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!


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