"Wow..."

"Wow." Those were the first words out of the doctor’s mouth when he came into the room where I was waiting for my baseline scan. But let’s back up a little bit…

The 2 week wait was horrendous – the worst one yet, I think because everything had gone SO well. It was like the perfect cycle. That’s a lot of pressure. I had moments where I felt like maybe it had actually worked and then others I felt like I just couldn’t believe it. I had some symptoms that I hadn’t had before (SUPER sore and puffy boobs!) and I noticed a lot of twinges in my abdominal area. But I told myself that it could just be side effects of the Follistim (or gas!).  Also, both weekends of the wait put me in situations where I was the only one in the group not drinking which was really not fun. It’s one thing to be the pregnant one of the group but being in that in-between “might be pregnant” place was not easy.

Friday – 11 days after my trigger shot and 9 days after I was supposed to have ovulated – I broke down and bought 3 pregnancy tests and went home and took one. I knew it was too early and that it wasn’t going to tell me anything but I was just tired of giving my period all the power (as strange as that sounds!) I wanted bad (or good) news from another source.  There was a super, super faint “am I really seeing this?” line – but I knew it could be the HCG trigger still in my system so it really didn’t help at all. (As an aside, the injection I take to make me ovulate is the same hormone that makes a home pregnancy test show positive. That’s why they tell you to wait 2 weeks after the trigger to test – it can be a false positive.) But I knew if I took another test and the line was darker, it could mean it was the HCG of a pregnancy. I broke down and took another test on Saturday (so impatient!) and it looked pretty much the same or maybe fainter.

Sunday was the 13^th day past my trigger – the day my period had come every other treatment cycle. I remember lying in bed that morning in pain from having to pee but being scared to get up and find that my period was starting. To my relief, it hadn’t. I decided no tests that day – if I made it through I was going to test again Monday. Then when I got up and around, I started to feel queasy – not like I was going to vomit but just upset in the stomach. Of course, I immediately Googled “how soon can morning sickness start?” and began to feel hopeful. The queasiness gradually developed into a feeling I can only describe as “weird” – I just felt weird. But then the lower abdominal cramping began to get worse.  We were standing in line at the grocery store and I knew it – it took everything I had not to break down crying.

As an aside, one of the worst parts of when my period starts is telling Jared. It’s always the same – me in the upstairs bathroom getting the bad news and then the slow walk downstairs.  He starts talking about something or asks me a question and I have to stop him in his happy tracks…

We were, of course, terribly upset – even though you try to remain as neutral as possible during the 2 weeks, it’s still a crushing blow. I think we were both terrified about having had a “perfect cycle” and it still didn’t work. But I also read that success rates of Follistim increase each time up to 3 times – I told Jared “we just need to play out our odds!” That night I had 2 glasses of wine and a big bowl of ice cream and tried not to cry.

 It was back to the clinic for a baseline scan to start another round of Follistim…or so we thought. (You know how something bad happens and you are upset, and then something worse happens and you look back and wonder why you were so upset about the first bad thing.)

As I said, the first thing the doc said was "wow." He and the nurse couldn’t believe we were back and that the cycle hadn't worked. As soon as he started the scan, I looked up at the screen and saw the big blobs and knew something was not normal. Yep – a bunch of pretty sizeable cysts on each ovary. The doc and the nurse said they were worried this would happen (a side effect of injectables that no one told us about!).  As I understand it, because I had so many follicles in the last cycle, the ones that do not ovulate an egg sometimes fill up with fluid causing the cysts. They would naturally go away but it meant we couldn’t start a new round of treatment this month and, to add insult to injury, without treatment this month, of course I will not get a period and I’ll have to take my 31-day round of pills to get it again. So that means we are out of the game until JULY. I started to bawl right there…

I wish I could accurately explain the pain I feel right now (and I will admit it is very raw at this particular moment in time). It’s a constant state of heartache. I feel like we are living a tragedy.

But even in my sadness, I feel like I have no right to feel sorry for myself - there is so much in all this that I have to be thankful for…

-- Unlike so many other couples facing a similar battle, we do not have to worry about the costs associated with these treatments. (I read online that one vial of Follistim, which I would go through in a few days, would retail for $900!!) Our insurance is such a blessing.

-- In the world of women with fertility problems, I am considered young (versus women trying to get pregnant in their 40s) – and my age increases our odds of success with treatment.

-- I follow some online infertility message boards because I like to read about other women’s experiences. I cannot believe how prevalent miscarriages are – there are women who are going through the same struggle I am but that have gotten pregnant and miscarried (sometimes more than once). I can’t even imagine going through that and I am thankful that I haven’t.

-- Most importantly, I am most thankful for Jared. He is the most supportive and caring partner that any person could ask for and he is fighting this battle right alongside me. My life is blessed in unimaginable ways and I know I have to focus on that at all times.

So what now? It’s back to life as usual I guess…and waiting for summer.

The Dreaded 2 Week Wait...

When we last left off, I was just starting my Follistim injections.  I was at the clinic for bloodwork and scans every other day (which was painful not only for my time but also for my gas tank and my veins –my arms are still sore). I started at 50 units, then it was 100, and then 150…by my 9^th injection day (a Friday), we finally had measurable follicles on the screen!  I was so relieved in that moment! After 2 previous visits of seeing nothing, I had begun to panic that the meds wouldn’t work. So they kept me at 150 through the weekend and at my Monday scan I had 5 measurable follicles! 2 of them were mature – a 17 and a 19 (I believe 16 to 21 is the goal). Plus, as soon as the doc started the scan, he said that my uterine lining looked the best it ever has (previously it was thin, making implantation more difficult)…I was totally overwhelmed with good news J


**Here is a pic of all my injection equipment:

 

They informed that I would do my HCG trigger shot right away and come in for an IUI the next morning. This kind of surprised me because the shot is supposed to make me ovulate 24-48 hours later, making a next day IUI a bit early. But I think they wanted me to do the shot ASAP so that none of the other 3 follicles got closer to maturity (risk of too many babies!).  Then there was another problem...

The nurse came in and said the lab was slammed for the morning of my IUI because the doc was in surgery in the afternoon and had to take all his patients in the morning…could we collect the sperm sample at home??!! I started to freak out and explained to her that it takes us AT LEAST an hour and 15 minutes to get to Danville. She said it would be okay as long as it was no longer than an hour and a half…I was like, geez – I have to risk my whole cycle and 11 days of injections on a 15 minute window! I could just see the spontaneous traffic on the bridge in Northumberland ruining everything.  Needless to say, I was not a happy camper. In the end, Jared and I decided that the risk was too much so we opted to drive back out to Danville that night and stay in a hotel. It made for a very strange, outside our routine 24 hours but I still think it was the best option.

When the doc and nurse came in for my IUI, they said that the lab paperwork had noted the sperm sample as “Excellent!”  This combined with my super uterine lining had us high with hope! The IUI was more painful that my previous 2 (which stinks because I will now have anxiety if I ever have to do it again)…the doc had a resident with him and he let her do it and I think she bumped my uterus making it contract. I am pretty sure he said “sorry” 100 times as I was moaning in pain, haha.

 

**I had Jared snap this pic of me after the IUI (they let you lay there for 10-15 mins with your hips elevated - it's actually very relaxing...a chance to take a breath and feel relieved.) -- I figured if we did make a baby this cycle, it would be a picture we'd be happy to have:

 

But all is a done deal now and we are officially in what I believe to be one of the WORST parts of these treatments – THE DREADED 2 WEEK WAIT. That’s how long it will take for me to (a) get pregnant; and (b) have it show up as a positive on a pregnancy test.  It’s 2 weeks of: Googling about success rates, questioning every abdominal twinge, worrying about how much I should exercise or if it can hurt my chances, wondering what could be going on in my body (or not going on). Also, I am choosing to have no alcohol this round. I have not drank before and then allowed myself to have a few in previous cycles. But I've decided to err on the side of caution this time because everything has gone so well.

I find myself walking that fine line between not sabotaging myself with negative thoughts and not getting my hopes up. I think that might be the worst part of the 2ww – the hope. I want to feel hopeful – it’s unlike other moments in time because I could actually be pregnant (or be getting pregnant ) – but I am also terrified of allowing that hope to creep in…because once it creeps in, it makes a sad outcome so much worse.

How to have a full scale melt down in the hospital pharmacy…

So after 2 weeks of waiting for my period to come after the Femara failure (which I knew it wouldn’t) and then my 31-day cycle of pills to induce a period, we were back at the clinic this week! It was actually kind of nice to have had the 6 week break. It gave me the opportunity to relax and focus my energy on things other than fertility meds…driving to Danville for scans…am I eating enough?...am I running too much?...am I ever going to be able to get pregnant?...It was like my brain got to be just a little bit quieter for a brief moment in time.

We knew we were starting injectable meds this cycle so Jared came along to my baseline scan appointment, which he doesn’t normally do. I knew I’d be getting injection instructions and I have a tendency to not listen when it’s important that I really pay attention. J (I am SO thankful he was there!) All went fine with the scan, everything looked good and we even got the happy news that our insurance would cover everything and we didn’t need to pay anything out of pocket up front. After my scan, they sent me next door for a blood draw (injectable meds involve scans as well as the monitoring of blood work – oh joy) and then I was to go the pharmacy in the hospital to pick up my meds (Follistim is the name of the new drug) and come back to the clinic for my injection lesson. I would be starting my first injection that night (cycle day 3). When we went to the pharmacy, I verified that they had gotten the script from the doctor and she began to get it ready. Then she called me up to the window – as it turns out, because it is such expensive medication, our insurance requires that we obtain it from a “Walgreens Preferred Pharmacy” – a mail order company – and that it had to be shipped to us!

I have to explain that upon entering the clinic and Geisinger Hospital in general again, I found myself to be on edge…I have so many sad and frustrating memories of this place – it’s like I was just waiting for the floor to drop out from under me. So when I heard this, I lost it. I pretty much had a panic attack and began to sob uncontrollably in the pharmacy.  I just remember thinking that if we couldn’t get the meds I wouldn’t be able to start the new cycle that night and I would have to take Clomid again, which doesn’t work, or go through another 2 month break. I just felt that cloud forming over me again – “it just shouldn’t be this hard”. I was overwhelmed in one moment with all the awful things that I try not to let come to the surface…it’s not fair that other people can just get pregnant…why is this happening to us?...Did we do something to deserve this?...I am never going to be able to get pregnant.

Long story short – despite the efforts of the wonderful pharmacy tech, who was on the phone for 40 minutes trying to get Highmark to grant us a one-time emergency exception, it was a no-go. Thankfully, we found out that the company could overnight the meds to us and, although not ideal, I could start the injections the next day (CD4). Did I freak out for nothing? Pretty much, haha. It made for a very long and exhausting morning…

So here’s where we are – 1 injection a day (they are easy peasy – in the belly, tiny needle, no pain – even a reusable injection pen which is way easy to use)…I go back to Danville in a few days for a scan and new blood work. Based on how things look, he could increase my dosage. (This is the nice aspect of injectables – with oral meds, I wouldn’t be able to increase dosage until the next cycle.) The nurse told me to expect probably 8-10 injection days until I am ready for my HCG trigger shot (to ovulate) and an IUI.  I am trying to not to get my hopes up because, as I learned with Femara, there is just no way to know how my body will react to any medication (stupid lazy ovaries!!). But, right now, I am thankful to be starting a new chance at getting pregnant.

It just shouldn't be this hard...

So I was in Danville last week for my first scan after taking Femara…I was trying not to get my hopes up but I thought I would get at least the same results as I did with Clomid, if not better. Well, there was not a measurable follicle to be found. Even on my first round of Clomid at the lowest dose I had SOME response…but there was NOTHING. I was really upset. The doctor said that we will definitely start me on injectable meds next time and to not get discouraged.  I hate it but when I go to the doctor by myself -- he just sounds like the teacher from Charlie Brown – I just don’t have a full understanding of what’s being said. (Plus, our doc has a pretty thick accent that takes some getting used to.) All I remember is a few fragmented phrases: “If we can just get you to ovulate…so we can get you pregnant…you have been with us for such a long time.” That last part was the killer: “You have been with us for such a long time.” I felt like I was now not only in the small number of women who need infertility treatment, I am now also in the even smaller number who have basic infertility treatment not work.  And wasn’t I ovulating the last 2 cycles?? If all of this wasn’t enough, when I relayed the info to Jared he reminded me…when there’s no follicles, there’s no period! So I am stuck taking my 31-day round of pills to get my period. I went from being hopefully about our February cycle to facing not being able to try again until APRIL.

 The doc had me return for one last scan in a few days to be sure the follicles didn’t grow, which they didn’t. Plus, at this appointment, I got more information about the injectable treatment I was in for in 2 months. There was no good news – more visits to the clinic, injections every day, blood work and scans, and more money. They even made me sit down with the insurance lady and sign a paper saying she went over my maximum out of pocket costs.

 As an aside here, I have amazing insurance coverage thanks to my wonderful husband being willing to work at a job he doesn’t really like that is an hour away. LOVE YOU!! We are beyond thankful that, at least at this point, we do not have to worry about how to pay for treatment. Now if we get into IVF, it could be a whole new ball game.

After this appointment I was realizing that we were moving into a new realm of treatment. The basics had not worked and now it was getting more invasive. I have really found myself questioning how far I am willing to go to get pregnant. I know, I know – most people would think, “if you really want to have a baby, you’d do anything”. But there’s a part of me that feels that it just shouldn’t be this hard.  And I am beginning to open to the idea that maybe it is not in God’s plan for me to have children.

So at this point, we have decided to definitely try one round of the injectable meds and see how it goes. But Jared and I have started to have some serious discussions about our “no kids” life and what it might look like. As of now, it's some time off from everything and waiting for spring...

An Introduction

I am not entirely certain that I know my purpose for starting this blog. I think a part of me just wants to get it out – to put down in writing what’s in my head. I also think, in part, that it could be a good tool to share with others who want to know what we are going through. I am not even entirely sure how much I want to share here. Of course, the technical side of things…but I am hoping I can be brave enough to also share the emotional side. I will work on that…

 Until then, here is our story so far:

 You know how you don't know how badly you want something until you can't have it? Then, you want it so much that it's all you eat, sleep, and dream about. Well, that's my tale of trying to get pregnant....

 I have dreamed my whole life about being a mother...it might actually be the only dream I ever had (aside from being rich and famous, of course!). I always wanted to be the "soccer mom" – the kind of mom who runs her kids all over town to practices and friends’ houses, who makes their birthday cakes and helps them with their science fair projects.

 It was June 2011 when Jared and I started talking seriously about starting a family. We had been married over a year and I had just quit my job an hour away in favor of a job not only less than a mile from our house but that also allows me to make my own schedule.  So at the end of June I stopped taking my birth control pills with the intention of giving my body some time to get back into the swing of things and to officially “stop trying to NOT have a baby” after we went to the beach the first week of August. I remember phrasing it this way because I didn’t want to get TOO excited (in retrospect, it’s like I already had a premonition that this was not going to be easy).

 In July, when my period normally would have come, it didn’t show up. I had read that it could take some time for the body to start doing its thing again so I didn’t immediately panic. But when I still had had no period by August, I emailed my doctor. She said to wait 3 months before making an appointment…well, 3 months came and went so I went in for blood work. Everything came back normal. So she referred me to an OBGYN, who put me on Provera – a pill a day for 10 days that was supposed to “jump start” my cycle. Three rounds of this and nothing. Now I was starting to worry.

 The next step? A consult with a fertility doctor in Danville (which is an hour and 20 minutes away – a drive that I have done so many times by now I am pretty sure I could get there in my sleep). It was now January 2012, six months since I stopped my Pill.

Our first fertility clinic appointment left Jared and I feeling a bit discouraged…we realized that was it could be a very long road. It began with blood work for both of us (which was normal), then a semen analysis (again, normal), then in the spring I had a procedure called a hysterosalpingogram (HSG). Let’s just say having dye shot into your fallopian tubes (to make sure they are open) is not a pleasant experience…I think I frightened every person on the radiation floor with my screaming. It was quite the traumatizing day. But again, all looked normal. By this time the doc was able to induce a period (which I had to have to get the HSG and all subsequent fertility treatments) – a combo of Provera and estrogen, a 31-day cycle of pills, did the trick.

 After the HSG, we needed a break. Plus, the doc said that some people have success getting pregnant after an HSG because it can clear out a partial blockage in the tubes (which could be why it was so painful for me). So we decided to just do our own thing for a few months…but nothing – no baby and no period. Things were just not working.

 September 2012

In August, I started my pills to get my period so we could begin treatments for infertility. (They still have not given me an official diagnosis – it’s unexplained infertility and/or ovulation problems). In September 2012, I did my first round of Clomid – a pill a day for five days – that is to stimulate my follicles/eggs to grow. However, the dosage was too low and my follicles did not grow enough so the cycle was cancelled. No period.

 November 2012

So October was “period pills” month and we were back in November to try another round of Clomid – 100 mg this time.  This time my follicles were big enough to “trigger” – meaning I got an injection of HCG (human chorionic gonadotropin ) in my belly that is to trigger me to ovulate in about 24 hours.  At this point, we wanted to keep some part of this process “natural” so we opted for timed intercourse over intrauterine insemination (IUI). The bad news: no baby. The good news: my period arrived! I was actually very happy about this because it meant that as long as I was getting my period, (a) I was likely ovulating, and (b) we would be able to try every month rather than having to take a month off between each cycle for me to take my pills to get my period.

 December 2012

The doc upped my Clomid dosage again – to 150MG – and again my follicles reached a good size (although it took longer than expected) and there were 4 of them, which is good. This time we decided to go with the IUI – no more messing around!  On IUI day, Jared has an appointment to do his part –cough cough wink wink – and then they “wash” his sample (ie. weeding out the marathon swimmers from the lazy ones) and 2 hours later I have my appointment where the doctor uses a catheter to inject the sperm into my uterus. Not a very pleasant experience but not horrible.

 I let myself get too excited in the December cycle. I don’t know why but I had convinced myself that it had worked. My period started the day before Christmas Eve and I was totally devastated.

 January 2013

Back to Danville we went. Another round just like December – 150 mg Clomid with HCG trigger and IUI. This time I had to give myself my HCG injection at home for the first time (instead of a nurse at the clinic doing it) – I was so stressed! But this round failed and my period arrived.

 February 2013

So that brings us to the present. I was just at the clinic last week for my baseline scan (first ultrasound of the cycle to ensure there are no cysts on my ovaries and that everything looks good). This time, the doc asked if I wanted to try a new drug – Femara. I course! I’ll try anything! It’s an oral drug just like Clomid. I feel pretty much the same as I did on Clomid although my night sweats, which were my only Clomid side effect, seem to be worse. I go back next week for my first scan to see how I am reacting and how big the follicles are.