"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.

How to...prepare and inject Meno.pur

Ok, here goes. 

NOTE: This is meant as a rough guide only and is based on the instructions given to me by my doctor. Always follow the advice of your healthcare professional.

Left-right: pod of Meno.pur; ampule of solvent; alcohol cleansing pad; syringe; large mixing needle; small injecting needle

First, clean your hands thoroughly and prepare a clean preparation area.

Remove the cap from the pod of Meno.pur and wipe the alcohol wipe over it. You can now throw away the wipe and cap.

Take hold of the solvent at the bottom, and with the other hand gently flick the top to force the fluid down into the bottom of the vial.

Gently snap off the top of the vial. Mine has a little blue dot which should be facing towards you when you do this, and note the position of my hands. With vials like these always snap away from you. My nurse advised me to do this with a tissue over the vial to protect from any flying bits of glass (nothing like that has happened though, touch wood). If the vial cracks, the glass becomes jagged or get into the solution, discard the vial.

Take the large mixing needle and firmly slot it on to the end of the syringe. Keep the needle cap in place until you are ready to use it. When removing the needle cap, hold on to the lip of the needle fitting (the green edge visible here) to prevent the needle sliding back off the syringe.

Place the needle into the glass vial and slowly draw the fluid up into the syringe. I find it helps to tilt the vial to the side to ensure you get every last drop.

Holding the plunger on the syringe firm so as not to let any of the fluid out prematurely, push the needle through the rubber top of the pod of Meno.pur. Be careful not to smash the needle into the bottom as it can go through quite suddenly. Release the fluid into the pod; the Meno.pur powder will dissolve instantly. Keep the needle in the pod. If you can see any bubbles, give the pod a flick to disperse them. When you are happy, push the needle to the bottom of the pod and slowly pull the plunger up to draw the mixture into the syringe. Try not to draw any air in before or after it. Once you've got it all, hold the plunger steady, and slowly pull the needle out of the pod. Discard the pod. You have to be pretty quick now because once it's mixed it needs to be used as soon as possible.

Tilt the syringe upside down so the needle is pointing to the ceiling. Draw the fluid back slightly away from the needle. Remove the large mixing needle carefully, and replace its cap. Take the small injecting needle and fix to the end of the syringe. Again, carefully pull off the cap (hold the lip - in this case yellow - to ensure the needle stays in place).

Keep the needle pointing to the ceiling. If there are any bubbles in the syringe, flick it until they disperse, or draw the fluid back down with the plunger and then push back up slowly. Slowly and gently push the plunger up so that the fluid goes right up into the needle. Be careful because once it gets there it goes pretty quickly and can squirt out.

Expose your tummy. You need to grab that natural little pouch under your belly button, either to the right or the left (you will alternate sides each time you inject). There is a temptation to grab really hard to divert attention away from the needle, but only pinch gently. When you are ready, push the needle in as quickly as you can (don't stab, be gentle but swift). Once the needle is fully in, press the plunger down slowly to inject the solution - for my single dose it takes about 8-10 seconds. Once the syringe is empty, carefully remove the needle and press a tissue or cotton ball over the inject site for about 30 seconds. ALL DONE!

Final step: pour a large glass of wine or have a large chunk of chocolate.


Also note: be careful how you discard the glass and needles. My clinic suggested I collect them all in a glass container e.g. used jar until the end of my treatment, then I will take them in for the clinic to dispose of. 


Yet another note: Only use each needle/syringe/pod etc. once. If you make a mistake don't assume you can fix it - it's probably safer to start again from scratch.

Pin Cushion

Cycle number:11

Cycle day:7

Meds: Met and Meno.pur

Outlook: Ouchie!

Nothing much to report other than I am slowly become adept at stabbing myself in the stomach with a needle >_< My first self-administered dose was Friday night, and it wasn't the best of situations because we were rushing to get ready and go out so I was even more panicked than I might've been. I faffed around loads, drawing the fluid up, letting it back down because I missed some, getting annoyed by all the bubbles etc. Even wasted one of the fluid pods because I didn't flick it before opening. I then aborted the first stab because it hurt and I thought I wasn't doing it right, so made 2 holes instead of one. It's quite an involved process....!!

When the nurse gave me my first dose last Thursday, I didn't feel a thing - no prick when the needle went in, no discomfort. Even with my much more relaxed last two doses I still feel the needle going in...I suspect I'm not doing it quickly enough. It's pretty hard to get a good angle too on your tum...makes your wrist all twisty.

I am planning to do a photo entry on how to prepare and administer the Meno.pur. I have no idea if this is appropriate, but before I started self-injecting I really wanted to see someone else's idea of how to do it to yourself - it's all well and good watching a nurse do it, of course she finds it easy! - but couldn't find anything illustrated. I hope it will serve both as a reference for those doing it and reassurance that it's really not that scary or complicated for those who are moving towards it.

Other than that, I have just been ticking along. I have a scan on Wednesday to check for follicle progress and to try to work out how many more days of Meno.pur they want me to take...

Easter Egg?

Cycle number: 10

Cycle day: 32

Meds: No change

Outlook: Intrigued

So I went for my appointment today...saw a very lovely doctor. The most excellent news is the cyst has gone! And the strange news is my lining was very thick - to the point that she even suggested early pregnancy - and I had what she thought might be a corpus luteum on the right. And in an odd twist of fate, I did actually have a few little twinges on the right last night, so I'm wondering if it's possible I did ovulate (none of the usual signs that it's happened yet though..)

They did a pregnancy test there which was negative (surprise!) and she asked me to do another one tomorrow - but obviously if I did O, and by some miracle get preggo, it wouldn't show up until at least a week's time. Either way, I got a script for Pro.vera, so I can take that if it ends up looking like I didn't ovulate. Now I'm not sure how long to wait...

I also picked up my Meno.pur and trigger. The Meno.pur looks so weird, I didn't realise it actually comes as a powder which you then have to mix! No sign of whatever I use to inject it with so I assume I will get that when I go in for my first dose. 

I'm feeling a lot more positive about this next cycle, pleased to be free of the cyst and excited to see how well the injects work =D I would be interested to hear anyone else's experience on Meno.pur....

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.

Ms. Egg

Cycle number: 9

Cycle day: 16

Meds: Met

Outlook: Shocked!

So there I was, just about getting my head around the fact that I was Clo.mid-resistant and dealing with the prospect of moving on to injectables and I was ready. I went to the hospital this lunch time for a scan to follow up last weeks - and from what the Dr said last week (that there was no response, that it wasn't working, that things weren't going to be as easy (ha!) as we thought) I was expecting no progress, no hope.

Imagine my surprise when this week's Dr said "You have one large follicle on the left"! A late response, but a response all the same. The follicle is currently 15mm so it needs to do a little bit more growing before it will be viable, and my lining is still on the thin side, but I cannot put into words how thrilled I am! 

An actual egg getting ready....it's so exciting. I have to start doing ovulation tests from tomorrow, then I go back for another scan on Friday which will be CD19 to see how it is doing. Of course we have to get busy in the meantime just in case, and I think I'm going to temp for the next few days so that I have another angle to confirm ovulation (assuming it occurs). Usually I don't temp because the anticipation makes me wake up earlier than usual just to do it, thus throwing my temps off and negating the whole process.


And the other good news we got today was that Bubble's repeat semen analysis came back good. His total numbers were at the lower end of the normal range but nothing to worry about, and everything else was excellent. One less thing to worry about.

One down..

Cycle number: 9

Cycle day: 11

Meds: Met

Outlook: Strangely calm

So I am Clo.mid-resistant. I found out yesterday when I went in for my first monitoring scan. I was upped to 100mg this cycle, CD 3-7, and I felt hopeful that I would have some kind of response, but apparently my follicles just aren't bothered. I was worried this would happen when I didn't ovulate last month, but I had read of people who didn't respond straight away but did later on a higher dose. If it was my choice I would probably try one more cycle with 150mg just to be sure that I just don't need a much higher dose than most people, but I have been told it's the end of the line for me and Clo.mid.

The good news is I will be moving on to Meno.pur, which contains human gonadotrophin extracted from the urine of postmenopausal women. No that wasn't a typing error. It's an injectable made up of follicular stimulating hormone and lutenizing hormone, which hopefully assists the eggs on their route to maturity. I don't know all the details yet but I do know I will be injecting myself in the abdomen with this tasty concoction, a scary thought in itself. I may even be able to start in a couple of weeks if my lining remains thin, rather than have to wait for my period or take Pro.vera again, which is also good news.

But in general it does seem like pretty bad news. I had always heard that Clo.mid was pretty much a wonder drug, people getting pregnant on their first cycle, people taking it for a couple of cycles and then stopping only to get their BFP, and when I was getting ready for my first Clo.mid cycle I really thought "At last I have a shot" - to at least ovulate if not get knocked up. And Clo.mid always seemed like the most obvious answer, like anything else was a last resort and it would be time to panic. I always assumed I would have the full 6 cycles (the maximum allowed) and only then if it still hadn't worked I would move on to something new. 

I'm left with mixed feelings - on the one hand, it would've been frustrating to sit through cycle after unsuccessful cycle with no ovulation and therefore no chance of pregnancy. But on the other I've now ticked off one of the most potent treatments from my list of options, a list that will only get smaller as time goes on.

I've tried to make myself feel better by telling myself it's clearly a sign that my body is too intelligent - Clo.mid works by fooling your brain into thinking that there is no estrogen in your system, so that your brain produces more and this should (in theory) be the kick start the follicles need to get ready for ovulation. But my brain isn't having any of it. I should've known better than to try self deception.

The Meno.pur, however, simply supplements the hormones you already have; it's a much more straight-down-the-line drug, no trickery. And reassuringly my consultant said that just because I haven't responded to Clo.mid, it doesn't mean I am less likely to respond to anything else. I go back for a scan next week but I'm confident there will be no change, and then I will just have to wait about 10 more days before starting the new treatment (they like to leave at least 4 weeks between treatments).

The Clo.mid did wreak havoc with my emotions though. On my second day of it, I was almost in tears for much of the day (stress at work) and then I broke down in the evening (for reasons I will expand on in a separate post). Let's hope the next one's not so bad...