Wednesday, October 29, 2014

(In)fertility Timeline Part 2

So after my loss mid October 2013, my betas fell to 0 the first week of November. I received no instruction from my OB except I could start trying after one period. 

C and I bought condoms but we quickly abandoned them. We used the pull out method but by Thanksgiving were not preventing by any means. I started taking HPTs (all negative) and wearing pads, expecting a period to arrive any day.

Meanwhile, I had transitioned from ferociously reading the miscarriage/loss board to the trying to conceive (TTC) after a loss board (and even the pregnant after a loss board). I learned from others that a period should arrive by 60 days after a loss. I learned about tracking cervical mucus and temperature to determine ovulation. Hell, I learned basically everything about how conception works from there! 

I called my OB and they brought me in for bloodwork and a pregnancy test. Test was negative of course. The nurse proclaimed because my LH level was three times as high as FSH I had PCOS. (I later learned that these ratios are best tested in day 3 of cycle, and many other criteria go into a PCOS diagnosis, but whatever, she was right). She felt I should go on birth control for three months to regulate then try again. I freaked out - I didn't want to waste 3 months. That meant no 2014 baby! (Now I think - cute little naive me!) Plus, I wanted to take my temperature and see if I would ovulate. 

The OB agreed with my request and said he was not ready to conclude I had PCOS. They prescribed me Aygestin to bring on a period. And, next cycle, I ovulated! But, no pregnancy resulted. I wasn't too bummed out because I figured my body needed a period to reset. Next cycle, though, I did not ovulate. Time crept on toward 60 days, so I got more Aygestin. And was told to try again. Next cycle, as I neared 45 days with no period or ovulation, I returned to the OB. I want Clomid, I declared. It seemed like the magical pill for anovulation and PCOS, which I felt strongly I had by this point. 

The OB said he would not prefer to go down that route, has only done it a few times. But he consulted with a fertility doc and agreed to do Clomid after he ran bloodwork and did an ultrasound. A few weeks went by (still no period or ovulation) when he got the results, he said my testosterone and free testosterone were so high, he wanted me to see a fertility doc to rule out issues. I was shocked and pissed. I wanted the Clomid!!! I had PCOS; what was the problem?? Now I would have to wait and get tested and spend more money. (In hindsight, I am thankful I was referred to a Reproductive Endocrinologist (RE). OBs are not fertility experts. They probably took a few fertility classes years ago but that is all. They don't know what all the results mean and how to adjust the treatments. Therefore, they often skimp on monitoring which is dangerous with Clomid because cysts could form or endometrial lining could thin. Plus, their offices are not open every day which would mean missing crucial testing and procedures. Furthermore, who wants to try and get pregnant and face pregnant ladies in their office all the time?) And, he wouldn't prescribe more Aygestin so I was hanging out in anovulatory hell. 

By April, I had an appointment with an RE (on like day 70? of cycle) and commenced testing (TONS of bloodwork for me, 1 and 2 hour glucose tolerance tests for me, an HSG, minimal bloodwork for C and sperm analysis) over the next few weeks. The doctor met with us in May and declared I had PCOS, hubby was normal, everything else was normal, and we would try 50 mg Clomid days 3-7 combined with an Ovidrel HCG shot to induce ovulation. He was positive I would be pregnant within three cycles. 

I started my first Clomid cycle at the end of May 2014. I had hot flashes and headaches but nothing too unbearable. We had lots of fertile window sex, I ovulated (one egg), but no baby at end of the month. 

The next month, C experienced a problem sustaining an erection and I was freaking out as it was in the fertile window. We were able to add in back to back IUIs, and combined with O-2 sex, we still did not achieve pregnancy. (Still one egg, stronger ovulation of 20 this time.)

Third month, I began to not respond to the Clomid. They upped my dose on day 12 to 75 mg (process called stair stepping) and I was able to ovulate one egg. We had smooth and plentiful timed intercourse but no baby again. The nurse said I should meet with the doc to discuss plans. I was sad because Clomid was *supposed* to work! With PCOS as the only factor, about 55% couples achieve pregnancy in three months. I felt like a fucking failure. I didn't want to meet with the doc. But I did.

He recommended to increase Clomid to 75 mg and add an injectable dose of gonadotropin (Gonal-F) to boost egg growth and hopefully yield more than one egg - i.e. give the sperm more than one target. I asked if I could follow the new protocol but switch to Femara since my vagina was so dry and painful since Clomid. He agreed (put me on 5 mg Femara) and sent us on the way.

Fourth cycle (now officially recognized at office and considered a regular - whoopee) had stellar sex, ovulated two eggs on right ovary, progesterone was highest ever at 30.5. Nurses, ultrasound lady, and even doctor (who I called and grilled about injectable only cycle? (No, he said, too risky for overstimulation plus I have responded perfectly to medicine so far) Ways to increase cervical mucus? (Nothing, he said, but I did start evening primrose oil this cycle thru ovulation which may have helped a little), Any other ideas of what's wrong? (He said everything we can test and control looks good. We would have an idea of egg quality with IVF but even then that is only a sample) Do I need day 3 bloodwork?) all touted my amazing results and gave me so much hope of pregnancy. Well, didn't fucking happen. 

Now onto fifth and current treatment cycle. We did back to back IUIs because doc felt that was best way to combat the cervical mucus problem. I figured it would also relieve C, who had been experiencing more and more penis issues, even during non fertile times. C called doc and got Viagra, which helped us during the fertile window. We both also started counseling recently (separately) so hopefully that will help our failing mental health.

Currently on 8 dpo (days post ovulation). Had two eggs again, one on each ovary, with a third that may have also matured. But estriadol was low and progesterone as well (only 7.19), plus I spotted at 1-3 dpo and have had cramps and ovulation pain since ovulation so I wonder if I have a cyst. I'm on progesterone suppositories (so disgusting, it looks like I have a yeast infection down there) until 14 dpo when I'm supposed to test. I'm feeling like this was a bust. It sucks. 


  1. Oh I hope this is your fifth and final cycle. What day do you test? Are you feeling any symptoms yet?

  2. Thanks for your kind words! Cramping and pain since ovulation are only "signs."
    Going out of town for a funeral
    so cannot test until Monday, November 3rd (13 dpo) at night.