"Super" Me

Cycle number: 11

Cycle day: 15

Meds: Met

Outlook: bluurghghgh

Well, the results are in: cycle cancelled due to "super-ovulation". I suppose it's sweet of them to try to make me feel successful at something -_- The clinic hadn't rung by lunch time so I called and left a reminder message. Then somehow my phone didn't even ring and the next time I looked at it I had a voicemail. Had to wait til I got out of a meeting at 3pm before I could listen to it. The only advice she had was to come back when I start to bleed....yeh thanks for that.

So I rang again and asked for someone to call me back as I had a few questions. The nicest nurse there called and I went through a few things with her:

- The oestradiol number was high, and from that they deduce that I will ovulate but they can't tell when. She said obviously there was a chance I wouldn't, and/or that one or more of the follicles would become a cyst.

- I shouldn't have sex for the foreseeable future due to the risk of a multiples pregnancy, but she admitted she couldn't stop us if that's what we decided to do.

- Even if I don't develop a cyst, chances are I will have to take next cycle off to let the ovary recover before doing any more treatment.

- My response has been unusual to both Clo.mid and Meno.pur and they couldn't have predicted what would happen, even with the intensive monitoring.

- The dose of Meno.pur I was put on was the standard dose that most people would start at, and for the next active cycle they will probably halve it.

- I should wait 2.5-3 weeks and if I haven't bled yet I should go back for a scan and then induce a bleed.

I'm still feeling really frustrated about this cycle and really upset, and after I put down the phone I just cried for about half an hour. If it's this hard to ovulate what chance do I have of actually getting pregnant? I'm starting to feel scared - what if none of the ovulation induction drugs work on me? What if I only ever over- or under-respond? Will I just have to move straight to IVF without passing go?

We are going to carry on trying this cycle. Me reasoning is this: a follicle that grows beyond about 24mm is considered too big to carry a 100% healthy, ripe egg. I have 2 that were at the top end of this range yesterday, so they will be even bigger by the time I finally ovulate (I did a digital ovulation test yesterday which was negative, so I assume I have a few more days before any eggs will appear) which means the chances of either containing a viable egg are small. Even if such an egg was fertilised it would be unlikely to continue beyond a week or so. So that leaves 2 follicles. If they both release and if they are both healthy there is a small chance both could be fertilised. I'm happy to take that risk.

I just can't sit back and do nothing for the best part of 2 months while life and time just tick away. If this cycle amounts to nothing (which I'm assuming it will) it will be July at the earliest before I get pregnant - and that's assuming that I'm incredibly lucky and get pregnant on my first proper successful cycle (which also seems unlikely). I'm completely fed up of waiting, it's all I seem to do. Wait wait wait wait wait. Everyone else gets a chance each and every month to get pregnant; I haven't even had one chance in the 4 years I've been trying. It's like I'm the only one not to complete a 100m race because I can't even find my way out of the changing room, let alone onto the track and down to the finish line. This is the most depressed and negative I have felt for a long, long time and I don't like it.

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.

Baby Steps

Cycle number: 11

Cycle day: 1

Meds: Met (and Pro.vera for the last week)

Outlook: Excited

Well, it doesn't look like I did ovulate last cycle, since AF arrived right on cue after stopping the Pro.vera. I'm not surprised. Unfortunately though this AF is giving me a world of pain >_< Not exactly the best way to be around a fertility festival.

I go for a baseline scan on Thursday and have to take along one of my pods of Meno.pur for my first dose. Very excited about this....I never had a very good feeling about Clo.mid, even before I started taking it, since it relies so much on a chain of reactions in your body working in perfect synch (not something my body is very good at unfortunately). The injects work directly into your system and so it seems much more likely that I will get a good response.

As I wrote in a previous post, I've had some problems with my mum not being supportive at all through my ttc trials, and specifically about serious insensitivity related to infertility. So I took a proactive approach recently and sent her a link to an advice sheet for friends and family of those suffering through infertility. It covers a lot of things I think are really important, and she said it was useful. If anyone you know is treating you insensitively, don't be afraid to speak up and offer advice - they may genuinely not understand how much they are affecting you.

She actually told me that she thought we would be stopping treatment now until after our honeymoon....that's December! She didn't know about my treatment in February so essentially she thought we were putting ttc on hold for a year. I told her how funny I found this - I've been waiting four years so far, I certainly don't need to be adding an extra one on for the fun of it - and also how in a serious sense, I'm less than 2 years away from being 30 and certainly don't need to tempt my egg quality to start decreasing on top of all my other issues. I can only conclude that she doesn't understand that longing for a child, and that she must've had me and my sister because it was the next natural step in her life rather than something she desperately wanted. 

Finally, I found out another friend of mine is pregnant and due in eight weeks! She's sure she told me a while ago but I gently told her I was sure I would remember if she had. I would like now to do a tally of how many people I know who are either pregnant right now or have given birth in the last few months........yep it's 10. There may be one or two I have missed. For some of these it's their second baby since I started ttc. And this list doesn't include people I know solely online on forums and stuff (it would be more like 20 if I included them). I do try very hard to keep focused on my own situation, and let other people's news wash over me, but it is very hard. Especially when you are in the no man's land of never having seen a BFP despite so much trying....it begins to feel like it's all a myth and not something that will ever happen to you.

Bleugh. Despite all this, yes, I am in good spirits - the weather has been glorious, I have been spending a lot of time walking in the woods and doing little indoor gardening projects at home and following the Royal wedding this weekend I just feel so uber excited about my own ^____^

What Not to Say to an Infertile

I have decided to keep a log of every insensitive, mean or downright ridiculous thing anyone says to me about ttc or infertility, and what I wish I had said back to them; hopefully it will be somewhat therapeutic -_-

(After a failed cycle)
Me: I'm so upset the Clo.mid didn't work, I'm going to be the only one left who isn't pregnant :(
My mum: Nevermind, you have a wedding to plan!
Yes I do, and obviously that precludes me from thinking about, wanting, or needing anything else in life! THANKS FOR THE SUPPORT!??>£"$

(During my "off" cycle due to a cyst)
Me: Luckily I've had all the honeymoon arranging to take my mind off of it
MIL-2B: Well sometimes that can work to your advantage
REALLY?! So my body is going to magically start working for the first time just because I've been thinking about something else?! AMAZING! What was I bothering with all those drugs for??

(From my pregnant SIL-2B when she found out I had PCOS)
SIL-2B: Well I was once told I couldn't have kids so I know exactly how she feels
Apart from the bit where you got pregnant without trying you mean?!

(My dad while I was playing with my BFF's baby)
My dad: See, all you need to do is get your ovaries sorted out and then you can have one of those!
Ahhhhhh is that all? Why didn't you say so before! 

(Pregnant friend who would complain incessantly about not being pregnant even though she and her husband only had sex once or twice a month - she finally got preggo after about 8 months of "trying" even though for about half of that they didn't have sex at the right time. Her benchmark for ttc lengths was her sister, who got pregnant first time on both tries)     
Chum: I know it took us a bit longer than most people, but you'll get there
Good grief, how did you honestly cope ttc for 8 months?! You deserve some kind of medal. And of course, you got there - and against all the odds it would seem - so that means I will too, I'm obviously making a big fuss out of nothing!

(Me fussing about on the sofa because of lumpy cushions)
Me: I just can't seem to get comfortable today
Dad: Are you pregnant?
Me: long pause No -_-
Dad: Oh, coz I've been hearing recently that that's a cause of it (He was referring to my nearly-8 month pregnant sister, who I haven't seen or spoken to since the news broke)
That's a cause of it if you have turned into a gargantuan heifer because you've been stuffing your face throughout the pregnancy.   

(During my "off" cycle due to a cyst, and after 2 failed Clo.mid cycles)
Chum: You never know, you might just get lucky and be pregnant in May. I have a friend who also has PCOS and she got pregnant on her first try when she came off the pill - maybe your first try after the treatment will be similar?
Well, I have a friend who has PCOS who hasn't been able to have a child despite years of trying and many different drugs; how do you know I won't be just like her?
 

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.

Emotion

Cycle number: 8

Cycle day: 37

Meds: Still the Met

Outlook: Sunny

I forgot to add to my last post something about the emotional impact of trying to conceive for a long time. It's probably better that this gets its own dedicated post anyway. It's not to be underestimated. I've touched on it before but it's worth reiterating, because although no-one* really recognises it, the reality for a lot of women is that it's a pretty traumatic experience, with a negative impact on self esteem, confidence and general happiness.

I'm talking about the feeling that you are a failure as a woman, that your body has let you down. Dealing with other peoples' insensitivity, lack of sympathy and sometimes downright nastiness and rudeness. Having to maintain a calm, collected facade at work when AF arrives for the 500th time (after all, it might mean the end of the world to you, but what is it to anyone else?). Having to maintain a calm, collected, happy facade when everyone around you falls pregnant for the first, second, third time. Fighting off the hormonal surges that tell you to reproduce and make you feel bad for not having achieved it yet, and may never...

And of course there is everyone elses' emotions intertwined with ttc: your parents waiting eagerly to be grandparents, wanting to see your family grow and flourish, unable (or sometimes unwilling) to provide any real comfort to you, their child. The way friends either feel too bad to let you in on their pregnancies or over compensate by treating you like a fragile flower, just in case you weren't already feeling awkward enough. And of course your darling partner, waiting just as you are to become a parent, feeling every hurt and frustration but sometimes unable to express it to anyone but you.

It's funny though how unaffected women seem by all this one they finally achieve their pregnancy. I guess the tremendous warmth you get from knowing there is a life growing inside you makes everything you have been through seem worth it a thousand times over. I wonder how many of these women even remember how tiring the whole thing was once they have their little one to dote on? Or do they just take it all in their stride? I wonder, then, what happens to the (relatively) small proportion of women who never achieve pregnancy or acquire a child in another way? Are there significant lasting effects to what they have experienced? What do they do to move forward without that hurt inside them? I would be interested to find out. I do hope I never get to that point.

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......