Get Me Off This Ride

It was a crushing blow to learn that my first complete round of injectables with IUI was a failure. This is the first time that I even feel up to talking about it. This is my second failed insemination and they say that if you don't get pregnant by the third, chances are that it will not work for you. I am too scared and too emotionally exhausted right now to try round three. I feel like I need to take a mental health break from this emotional roller coaster so that is what I am doing. I am meeting with my doctor again on March 25 and until then, I am going to try to relax and focus on me. I could say that I will take these three months off of thinking about my infertility but that would be a lie. I think about it every time I see a baby or hear someone talk about their children, every time a patient asks me if I have any kids or I see some adorable baby clothes in the store. No, I cannot block my brain from focusing on the giant gaping hole in my heart but at least I can take a little while where I don't let the obsession of infertility treatments and the devastation that inevitably happens every month run my life. I will sign back on in the spring. Until then...

Waiting

Well, I finally got to complete an IUI cycle with the hybrid medication. Everything looked good to go on my day 10 ultrasound so I gave myself the Ovidrel injection to cause the egg to release on Tuesday night and had my IUI Thursday morning. Now we are in the torturous 2 weeks of anxious anticipation to see if it worked.

Cycle 18

It has now been a year and a half of trying. Last cycle didn't work but that isn't surprising. Today I had my day 3 monitoring ultrasound to see if I can go ahead with the hybrid therapy and insemination this cycle. Everything looked good which apparently means that the cyst I had last cycle is gone. Yea! This time I will be using Femara and half the Gonal-F strength as two cycles ago to prevent overstimulation. Please wish me luck!

National Infertility Awareness Week

This week is National Infertility Awareness Week. Stop by the RESOLVE website and you can send a letter to your House representatives to encourage them to support The Family Building Act of 2007 (HR 2892), introduced by Rep. Anthony Weiner (D-NY) which would require insurance coverage of infertility treatments (including IVF) by all health plans that also cover obstetrical benefits. You can also send a message to your senator to support The Adoption Tax Relief Guarantee Act, introduced by Senator Jim Bunning (R-KY) and Joe Wilson (R-SC) which would make permanent the tax credit available for families who adopt. There are also other resources and information. Please follow the link below:
http://www.resolve.org/site/PageServer?pagename=evt_niaw07

Dissapointments and Delays

So, we did not get the anniversary present that we were hoping for. I guess I would have gotten the same result if I had followed their instructions so nothing ventured nothing gained. Nonetheless, the two weeks of anxious anticipation followed by the blow of failure is really wearing on me.

The plan for cycle 17 was to do the hybrid therapy again, Femara pills plus Gonal-F shots, but to cut the dose of the Gonal-F in half to decrease the chance of over ovulating again. So I went in for my day 3 ultrasound to make sure that everything was good to go and found out that I couldn't do the treatment this month because I have a 17 mm cyst in my right ovary. Gonal-F can increase the size of cysts so they do not allow people to take it if they have cysts that are too big. Last cycle I had one that was 15 mm, just below the cutoff, so I was okay but this time I was above the cutoff so no Gonal-F for me. What a bummer. But what do you expect with Polycystic Ovary Syndrome? My doctor said that she would allow me to go ahead with treatment but it may not work because the ovary with the cyst may not respond to the medication or it could produce hormones on its own that would prohibit either ovary from responding. She said that there is a 80% chance that the cyst will go away on its own and I can do treatment again next cycle but if I went ahead with treatment this cycle, there would only be a 50% chance that the cyst would go away. With the lower chances of the medication succeeding, the lower chances of the cyst going away, and the cost of the treatment factored in, I made the tough decision to go ahead and skip Gonal-F and insemination this cycle. I did still take the Femara to help me ovulate but I am not holding my breath for any success this cycle. It is disappointing enough to go through treatment and not get the results you want but it is even more difficult when you can't even go through the treatment!

No IUI For Me :(

On Tuesday the clinic cancelled my intrauterine insemination. I was using Femora and Gonal-F shots and apparently they were too effective. My day 10 ultrasound and blood work looked good with one dominant follicle developing but by my day 12 ultrasound and blood work I was supercharged with 4 good follicles. They said that the risk of multiples was too high (25% chance of twins, 5% chance of triplets, 1% chance of quadruplets) so they cancelled my IUI and told me to abstain for the next week. I was quite devastated but then I thought, ' more is better than none,' so I ignored their advice and, although we didn't have the benefits of insemination, we tried the old fashioned way. I will know on our 4th anniversary, October 25, if it worked. Please say a prayer for us! And throw in that prayer the wish that I am not pregnant with more than 2 babies!

Inspiration

I started reading a great book today, "Empty Womb, Aching Heart" by Marlo Schalesky from which I adapted the title to my previous blog entry. It is a compilation of true stories of couples experiencing infertility and how even though they did all not find answers or get pregnant, they all found comfort in God and strength in faith. It is very insightful and deals with all sorts of problems like strained marriages, tests of faith, jealously at other people's pregnancies (especially unwanted ones), feeling punished, losing yourself to your despair, insensitive people and their unsolicited advice, etc. I have been feeling like we aren't a family anymore with Rachel in New York and a particular narrative in the book helped me realize that we are a family, even if it is just the two of us. I especially wanted to post a great poem from Chapter 18. Unfortunately, I have no clue who to credit for it.

He Is There

When dreams are as dying things
Withering in your grasp,
When hope becomes a stranger
In a parched, desolate land,
When vision has all but vanished
As mist before the fire,
He is there.
When prayers crumble at your feet
In wisps of shattered words,
When night gathers dark and deep
Shrouding trails of light,
When all seems lost forever
As if day will never dawn,
He is there.
When you look deep inside
And see the barren soil,
When despair has gained mastery
And tears have all run dry,
When there's no one left, nothing left
But the bitter taste of death,
He is there.
As He was in Gethsemane
The night before the trial,
As He was at Calvary
When nails were driven deep,
As He lay within the tomb
Before the dawn of life,
He is there.

Empty Womb, Broken Heart

Okay, so a dramatic (and slightly plagiarized) title but I am now on cycle 16 and getting very frustrated. Cycle 14 in which I did Clomid and Metformin was not a success. Cycle 15 was my 6th and last allowable cycle with Clomid in which I did intrauterine insemination which failed. I took a pregnancy test a day early which was negative but was not without hope that I would get a positive result in a few days. But my hopes were crushed when my period arrived at work on Friday and the sorrow rushed over me like a tidal wave. I had to go into the bathroom and cry through my lunch break.

I called my doctor's office and they told me that I would have to skip the next cycle as I could not get in to see my doctor until the end of October and I obviously, couldn't start a new medication without a prescription and consultation with her. I emailed her and the angel called me right away and set a new plan into motion so I can do IUI again this cycle. I am doing what they call hybrid treatment, taking Femara pills days 3-7 of my cycle and injecting Gonal-F from day 7 until they tell me to stop. I had an ultrasound on day 3 to make sure that I didn't have ovarian cysts before I start the drugs and I will need repeat ultrasounds on day 10 and day 12. I am not sure how the IUI factors into there but I will find out on Thursday when I receive my injection instructions. I am a little nervous about the injections. I can stick a needle into other people without a problem but I may have a little trouble doing it to myself.

I felt a little better when my doctor explained why the IUI cycle failed last month. A side effect of Clomid is that it can thin out the uterine wall which effects Estrogen levels and can make it hard to get pregnant. This is why they limit the use of Clomid to 6 cycles. My uterus was quite thin on the ultrasound done the day before the IUI so a result of pregnancy would have been highly unlikely despite the fact that I had 4 good follicles and Paul's swimmers were all cleaned and polished. That made me feel less like a failure but more like WTF! why did I spend the money on an IUI that they figured wouldn't work! This new drug combo should not thin the uterus and is proven to be more effective (but more expensive) than Clomid.

Please keep me in your thoughts and prayers this month!

Cycle 14?

I think that I am on cycle 14 now. I can't even remember. All I know is that it has been a heck of a long time. I decided to give Clomid plus Metformin a one cycle chance and, if that doesn't work, move on to insemination on my last Clomid cycle. Rachel will be leaving to go to New York at the end of this month (so sad) so it will be easier to focus on insemination and all the appointments related to it then.

We had a different leader at our RESOLVE meeting last weekend who, when noting my pessimism and Paul's optimism, talked about positive imagery and its impact on fertility and fertility treatment as she learned from the book "Getting Around the Boulder in the Road: Using Imagery to Cope with Fertility Problems" by Dr. Aline Zoldbrod. I found this very interesting but, as of yet, have been unable to get my hands on a copy of the book as it is out of print. However, from the little bit she told us, I am trying to be more positive and think of in terms of "when" I get pregnant, not "if". I also am trying not to assume that each cycle has failed and therefore look toward the next step. (I am obviously not doing well at that part since I just mentioned my next steps earlier in this blog!)

Blah

I think that I am having pre-menstrual cramps which is, as always, devastating. My doctor says that it is time to move on to insemination. I am glad to be proactively moving forward but sad that we cannot accomplish our task in a more natural manner. She added Metformin to my Clomid which is a drug given to help control Polycystic Ovary Syndrome and help increase my fertility. She confirmed that I only get 2 more cycles of Clomid. After that, it is onto more expensive shots in the stomach. I am currently debating between trying one full cycle of Clomid plus Metformin before insemination or just going for it next cycle. I have to decide soon because the ball starts rolling after day 1 of my cycle.

I forgot to mention in my last blog that at the beginning of July I went to a RESOLVE peer support group meeting. RESOLVE is the national infertility association whose mission is to provide support, education, and advocacy to the 7.3 million Americans who suffer with the disease of infertility. I met some really nice people. It was great having people who can relate to my problems. They are much further along in the infertility journey than I so they provided a lot of advice and support. It was nice to hear that I am not being selfish and illogical as I find myself increasingly annoyed with pregnant women. (This week I heard of two more people who got pregnant before they even started trying. Argh!) It was also very nice to see that infertility has made them all stronger as couples.

I also forgot to mention that I finally spoke with my mom about our fertility problems. She was awesome. I have absolutely no idea why I didn't confide in her sooner.

Long time, no blog

Apparently it has been a long time since I last posted. Sadly there have been no positive developments. Paul finally got in to see a Urologist who confirmed his teratozoospermia with another semen analysis but there is apparently nothing they can do to help. A fixable cause would be a varicocele which is a dilated blood vessel that is basically causing the little guys to be cooked to deformity but apparently he doesn't have that. He also has a normal testosterone level. So in the absence of these problems, there is nothing they can do to raise the percentage of normal sperm. He suggested intrauterine insemination which is another name for artificial insemination. They would give me drugs to stimulate ovulation (more powerful than my current Clomid) then when the time is right they would take his swimmers, wash and concentrate them, picking out only the normal ones, and place them in my uterus. My doctor has also suggested this as our next step if Clomid is unsuccessful for us. I have taken Clomid for the past 4 cycles with no success and the maximum amount of time they let you take it is 6 cycles. I see her in about an hour so I will see what she says...

Yes or no

Well, ovulation has occured this cycle. Now the waiting game of did it work or didn't it...

Is it hot in here?

I am on day 6 of my cycle which is my second day of Clomid and I am having the fun side effect of hot flashes like mad. I am not looking forward to menopause! I didn't have any side effects last month but this time I am not so lucky. Whew!

Onto cycle 11

Well, the Clomid didn't work for us this cycle. I was so sure it would. I am disappointed beyond words. I had a negative pregnancy test when I was 2 days late and was going to try again when I was 5 days late but the answer came on day 4. I took another test anyway but, of course, it was negative. Poor overly positive Paul, he was so sure that this was it too. He even had a dream that I was pregnant. I have to hand it to him, he bounces right back with, "better luck next month, the trying is the funnest part." I, on the other hand, have been moping all day.

I wanted to give my mom the best mother's day present- grandmotherhood. I haven't even told my parents that we are trying because I wanted it to be a complete surprise when we got pregnant. I know they can't wait for me to have kids. But now with our apparent problems and the failure of the first round of medication, I think I need to tell them what's going on. Not only so that they aren't out of the loop but also for their support. I am really worried now that the Clomid may not do the trick. I need my mommy.

10 cycles and still trying...

I know that I am not the first person to have difficulty trying to get pregnant and I certainly won't be the last. I know that this story has been told a thousand times over but this time it's my story. I come from a strong and persistent mother who fought like heck to have me and was unable to have any more children. Now it seems that I am destined to continue her fight but hope to God that I can find the strength.

My last pill was on August 9, 2006. After years of procrastination, we threw out the pack mid-cycle. The usual "let's first finish this project, pay this off, save more money, etc" excuse list that can carry on for a lifetime had grown lame. We just found out my sister-in-law was pregnant and my husband thought it would be great to have cousins close in age. I said, "sure!" to my surprise and into the garbage the pills went.

At first it seemed fun but after many cycles went by, the waiting really got to me. I admit, I am not at all patient. When I want something, I want it NOW. 9 months already seems like long enough to wait! Finally, my primary care doctor agreed to refer me to a reproductive endocrinologist to see what the problem was.

I met with my fertility doctor for the first time on March 20, 2007 and I just loved her from the start. She was very straightforward and seemed quite proactive. She ordered a battery of tests. First, we did a sonohystogram which is an ultrasound procedure to visualize the inside of the uterus and endometrium. She put a catheter in my cervix and inflated a small balloon to hold it in place. Then she injected saline into the uterus and watched on the ultrasound as the saline moved through my fallopian tubes to make sure that there weren't any blockages. She also looked at my ovaries for cysts or abnormalities. Everything looked good so that was a relief since my mom suffered so bad from endometriosis and uterine fibroids. The procedure caused a lot of cramping but it subsided shortly after it was done. I also did a bunch of blood tests including a Clomid challenge test where she checked my follicle stimulating hormone, lutenizing hormone, and estradiol on day 3 of my cycle, then I took 100mg of Clomid on days 5-9 then she checked my levels of follicle stimulating hormone again on day 10. (Clomid is a fertility drug that influences the way that the hormones required for ovulation interact and ultimately leads to the release of one or more mature eggs - ovulation.) The blood tests showed that I have a hormone imbalance which is quite similar to Polycystic Ovary Syndrome but doesn't quite meet the requirements for diagnosis. Anyway, the hormone imbalance could lead to me either not ovulating or not producing mature enough eggs for fertilization. The good news is that I responded quite well to the Clomid so there is hope.

My doctor also ordered a semen analysis on Paul which he was so not happy about. She said that he had a record number of swimmers, more than they had ever seen in their lab, but that 95% of them were abnormally shaped. The good news is that 20 million normal sperm are the minimum they feel are required for a shot at fertilization and with his high volume, he had 40 million normal sperm. However, she suggested he see a urologist because he may have a varicocele which is a dilated blood vessel that are overheating the sperm and causing them harm. This is apparently quite common and easy to fix. Again, he is not so happy about the prospect of seeing a urologist. I made him an appointment with his primary care doctor on May 23 to get the referral assuring him that if I become pregnant in the meantime, he doesn't have to go.

So from the tests, the action plan my doctor and I agreed on is for Paul to see a urologist and for me to continue trying Clomid for the next 3 months. We will then meet again and see if we need to move onto insemination. I am hoping that the Clomid works, not only because it means that I will be pregnant finally, but also because my insurance does not cover any fertility treatment besides diagnostic testing and has a $5000 cap on fertility medications. Isn't that nice? "Yes, we have determined you have a fertility problem, now too bad for you because we won't help you fix it!" My doctor said that when it comes to fertility-challenged couples (I hate the term infertility, it makes it sound like it's impossible) 1/3 of the time it's a problem with the woman, 1/3 of the time it's a problem with the man, and 1/3 of the time it's a problem with both. Apparently we fall in the last category with my pseudo-PCOS and Paul's teratozoospermia.

Meanwhile, my sister-in-law just gave birth to a healthy and happy little boy. I am so happy for her but at the same time cannot help my envy as she is already at the destination and I cannot seem to catch a train...