A New Found Hope

I am convinced that I met an angel today.

My husband and I decided to seek a second opinion from another RE. We have been with our current clinic for 2 years. But 6 serophene cycles, 5 IUIs, and 1 laporoscopy later - we are still not pregnant. I know that my current RE wants me to move onto the next step - IVF. But before we take that leap, we want to make sure that our doctor isn't missing something.

Because in my gut, I really feel that there is something that is being overlooked. Despite the fact that I respond well to meds, I have no blockages, and my husband's sperm count is normal, I am still not pregnant. And I'm just not ready to go the IVF route when all current conditions seem to be so optimal.

So my husband and I spent last night devising a two page "speech" for our consult with this new doctor. In a nutshell, we want to know WHY we are not getting pregnant despite "perfect" conditions. Is there a root cause that is being missed? Was I diagnosed properly in the first place?

So today, we entered the doctor's office with two page speech in hand. The first thing he asked me was: "So what's going on? What's the problem?" I take a deep breath and begin to delve into my speech: "Well, we've been with our current clinic for 2 years and we've tried Serophene and IU..." and the doctor quickly interrupted me with: "Wait, that is the TREATMENT you've been receiving, but what is the PROBLEM?" I was quite taken aback by that - in a good way. Before I could even get 10 seconds into my word vomit, he got to the heart of our frustrations. Not knowing what the PROBLEM is in the first place. Amazing.

So after he looked through my forms and asked me some key questions, he presented us with a few problems he wanted to investigate. First, he wants to make sure that I actually do have PCOS in the first place. Secondly, he wants to see whether I have any anatomical issues with my uterus that could be preventing implantation. Another possible root problem he mentioned was immune infertility which means that my body is basically treating my husband's sperm as a foreign body and attacking it. Lastly, he mentioned that perhaps there could be an issue with sperm DNA fragmentation, which prevents the sperm from fertilizing the egg. After he mentioned all these things, I almost wanted to cry. These were the exact issues that my husband and I have thought of over the years but was quickly dismissed by my current RE when I mentioned them to him. I've always had a gut feeling that there was something anatomically wrong with my uterus. When I had my HSG done last year, the dye kept rushing out, despite the catheter being inserted properly. My RE didn't think much of this issue and just ordered me to do a laporoscopy. But I've always wondered why it was that the dye kept rushing out. And this new doctor is finally taking these concerns seriously.

The last thing the RE said to me before we left really gave me a bit of hope. He said that the average couple takes 6-12 months to conceive. Because I rarely ovulate, I've really only "ovulated" about 10 times in the last few years. So we aren't really that far off from the average, normally ovulating couple. Really puts things in perspective.

Lesson of the day: find a doctor that really listens to you and gives you hope. I really do feel like he is a God send. What are the chances that this doctor would open up a new clinic just a few minutes from my house? And I happened to stumble upon his website just as I was losing all hope? I really hope this is the turning point for us.

Finally!

After 58 days, I finally got my period! It started out as spotting which lasted close to a week, but it has finally turned into a normal, run-of-the-mill period. Thank goodness. Although I sometimes have my doubts about acupuncture, it does seem that I am having more periods of my own making (?) since I've been receiving treatments. And I do feel a lot more content and relaxed in general so it must be a good thing to continue. Why I need to pay $79 a week for a monthly bleed and some relaxation is beyond me, but what can you do? Why I need to pay any money AT ALL for all these things that should happen naturally is quite frustrating, but I've learnt to look past that all. It is what is, and I just need to do what I need to do to get where I want to go. You know?

Limbo

Turns out I haven't ovulated after all. My wonky temperatures have fallen again and I have given up any hope for this cycle. So again I sit and wait in what feels more and more like some kind of infertility limbo. I have decided to get a second opinion from another doctor before moving on to my next (and probably final) IUI cycle. IVF is knocking (pounding) on our door and we want to seek another doctor's opinion before we take that giant step. But I need to get a referral from my family doctor to see this new doctor. And apparently this doctor is very busy. Very good, but very busy. So I wait some more. While my eggs get older and dustier. Fun stuff.

I suppose this forced break comes at a good time, if such a thing exists. I have been absolutely swamped since the new school year started. So I apologize if my blog updates are few and far in between. I really don't have much to report on anyway. But do please share what is going on with all of your journeys. I hope they are more eventful and successful than mine!

Temping Tantrum

Now that I'm taking a (forced) month off of medically induced cycling, I've sort of been taking my temperatures here and there without much thought. I'm doing it more out of force of habit than anything else. Usually my temps hover around 36.12 C or so. So imagine my surprise when I took the thermometer out of my mouth this morning to see 36.48 staring back at me. What the? I almost never ovulate on my own so seeing this temp on CD22 is a bit of a shock. Now I'm counting backwards trying to remember the last time the hubs and I BD'd last. Did we miss this miraculous egg-dropping? Did we lose our chance at a free chance to get pregnant?

Oh gosh. Fertility anxiety never ends.

Waiting

Is it just me or does it seem like this whole TTC journey is comprised of a whole lot of waiting? Waiting for your period, waiting for follicles to mature, waiting to see your doctor, the two-week wait, waiting for results, waiting, waiting, waiting... And now I am waiting, yet again. Waiting for these darn cysts to go away.

It's been a while since I blogged, so let me back up a bit. The hubs and I had a great time in Hawaii. It really helped ease the anxiety of the 2 ww. However, I was pretty bloated most of the time with a mild case of OHSS. I looked to be about 4 months pregnant. Not exactly a bikini-ready body but at least I wasn't in any sort of pain. I knew I wasn't pregnant when my OHSS symptoms started to go away towards the end of the trip. And then I REALLY knew I wasn't pregnant when I got my period full force on the last day of our trip. Extremely crampy and irritable is not exactly how one would like to spend their last day in Hawaiian paradise. So I apologize to the hubs for being a bit of a *bleep*. A sour end to our vacation, but the rest of it was so wonderful that it didn't really ruin it entirely.

So I am now on CD10 but my day 3 ultrasound revealed quite a few cysts - the biggest measuring around 5 cm and others around 2 cm. The doctor didn't want to take the risk of starting me up again on meds until the cysts resolved. So we are not doing anything this month besides trying the good ol' fashioned way. Which is pretty pointless because I very rarely ovulate or get my period on my own. But it's still worth a try, I guess. MIght as well make it a fun wait!

Welcome to the 2ww

Wow, there was a lot of word vomit spewed forth in yesterday's post. Sorry about that. I haven't seen that anxious and paranoid part of myself in a while, but I think I have almost successfully hidden her away. What's done is done and there is nothing I can do about it but be as positive as I can be.

I am now embarking on the 2ww. I've always kinda loved the 2 ww because it is the closest I can feel to being pregnant. Analyzing every symptom, picturing the little beanie that is snuggling into my womb, visualizing the moment when I find that (+) sign. Delusional, I know but I'll take what I can get. However, this wait will be a little different from others because my hubby and I are going to Hawaii next week! I'm sure there will be enough there to occupy my crazy mind, and my hubby and I are both eager to step into paradise for a week. This trip was a bit of a last minute decision and we timed it such that it would fall during this waiting period. So sort of a planned spontaneity. And it didn't hurt that we got an amazing deal on it. I've been so focused on this treatment cycle that I haven't really given myself the chance to digest the prospect of this trip. But now with nothing else to do (besides obsess about hyperstimming in a foreign place and not knowing where to go) I will refocus my energy on planning and packing.

Is it crazy that I just googled the nearest fertility clinic in Hawaii? I don't know... just in case? :)

IUI

Well, a lot has happened since my last post. I actually can't believe how quickly things have progressed in the last couple of days. So here's an update:

(and beware - at the end of this post you will find some panicky questions that I need help with):

On Sunday I had 6 follicles ranging from 1.4-1.5 (I think) in size, 3 on each side. My E2 level was getting quite high and the doc was worried about the risk of multiples so he lowered my Gonal-F dose for that night to 75, in the hopes that only the lead follicles would mature, and smaller ones would not. He also suggested that I trigger as soon as follicles reach 1.8 so that others would not catch up.

On Monday I went in to the clinic again for b/w and ultrasound and they found 2 mature follicles measuring 1.8, one on each side. There were also about 3 other follicles that were about 1.5 or 1.6 and were trying to catch up. Now, before I went in for this appointment I prepared a whole page of questions for the doctor, something I have never done. I had various questions about ovarian hyperstimulation (OHSS), ways to help prevent it (like giving a half dose of HCG trigger), and questions about my hormone levels. Well, as I sit there in the room waiting for the doctor, notepad of questions at the ready, the doctor walks in and tells me that she needs to be somewhere else. What?! She quickly looks at my chart and tells me that I have 2 follicles at 1.8 and various other slightly smaller ones. I get the feeling that she is about to tell me to wait another day when I cut in and tell her that the doctor doing rounds yesterday said that I should trigger as soon as they reach 1.8 to decrease the risk of multiples. Also, my E2 level was already getting dangerously high. Once I told her that, she stopped to think about it a bit and told me that this was "a tricky situation". After she pondered a bit, she told me that this is one of the situations where she may wish tomorrow that she triggered me today. So she told me to trigger today. I asked about OHSS and she said that I am not going to get OHSS. I didn't know that she had a crystal ball, but whatever. So I went to the nurse and got the HCG shot (this was around 10 a.m.) I asked the nurse about the potential for OHSS and she said I may get it because I have a lot of the risk factors (PCOS, thin frame, under 35 years of age, high E2 - the day of trigger E2 was 7500). I really don't care if I get OHSS. I can sit at home and deal with it. However, my hubby and I are going on vacation next week and I am really worried about being in a foreign place and not knowing what to do if things go bad with the OHSS, like having to go to the hospital and getting my abdomen drained. The nurse just told me to continue drinking Gatorade, water, and Campbell's soup. So far, I haven't been having any symptoms of it so fingers crossed it won't happen.

So today, Tuesday, I went in for my IUI around 10:30 a.m. (24 hours post HCG trigger). After the IUI I decided to lie there for 10 minutes or so, but a nurse knocked on my door and told me I could leave. I decided to stay there for 5 more minutes and gingerly walked to my car so as not to jostle any of the precious sperm. On past IUIs, fluid always leaked out after. So when I got home I lay down on the couch for about an hour. I went to my acupuncture appointment today as well, and when I got home from that I found that I did leak out quite a bit of fluid. Has anyone ever heard of a condition of fluid or sperm just not being able to stay in the uterus? Because I'm afraid I might have that. When I had an HSG (dye test) done a few years ago, the doctor was unsuccessful because while she was able to put the catheter through my cervix, the dye kept gushing out of me. Coincidentally, this is the same doctor that did my IUI today. My RE assured me that I do not have a problem with this. They did a laparoscopy on me and found everything to be fine. But I still wonder.

I should be happy that I have at least 2 eggies and hubby had 42 million washed sperm with 80% motility. But my neurotic and anxious self is peaking through the surface and I worry that hubby and I should BD tonight, even though I have another IUI scheduled for tomorrow morning. The doctor advised us not to, since my hubby will be giving another sample tomorrow. But I'm worried that the timing is off and the sperm inserted today will not make it to when I ovulate which will likely be some time tonight. And that the sperm inserted tomorrow will be too late because my eggs will have disintegrated. Does anyone know how long washed sperm live in the uterus? I am seriously considering going against doctor's advice but I feel bad if I do. So here's my question: Does this timing sound right to you? --> HCG trigger. IUI 24 hours later. Second IUI 48 hours later. BD 58 hours later. How long do washed sperm live? Do eggs live longer if more than one is released?

I'm sorry this was so drawn out and long-winded. I am freaking out a little bit even though I am trying desperately not to. The fact that I am this anxious on a day I had acupuncture is a little scary. I am usually so zen on acupuncture days.

Must calm self.

Follies Update

I went for an ultrasound and b/w this morning and I am thankful that things seem to be progressing well. I have 5 follicles that are 1.3-1.4 cm in size, 4 on my left and 1 on my right. I didn't ask about my E2 level. That was a concern for me last cycle because my E2 level skyrocketed and I was at risk for OHSS. I almost don't care this cycle about too many follies/high E2. I feel like throwing caution to the wind because if I don't, Mr. IVF may just come bursting through our door. And we are not ready to welcome him into our lives. So I'm glad that I'm responding well to meds this month. Those follies are definitely growing in there - I am bloated beyond belief and I can definitely feel a heaviness in my ovaries. So nice to actually feel something going on in there. Rather than the barren emptiness I feel when I am between cycles. Before I started fertility treatment and before I even knew that anything was wrong with me, I used to joke that my uterus was like a desert. I could practically hear the swoosh of the wind and see the tumbleweed roll along its emptiness. Looking back, I guess I always had a gut feeling I would have fertility issues.

Anywho, things are actually happening inside of me now and I shall get back to sending my follicles positive vibes.

Back in Business

So I finally got my period last Friday. Yayy! I went in for b/w and ultrasound on Sunday and I have one cyst on my right side but the doctor said it was nothing to worry about. So I have begun Gonal-F at 112.5 and hopefully this will be the magical dose to give me the right amount of follies. I go in for CD7 ultrasound and b/w tomorrow so fingers crossed things are progressing nicely.

I get the feeling my doctor wants us to jump on the ivf train pretty soon. He said, and I quote: "So we're going to try this one more time, right?" I didn't really know how to respond to that. Did he mean "one more time" because hopefully we will get pregnant this cycle or did he mean "one more time" because we are going straight to ivf if this doesn't work? I don't know. I just muffled an "uh-huh" and left it at that. Nevertheless, I shall try not to get ahead of myself and psyche myself out. I resolve to be as positive and optimistic this cycle as I can possibly be. Let those zen acupuncture feelings carry me away!

BFN, Let's Try Again

So I went in for a pregnancy test on Sunday. I knew it was going to be negative because: 1) I did not ovulate and 2..... well, 'did not ovulate' is all the confirmation needed, I guess. But even though I knew it was going to be negative, the nurse's voice on my answering machine actually telling me it was NE-GA-TIVE (yes, she pronounced it that slowly and clearly, like 3 little punches in the gut) was still disheartening. So now I am taking Provera to bring my period on so that we can get this show on the road. Today is my 3rd day of Provera-popping and I need to take it daily until Sunday. From there, I have to wait another 3-7 days for my period to start. Ugh. I hate all this waiting. Especially now that I am on summer holidays and have all the time in the world to live at the fertility clinic.

But as I wait for that period, I am continuing my acupuncture sessions and three times a day herbs. I don't know if the acupuncture is helping me fertility-wise (I have a gut feeling it is helping a little bit) but I am feeling better than I have in a long time. I feel content and happy and energized. And thus, much more equipped to deal with everything. Yes, it is burning a hole in my cheque book, but for now I feel that it is worth it. Needless to say, my acupuncturist didn't seem too pleased when I told her that I started taking Provera. Here she is trying to regulate my cycle using a natural and holistic approach and there I go running to the nearest pharmacy for Western medicine's quick fix. But I think she was okay with it once I told her that I did not ovulate and will likely not get my period on my own.

Well anyway, that's my story right now.

Patiently twiddling my thumbs and serving as a peaceful pincushion until AF arrives.

In The Presence of a Pregnancy

Today I saw a friend of mine who I haven't seen and have barely spoken to in 6 months. I needed space from her (and others) back in January when I had, yet again, failed to become pregnant for what felt like the bazillionth time. I had reached rock bottom. I was crying constantly. In my bed. In the car. In the shower. As I got dressed for work. In the middle of work meetings in front of my principal. Not a pretty time in my life. In the midst of this intense heartache and helplessness, I found out that my friend was pregnant. For the second time. Since I started trying for my first. And most likely by one lucky quickie whilst their baby slept in the next room. Not the news I needed or wanted to hear. So I told her I needed space from everyone. Just to deal with things on my own without the pressure and paranoia of discovering another pregnancy from amongst my apparently very fertile friends and family.

Well, time wore on and I patched myself up emotionally. I could've talked and seen her way sooner but the longer I waited, the more difficult and awkward it became to give her a call. And the bigger her belly became. But finally today, we found the time to see each other. Along with her 19-month old son and her 7-months along protruding belly. I won't lie, It was definitely awkward and uncomfortable at times. What do you talk about with that giant elephant in the room? And me trying to avoid eye-to-navel contact with her pregnant stomach?

But we managed. Talked a bit about everything else besides the obvious. Even managed to have dinner with her family and my husband and I. Despite the moments of discomfort, I'm glad I saw her. It eased the guilt that was growing in me. And it showed me that I am much stronger than I think.

Dum Da Dum...

^^^ That's me rapping my fingers on the table in a bored and impatient fashion. (Well, not me really, that is obviously a man's hand, but you get what I mean). I hate being stuck in this infertility limbo. I need to wait until Sunday before going in for another beta. It's not a 2ww... that would be much more exciting. It's just no ovulation, no period, no nada, but still have to wait the requisite amount of days before verifying the non-pregnancy state that I most certainly am in, and artificially starting up my next cycle. Ugh.

On another related note, I have the tiniest inkling that my period might come on it's own. I don't know. Maybe it's because I've been hovered over the computer for the last 3 hours. Or because I ate a very late lunch and am still hungry. Or because I've been holding in my pee. But nevertheless, I swear I feel a little crampy pain in my uterus. I have been a little bitchy towards the annoying people on T.V. lately. But I haven't had my requisite pms sugar and salt craving yet. If Aunt Flow does decide to grace me with her presence within the next few days it will be a bloody miracle. Heh. Get it? Bloody, miracle? Anyways, as those of you with PCOS know, getting a period when you want to get your period is a cause for celebration. Could my hormonal system be turning into some semblance of normal?

Hmm. If I do get my period, I swear, I could be the poster child for acupuncture. Ever since I started acupuncture a few months ago, I have gotten my period each month. Maybe not exactly on time, but I've still gotten t it. Oooooh. I'm getting excited at this exciting new revelation! Let me break it down:

First cycle with acupuncture + Gonal-F and IUI - ovulated early (CD 12, I think?) 1 mature follicle all by myself (i.e. without the use of the HCG trigger), then got AF 2 weeks later;
Second cycle with acupuncture + Gonal-F and IUI - upped dosage of Gonal-F so developed over 7 mature follicles and E2 shot way up high. Cancelled cycle on Day 13. Got AF on CD 18. RE told to 'ignore' this period --> may just be due to fact that stopped meds all of a sudden.

Now, CD 29 and am starting to feel crampy.

Please! Period, come!

My Infertility Stats

I guess I should give a background of my journey thus far. I've never typed this out in black and white, so here goes nothing:

Age:
Me - 30 years old
DH - 30 years old

Diagnosed with:
Me - PCOS
DH - nothing (however, I think his sperm count is on the lower end of normal )

TTC since:
Naturally - 1 year
WIth medical intervention - 2 years
So a total of 3 years (in case you couldn't add 1+2 haha!)

Interventions tried so far:
Clomid - 6 cycles (I think?)
IUI with Gonal-F - 5 cycles
Acupuncture - 1 cycle
Acupuncture + herbs - 2 cycles

Tests/Procedures done:
Sono - ouch!
HSG - triple ouch! The doctor was not successful with this --> although the catheter went through my cervix, the dye kept rushing out and down my legs
Laporoscopy - clean --> everything found to be in normal, tip-top shape

Where I stand:
According to the doctors, I respond well to the meds. Perhaps too well -- last cycle I had at least 7 mature follicles and an E2 level of above 11,000. Difficult decision, but cancelled cycle due to high chance of OHSS and multiple fetuses. Before that, have had 1-2 mature follicles per cycle but NO pregnancies. Don't really know what's up. Besides the PCOS, everything else seems fine and I respond to meds. Not ready to try IVF quite yet.

Currently:
I am waiting out this cancelled cycle. Going for a beta test on Sunday. If it's negative (which it will be - did not ovulate on my own) will start Provera and begin another cycle of IUI and Gonal-F, this time on a dose of 112.5

So that's it in a nutshell. Left out the hundreds of blood tests and vaginal probe ultrasounds. Not pleasant but an unfortunate fact of life these days.

Where To Begin...

My TTC journey has been inspiring me to do a lot of things lately. Write in a journal. Drastically increase my fruits and veggies intake. Do pilates, Exercise. Run. And now... blog. I'm sure that anyone going through the TTC journey can attest to the same feelings I feel right now. One of them being the strong NEED to talk to and tell others about this most horrifying time in my life, but yet finding absolutely no one that can really listen. At least listen the way I want and need them to listen - with complete understanding and empathy for what I am going through. I find it ironic that I find more solace in strangers going through the same thing as I, and not the loved ones that supposedly know and love me inside out. I know that my family and friends (the few I have left) don't know how to talk to me. They walk on eggshells around me. Not knowing what bit of information or question might be too sensitive for my infertile mind and body. Because of this, I am slowly losing dear friends and drifting away from my family. Particularly the friends and family that have recently become pregnant with no outside help or motivation whatsoever. Pregnant by chance. Pregnant by that one romp in the sack. But I digress...

So I am here starting up this blog. I will be as candid here as I can be. I'll try not to sound as pitiful as I just did in the above paragraph. This is NOT going to be a pity party! Well, if you're reading this, thanks for reading. Welcome!