature they release an egg. I had one follicle measuring at 17. Not big enough. Homework assigned for the 25th between 8:45pm and 4:45 am so they could do a post coital test. This is where they take a sample of the semen off the cervix and see if it can get through the cervical mucous (gross I know).
08/26/04: Went in for another ultrasound. The follicle now measured 20. Still not big enough. Post coital test was done, everything looked good. More homework for the 27th.
08/28/04: Yet another ultrasound. Follicle measured 23. Now it's big enough. They gave me the option of getting a shot of HCG to make me ovulate or wait another two days to see if I could do it on my own. I opted to wait. Homework assigned for the 29th.
08/30/04: You guessed it, another ultrasound. I had ovulated on my own! No shot. More homework that night.
09/03/04: More bloodwork at 7am. Called back at 1pm for results. My progesterone level was low at 14.1. I needed a supplement. Then they told me the supplement was in the form of a vaginal suppository. Can this get any more fun? I called two pharmacies to find it. Finally I found one and got the prescription to them. Then the dreaded wait. I had to wait until 09/13/04 to see if either I got my period or was pregnant.
09/08/04: Had some spotting. I figured I was going to either get my period early, or it was implantation spotting. Once an egg is fertilized it implants in the uterus 7-10 days later; this was 9 days after I ovulated, so right on time for implantation.
09/10/04: We went to Ocean City to try to relax. I've decided to take about 2 weeks off work to try to destress. The stress from the medications and treatments was making me sick. Between worrying about all this and how to pay for it (our insurance doesn't cover a whole lot, and doesn't cover medication at all) I needed a break.
09/11/04: I took a home pregnancy test and got a very faint second line. I've never had this before. I was so excited I took another and the same thing happened.
09/12/04: I took another test, this one was negative. I had no idea what was going on.
09/13/04: I went in for a blood HCG (that's the hormone you make when you are pregnant, it's what they test for in pregnancy tests) test and a progesterone test that morning. I called back at 1pm for the results. It was positive, but just barely. Anything less than 5 is considered negative. Mine was 5.2. And my progesterone also dropped to 3.8. I was pregnant, but they said it wouldn't last with numbers so low. I was to come in in two days to recheck my levels and to keep taking the progesterone supplement. I cried and cried. Here I was pregnant, but couldn't be happy about it because I was going to lose it.
09/14/04: Cried all day again. Just sitting around waiting until they can recheck my levels or until I start to actually miscarry. That night I got up twice because I was sure I had started bleeding. The cramps I had been having for two weeks intensified and I started having back pain. I was up all night. No bleeding though
09/15/04: On my chart my temperature dropped, a sign that I may start bleeding soon. Went in at 7am to have my levels drawn. I won't have the results till this afternoon. The nurse said they actually want to see my levels fall since that means it's going away. She said there was something wrong with the pregnancy and it's best for it to end quickly. If my levels go up they will have to keep monitoring me to see what happens. At 11am I got a call from the nurse's there saying there was an accident in the lab and my blood sample from this morning got dropped. I had to go back in to have it redrawn. I should know something by this afternoon. The waiting is killing me though.
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