Wednesday, April 28, 2010

And the side effects begin!

I am sitting here doing nothing.  Typing on the computer, yet I am burning up.  Can you say HOT FLASH anyone?  Baaahhhh....much worse than Clomid.  Also, I am feeling less emotional (much less) than normal.  The last 3 years have been hard, wondering why this is happening to me, and the tears are not usually far.  But today?  Nope, no tears in sight...well, except after reading some not so good news from a friend from iVillage that is going through a similar situation that I am.  But other than that, I feel like a robot.  I will have to look it up and see if that is a side effect. 

Something else that has been on my mind is WHY?  What did I do or not do to deserve this?  I know that God has a plan, but why do I have to suffer like this?  How come so many other people get what they desire?  I know that I am not a horrible person, so what would the reason be for not blessing me with another child?  Do I just have to let go and try not to worry about all of this TTC stuff?  How can I not worry when I have to wake up early to take a pill and inject myself with drugs?  Aaarrrgh...tears in my eyes now.  I hate crying. 

The next couple of weeks are going to be extremely hard.  Especially if this cycle doesn't work.  I am trying to put all of the worrying and what ifs out of my mind during the day, it is helping a little, but my mind always drifts back...

I feel as if my time is running out.  I know I am not "old", but I didn't want all this space in between Chloe and her brother or sister.  Chloe is such a great kid, I want to bring another child into this world so they can share experiences with her.  Oh, something she started saying recently...she thinks that when I do get pregnant again that there will be a boy AND a girl in there.  Couldn't figure out where she got that until I sat and watched Dora with her today (Dora's younger sibling are boy girl twins).  Chloe is a funny kid... 

All I have left to say is that no woman in this world should have to experience this. It is heart wrenching. I can't describe it to someone that has never experienced infertility....I feel as if I am broken and I can't even be a real woman anymore. I feel alone and I feel desperation, jealousy, embarassment, hopelessness, and many other words that are escaping me right now. 

On that note it is Wednesday.  Girls night.  Hope to get my mind off of my mess for a little while...;) 

Tuesday, April 27, 2010

Stupid insurance...

I had to post again.  Just had to.  My day was going ok until I called the pharmacy to check on my Gonal f.  NOT covered by insurance because I am having an IUI.  Aaaack!  What if the Gonal f doesn't help any follies grow and I don't end up having the IUI???  I paid gobs of money for the drugs and I might not even have the procedure!  If that ends up happening I will talk to the doctor's office about not anticipating that I will have an IUI next time, then insurance will pay for the drugs and if the drugs don't work again I won't feel so cheated.

On a positive note, at least I am getting a bunch of points on my credit card.  Yay.

One more week!

7a.m. came really early today.  I work afternoons...how does morning get here so quickly?  Aaaarrrrgh.  I have remembered to take my pill every morning so far (googled it and it is considered a "mini pill").  Sunday I started taking my daily injections of Lupron.  Everything got thrown off because we had Navy Reserve drill weekend, so hopefully it doesn't matter much that I took the drugs a little early. 

The Lupron injections are not bad, just sting a little bit when inserting the needle and injecting the drug.  I thought that it would get easier or better for me the more injections that I took, but I think lack of sleep might be having an effect on my injection skills.  The silly needle wouldn't go in this morning. After my appointment next week I will only have 4 doses left of Lupron so I am not sure if I will be getting another prescription?  I guess I should probably check the paperwork and see if I need to order another 14 day kit. 

Still trying to get my FSH (follicle stimulating hormones) figured out.  Insurance is holding things up, not sure if the drugs will be paid for or not, and I am not holding my breath.  At least I will get many many points on my credit card...(trying to look for a positive in all of that money that will be spent).

Side effects you ask?  No, I haven't noticed any yet.  I have been expecting hot flashes and other side effects of menopause, and thankfully none have shown up yet.  Ok, I lied.  I have been bloated, but that could be leftover side effects from so many months on Clomid.  And I have also been moody, but I have been that way for over a year now.  I am 99.9% sure that DH would disagree, he would say it has been much more than a year of moodiness.

So the countdown is on until my appointment next week, they will be doing an ultrasound and bloodwork to check and make sure the drugs are working like they are supposed to and I could start taking the FSH that day!  I have looked into how long it takes the average woman to produce follies and it is 8-10 days.  Hopefully I am an average woman.  I sure wasn't on Clomid.

7 DAYS!!!

Friday, April 23, 2010

Psycological component of infertility

I read a great article today, on my search for infertility blogs. This article is long, but there are circled areas and underlined areas that could have been written by me! It is so hard to try and get a fertile person to understand what I am feeling...from what I skimmed over in the article it hits it pretty much head on.

The Psychological Component of Infertility

Hoping the weekend flies by...bet you haven't heard that lately? LOL. I have drill (Navy Reserves) and dread it the week leading up to it, but once I am there it is ok...;)

Thursday, April 22, 2010

Doctor Google has answered so many questions...

So, what should I eat after the IUI? (assuming this month will not get cancelled like the other months) Dr. Google to the rescue! A small amount of fresh pineapple is suppose to aid implantation. Hummm...I just might have to try that!

What should I do or not do? Well, I will definitely NOT be lifting the 45 pound computers at work, and I will definitely NOT be picking Chloe up. So I will have to pretend I am already pregnant and take it easy...

May 4th can not get here soon enough...please let everything work how it is supposed to this time! Come on drugs...do your job!

Wednesday, April 21, 2010

Clomid

So, there are lots of different websites with info about Clomid. It is supposed to induce ovulation in 80% of women (if I remember right) and after 6 months on it, 30% of those women get pregnant. :( So it didn't work for me on the FDA's recommended dosage. My RE didn't want to go up to a higher dosage because of the negative effects it would have on my reproductive system.
I am too scared to look up the stats on PCOS and injectables. I have read about fertility doctors wanting to go straight to IVF as it is a lot more accurate. They place 2 fertilized eggs in your uterus (sometimes 3), but with injectables they have no way of knowing how many eggs will get fertilized. <- Hence Jon and Kate plus 8. They went through an ovulation induction cycle and the sextuplets were the result. My fertility doctor will refer me to a multi fetal reduction doctor if something like that happens. He will refer me to one if there are too many follicles growing, I think the max is 5...the doctors have no clue how many will get fertilized and how many will implant. He explained to me the additional stress that each pregnancy has on the woman and the baby(ies), it made complete sense and I am not looking to become a reality show. I just want another baby to hold in my arms and love.

I started Norethindrone today...4 more days and I start down regulation (suppress hormones = menopause). Looks out everyone...and you thought the Clomid crazies were bad enough, right? LOL

All about PCOS

Polycystic Ovarian Syndrome
Polycystic ovarian syndrome (PCOS) is one of the main causes of infertility in women. It affects anywhere from 5-10% of women between the ages of 20 and 40, making it the most common reproductive syndrome for women of this age group. However, a further 30% of women may have some of the symptoms associated with PCOS although they won’t be diagnosed with the syndrome.
What Is PCOS? Women who suffer from PCOS have cysts (fluid-filled sacs) on their ovaries that prevent the ovaries from performing normally. PCOS affects regular reproductive functions, like the menstrual cycle, as well as fertility. Ovaries of PCOS suffers tend to be from 1.5 to 3 times larger than normal ovaries.
Although PCOS has been recognized as a syndrome for more than 75 years, no one is sure exactly what causes it. Some experts speculate that it may be hereditary but others suspect that there might be a link between PCOS and diabetes. Because so many women who have PCOS also have high insulin levels, this link does not seem unreasonable.
A connection has also been made between the seizure medication, valporate, and PCOS. This particular medication may cause or worsen the symptoms of PCOS. However, doctors are not sure if it is actually the epilepsy that affects PCOS or the valporate, but it is usually recommended to switch seizure medication if you’ve been diagnosed with PCOS.
PCOS Symptoms
While cysts are the most common symptom of PCOS, some doctors will diagnose a woman with PCOS even when cysts aren’t present. In these instances, the diagnosis is based on the presence of other symptoms and hormonal abnormalities.
Symptoms of PCOS include:
Amenorrhea (cessation of period) or infrequent periods - That is ME!
Irregular bleeding - ME again!
Infrequent or no ovulation - Lookie here...we are on a roll!
Cysts on ovaries - ok...getting scary
Increased levels of male hormone, like testosterone - nope
Infertility - yep, Chloe=spontaneous ovulation
Chronic pelvic pain for six months or more - no, but have had pain before Increase in weight or obesity (most women with PCOS are overweight) - nope
Diabetes; over production and inefficient use of insulin by the body - on Metformin now
Lipid abnormalities (high or low cholesterol, high triglycerides) - no idea
High blood pressure - def not, low...
Excess facial and body hair growth - um, I am part Greek, so yes
Male-pattern baldness or thinning hair - nope
Acne, oily skin, or dandruff - um...dry scalp count?
Dark-colored patches of thick skin on neck, groin, underarms or skin folds - no
Skin tags in the armpits or neck. - yes, small ones on my neck
Diagnosing PCOS
PCOS is one of the most under-diagnosed reproductive syndromes in women. Because the symptoms often seem unrelated to each other, doctors may try to treat each problem individually rather than evaluating them together (2 years WASTED!). However, during a pelvic exam, your doctor will be able to feel any cysts that might be on your ovaries. Once these have been identified, a vaginal ultrasound will be performed to help the doctor get a better view of the cysts. PCOS cysts are often referred to as a "string of pearls" because of their resemblance to a pearl necklace. Next, a blood test may be ordered to evaluate your hormone levels as well as your insulin and glucose levels. Tests may also be ordered to measure your cholesterol and triglyceride levels.
Unfortunately, there is no standard criterion for diagnosing PCOS. Some doctors may give a diagnosis once a woman shows a minimum of three PCOS symptoms while others may use exclusion of other problems to narrow it down to PCOS. Regardless, it is important to receive a proper diagnosis in order to receive treatment. Left untreated, PCOS can lead to many health problems including endometrial hyperplasia (excess growth of the endometrial lining), endometrial cancer, Type II diabetes, high blood pressure, high cholesterol, and heart disease.
PCOS Treatment
Traditionally, doctors have only been able to treat the symptoms of PCOS. Since the cause of PCOS is unknown, there is currently no cure. The birth control pill is often prescribed to help regulate the menstrual cycle as well as reduce the levels of hormones and minimize the appearance of acne. Other medications can also be prescribed to help with blood pressure, cholesterol, hormone levels or cosmetic problems.
Because so many women with PCOS have high insulin levels or their body does not use insulin efficiently, insulin medications are also commonly prescribed. Normalizing insulin levels has been found helpful in regulating periods and promoting ovulation. Women who prefer a more natural way of easing the symptoms of PCOS are frequently recommended to do so through diet and exercise. Maintaining a healthy weight has been shown to help insulin and glucose levels as well as promote fertility. Since PCOS can worsen over the years (although it should improve as you approach menopause), living a healthy lifestyle is one of the best ways to protect yourself.
Surgery is available for PCOS however it is not recommended as a first line of defense. Ovarian drilling is an outpatient, laparoscopic procedure that uses a small needle to puncture the cyst. An electric current is then employed to destroy part of the cyst. Unfortunately, the surgery has a success rate of less than 50% and the long-term effects are not known. Plus, there is the possibility of scar tissue forming or other damage being done to the ovaries, thereby compromising your fertility even more.
PCOS and Pregnancy
While it is possible to become pregnant, women with PCOS tend to suffer a much higher rate of miscarriages. Estimates put the rate of miscarriages in women with PCOS at 45% although some believe the figure may be higher. However, experts aren’t sure why exactly this is. Fertility problems experienced by women with PCOS may be related to the elevated hormone, insulin, or glucose levels, all of which can interfere with implantation as well as development of the embryo. Additionally, abnormal insulin levels may also contribute to poor egg quality, making conception more difficult.
Stabilizing hormone levels can help fertility by promoting ovulation. Some doctors may also prescribe ovulation medications, such as Clomid, to encourage ovulation. If you are thinking of conceiving, be sure to discuss the issue with your doctor. Not all of the medications used to help PCOS sufferers are safe to use during pregnancy and may need to be discontinued.
Although getting pregnant can be problematic for women with PCOS, many have found it easier to get pregnant the second time around (No, not true...). Additionally, some women have found that their menstrual cycles regulate themselves after a pregnancy (yea...not true again!). Following a healthy diet and exercising regularly will also help to promote fertility. Tried that over the last 3 years...didn't work for me...:(
http://www.fertilityfactor.com/infertility_PCOS.html

Tuesday, April 20, 2010

Tomorrow

I got the call yesterday from the fertility clinic, I am starting this new cycle tomorrow! It will be a long one as I won't even start stimming (follicle stimulating hormones/injectables) until after May 4th (or 5th). From what I have found online, the average stimulation with the injectables is 7 days. I hope that I fall somewhere in that average as those drugs are scary expensive!

The clinic sent me a package with a lot of paperwork in it, but me being my usual self I misplaced it. Not that it is a huge deal, I can find all the info on the internet...but it had some cool spread sheets in it for me to keep track of when I take meds. I asked Doug to look for it in his car, maybe I will get lucky! Humm...if I don't find the paperwork I will just note everything on a calendar or something...


It is hard for me to feel hopeful. I know my body doesn't work right, I have "known" that for a long time (took a fertility doctor to figure it all out, that is nuts). I don't want to think negatively, but how can I not? All these years...feels like they have been wasted...seeing friends and family on their 2nd or 3rd or 4th pregnancy, I can't even begin to describe the feeling of defeat.


A little over one month from now I could be pregnant. I have been thinking that way for 30+ months and with each month that has passed I feel like a little bit of my heart has broken. The last 4 months have been much easier...I know what is going on with my body, I have seen proof of it on the ultrasound monitor. So even if these new drugs don't work, there will be a plan for the next month, and if that month doesn't prove fruitful then there will be a plan for the month after that...and all of that could get me one step closer to what I have been hoping and praying for all this time...

Monday, April 19, 2010

2 more days

2 more days and I start the first med...then 5 days later I start taking another...then 5 days later I go in for the ultrasound and E2 levels. Yay! Getting excited and anxious...

I met a great lady on Saturday, she went through 5 IUI cycles and 4 IVF cycles, she ended up adopting a newborn little girl. I am not sure of the cost of doing that, but I know I would love any adopted child as my own.

I never thought these things would happen to me, especially considering we already have a child...on that note, I know I am starting to cope a little bit better. I went to a baby shower this weekend, I even made a diaper cake for it. Doug couldn't believe that I made it all by myself, it was pretty nice if I do say so myself...;) The next baby shower I am going to I will make a bigger one, in that one there will be a bottle of champagne...thought that would be a little different...

Thursday, April 15, 2010

Google

Why do I do this to myself? I have been "researching" (HA Googling) PCOS and infertility and what Tricare (our insurance) will pay for. Well, they won't pay for my really important med if I do any type of artificial procedure. You don't want to know how much this would cost, when the pharmacy told me the price I felt a little throw up creep up my throat. So I called and left a message at the fertility clinic's billing office. I hope hope hope that they don't send the authorization with information on it saying that I am having an IUI. Because if so, we will just do a timed intercourse cycle and see how that goes before I shell over the big bucks. And if I don't end up ovulating then I won't be wasting good money on a cycle that is a bust.



As for PCOS, I have read a lot about women that Clomid didn't work for and their fertility doctors recommending them for IVF after Clomid failed to produce anything. That makes me nervous. I just don't get it. I can't afford IVF right now, but if that is what it boils down to DH and I will have to talk...How is it that I have been pregnant (twice now) and it is taking soooo long? How do I get through each day...it is hard. I have probably said this before but I am thankful for Doug and Chloe, work, shopping, video games, and TV.



Adoption...I will have to look into what it would take for a domestic adoption, maybe a child from our county? Not sure about all that, but my job will put $$$ towards adoption, that is pretty nice. Off to Google...

Wednesday, April 14, 2010

One month and a day...

One of the hardest things I have had to deal with in my life is the loss of my second pregnancy. May 15th. That was the date I was due. That date is creeping up quick. And I had high hopes that I would be pregnant again by then.



Forgot to mention that I helped a friend who is pregnant with her registry at Babies R Us. That was pretty hard. Hard not to stare at the big bellies walking by, hard not to tear up when I hear the couples talking about the right car seat, hard not to scream when walking by all the cribs and glider rockers. After being in the store 5 minutes I realized that I would have to go through the motions but be in another place at the same time. It worked. Of course I bet I looked like a unemotional witch, but hey...whatever works, right? I am dreading that baby shower, the pregnant gal that I went shopping with will be having one and I don't know how I will be able to do it. I haven't been to a baby shower in over 2 years, and that one was hard then. Can't even imagine going to one now.

That is how I have felt for a couple years...going through the motions...hoping for another surprise like Chloe. Something has been weighing heavy on my mind for a while now. Normal people love weekends, I am ok with them until Sunday. Going to church is great, but I feel like I am just going through the motions there also. Why me? Why do I have all these issues and everyone else I know can get pregnant? Why hasn't God answered the prayers? What else can I do? I am trying not to be mad at God, but that is a losing battle these days.


At what point should I just give up? That question has messed up so many years of trying to get pregnant. I have given up so many times...I can't even count them.

Oh, and thank you infertility, Clomid, and all the other drugs and hormones I have been on for the extra 15 pounds on my butt. It is lovely.

Another day closer...

4 Provera pills left. The waiting is horrible. Oh, and just so you know, Google is NOT my friend! I am nervous for all of this...nervous that I won't respond to the meds, nervous that the drugs are going to cost too much money (guess I am going to have to keep driving around that car that really needs to be replaced!), nervous about pretty much anything I can think of. I am liking the idea of looking at this in steps. Step 1, monthly "gift". Then I can worry about step 2.

Then I think about what we will do if 3 cycles of this doesn't work? First the doc has to get me to where I am producing follicles and ovulating, but after 3 cycles of that he will probably recommend us for IVF. If it gets to that point I want to do it, but I know we can't afford it. I mean, really? I have a child...had her unmedicated (after 5 years never on birth control)...what is the deal with this time around?

I am glad that my doc is being aggressive. It really does help to have a great doc. 2008 and 2009 were pretty bad with my OB, obviously letting nature take its course doesn't work with someone like me...

If this works and I carry to term we will be going back to this doc and trying again right away (those are the plans for now).

Tuesday, April 13, 2010

Thinking of Venice...



We have planned a trip to Venice, Italy with some friends next summer. I am so excited to go, yet I have no clue if and when I will become pregnant. I have been working out the months in my head and figuring out when we should go, what if I get pregnant this month or next month or 4 months down the road? Ugh...

Straight injectables cycle

Buzzbuzzbuzz...snooze...dream that I was late to my injections/down regulation class this morning...aaack! What a way to wake up.

5:45 came awfully early...that is when working 2nd shift really wears on me. Warning: please stay way from me today I will probably be very grumpy!

So I was utterly confused about the huge packet of information that arrived on Saturday. I was so worried about what drug I should pick...then I had the classes today. They helped so much! The nurses at Dr. Corfman's office are great. So I was a little confused and thought that I was going to be on a similar drug to Clomid (Femara) and then injectables to help get those follies growing. Nope. I am going to straight injectables. The first step is to get my monthly "gift", then I call the nurses, and that is when they give me "the plan". So (from what I understand) I will be taking Lupron and Norethindrone, they will overlap each other. During that time I will go in for an ultrasound and E2 levels (estrogen level). This ultrasound is to check and make sure that hormones are suppressed (down regulation) and once that happens the follicle stimulating meds can start.

Out of the list of injectables I have on the prescription list to choose from, I decided on the premixed pens. There are 2 meds that have the pens and I am hoping that insurance covers them, but if not I will have to pay out of pocket. At this point I am not too concerned, but I am sure that will change when I hear the total...;) I am also hoping that insurance gets billed as trying to induce ovulation and then all the appointments and ultrasounds will be covered. We'll see...

The nurses went over a lot of additional things with me, OHSS which is ovarian hyperstimulation syndrome, cancelling of a cycle either because of poor response (been through that enough times already) or too way too many follicles, multiple gestations, and multi fetal reduction (MFR). OHSS is pretty rare, but you never know with me...there are quite a few things that I have or have experienced that are rare (G6PD deficiency/allergy to many medicines including aspirin, post partum PUPPS <- I was allergic to my own milk or the hormone involving milk). There is a 25% chance for multiples, most of the time the result would be twins, if there are too many follicles then the doctor will have a talk with us about it and MFR could come into play if we end up pregnant. Not a big fan of MFR, and I don't want to think about it right now. I need to get to the point where I ovulate and then I can worry about the next step...

So, I am guesstimating that down regulation will start in about a week...keep you fingers crossed!

Monday, April 12, 2010

New drugs

Monday. Not a big fan. I received the new information packet from the infertility clinic, it arrived Saturday...talk about fast! Anyway, I have to choose one of 6 or 7 injectable medications. Not sure which one to choose so I will have to ask tomorrow at my "how to inject myself" class. Of the little research I have done I think I am leaning towards follistim but I guess the treatment cycle will be the tell all.

I was thinking about it today and other than the Clomid induced ovulation last August/September I have not ovulated in more than 15 months. As for when I ovulated before then, I have no idea. So, hoping that these drugs work. And that they don't work too well, too many follicles would be bad.

Friday, April 9, 2010

Yet another ultrasound

CD20, had follicle ultrasound, no growth over 9mm. There were a ton of follicles (lots more than Monday) but they were all small. The nurse called me a little later and said the RE was giving me 2 options: increase the dosage of Clomid to 150mg or move on to another drug with a combination of injectable hormones. I chose the drug with the injectable combo. I have read up a little on this and found that many women with PCOS hyperstimulate on these drugs, to go from no follies to too many...cancelled cycle after cancelled cycle...I hope it works out well. Not sure if insurance covers all this but I guess I will find out!

Monday, April 5, 2010

Another follicle check

So today is cd16. Six days after my 10 days on 100mg of Clomid. I was trying to be positive about this appointment but after all these months it sure is hard to keep my chin up. We are quickly coming up on 3 years of trying to get pregnant. THREE YEARS...ok, for a year of that I was clueless to all of this stuff, but last January I started the researching and I have learned so much in the last year+.

Doug (DH) went with me to the appointment, it was very nice of him, and I think it helped him understand things a little better. Before the nurse started I had a question. I asked her what the next step would be if the 100mg of Clomid for 10 days didn't work, she said that is usually does and not to be worried. I bet she wishes she could eat her words now. There were a few follies, one on each ovary, but they were much too small. They usually look for follies that are 16mm, mine were 7mm and 8mm. The nurse apologized and asked if I had ever been on injectables (I haven't) then she said they would call later to tell me what to do next.

So I received a call on my way to work, two choices: have another ultrasound on Friday or start drugs to induce AF now. After talking to DH I decided to wait until Friday. Maybe they grow late? I can hold on to that hope I guess. I ovulated on a higher dosage (which my new doctor won't out me on because of the side effects), but I didn't ovulate until cd18. So maybe I will get lucky and they will grow.

I feel almost as bad as I did after that miscarriage in September. At least I ovulated then. I just want to lay down and cry...there have been tears in my eyes all day. I have been avoiding people...don't want some comment to set the tears in motion...