Angry Chair

Cycle number: 11

Cycle day: 14

Meds: Met

Outlook: Really f%*!ed off

I am beginning to lose faith in the fertility consultants I see, particularly the one I bemoaned in the last post, even though I am lucky enough to go to a hospital which specialises in fertility.

So after last Wednesday's secretive scan, I toddled back on Friday not knowing what to expect. I was thrilled to discover I had 3 follicles maturing on the right side - one at 14mm, one at 14-15mm and one at 15-16mm - and my lining was looking good. She sent me for another oestradiol test (a horrible man who was clearly new to taking blood (or a sadist) and did the whole thing in painfully slow motion so it hurt as much as possible) and told me to halve my Meno.pur dose over the weekend.

So all weekend I was really excited, even though I was having to waste half a pod of drug each night (so pointless) and, yet again, started to think at last this was the cycle that was going to give us a real chance to get pregnant.

I was told to come back in today and so I went. First off, I had to wait nearly half an hour to be seen in a boiling hot waiting room (so hot a trickle of sweat came down to my elbow from my armpit) and then it was a doctor I've never seen before. He was really thorough at the scan, again saying my lining was excellent and then started measuring the follicles. This is where it started to go wrong. The three she saw on Friday have all grown to a mature size (between 20mm-23mm) but there is a fourth that is catching up (17mm) and a fifth which is smaller. He said I have over stimulated and the cycle would have to be cancelled.

I had to fight back tears on the couch (luckily it was dark so he couldn't see). He then was at pains to explain to me why they would not be giving me the trigger. I asked what would happen if I just ovulated on my own and he said "Well you can't have sex". WHAT?!?! "You could end up with quadruplets and you don't want that! Hahah!" He then spent ages working out the precise dimensions of the offending follicles before saying "Yes this can happen with PCO".........again WHAT?!?!

I then went to sit in the waiting room while he went to get the opinion of a nurse. I went in to see her and she said actually they were going to check the "cycle cancellation" decision with another doctor (Ms Helpful from Wed/Fri) but it looked likely it would be cancelled. She then told me to continue with my half dose of Meno.pur tonight and this time I said it out loud "WHAT?!?" She said she didn't want to be the one to make a decision to stop taking it (i.e. that it should be the doctor telling me) but I was like "Surely if I take more tonight, the biggest ones are just going to get bigger, and the ones that are borderline are going to catch up and there will be even more?" and she said "Ok don't take it tonight" - I was in disbelief. 

She then said I would have to go for yet another blood test (my third in less than a week) and based on my scan and the blood test results she would discuss with Ms Helpful tomorrow and give me a call. I then had to fight back tears all the way up to haematology. And - typical - of all the appointments I've had there, this was the one time Bubble couldn't come with me.

So there are several things that concern/down right annoy me:

• If there were too many follicles growing, why didn't Ms Helpful notice on Wednesday and tell me to halve my dose then?
• If there were definitely too many on Friday, why didn't she get me to stop the Meno.pur over the weekend and reassess on Monday?
• Surely my oestradiol numbers are the most reliable source of info - why after 2 blood tests and all these scans was this not picked up earlier?
• If over-stimulation typically happens with PCOS (and particularly after my over-response to Clo.mid) why wasn't I started on the minimum dose possible? They could then have increased it later on if I wasn't responding well enough
• If I ovulate tonight or tomorrow - as seems likely with follicles that big - telling me not to have sex from now isn't a failsafe way of preventing me getting pregnant since we already did it yesterday! So they have put me at risk of conceiving 4 babies
• If my follicles are already so big that I could ovulate at any given time, why then increase the chance of adding a couple more to that number by telling me to continue with the Menopur tonight?! And why did the nurse try to take the decision herself if she wasn't sure (which she obviously wasn't since my layman response made her change her mind)?
• Are these large follicles actually going to rupture at all, or am I going to be left with a mass of uncomfortable cysts that need another cycle off to get rid of?

Overall I'm gutted. It's now been 7 months since we started treatment. This is only my third medicated cycle and the third that has been a wasted opportunity for a pregnancy. All this just to ovulate, and I'm not even getting that right! Pregnancy seems a very very long way away tonight, and a real, actual baby even further. I can't believe that with all the injections, all the blood tests, all the appointments, somehow this has still gone wrong.

Of course, they can't stop us going ahead and having sex if we want to. And a large part of me is very tempted - why should I waste the only chance I've had so far?! Will wait and see what they say tomorrow, but I'm not holding my breath.

Persistence

Cycle number: 10

Cycle day: 4

Meds: Met

Outlook: =/

So I didn't get pregnant. Not even a hint of a line on the few tests I used over the weekend. AF has been light and mercifully pain-free - presumably another Clo.mid side-effect (or due to the copious amounts of rosehip tea I have been drinking recently). I went for a base-line scan today and most frustratingly the Death Star is still lurking! I learned it was a whopping 6cm x 4.7cm at its largest.....scary big. Today it had shrunk down but at 3.5cm x 2.4cm it's still too large a presence for another medicated cycle just yet.

The Doc (a new one I hadn't seen before) gave me two options - either leave it and hope that it shrinks to nothing over the course of this cycle, or take progesterone to force it to shrink. I opted for the former: I really don't want to be messing with my hormones any more than absolutely necessary and she said that around 90% of cysts disappear after the second period. If it's still there by the end of this cycle I'll do whatever it takes to get rid of it. I may even look into doing a caster oil wrap during this cycle to help it on its way.

And I am relieved that the wait for the next cycle isn't that long. I'm already on CD4 and can go in on CD28 for another scan if I haven't detected ovulation or got my period and they will give me Provera again. A frustrating wait doing nothing but only 3 weeks to go. I still intend to temp and do some ovulation tests (though I have no idea when or even if I will ovulate) so I guess there is still a small chance for this cycle.

I also started taking some additional supplements on CD1 of this cycle: 

- Chromium - I read that a lot of women with PCOS are deficient in this mineral so I am taking 200µg each day

- Vitamin B Complex - PCOSers can be deficient in certain B vitamins and I also read that Metformin depletes one of them (aren't I a font of knowledge....) so I am taking Vitamin B1 20mg, Vitamin B2 20mg, Vitamin B3 30mg, Vitamin B5 10mg, Vitamin B6 20mg and Vitamin B12 50mcg each day

- D-I-M - This is a naturally occurring substance found in veggies like broccoli and cauliflower which helps to metabolize estrogen. Thought it couldn't hurt as PCOS is an estrogen-dominance issue. I am taking 100mg daily.

I also bought fish oil and a calcium/magnesium/vit D/iron tablet but I haven't got into the routine of taking them yet. Additionally yes my poor purse is feeling rather empty right now I got a natural progesterone cream to try if/when I ovulate...I've read that these creams don't really give you enough to make a difference but I'm happy to give it a go, especially when it is lavendar scented! Finally, I bought a pack of red raspberry leaf tablets - originally because I thought I would be carrying on with Clo.mid and read that taking this from CD1>ov can help to thicken the uterine lining (which Clo.mid wreaks havoc on). However, after talking to the Doc today, I learned that I don't have to take Clo.mid again if I don't want to and my next active cycle will probably be using injects. Still, a bit of extra help to achieve a nice thick lining won't hurt.

So back to waiting, again, and hoping that the Death Star has burned out in three weeks time...

The Death Star

Cycle number: 9

Cycle day: 24

Meds: Met

Outlook: Frustrated

It's been a bit of a nightmare the last few days. I went for my CD19 scan and the left follicle had grown to 27mm. They also found a 12mm one on the right. I was even more thrilled than before. The doc decided not to give me my trigger shot as my lining was still a little thin (6.5mm I think) but she said with a follicle that size I would most likely ovulate on my own over the weekend.

I was really hopeful and happy, but as the day wore on, doubt started to creep in. I read that a follicle over 25mm probably didn't contain a viable egg, and I wished I had requested the trigger at the appointment so that it ruptured as soon as possible. I was using the ClearBlue digital ovulation tests, as recommended by the clinic. They told me to use one a day, first thing in the morning and they were all negative. However, for my own purposes I used a strip test on Saturday night (CD20) and I thought it looked positive....

Sunday (CD21) and I started to feel very uncomfortable in my abdomen on the left. I was also having to go to the toilet a lot more frequently than usual. My CB test was negative again, and so I assumed the strip test the night before had been a fluke.

Monday (CD22) I rang the clinic and told them I could still feel the follicle, was in quite a bit of discomfort and that all my CB ovulation tests had been negative. I went in for another scan and the left follicle was a gargantuan 35mm! I was not happy, and again asked the doc if this meant there was no viable egg inside, but he insisted that because the follicle had only grown within the cycle, there was no reason to assume it didn't have an egg. It was quite disturbing to see this massive black mass on the ultrasound, like a lost alien spaceship. Helpfully though, my lining had increased to 8.5mm - ideal for implantation.

He didn't spend long looking at the right ovary - I guess because all the attention was on the giant lefthand one - but he said he couldn't see anything significant in there, and that the follicle had most likely shrunk back. He then said they would (finally) give me the trigger shot, which was fine, and that I would ovulate within 24-36 hours.

I went home happy again but (again) the doubt started to creep in. I wondered if in fact the cheap strip test from CD20 was accurate and if the right hand follicle had reached maturity and ruptured secretly. Then I was worried that the trigger shot would cause harm if I had already ovulated. And I was in so much discomfort I began to wonder if even the shot would be able to rupture the Death Star.

Tuesday (CD23) I was in considerable discomfort just walking around. We tried to do "homework" as the fertility nurse calls it, and it sent shooting pains up the left side of my abdomen. I was bloated and had serious trapped gas. I did, however, start to get sensitive nipples - usually a sure sign that I have ovulated - but I wondered if it was just from the shot. But then, I put my temperature into my chart, and the chart automatically put me at ovulating on Saturday (based on my temps) - if you take into account the possibly positive OPK on the same day it looks fairly promising.

So here I am on CD24, almost 48 hours post trigger and I can still feel the Death Star. I'm now convinced it is a cyst and I'm not happy. I am going in for another scan tomorrow and I hope they will be able to give me some answers. Specifically:

• Is it a cyst formed from a ruptured or unruptured follicle?
• Is there any chance I already ovulated from the other ovary?
• If it is a cyst, and I did ovulate, could it impede a pregnancy this cycle?
• If it is a cyst, when and how can we make it go away?

I feel pretty gutted. I knew it was too good to be true when a follicle appeared out of nowhere. I've been reading up online (I know, it's not good) and apparently it can take 1-3 MONTHS for a cyst to shrink! And obviously it's not possible to start another round of fertility drugs until it's gone. I've also read of people who had to take BCP for a month to help shrink it! I really hope it doesn't come to that, it took me a year to get back any semblance of a cycle after I stopped BCP the last time, it will really feel like a step backwards.

Thankfully, we got in a lot of "homework" this cycle - if I did ovulate on CD20 we have all our bases covered. We were also using Pre-seed.


Yet again I am struck by how unlikely pregnancy is.....I just don't understand how it can happen so easily for some. I also can't believe how much stress and detailed observation is required for just this part of the process! If I ever do get pregnant I will truly see it as a miracle.

The Waiting Game

Cycle number: 8

Cycle day: 34

Meds: still the Met

Outlook: serene

Today I booked an appointment at the fertility clinic. I will go there next Friday for a scan to check my lining. If all is well, I will take Pro.vera to induce a bleed, and will then start on my second round of Clo.mid. I'm excited to be moving forward again. I tried Clo.mid for the first time in October, but didn't ovulate. Bubble and I have since been on a ttc break as our wedding is in September and we didn't want to risk a baby due around that time. It's been a strange time...no active thinking about baby-making but no prevention either apparently I have my own in-built contraceptive... It's just been a time of waiting and waiting.

So I am uber excited to be doing something about it again. My dose will be upped to 100mg and hopefully I will ovulate this time. Just to ovulate would be a massive achievement, to know that it is possible. People who "just" get pregnant simply don't know how lucky they are not to have to think about this kind of stuff. As I have written about before, my sister is currently pregnant. She wasn't actively trying and it was her first month off birth control. She didn't even realise she was pregnant until she was nearly 10 weeks gone. She's never read anything about trying to conceive, or pregnancy, never made any changes to her lifestyle to improve her chances, never even talked about having children to my knowledge. And yet here she is, over halfway towards having her own child.

It is tiring having to actively try. Even if you don't go completely overboard and become quite obsessed - which understandably happens to a lot of women trying for a child - there is so much involved in the whole process for those to whom it doesn't just happen after the initial "honeymoon" couple of months when you are blissfully unaware:

• The Science - how the hell does this conception thing work anyway? Bizarrely, one of the most natural and personal endeavours in the world is still a mystery since they forgot to include it in any school curriculum. Terminology, maths, biology, charting (I'll come back to that), you pretty much become a certified fertility nurse after the first six months
• The Reading - anything, everything, online, in books, in magazines. Definitely online. Stories of conception and birth and what worked and what didn't, sifting through medical journals and horror stories and old wives tales, self diagnosis, message boards, forums, blogs.....especially blogs ;) Trying to absorb and make sense of this large quantity of text can be extremely challenging
• The Self Obsessing - Symptom checking, fretting over this pain and that... is something wrong with me? If so, what is it? If I felt a twinge on CD7 does this mean that I have PCOS? Am I pregnant? If I felt sick at this point last cycle and I don't now, does that mean something? O_O The constant self analysis can be incredibly draining and psychosomia-inducing
• The Charting - a fresh hell for anyone who is already starting to panic about ttc. Temperatures, taken to the very same minute each morning otherwise they could be misleading, but is the thermometer accurate? Are my multivitamins interferring? Did that curry last night cause it to be higher than usual? For me, the anticipation of my morning temperature-taking would always cause me to wake before I should, which then made my temps inaccurate, and the whole thing just made me tired before I could even start the day
• The Deed - what was once an expression of love between you and your partner suddently becomes a regimen even the army would be proud of. To do it every night or every other night? Or the SMEP system? Or twice a day if we can manage it? And should it be in this position or that, using Pre-seed or egg whites or some kind of headstand at the end? This is even more frustrating if you don't ovulate at the same time each month (or hardly ever at all) and you just have to keep going for weeks or months with no end in sight just in case you miss that egg.....!!
• The Waiting - waiting to ovulate, waiting the Two Week Wait, waiting through symptoms and negative HPTs, waiting to start fertility treatment, waiting for appointments, scans, procedures.....and ultimately waiting for that little magic to spark inside and create a life

I almost can't imagine conception from the perspective of a fertile, just being able to decide one day "I think I want a baby" and within a few months knowing it is there; finding out you are already several weeks pregnant without even knowing; getting excited at the prospect of getting pregnant and then having all your dreams fulfilled instantly. The rest of us work so hard to get and stay pregnant, and when it finally does happen, it must be the greatest achievement of our lives.


Don't get me wrong, I'm sure fertiles love getting and being and staying pregnant, and love their babies and the whole shebang. But the test you turn up for on the day without revising never means as much to you as the one you spent months studying for; instant gratification is never as satisfying as something you have worked hard for and has consumed your life; and in the same way I feel almost lucky to be in my position. When I do eventually have a baby, it truly will be a miracle for us; I will never take a single day of its life for granted or all the moments leading to it. I will have worked really hard for it and I will spend each day being thankful for my reward.


I just have to wait a little bit longer......

The Very Beginning

Ahhh my very own blog. A fairly scary prospect, putting my thoughts, fears, hopes and dreams out into the midst of the interweb for any old person to read. But also very exciting, controlling my own space, getting some of the things that burn a hole in my brain out, and by putting them into words, hopefully understanding myself and others more. 


But make no mistake, this isn't some random, thoughts-plucked-out-of-the-air, "what has annoyed me today?" type blog. My poor other half has to cope with all of that. No - this is very specific, on a topic I can't discuss with many people:

Infertility.


Not the sort (touch wood) where I have been told I can never have children. That would be a very different blog. I am not at that point. There is hope for me but fertility is not one of my strong points. 


When I first got my period at age 11, it was the worst moment of my life. I suddenly felt very alone, not knowing anyone else in my peer group who had, and felt marginally disgusted by my body doing this vile thing. This disgust and horror continued for a few years, not helped by very heavy periods, horrendous cramps and feeling I had lost control of myself.

It wasn't until I was 15 that I began to suspect something was wrong. Where other friends were by now used to their monthly visitor, I was still wary, and I realised it was because it wasn't happening monthly. Two might happen consecutively then nothing for three months, nothing for six months. My GP batted away my concerns like a predictable bowl - it was nothing worth worrying about until I was ready to conceive and would likely be resolved by going on the pill.


Mostly I was relieved that it was nothing "serious" but underneath a tiny pair of teeth started to gently bite something is wrong, a gnawing that would grow over the years.


Simultaneously I started to dream about the future, as teenagers are occasionally known to do, and in my blissful ignorance I would tell anyone who cared to listen how I hoped to have 8 children, a nice big family where something was always going on. Having come from a small and somewhat cold family myself this seemed the perfect aspiration. And of course you are flippant at that age. Children were something for the future, sure, but what really mattered was education and a good job and prospects. Children were the easy option for those who failed, a natural, biological process as old as time (and a little bit older). How little I knew.


And so we spring forward to now. I am approaching 28 and have never been pregnant. I have been trying to achieve this magical, elusive state since March 2009 with my lovely Bubble (since February 2007 with a previous partner). I have poly-cystic ovary syndrome. I am about to start fertility treatment.


The end of the post, but this is only the beginning...