The Shaky Start of Cycle 17

After having made it through last month, I was ready to put things behind me and move on to our next cycle. It was to be another double IUI cycle, assisted by Letrozole and a trigger shot. My period started, I went in for an ultrasound, and started the letrozole on day 3 – thankful that day 5 fell on a Saturday, so my migraine day would be on a weekend and I wouldn’t need to use a vacation day for the headache. The nurse sent in my prescription for my trigger shot, and advised me I would have two this cycle. She then scheduled me to come back on day 13 for my ultrasound to see if my eggs were ready to trigger.

This made me nervous, since I’ve been ready to trigger anywhere between day 11 and day 14. But I’d asked for an earlier scan the prior two months and had to come back in a second time because I wasn’t quite ready to trigger. So I figured it would be fine. So I went home, started my letrozole, and waited for my shots to arrive.

Let’s talk about the shots for a minute. Previously, I’d been using Novarel. It came as powder in a vial that I had to mix when ready, and Robert (or someone else) needed to inject it into my rear. This is the only trigger shot that I’ve every used. This time, however, I was prescribed Ovidrel, which is a pre-filled syringe that you inject into your stomach. I was excited about this because it meant I could inject myself if I required the shot in the middle of the day, and I didn’t have to mess with mixing the shot. But it was different, and I was curious why. So I intended to ask the nurse about it when I went in for my Day 13 scan.

Now, leading up to the trigger shot, they have you start using your Ovuquick ovulation tests on day 10. The very first time I used these kits was during my clomid challenge test and they came back positive every single day I used them. I believe that this was actually a reaction that I had to the clomid, because my next cycle (back on letrozole) I didn’t have a single positive the entire cycle. Which brings us back to this cycle. I started testing on day 10, knowing it would likely be negative. But by day 11 I was really starting to feel my ovaries, and I suspected that I was probably getting close to ovulation.

Sure enough, I tested on Day 12 and I had a big fat positive. REALLY positive. So positive that the majority of the dye went to the test line, and the reference line was really pale. Knowing that there was no point in stressing over it, I called the clinic to let them know and ask if I should come in for my ultrasound that day. At this point, I will admit that I was a little flustered because we had company and were hosting a get together at our house in a few hours and I was behind on getting dinner in the oven and having everything ready.

Ultimately, the nurse told me to take my shots when I got off the phone and we would be in the next morning for an IUI.

Well, shit. I did not get an ultrasound, so I didn’t know how many eggs I had this cycle. I was on a new trigger shot and didn’t get the chance to ask why they changed. And I had no idea how to administer the shot. Thankfully, the internet exists and other fertility clinics and pharmacies post “how to” videos for giving injections.

However, that left us in the unfortunate situation of having an ideally timed set of IUIs. So after some discussion, Robert and I decided that even though we had company it was probably best to sneak upstairs for an afternoon delight as a precaution. So, up we went. With my new shots, a video on how to give them queued up, and some embarrassment.

I managed to give myself the shots, but it was not the most pleasant thing I’ve ever done. I am pretty confident that I could never become a drug addict. But I got it done. And, I’m a bit relieved, since if we require additional cycles I know that I can administer the shot(s) to myself. Afterwards we participated in a little natural insemination, and had an IUI on Easter Sunday (with 40 million sperm this round).

As for the Ovidrel, I’m definitely having stronger side effects from the medication. My boobs are killing me and I have some really wicked nausea. In addition, I’ve had a relatively upset stomach for the past two days. It’s possible that I may have a mild case of OHSS – but I’m not having any levels of pain that concern me. I’ll mention it to the nurse the next time I’m in the office. I don’t know if my reaction is because I had a higher dose, or from the medication itself. I’m not entirely sure how the dose of Ovidrel vs. the dose of Noravel compare since they are measured in different units and the internet seems to be largely failing me on finding this information. All I know is that I had two shots instead of one.

I am a little disappointed/upset that I didn’t trust my gut and indicate that I felt day 13 was too late. I won’t make that mistake a second time. I really hope that we didn’t blow this cycle by either inseminating too early, because we didn’t do the scan and trusted that the kit didn’t provide a false positive – or by missing the window and triggering at the wrong time. My ovaries definitely hurt yesterday and were sore, which is consistent with my other trigger cycles. But they’ve also been more tender in some of the other cycles as well.

Robert and I intend to go ahead and do a few more afternoon delights over this week, just to be sure we didn’t miss it. But as of right now we are technically into our two week wait. I really hope this cycle isn’t a waste because of timing.

In other (somewhat good) news, my most recent bloodwork from my appointment with the hematologist came back and there are some improvements. My white blood cell counts is just barely high – but significantly down from my stay in the hospital – so hopefully it continues to drop and get back to where it was when I had my February labs done. But, in more exciting news, my High Sensitivity CRP is starting to drop. It went from 17 to 32 back down to 17 (in Feb) and was 12.5 on Friday!

This is exciting because it means that one of two things is potentially happening: the tooth infection has been present for awhile and is the cause of my issues or the Plaquenil that I started back at the end of February is starting to work and is bringing my inflammation down. Either option is positive though, as my inflammation has been suspected of causing complications with my attempts to conceive. So despite the reason that I’m getting better, I’m happy to be finally be seeing some results on this front.

So, I suppose, all things considered things could be worse. I’m not trilled with the way that this cycle started, but I’m also not quite ready to write it off, since it’s quite possible that we caught my ovulation in time. I guess we will find out in two weeks, on May 4th, when I can take a pregnancy test.

The Sad Story of Cycle Sixteen

As I sure you may have guessed from the title of this post, I am not pregnant.

Things started out normally. I had my scan on day two. Took my medication. Had 2-3 eggs that would mature and release. Robert had excellent sperm. We did two IUIs – one with 68mm sperm, one with 44mm. And we started our two week wait. It didn’t take long for things to go south.

The Monday after my second IUI I felt like I was coming down with a cold. My nose started running, did that thing where all your snot runs down the back of your throat and makes it super sore. I thought it was just a cold and went on with things as usual. By Wednesday I was so congested I couldn’t breathe through my nose or taste anything. My teeth started to hurt. On Thursday, my lower left jaw hurt so bad that I couldn’t chew anything on that side of my mouth and was starting to swell a little bit. Friday morning I went to see the doctor.

The doctor started me on some antibiotics (Augmentin) and advised me to take some tylenol for the pain I was having in my teeth. By 3:00 Friday afternoon, the pain was almost unbearable. Robert had called the doctor’s office to let them know, and when the office called me back all I was told was that my doctor had left for the day, they wouldn’t prescribe painkillers over the phone and I would just need to deal with it until the antibiotic started working. I was very upset, as by this point I could hardly open my mouth and eating soup caused so much pain that I could barely manage it.

I took a vicodin I had left over from a crown being done last year. Don’t worry, vicodin is pregnancy safe.

About 8:00 Friday night, I decided I was going to try to sleep it off and hope that I felt better in the morning. Within about an hour of lying down I simply couldn’t tolerate the pain anymore and ended up holding my face and rocking back and forth crying in the bathroom. Robert decided that we were heading to the emergency room.

After waiting, in great pain, for about 90 minutes in the ER we saw the doctor. He looked at my swollen jaw, asked some questions and decided I likely had a tooth abscess. He debated doing a CAT scan, but since we weren’t sure if I was pregnant or not, he indicated he’d treat an abscess the same either way regardless and we opted not to do the scan. I was provided some Vicodin, given a prescription for more, told to keep taking the antibiotics and sent on my way with a list of free/low cost dentists in the event that I didn’t have one (despite my indicating I did, indeed, have one).

The Vicodin numbed that pain enough for me to sleep…for about three hours. At which point I woke up in pain again. I got up and used the bathroom, felt lightheaded and immediately started sweating when I got back to the bed. I laid in bed and watched the clock for the next three hours until I could take more vicodin for the pain. About 5:30 am I took two more tablets, and slept for another three hours. I woke up, again, in pain and went to use the bathroom with the same lightheaded feeling from the effort of walking from the bed to the bathroom.

This time, I looked in the mirror on my way back to bed. To my shock, the swelling in my left jaw had tripled and spread half way across my face towards my right jaw, including my neck. I looked like I had gained 100 pounds overnight – or that I had been given a fat suit like they use in the movies. I went and woke Robert up, and we immediately went back to the ER calling the dentist’s emergency line along the way.

We got to the ER about 9:30 am and this time I was given a bed right away (apparently, I’d hit a lull in activity). I saw the doctor within 30 minutes, and we explained the situation. Well, mostly Robert did as by this time I couldn’t really open my mouth, it was incredibly painful to swallow and I was having a hard time talking. The doctor asked why we were back in the ER and when we explained how much the swelling had increased in roughly 9 hours and that we’d had three doses of the Augmentin, he ordered the CAT scan.

The CAT scan showed that there wasn’t an abscess, but that there was severe infection coming from the last molar of my lower left jaw (the tooth that had been hurting since Wednesday – an oddness given that it had a root canal almost a decade ago). The doctor advised me that I was going to be admitted to the hospital, I was quickly started on IV antibiotics and given morphine for the pain.

While I was waiting to be admitted, Robert went outside and got in touch with the dentist who indicated that we had done the right thing going to the emergency room – as that would have been what he had us do – and that we should keep him informed as things progressed. Robert spoke with the dentist a few times that day, and the dentist went into the office to review my file. He also called me Saturday evening to see how I was doing and let me know to call him as soon as I was released so we could figure out was going on.

48 hours, IV fluids and 8 rounds of IV antibiotics later I was finally able to eat solid foods again, provided that it was in small enough bites, and was released. I left the hospital about noon on Monday with a 7 day dose of clyndimyacin, strict instructions to finish the antibiotics and an order to see my dentist within 24 hours.

I went to the dentist 2:30 Monday afternoon. He asked me “did the doctor tell you how serious your condition was?”, “um, no”, “well, if you had swollen much more you could have cut off your trachea – if the swelling started to go the other way it would have cause swelling in your brain. You had a life threatening condition”. I am actually rather glad that I was not told this while I was in the hospital as it probably would have freaked me right the fuck out. My swelling had probably reduced by 50% at this point. The dentist did an exam and assured me that there was nothing that anyone could have done to have prevented the infection (a statement also made by the doctor in the hospital) – apparently sometimes these things just happen. Bacteria can apparently just reside dormant in a tooth that has had work done, or a root canal can fail, and some random event will trigger it. It can’t be predicted or even known that it will occur. Who knows how long my body has been trying to fight this infection without my knowing it.

Anyhow.

The dentist personally called the endodontist to see if he could get me in that day, and we went over to see him. He took and xray and pointed out the infection where the tooth and jaw meet, and where the bone was starting to fail in my jaw. He told me “I don’t say this lightly, and you know I mean it since this is how I make my money, but we’ve got to get this tooth out”. Assured that I can get an implant once the jaw heals (about a year), he sent me over to an oral surgeon.

I met with the oral surgeon on the following day. I contacted the fertility clinic to see if I was far enough along for a blood test to determine if sedation was an option. They were really great – indicating that I wasn’t, but that they were okay with the sedation. They worked with the oral surgeon for a treatment plan – letting him know what was okay and what wasn’t, going under the assumption I was pregnant since we simply didn’t know. Since I couldn’t open my mouth wide enough for the surgery, it was tentatively scheduled for Friday and I was given some things to do to try to get the swelling to go down and the range of motion on my jaw back.

I was able to open my mouth almost its full extent on Friday and the surgery went as scheduled, with the sedation. My tooth is healing well, and I’m able to eat just about anything. I required a few small doses of vicodin the day of the surgery, but was fine after that. Right now I sorely miss my tooth, and am leaning towards having the implant down (at great cost to us, I’m sure), but we will wait and see how I’m feeling about it come a year from now.

Saturday, against my better judgment, I took a pregnancy test. I pretty much expected it to be negative. There is just no way I would hold a pregnancy through the trauma I just went through. I knew that this was true. But the confirmation of the test was still upsetting after what started out as such a great IUI cycle. Even though I know it was probably for the best this cycle, and if I’d ended up pregnant I would have spent nine months questioning the effects of the past week and a half, I was still upset and had a good cry about it. Actually, I was downright down. I feel like this is never going to happen and the universe is against me. I mean I can’t catch a fucking break any which way I try and it’s frustrating as all hell. I go between wanting to keep going at this because SCIENCE is on my side here and waivering because it’s so damned hard to get that negative every month and ride the roller coaster of emotions that come with it. I’m just so fucking sick and tired of feeling disappointed and like I’m living my life around something I can’t make happen. Every decision I make has a reflection of the future we are trying to procure for ourselves.

I finished my antibiotics yesterday. The swelling in my face is gone and I look like myself again, albeit with some acne – either as a result of lying in a hospital bed for two days or the plethora of drugs that have gone through my system. I need to take some me time to go an have my eyebrows done, because they are getting out of control and I’m growing selfconscious about it. Well, that and being off the birth control has seen an increase in hair growth on my face and makes me feel a bit…I dunno. I’m sure it’s 1000 times more noticeable to me than anyone else, but it’s definitely a hit to the ol’ self esteem. Apparently it’s a side effect of the PCOS that I didn’t really notice because I’d been on birth control for the past 18 years. I’m not a vain person, but sometimes you just want to feel beautiful and that’s hard when, well, you don’t.

Anyhow, my period started today. So it’s on to cycle 17. I guess that means it’s time to get back in line for the roller coaster. Maybe this time I’ll enjoy the ride, but I doubt it.

Sweet Sixteen?

Lots of things have happened since my last post. I really should be better about writing here, since keeping diary was one of the “stress relievers” that was listed on ways to cope with infertility. But between being busy and not wanting to cope with some of the sadness that comes with posting here, I always manage to find an excuse not to make time to jot down my thoughts.

Anyhow.

We are getting ready to start on our sixteenth month of trying to conceive. Each month it gets a little hard to stay positive and believe that it’s going to happen, regardless of how much I try to convince myself otherwise. I know that there is a lot that science can do to help me with this goal, and that we are only scratching the tip of the iceberg in this regard, but I would be lying if I didn’t admit that I question at least once a week why it has to be so damn hard. It just doesn’t seem fair.

I suppose I should stop myself before I fall into a pity party of one.

We saw the endocrinologist again a couple of weeks again for a reporting on my blood work. My inflammatory markers are still quite high, but we still aren’t sure why. But he definitely thinks that they are part of our difficulties, and wanted to treat them. We basically had two options: Prednisone and Plaquenil. Prednisone is a steroid that is commonly used, and often utilized for women trying to get pregnant, but does carry a side effect of a small chance of the development of a cleft palate if taken during the first trimester. Plaquenil is an antimalarial drug that, for whatever reason, helps with the treatment of inflammation. It has been around since the 50s, and a lot is known about it.

After a lot of conversation, the doctor basically left the decision up to me. Something that I wasn’t really thrilled about. When I expressed to him that I’m not a doctor, and I wasn’t 100% comfortable having to make the decision, he indicated that he felt we should follow my Rheumatologist’s suggestion of the Plaquenil. He did indicate that it’s not a common drug used while conceiving, and is class C or D, there hasn’t really been in indication that it is harmful in pregnancy and he’d treated a fair number of women over the past decade that had successful pregnancies while on it. He did indicate that he wanted my Rheumatologist to dose it, since he wasn’t sure what dose she’d want me on, but was also going to send her a memo that he felt it was a good treatment option.

The same week I started taking 400mg of Plaquenil a day. While I’m excited about getting my inflammation under control, the downside to this drug is that it can take 8-12 weeks to start to see results, and can take up to six months to be effective.

We also go the results of the Clomid Challenge test back, and I responded to it appropriately, so there is no concern about my egg supply yet. Since we hadn’t started an inflammation treatment yet, we opted not to do an IUI last cycle since it had a high chance of not being a viable pregnancy if I got pregnant. And since Robert was sick when I ovulated, and we missed the actual TIME of ovulation (even though we had gone through the night previously), I had pretty low expectations of having a positive pregnancy test. I was right. My period started right on time – and we are moving right along to my next cycle.

Everyone agreed that it was best to go back to the letrozole for this cycle, and I started this cycle’s medication last night (which likely mean a killer migraine tomorrow, if the past dictates anything!). We are going to go ahead and move forward with an IUI cycle this month, and assuming I’m not pregnant, for the next two months as well. At which point, if I’m still not pregnant, we will reconvene with the doctor and discuss if we want to alter my treatment plan. Assuming that the insurance covers it, we are going to do two IUIs per cycle. So we will be back to (most likely) three eggs, a trigger shot, and an obscene amount of sperm being given the best chance to succeed.

So that’s that.

Speaking of medication, I am currently taking 16 pills a day in my efforts to conceive. I had to breakdown and buy a pill organizer to help me keep track of everything. Three of those medications have a side effect of upset stomach – and I’m in the bathroom no fewer than four times a day as a result. It’s pretty miserable. But hey! I’ve lost ten pounds…because anything I eat comes right back out. On the plus side, my last round of bloodwork with my Hematologist showed that my while blood cell count was back down to normal levels; which is great news since they had been high for over a year.

In other news…

We also bought a house. We closed on February 21st – and I really enjoy the house. But the truth is that we bought a house for a family that we don’t have yet, and that reality doesn’t escape me. We did all the right things, accepted a longer commute so we could be in a good school district. Budgeted for childcare in the future. Took steps to get our debt in line and paid off. And I can’t help questioning how I’m going to feel if I never get pregnant. Here I am, with this big house, in the right places, and no baby.

In case you can’t tell, I’m not in a really great headspace right now. I’m feeling pretty defeated and it’s pretty hard to see a light at the end of this ever-growing tunnel. The truth is that neither of us are getting any younger. Things aren’t going to get easier. And what started as an uphill battle now feels like I’m trying to fly to the moon on a paper plane.

I don’t know why I feel so down. The doctors feel good about things. Robert has forgone his ever present logic to express positivity (probably because I need it). But I can’t seem to get out of this slump…and there are pregnant people everywhere, which only makes me feel worse. We are getting close to coming out of the rainy season here in Seattle, so maybe a little sunshine is what I need. It’s supposed to be nice over the weekend, so maybe we will take the dog for a walk and explore our new neighborhood a little more. Just anything to take my mind away from reality for a while.

Mixed Feelings

This past Friday I had my first official visit with my Endocrinologist. We had been working with a fertility person at my Ob/Gyn’s office, but due to increasing issues with timing, their limited availability, my advanced issues and insurance, we made the move over to the RE. It’s the same doctor that did my IUI last month, and after having a full appointment with him, I like him quite a bit.

Prior to my appointment, I’d had some of the blood results from my Rhumetologist sent over for review, and when I arrived the doctor had already been reviewing my file. Not only had the doctor been looking over it, but everyone that I worked with that day was aware of my inflammation issues, and on board to see if we could get them in check. I brought a note from my Rhumetologist with me suggesting a treatment, which the doctor reviewed and will be in touch with my other doctor about to determine the best way to treat my sky rocketting inflammation. This made me very happy. Finally! Some treatment! It sounds like we might be looking at a low dose steroid treatment, but I’m not positive yet.

The only thing that I left my appointment relatively unhappy about was that I have to do a Clomid Challenge Test to determine my egg count. I’ve specifically avoided Clomid for a myriad of reasons and had opted for Letrozole treatments, which have been successful for me. However, the doctor indicated that there have not been enough studies done with Letrozole to determine if it can be used to successfully count your eggs. As such, this test must be done on Clomid. I’m pretty unhappy about it, but understand it needs to be done. Once we are past it, I will be pushing to go back to the Letrozole.

Additionally, I learned that I definitely had a miscarriage in December/early January. The RE ordered some blood work to see if we can narrow down why this happened – and it seems like the options are just a genetic issue that made the pregnancy not viable, or an autoimmune issues that caused either blood clotting or constricted blood vessels (which seems more likely given my already known autoimmune problems). Depending on what the blood work shows, I may have to start heparin shots, in addition to the daily aspirin that I”m already taking, to keep my blood thinned and allow for a successful pregnancy. If I continue to have miscarriages, I will have to have additional testing done to try and nail down what is causing them. Hopefully this will not be required.

I have mixed feelings about the miscarriage. On the one hand it is good to know that I CAN get pregnant. And the doctor seemed to  view it positively – indicating that we were in a better position then someone who has been trying as long as we have and has had no pregnancies at all. On the other hand, I feel a little bit like this is all my fault. That maybe my body can’t handle this amongst the Myriad of other problems that it is currently facing. And that is a little frustrating, since I don’t know how to fix it. Hopefully we will be able to come up with a treatment for the inflammation that will help both the issue and with getting pregnant.

In addition to all of this, I was also given another small regimen of medication to take. This included a prescription Pre-Natal vitamin and some additional suppliments. He also indicated that if my body isn’t doing well on the full 2000 mg of Metformin, I can go back down to 1500 mg. In addition, he ran some blood work to confirm I really do need to be taking the metformin.

One of the hand outs that we received in our packet from the doctor was with regards to stress. It acknowledged that once you are at this point with infertility, there is going to be stress involved. I really like that was acknowledged, as opposed to something just saying “don’t stress”, because it’s simply not that easy. It also encouraged you to not sit on your feelings or bottle them up, because that just makes them worse. I made Robert read it too, because I really think he needs to understand that logic isn’t the solution to all problems. A few of the things that they recommended was engaging in a hobby, exercising, deep breathing activities, doing romantic things that are intimate but don’t lead to sex and keeping a journal.

Well, I’ve already started doing a number of those on my own, but there are a few others that were suggested that I may try to incorporate into what we are already doing. Because infertility IS stressful. And it IS hard not to think about it. And it IS upsetting. And someone telling you not to stress over it pretty much makes me want to punch them in the face, because it’s clear that they don’t understand what you are going through.

Anyhow. I’ve a slew of doctor’s appointments lined up for this week. We will be doing another trigger shot this cycle, because I am keen on being aggressive, but I haven’t decided on the IUI yet. The doctor indicates that if we are doing the trigger shot, we might as well do the IUI – but Robert’s insurance doesn’t cover his portion of it, so until we figure out treatment for the inflammation and miscarriage issues, I’m not sure if we should undertake the extra expense, if it’s likely to just end up with another miscarriage. And, well, the first time I got pregnant was without the IUI. So we shall see.

Until then, we will continue this crazy emotional whirlwind.

Letrozole Round Two, Metformin and IUIs.

Last month, after apparently becomeing “a little pregnant” and not having the proper hormone levels to qualify a viable pregnancy, it was inevitable that I would be starting another round of fertility treatments. It’s been quite an adventure.

I went in for my ultrasound on January 8th and started my second round of letrozole treatments that night. This threw me off a little bit, as I had planned on starting them on day five again like my prior cycle, and had taken time off work accordingly. It was no big deal, I was able to adjust my time off, but had to go in after my first dose and felt a little crummy through that day.

In addition to starting the letrozole, they had me start a drug called Metformin. My doctor feels that I may be borderline PCOS. Apparently my LH is very slightly higher than my FSH, and my ovaries look polycystic. What confuses me about this is that I’ve had like 30 ultrasounds, and this is the first time that it’s been mentioned. Which makes me wonder if it’s the letrozole that is causing my ovaries to look this way. I’m not posititive and I haven’t asked about it yet. Anyhow, a symptom of PCOS is apparently insulin resistance and the Metformin will help glucose transfer through your cells more freely. Or something to that effect. I have no idea if it’s working or not, only that it makes me feel constantly nasueous and that it seems to be causing my eggs and what not to be matured earlier in my cycle than expected.

Speaking of eggs. I had three again on this cycle of the letrozole. This is a very positive response to the drug, so I am happy that I continue to respond well. I had fewer side effects this cycle – with the only one of note being having a migraine on day two again. This was also the first cycle that Robert had to give me my HCG injection, which proved to be a little more nerve wracking for him than I think he anticipated, and somewhat amusing for me, as it’s not often that things indimidate Robert.

Another thing that we did this cycle was to include an IUI. Basically, they take Robert’s sperm and run it through a wash that seperates the winners from the losers. They then use a small catheter in your cervix to insert them directly into your Fallopian tubes to meet the eggs. It was a relatively quick proceedure. Robert had to go in an hour or so before me to leave his sample. I went in and the total proceedure took about 30ish minutes from start to finish. They injected 48 million sperm into my cervix – so here is hoping that at least one of those finds one of the three eggs that were released. I don’t know if the plan is to do an IUI every cycle from here on out or not, but I suspect it might be given how long we have been trying and my age.

Because of my insurance, we will be moving to the reproductive clinic full time if this cycle wasn’t successful. I’m not entirely sure what my thoughts are on this. I really liked working with the infertility specialist at my OB/GYN’s office, but there were some down sides to it as well. I like that there is always someone at the clinic 7 days a week, so it doesn’t matter if your cycle is on a weekend or you need a procedure on a weekend. There is also always a doctor there to tend to the patients, and since it’s specifically dealing with reproductive issues, there will be no more waiting in a waiting room full of pregnant ladies.

I met one of the doctors at the clinic while doing my IUI, and I’m not sure if he is the one I will work with full time or if it will be the other doctor. I do know that they may want to do some additional testing – including a clomid challenge test – to count my eggs, which I am not thrilled about. It will only be for one cycle and then I will be able to go back to the letrozole, but I really don’t want to do a cycle of clomid. It’s also a little disappointing given that I’ve had such positive results with the letrozole. But, apparently, there hasn’t been a large enough study done with the letrozole to do the same type of test.  At least it will only be for one cycle.

Of course, if I get pregnant this cycle, that will all be moot. Because I had the HCG shot at 10:00 pm on Sunday, I won’t be able to test to see if this cycle was successful until February first.

I’ve actually decided that if I have to go through treatment again next cycle, and will be doing trigger shots, I’m going to buy some of the internet cheapie pregnancy tests and pee on them starting the day after the shot to track how long the shot stays in my system. Because, SCIENCE! And, well, I’m still not convinced that my positives last cycle weren’t the result of the shot staying in my system longer than they had anticipated.

Anyhow, that is my current status. More drugs, another two week wait and a lot of unknowns. Just to make things extra fun this month (and next!) we’ve purchased a house. Closing should be at the end of February. So perhaps this will take my mind off the whole infertility thing at least a little bit. At the minimum it will give me another project to focus on and obsess over!

Infertility Isn’t Easy For Anyone

I have been giving a lot of thought to infertility and support for those struggling to conceive lately. Probably a lot more than I should, honestly. Part of this thinking was brought on by the continual debate on whether or not we should tell Robert’s parents that we are trying to have a baby. Originally he wanted it to be a surprise to them, but as it’s gone on and on, and they keep stepping in it and upsetting me with commentary that they don’t know upsets me and subjects that are sensitive, we’ve been rethinking this stance. Ultimately, we still decided not to say anything to them, because we think it would only spur many “how’s it going” “any news yet” conversations that we’d rather not have. And weighing out how many times we see them in a given year vs. how many times they’d text/call/whatever with those questions, we decided that it was probably less stressful to deal with them occasionally and unknowingly putting their foot in their mouths.

Over the holidays, partly because of Robert’s parents and partly because of who we were going to have to be around celebrating the holidays with his parents, I’ve been giving a lot of thought into my own support network as I struggle through this. My mom is fantastic. She never asks how it is going, but always listens when I’m upset. She’s even told me that she doesn’t want to ask and put pressure on me, but doesn’t want me to think she doesn’t care. Robert does the best he can. He consoles me when I’m upset. He tries to keep me grounded. But the truth is that his mind and mine just work in vastly different ways and we just don’t think the same way. His default device for dealing with any problem is logic. Only problems of the heart can’t be solved with logic. He does the best he can, but sometimes he just doesn’t understand.

So that brings me to thinking about how I have outside of my most intimate circle to talk to about all of these feelings and emotions. I’m pretty open with most people about what is going on, but I often also leave out the most intimate parts of my overwhelming sadness or the deepest truths behind how hard this has been for me and the toll it has taken on me. Not many people know that almost every month I crash and burn as I have yet another negative pregnancy test. I curl up in bed or on the couch and simply weep because I don’t know what else to do. Eventually I pull myself back up, but it’s a little harder each time.

Which actually brings me to why I came here today to write a post.

You see, I have this friend who is also going through her own infertility struggles. She’s been dealing with it a little longer than I have, and unlike me, has a known cause for her infertility. Nonetheless, she’s gone through a lot of the same things I have both treatment wise and emotionally. One would think that this would make a good partner or person to share with and talk to about these struggles. But unfortunately, I think her emotional plate is just so filled up with her own struggles that she doesn’t have room to think about anyone else’s. And that’s fine. I totally get that. And I try to respect it. I don’t push. If I reach out and she never responds, I just assume that she doesn’t want to talk about it and move on.

But because one of our social circles overlaps, a circle which can be used as a great support network when needed, I constantly feel like I’m walking on ice and have to limit what I can share or seek comfort or advice on, so as not to be insensitive to her feelings and emotions. Except in the process I’m hurting myself by removing the same network of support that she has open to her – and it feels a little unfair.

I spent a lot of time thinking about this, and why I feel like I can’t fully share in this venue. I often feel guilty saying anything about my struggles because I question how that information will affect her. And when push comes to shove, the truth of the matter is that I often get the feeling (even though I don’t think it’s intentional) that she feels that my infertility struggles are lesser than hers. Despite the fact that I’ve been trying for fourteen months, and we don’t know why I’m not able to conceive, I feel like somehow she views my infertility as simply not as significant as her infertility. And, to be honest, to know that I try to hard not to make comments that would upset her, and basically turn off an entire support network in this very difficult time for me, yet offer support and hear everything she is going through, well, it’s frustrating and hurtful. It’s quite possible that I’m being oversensitive about it, or reading too much into her commentary or behavior. But it doesn’t feel that way at times.

I fully understand that she has some infertility struggles that make it exceedingly difficult for her. But that doesn’t mean it’s any easier for me to take a monthly pregnancy test, only to find out I’m still not pregnant. It doesn’t make the fact that my last round of blood work show that I didn’t have enough “hormones for a viable pregnancy” after having gotten a positive test any less heartbreaking. It doesn’t mean that I don’t question what I’m doing wrong and what is so wrong with me that I can’t get pregnant on almost a daily basis for the past fourteen months.

The truth of the matter is that infertility is hard. Full stop. There are no qualifiers for it. There is no “mine is harder, because of xyz”. Infertility is a struggle and heartbreaking for every single person who experiences it. Everyone affected has the right to express those frustrations and seek support because it’s a soul crushing experience. As a person who is a bit of a control freak, perfectionist and doesn’t handle failure very well, this experience has been exceptionally difficult for me. I’ve often questioned if I have the ability to keep trying, know that inevitably, in 28 days, I’m going to end up inconsolable and curled up in my bed, with Robert petting my hair assuring me that everything is going to be okay.

Ultimately, I have made the decision that it is perfectly okay for me to share my struggles and seek support when I need it. I understand that, maybe, this decision will mean that I might end up distancing myself from this friend – which I do not want to do, and would sadden me greatly – but after much thought, I have decided that is a much better alternative than sitting here feeling both alone and bitter with more emotions than one person should be allowed to even have because I have put this one way restraint upon myself.

With that said, I’m sure that I’ll have another update or two shortly and I’ll probably be open to sharing a little more about what is going on. I go to the doctor today to determine if we can start another round of the Letrozole. If so, I think she wants to try an IUI this cycle. One step and one day at a time.

Letrozole, Round One

I mentioned in my last post that I was finally able to start some fertility treatments this cycle – which was a much needed relief from the increasing feeling of despair that was starting to settle into my head. I was given Letrozole (Femera) to help stimulate super ovulation – or the creation of more than one egg per cycle. When this was first suggested to me, I questioned it since I was ovulating every month already. But as this process has started to drag on longer, I welcome any help I can get!

The Letrozole treatments weren’t terrible on my body, but they also weren’t without side effects. One of the five days I had a wicked headache that made me want to just sit around in a dark room all day. One of the days I woke up at 2:00 am with an upset stomach that kept me awake for another two hours. And most days I had intermittent periods where I would feel very flush or mildly nauseous. But, overall, it wasn’t too bad. I didn’t notice any huge mood swings and I largely felt that I could easily deal with my day.

However, any discomfort that I felt seemed to be worth it as my body had a very positive response to the treatment and I produced a whopping five eggs this cycle. That being said, my body will only produce enough LH to release maybe three of the five. As such, it was suggested that I do some HCG injections to trigger a release of up to all five of the eggs. I was encouraged to pursue this treatment, as the additional risk for multiples with the letrozole + injection wasn’t much higher than with the letrozole alone. Because each egg has a 20% chance to become fertilized, I am pretty excited about the odds should all five of them release.

While I know it is foolish to feel too hopeful at this juncture, it’s hard not to feel just a little excited at the possiblities. I am excited that I had such a positive response to the Letrozole and I am excited about the aggressive approach we are taking. Even if this round isn’t successful (which I am sure will be upsetting), I am pleased about the options open to me right now.

Here’s hoping that this cycle will finally be the one that is successful!