an update...finally

As some of you know, we did an IUI on the 8th. Then came the dreaded 'two week wait.'

On the 13th I had my progesterone level checked and it came back at 22. Anything over 20 is awesome, so now it's a waiting game.

On the 14th I took a home pregnancy test and it showed positive. The next day it was negative. Now I knew for sure that the trigger shot was out of my system and any positive test would be an actual pregnancy. Negative, negative, negative...

Finally, on the 21st I got a positive test! Only problem is I started spotting only an hour after I took the test. Everything cleared up and I let myself get excited.

I had my blood work checked on the 22nd and didn't like what I heard. My progesterone was at 9 (still should be over 20) and my hCG was at 33. Anything over 5 means a pregnancy, but 33 is really low. So I started progesterone supplements and waited some more.

I started spotting again on the 26th and had my blood work redone on the 27th. My progesterone was high enough but my hCG was only at 56. In a good pregnancy, the hCG level should double every 2-3 days...it didn't even double in 6 days. So that combined with the spotting, the doctor said that the pregnancy just isn't meant to be.

Technically this is called a chemical pregnancy since there is no visible evidence of a pregnancy. But that is just a polite way of saying it's an early miscarriage.

Now I have to wait until July 5th to make sure that 1) it's not a tubular pregnancy and 2) that my hCG levels are actually going down. I have to wait until it is below 5 (preferably 0) before we can try another IUI round.

So, if anyone was wondering why I seemed so stressed...you know now.

Also, I will not be continuing this blog. I love having my story out there, I just can't continue to share with people who don't care. If you want to know what's going on...please ask, it's the people who do care that I started this for.

2 week wait 2009

Sorry, this one is taking a while to write.

Most of you know that we had an IUI that worked. Well this is it! Here's how my 2 week wait went...

Thursday 05/28 - IUI

Wednesday 06/03 - My grandmother passed away. This is MY Mema. She was the one who was always there. She helped my mom when we were younger. She drove us to school, helped with laundry...her house is where we always went for Chirstmas Eve with the whole family.

She went into the hospital (like many times before) with chest pain and difficulty breathing. She had survived 5 heart attacks, double bi-pass (which she wasn't expected to make it through), 3 kids, 8 grand kids, and 3 great grand kids (at the time). After a long wait in the ER they decided to admit her...again. Here's what I saw...

My grandfather called my mom (who I worked for at the time) to let her know that Mema was being admitted to the hospital again. My mom told him to call when he knew what room number and she would be up there around lunch time. An hour later, my mom busts through the door from the warehouse looking like she was going to throw up. I stood up and asked what had happened. All she could manage was, "She's gone!" I knew exactly what she was talking about, but I don't think it really registered. We stood there holding each other for what seemed like forever. Then shock came over her face when she realized she now needed to call her sister and her brother and tell them what had happened. I did what I could to comfort and help her as she called person after person. And the pain would hit her again every time she said the words, "mom died" and every time she thought of someone she needed to call.

Things were blurry after that for the next few days.

Thursday 06/04 - The viewing was surprisingly okay. Mema looked very peaceful and there were TONS of stories being told. I guess it didn't seem quite real because she was still there physically.

Friday 06/05 - The funeral. This was VERY hard emotionally. I'm sure most people have been in a similar situation so I'm not going to get into it. Looking back, I should have known something was up on the pregnancy front but I was a little distracted, to say the least. My breast hurt so bad that I cringed every time someone wanted to give me a hug. Not just because I didn't want her death to be real, but it hurt like hell with every hug.

Saturday 06/06 - I told my husband that I refused to even think about taking a home pregnancy test until after my Mema's funeral, so Saturday morning I peed on that little white stick. I got the digital read out ones because I didn't want any question of whether there were 2 lines or just 1. I had enough time to finish my business, wash my hands, walk into the living room, and sit down before it registered "Pregnant." My first thought, as funny as it seems, was 'holy crow! they actually do work!' Then came the cautious optimism. It could be reading positive because of the trigger shot (it's the same hormone that is read on a pregnancy test). I mean, it had only been 9 days...still 5 days before my 'missed period.'

Sunday 06/07 - Another positive pregnancy test. I, again, tried to not get my hopes up...but it was getting REALLY hard.

Monday 06/08 - ANOTHER positive pregnancy test. Now my heart is fluttering and I can't sit still. My sister-in-law delivered her daughter this day and she wanted all of the women in her life to be there at the delivery. If I hadn't seen 3 positive pregnancy tests, I probably couldn't have been there. She pushed for about 3 hours, but after about an hour I thought I was going to pass out. Psst! Feeling light headed is VERY common in early pregnancy...much less with what was really going on inside of me.

Tuesday 06/09 - Another positive pregnancy test.

Wednesday 06/10 - Another positive pregnancy test. I never thought I'd like peeing on a stick so much! I should have known there was more going on when, the day before my missed period, I pee on the stick, set it on the side of the bath tub and before I can even stand up it reads positive. :D

Thursday 06/11 - I ran out of home pregnancy tests, but I went in for a blood test. Then I had to wait for the nurse to call me with the results. So me and my husband twiddled our thumbs and tried really hard to think of other things to maybe, just maybe, the time would pass a little faster. My blood was drawn at 8:30am and my phone didn't ring until about 2:30pm. Talk about nervous. When she called, her first words were, "Congratulations! You're pregnant!" Oh my God! I never thought I'd ever hear those words.

She told me that my hCG level was 313. She wanted me to come in the next week for another blood test to see what my doubling time is. (the hCG level should double every 2-3 days in early pregnancy).

Thursday 06/18 - The results of this test was 4044! My first ultrasound was scheduled for 2 weeks later (7 weeks pregnant).

Wait and and see what we found out... (yes, I know most of you know the answer...but it's fun anyways)

sorry for the delay

Life has been crazy! I'm sure everyone can relate.

My E2 level came back at 358 and Dr. P said we were a go for Wednesday. So Monday night at 10pm (and yes, it is specific as to when it's given) my husband gave me the trigger shot. I forgot how much that thing burned! We followed doctor's orders to have intercourse and crossed our fingers.

Wednesday morning we woke up and found out that we had a new niece. Congratulations to the new mom! Then we went to Dr. P's office in time for my husband's appointment and waited. An hour an a half later, we did the IUI.

And then we wait.........

I go in Monday morning to see what my progesterone level is and if it isn't high enough I will have a 'fun' medication to take. And we wait........

Current Events

I went in for an ultrasound Friday and I had 2 follicles that were noteworthy. On the right, I had one measuring about 15mm and on the left, 13mm. Both had grown, but neither was big enough. My E2 (estridiol) measured at 131! This is fantastic for follicles of this size.

The nurse gave me my Gonal shot for Friday, and since I am out of my injectible pen she gave me sample size injections. The dose is the same but the procedure is very different. With the pen I twisted the end to the dose I need, clean the injection site with alcohol, insert the needle (comparable to an insulin needle...very tiny) then push the end of the pen to dose out the medication. Easy. Now with the samples we have to put an 18 gauge needle (really big) on a syringe and push the saline water into the medication vial to mix it with the powder, take the 18 needle off (thankfully) and put on the tiny needle. Then draw up the medication out of the vial, clean the injection site, then insert the needle and inject the medication. Fun...right?

I have an aversion to injecting myself with a full fledged needle and syringe combo, so my husband gets to help out there. Saturday we decided to go to the mall so I brought my medication with me. When the time came (this medication needs to be given at about the same time every day) we tried to find a place where I could take my medication without making other people think I'm shooting up. So we went into the family bathroom and proceeded to mix my medication and...oops, while pulling the medication into the syringe, we accidentally pull the plunger out the bottom and my medication goes on the floor.

The on-call nurse tells me that they will be in the office Sunday and I can just come up there and pick up another sample...Thank YOU!!!

This morning I went in for another ultrasound and more blood work. The follicle on the left side is now about 17mm and the one on the right is now between 21-22mm!!!!! This means the IUI will be scheduled for Wednesday or Thursday depending on my E2 level.

I'm sooo excited, but I'm trying to keep my head on earth. I know this doesn't always have the outcome I hope for and I don't want to be an emotional wreck if it doesn't work. Easier said than done.

Round 3

Baseline ultrasound shows everything is good and ready to go, so we start again. We sat down with Dr. P and he explained to us that if this IUI didn't work we would be moving on to IVF, but he was going to up the medication again to give us the best possible shot.

(I got a copy of this cycle, so I have actual dates and numbers for you.)

5/13 - I started my period

5/14 - I had my baseline ultrasound and started my medication.

5 days of Femara (as usual) followed by 3 days taking 125 units of Follistim.

5/21 - I had several measurable follicles. And my Estradiol was 73.6

Here are the sizes: 13.17, 13.03, 11.31, 10.32, 9.95, 9.19, 7.69. Yep, I had 7 follicles worth looking at...kinda scary since I had only had 1 or 2 to look at up until now. But because none of them were big enough to do anything, I did another 5 days of 100 unites of Follistim.

Estradiol is a hormone. This should be reading 150-400 per mature follicle. Obviously, smaller, not mature ones will produce some estradiol too.

5/26 - My Estradiol was 899!!! And I had 2 great looking follicles (sadly, I don't have the sizes) and 1 that may or may not release. We were then spoke to in a concerned voice that, should this work, we could have multiples. We didn't care! We did the trigger shot that night and...

Thursday 5/28 - We came in and did our IUI and I was put back on the progesterone suppositories. We were very hopeful this time because this is the first time our doctor seemed really excited about us getting pregnant.

And again...we waited.

Round 2

We started round 2 on a bad note, but Dr. P said we were going to add an injectable medicine this time around so we were a little hopeful again. It stared off the same as round 1. Ultrasound looked good and I took 5 days of Femara THEN we followed it with 3 days of Follistim. The first mid-cycle ultrasound looked pretty good with one dominate follicle and a few smaller ones. I did a few more days of Follistim and went back for another ultrasound. Now we had 1 really good looking follicle that needed just a few more days. Another 2 days of Follistim and we did the trigger shot on a Sunday night.

On Tuesday morning (our 2nd wedding anniversary) we went in and did our second attempt. Again we talked about what this could mean, but with reserved optimism this time. Dr. P also put me on a new medication.

Medication #7 - Progesterone suppositories - Progesterone is one of the hormones responsible for making the uterine lining nice and thick for egg implantation. So....Here's the 'fun' part. I'm supposed to take 1 vaginal suppository when I first wake up and 1 at bedtime until I'm told I can stop. It will be for, at least, the next 2 weeks. OH, and they have to be kept refrigerated because they melt at body temperature. I'll let you use your imagination as to how 'fun' this is.

On our way to dinner that night we stopped by the hospital to see the baby girl my friend had delivered earlier that day. Because it was a hopeful day in my cycle, I could be happy for her.

No positive home pregnancy test and a phone call from the lab with my blood work results made for an interesting week. The lab tech said that my HCG level was elevated, but not high enough for them to say I was pregnant. I was told to come back in 3 days to re-test, but not to get my hopes up. Chances were, I wasn't pregnant and they were only seeing residual from the trigger shot. 2 days later, I started my period. Yet they still wanted to do a blood pregnancy test the next day. Talk about heart breaking!

So we did it again...

hurry up and wait

This morning I had an appointment with Dr. P's IUI lead for an ultrasound. We were looking to see how many follicles I had growing and how big they were. She found 2 on my right side measuring about 13.5mm and 9mm and 1 on my left side measuring about 9.5mm. We want one to be pushing 20mm if possible. So I will be doing 3 more days of injectable medication. I go back in Friday morning to see what's going on.

She also saw that I have fluid in my uterus (again), but Dr. P says it's no big deal yet because I'm not ready to ovulate. He thinks it will go away by the time we are ready for the IUI.

Hurry up and wait, hurry up and wait.

intermission

I was going to post my blog about our first IUI round, but I had an epiphany...wait until you get a copy of that round from the doc. That way I can get all the numbers right and give you more information than my twin-mom brain can hold onto. So instead, today I'll just give you an update on what's going on.

I've had 2 days on Gonal and there are side effects I forgot about. I anticipated (and warned those around me) about the mood changes and the fact that I will get pissed about the dumbest stuff and that I may cry at sappy commercials. But I completely forgot how stinking tired this medication makes me. My only saving grace this weekend is my cousin. My husband was out of town from Friday afternoon until Sunday night and all of the usual helpers were busy since it is Memorial Weekend. I still had to clean, do dishes, make food, change babies, listen to them cry and get up in the middle of the night when neither of them would sleep for more than 2 hours at a time (Friday night was a bad night), but I didn't have to chase them around or try to entertain them...my cousin so very kindly did that. THANK YOU!!!

I'm sooooo excited to go see Dr. P tomorrow and see how my follicles are growing! In a perfect world we want them to be over 16mm, 18-22 is ideal! I'm also curious to see how many follicles I have that are growing...keep in mind, the one that worked last time I had 2 dominant follicles and they both released, they both fertilized, they both implanted, and they both grew into healthy babies. So I'm a little leery of anything more than 2. I don't want to end up with 5 or 6 kids at once...I already have 2 at home. :D Have a wonderful day!

Round 1

WARNING!!! Lots of anatomy terms that could be embarrassing will be in the following post.

In March 2009 we did our first IUI cycle. I was excited, terrified, and very hopeful!

I started my period and made THE CALL. I was scheduled for a 'baseline ultrasound' on day 3 of my cycle. It was to check my ovaries for cysts and my uterine lining to make sure it had thinned out properly. Everything looked good. I had a few small cysts on my ovaries, but nothing to be concerned about. I took my Femara for 5 days then went back for another ultrasound to see how my follicles were growing.

Now when I say 'ultrasound,' Dr. P doesn't do the nice, cold gel on your belly, external kind. He only does the exposed, undress from the waist down, 'you'll feel some pressure,' vaginal kind. Needless to say, I kind of go used to 'exposing' myself in front of Dr. P, various nurses, and several medical interns.

I don't have the exact numbers, but I know that nothing looked very promising. I may have had 1 follicle that looked 'okay.' Dr. P said that it should continue to grow over the next few days and we would do the IUI in 5 days. 3 days later I had my husband give me the trigger shot (my first injectable) and 2 days after that we had our first IUI.

Here's the procedure as I recall it: We arrive at the fertility center at about 8:30am. My husband goes to the designated room to do his part, then we sit and wait. While we wait the lab washes the sperm. This basically means that they separate the sperm from the surrounding fluid to make it more concentrated. They also check the sperm count, motility, and mobility. Once again, everything looked excellent and we were a go for the IUI. About an hour and a half later I found myself, once again, on an OB table with my feet in stirrups. Dr. P inserted a small catheter into my uterus and deposited the washed sperm as close to the fallopian tubes as possible. This is ideal for many reasons. The sperm don't have far to go to find the egg (if it's there) and it doesn't have to fight through any mucus (which kills sperm). Once that was done, I got to lay on a tilted table for 15 minutes talking and dreaming about the possibilities with my husband.

We spent the next 2 weeks hoping and dreaming and holding my belly, wanting so badly to be pregnant. If you know me, you know I can't wait for surprises. So 5 days before 'my missed period' I started taking home pregnancy tests. Every day it was negative and every day I kept telling myself that some people don't test positive until after they've missed a period. But the blood work 14 days after the IUI came back about as negative as you can get.

On the emotional side...

Right after we started the medication I went to my sister-in-law's baby shower. I thought it was hard. It was hard to see her so pregnant, talk about being pregnant and feeling the baby move. The worst part was hearing her answer questions like, "Is this the first grandchild?" In my head I answered, 'Yep. I'm never going to be able to have one, so she's gets to have the first.' I know that's not why the questions were asked, but that's where my brain went.

Even better? We got our negative blood work results on a Wednesday, I started my period on Friday and I went to a friend's baby shower Saturday. I probably shouldn't have gone, I know I didn't bring a very happy attitude. Fortunately it was a couples shower so my husband was right by my side. And when we left early because I couldn't choke back the tears any more, he drove us home because I couldn't stop crying enough to drive.

So we do it again...

Christmas, New Years, and surgeries

Ok, back to the last journey.

Christmas 2008

We couldn't wait any longer. Something had to get moving. Since there was no immediate hope for a cadaver bone, we decided to get moving on the fertility front. After a visit to Dr. P we were instructed to have timed intercourse, he wanted to try the least invasive methods first. We were supposed to have sex 'every other day between days 10 and 20 of my cycle.' Some of you might think, "Awesome! That's guaranteed sex 6 times in 10 days." Think about this... You 'get' to have sex with your spouse on set days at set times. It kind of kills the romance.

We still have to pay the bills, so we both occasionally have long, exhausting days at work. We still have to keep the house running, so we still have to do laundry, dishes, cook, and clean. But we still 'get' to have sex...every other day for 10 days. So we do what we are told to do and try our best to enjoy the moments.

One thing you hear in the infertility world a lot is how draining the '2 weeks wait' is. This is referring to the 2 weeks between conception and a missed period. Now imagine that over Chirstmas. I had a good Christmas with our families, but we were supposed to have a baby by then. This was supposed to be his/her first Christmas and I wasn't even pregnant. Kinda makes the holidays a drag. And of course, right after Christmas we found out that we weren't pregnant. Not really surprising.

With New Year's we tried to 'make a new start.' This would be the year that we get pregnant and have a baby...damn it! Since the timed intercourse didn't work, we decided to get my other problems taken care of, then jump back into fertility treatments full speed. In, mostly lost, hopes we did times intercourse in January. Again, not pregnant.

So in February I had surgery on my ankle. The doc said if I needed to replace any bone or cartilage he would just take it from my knee. It wasn't exactly ideal, but it would fix my problem and I could do strengthening exercises for my knee. Fortunately, nothing had to be replaced! I just needed to have a TON of scar tissue removed and a little bit of cartilage removed. This was awesome news because I would only be off my leg for 2 weeks instead of 2 months. I figured, while I'm out of the baby making game, let's just get my wisdom teeth out. The bother me all the time and all 4 have to be surgically removed. So I did it. 3 weeks after my ankle surgery, I had my oral surgery. And 2 weeks later I was healed enough to get the party started.

Update

I promise, I will get back to my past journey...tomorrow.

After 6 phone calls to 3 pharmacies, 2 insurance companies, and my REs office I finally had an answer about my medication. But my insurance company didn't want me to have Follistim. They would rather me use Gonal instead. Fortunately, these are the same medication with different names. I don't understand how an insurance company can tell you which medication you should use when my doctor is the one who went to school forever and has years and years of experience, but it is what it is. They overnighted me my medications and they arrived this morning!

Common Side Effects of Femara (the pill I've been taking the last 5 days): back, leg or arm pain; breast pain; constipation; cough; diarrhea; dizziness; headache; hot flashed; flushing; increased sweating; indigestion; joint or muscle pain; loss of appetite; mild swelling or fluid retention; nausea; night sweats; sleeplessness; stomach pain; tiredness; vaginal dryness or irritation; vomiting; weakness; weight gain or loss.

The reason I tell you this is to explain just how messed up my body is. Usually I react with at least 1 negative side effect if a medication causes it...not on this stuff! I have had no pain (other than a mild ache in my belly), no tummy troubles, my night sweats and hot flashes have gone away, my heartburn is gone, I've been eating everything under the sun, and I've lost 2 pounds. So I am "suffering" some of the mentioned side effects, but I'm happy to suffer them. Hehe.

It's funny...I start giving myself injections tomorrow and I'm not overly nervous about it, even with my husband out of town. I'm excited to see how well these medications are working!! If all goes well, we might be doing the IUI at the end of this week or the beginning of the next. I'm soooooo excited!

mail order meds

I have to get 2 mail order injectable medications for this cycle,

Medication #5 - Follistim - This is a 'pen' that you attach a small (insuline-like) needle to the end, dial your dose and inject it into the belly. This medication is meant to help the follicles grow.

Science lesson - A woman's body usually has one dominant follicle form during her cycle. Around day 12-14 of her cycle, the follicle releases an egg and we all know what happens after that.

Medication #6 - HCG - This comes in a vial. You have to draw it up into a syringe and inject it with a not-so-small needle into the belly. This is also known as the 'trigger shot'. It tells the follicles to release the egg it is holding.

Here's where the fun part comes in. I was told that the mail order pharmacy will be calling me to get my insurance information and they will be sending me my medications. So late yesterday afternoon they called, I gave them my information and they said someone would be calling me back with the cost. This morning I get a phone call, but they tell me that in order for my insurance to cover any of the cost I have to get it from their 'specialty' pharmacy. Here's where it gets complicated.

I have Aetna medical insurance and a completely different pharmacy insurance. I was told I needed to get my medication from "Aetna Specialty Pharmacy." The phone number I was given turned out to be a fax number. So I used my brain and decided to call the customer service number, thinking I would be transfered to the person I needed. Silly me. The CSR I spoke with said I needed to contact my pharmacy insurance because my Aetna coverage was for medical only. Okay... I called the mail order pharmacy back to verify I had my information right. Turns out they gave me the wrong number to call. Now I have the right number so I call it and I get to talk to Mr. Attitude.

"When did they send the prescription over?"

"They faxed it this morning."

"Well it's not in the system."

"Okay, so what do I need to do?"

"Well, we have a 48 hr process time, so it may just not have made it into our system yet."

"That's not going to work for me because I HAVE to have one of those medications by noon on Saturday."

"That will work then. It's faxed on Tuesday, processed on Thursday and we can overnight you the medication."

"And if their is another problem?"

"You'll just have to deal with that if it happens."

Awesome! I called again this afternoon in hopes that whoever is in charge of taking paper off the fax machine has done their job, but I had no luck. So I'm still waiting and desperately hoping I will get my medication in time.

Can anyone tell me why and Aetna CSR doesn't know that they have their own pharmacy? I still can't figure that one out.

Here's yesterday's post:

Today I went to Dr. P's office and had a baseline ultrasound. I love quick and simple doctor's appointments. (It helps that I know what to expect this time around.) The ultrasound looked great! The lining of my uterus has thinned out and there are no remarkable cysts on either ovary. So I was given my schedule of medication and my prescription for Femara and I was out the door. Well, first I had to check out at the desk and pay my part.

"That will be $335 please." She said with an expectant look. As I gave her a dumbfounded look she added, "Oh, and I need a copy of your insurance card. I know you don't have coverage, but we need it on file anyways." .....

The funny part is that I was told at my last appointment (by the same person) that I did have coverage. And since we knew we were going to probably need it this year, my husband and I made sure we had fertility coverage (and we pay for it too). So you see how I still haven't responded yet. "Um, I'm pretty sure I have coverage." I said. "Nope. It says right here that you have coverage for diagnosis, but not for treatment."

After a brief conversation where I tried not to yell at her, I payed my $335 bill and briskly walked to my car. I called my husband to complain and said I would call the insurance company when I got home, but if we truly didn't have coverage we would only be able to afford one cycle right now. Fighting back tears by blaring my music, I drove to the pharmacy to get one of my medications for this cycle.

I get to the pharmacy, drop of my prescription (15 minutes until it's ready), get a Starbucks drink and coffee cake, and sit down to talk to my friend and let her know how things went. By now, I've calmed down and I'm trying to stay positive that either this cycle will work or we have insurance coverage...hopefully both. When I go t get my medication, the pharmacists comes to me and says we have a slight problem. Not what I wanted to hear. She said that on the prescription it says the medication name, the concentration of the pill, the number of pills, and to "take as directed." The problem with this is that the pharmacist doesn't know what directions to put on it. She has a call in to the doctor, but has to wait to hear from them until she can give the medication. Awesome!

So I go home and sit and chat with my aunt, who was there to watch the girls while I was at my appointment. 30 minutes later, the pharmacy calls and says all is well and the medication is ready for pick up. Fortunately I live about 2 minutes from my pharmacy.

After that whole fiasco, I got home, took my pill, and decided it was family nap time. My husband was already napping because he had been up all night on work calls and it was nap time for the girls so I took advantage. 2 hours later I woke up in a whole different world. I had forgotten how quickly these meds can work. I felt like a normal human being for the first time in a few months...my hormones were close to balanced.

Time to bite the bullet and call the insurance company. I call and ask the representative if I have fertility treatment coverage. It took her about 2 seconds to tell me YES...BUT I have to 'sign up for it'.

So now I get transfered to another department to answer 15 questions about my infertility. Once that's done, I'm signed up and Dr. P's office needs to call an 800 number to get authorization for my treatment. Now I only owe $45 (co-pay) plus 10%...much more affordable.

To let you know how much this costs:

visit 1: baseline ultrasound - $335

visit 2: mid-cycle ultrasound and blood draw - $400

visit 3: 2nd mid-cycle ultrasound and blood draw - $400

(it's possible to have more than 2 of these)

insemination - $410

progesterone blood draw - $100

This means, without insurance it would cost at least $1645 for each IUI cycle.

In the grand scheme of things, that's not a TON of money (IVF is much more expensive). BUT that is a LOT of money to spend in 1 month, and if you have to do it more than once... You get the idea.

Look at it from this point of view (the one I had the first time around). It costs me that much money for that one little part. Keep in mind I've already had many many tests and a surgery to be able to get to this point. Now think how much it costs most people to get pregnant...ZERO. This is one of the reasons why some women who go through fertility treatments want to beat the crap out of pregnant women who complain all the time. We would spend more money that you can imagine and go through hell and back to be able to smile when we get kicked in the bladder.

I will post today's post tonight after the girls go down. Sneak peak? Mail order injectable medications for infertility aren't easy to come by.

WARNING: Emotional Breakdowns Ahead

The week after I went off birth control, some good friends of ours celebrated the birth of their first child. We were excited for them and for a glimpse into our future (hopefully). But as time went on and more and more of our friends got pregnant and had their baby showers and had their babies. With every text, phone call, or facebook status saying “We’re pregnant!” my heart sank. I started hating any woman that I thought was pregnant. Crying and breaking down in the car after grocery shopping because some woman I didn’t even know and probably would never see again was walking around happily pregnant seems silly to most people, but I couldn’t control my emotions at that point. I wanted to yell at people who had kids and ignored them. I wanted to punch women who complained about basic pregnancy symptoms. I would have done anything to be uncomfortable, nauseous, and kicked all the time.

And in October, my world felt like it came crashing down. My husband got a phone call from his mom telling us that his sister (who fought infertility herself) was pregnant. And because her husband was being deployed for 7 months with the Navy, she was moving back home for the remainder of her pregnancy. (To be honest, if I lived 1300 miles away from my family and my husband wasn’t going to be around, I would probably move home too.) But that meant not only would I hear every detail, but I would see it to.

So here I am, in one of the toughest positions I’ve ever been in. I desperately wanted to be happy for someone who was able to realize her dream of being a parent, but I couldn’t let go of the harsh feelings I had toward every potentially pregnant woman because I didn’t know if I could ever live the only dream I’ve ever had.

Before I get too dark, I want to say that I am glad my sister-in-law got to have a happy and healthy pregnancy despite my issues trying to be happy for her. Although it felt like I was constantly being attacked and it felt like every tiny comment she made about her pregnancy was being shoved in my face, I know now that it was NOT the case. If you have friends who are fighting infertility, don’t push them away because you think you are upsetting them. Don’t apologize or feel bad for being happy. We don’t want that. (We might laugh a little too hard when you get kicked in the ribs, but we don’t wish you any harm.)

October 2008 – Happy Birthday to me. 3 weeks after my sister-in-law moved back to town, I turned 26. Every girl has the ‘perfect’ life plan laid out about the same time she’s convinced boys may not be covered in cooties. I had a plan for my life and that didn’t include turning 26 with no kids. It wasn’t my best day.

November 2008 – We are still waiting to hear from Dr. B about a donor bone for my ankle which means no movement on the fertility front. And my sister-in-law is going to doctor’s appointments, getting ultrasound pictures, buying baby stuff, and complaining about every bout of nausea and trip to the bathroom. (To set it straight, she didn’t complain more than any other pregnant woman, but because it was her and because I was dealing with what I was dealing with it seemed like every word was pregnancy related.)

Thanksgiving was the worst! I was being pulled in a million different directions emotionally, and I couldn’t control any of them. We had Thanksgiving ‘dinner’ with my family (it was actually at lunch time). A few of us sat in the kitchen before the food was ready making small talk. As my niece and nephew ran through, my step-brother’s wife asked when we were going to have some rug rats. I actually yelled at her. She had no idea we had been trying for a year and a half, she had no idea I had uterine surgery, she had no idea I was a ticking time bomb. I yelled that we were trying and might never be able to have kids, then went to my mom’s bedroom (the off limits room) to drench the pillows with tears. Fortunately, my aunt smoothed things out and explained my reaction. Once I composed myself, we finished our visit with my family and headed to my husband’s parents’ house for and actual dinner time Thanksgiving dinner.

I was already having a rough day and now I went into a house where every conversation (seemingly) was about the ups and downs of my sister-in-law’s pregnancy. As long as I’ve been part of my husband’s family, they have gone around the Thanksgiving dinner table and said what they were thankful for from that year. Even though I knew this was coming, and I knew what would be at the top of the list, I was really hoping we could skip that part…or at least give me enough warning so I could excuse myself to the bathroom for those few minutes. After my mother-in-law and sister-in-law got teary eyed as they stated the obvious, I couldn’t even give my answer. I’d like to do that now…

I was grateful for my family…all of them. I was grateful that a woman I know got to experience her dreams. I was grateful, most of all, for my wonderful husband who stood by me, whipped my tears, held my hand, and held me as I cried. He told me that everything would be ok. He said we could use donors if we had to or even adopt, if it came down to it. He helped me face some of the hardest days of my life.

I had warned my best friend that this was going to be a bad day and she offered to come pick me up so I could get away if I needed to. So as I fought back tears at the dinner table, I texted her and asked if her offer still stood. 20 minutes later she was waiting for me in the driveway. I didn’t want to ruin the holiday for the whole family, so I removed myself in an attempt to let them have a good evening. Her hope of distracting me with mindless girl talk was smashed by me bawling on her shoulder all the way back to my house. She was even nice enough to sit and stare at nothing with me until my husband got home.

That day haunted me for a very long time.

More History...

Alright, back to my story…

Appointment day finally arrived and we got to talk about what my diagnosis was. Dr. P looked at the X-rays and calmed some of my nerves. He thought it was a septum instead of a true bicornuate uterus. He also said that just by looking at me he knew I had PCOS and that I was probably was insulin resistant (this is where the body over produces insulin to minute amounts of sugar and/or carbs thus preventing the right hormones to release to tell the body to ovulate). Some blood work for both my husband and myself and a semen analysis were ordered and an appointment was made for 2 weeks later. When I say 'some' blood work, what I meant to say was 3 vials of blood from my husband and 14 vials from me. It was highly suggested that I didn't drive after that lab visit. And to save face I'll just say all of our problems trying to get pregnant were because of my issues. All of my husband’s tests results came back beyond perfect.

At my second appointment I had my first ever ultrasound. That's right, a year of trying (with obvious issues) and someone finally thought to look at the problem area. After describing to us everything he was looking at and looking for, I got dressed and we met Dr. P in his office to talk about what was going on. My blood work said that I have PCOS and definitely was insulin resistant. Interestingly, I also found out that I am Rh neg. (That will come into play later.) Surgery was scheduled for 2 weeks later to remove several cysts on both ovaries and to (hopefully) fix the shape of my uterus.

My poor husband had to deal with an emotional wreck for 2 weeks, but he tried his best to comfort and calm me when I thought my dream of being a mother might be torn from me. To make it harder, we had to tell several people what was about to happen. Some of them didn’t even know we were trying to get pregnant. My dad was sympathetic and wanted updates whenever we had them. My mom seemed to finally understand that I had legitimate problems getting pregnant. The one that really hurt, was my mother-in-law’s reaction. She had been trying to help her daughter (who is only a month younger than me) cope with her own fertility issues and for her to find out that we were having issues as well hit her hard. “I guess I’m just not meant to be a grandmother.” Just like I can’t speak for my husband, I can’t speak for her either. I don’t know what it’s like to have 2 of your children struggle with infertility, I only know what it’s like for me. After her initial reaction, she has been nothing but supportive of the entire process. But hearing those words were awful! I didn't want to be the reason her son couldn't have children.

According to my husband, after the surgery I asked every person who walked passed me if I was going to be able to have kids. Apparently I asked him several times in the first 12 hours how everything went. I don’t remember a whole lot, Dr. P gives good pain meds. BUT everything went wonderfully. Dr.P said he got all of the cysts off and that I had a huge septum in my uterus. All he had to do to fix it was cut it out. The only thing is that no doctor in their right mind would let me go into labor because of the large amount of scar tissue I now had on my uterus. “When” (he used the word WHEN) I get pregnant, I’ll just have to have a C-section to deliver. Considering the possibilities I was facing pre-surgery, a C-section sounded great! I can have kids!

Insert bump in the road. In 2005 I had surgery on my ankle where I had part of my bone replaced with ‘false bone.’ I did awesome after the surgery, but it was starting to cause problems again. After much discussion with Dr. P and Dr. B (my ankle surgeon) we decided to hold off on fertility medications until we got my ankle fixed (it’s now August 2008). We were planning to wait for a cadaver bone to replace the ‘bad’ one, but I’m 5’1 and finding a donor bone that would fit proved to be much more difficult than we thought. So we waited...

I know I said I would give you more on my previous journey, but I have a completely different post to make today. I promise to get back to it tomorrow.

So let’s fast forward to present day…

I was put on birth control for a month to ensure a relatively predictable start to my cycle. I took my last active pill Tuesday night and woke up this morning to find that I started! This puts us at Day 1 and to someone going through fertility treatments, Day 1 is a big deal. This could be Day 1 of ‘let’s wait another month.’ This could mean Day 1 of a heartbreaking 28 day cycle. OR this could be Day 1 of a wonderful pregnancy.

Creating a life to me isn’t some wonderful date night with my husband. It’s not thinking back, out of the blue, when I think my last period was. It’s not an excited trip to the drug store to buy a (single) pregnancy test. It’s protocol, phone calls, ultrasounds, blood work, pills, and injections. It is waiting for days or weeks and watching every second tick away on the clock. It’s buying pregnancy tests in bulk while hoping the cashier doesn’t ask any questions. So we start…

Protocol for Day 1 is to call Dr. P’s office and schedule a baseline ultrasound. I now have an appointment for Monday morning to make sure I haven’t developed any more ovarian cysts and to make sure my uterine lining is the right thickness. If all looks well, I will be given at least one prescription for

Medication #4 – Femara – With popular TV shows about people have 4, 5, or even 6 babies at a time, we’ve all heard of Clomid. This is a very similar drug but it has fewer side effects. One of the good things about Femara vs. Clomid is that is usually doesn’t cause the body to produce multiple follicles, therefore multiple births. Oops, guess my body didn’t read that memo. J

There are several factors that come into play to determine how much I take and how many days I take it. Also, I may be put on another medication at the same time. We’ll cross that bridge when we get there.

Now we wait. Waiting is a big part of fertility treatments. And you never get used to it.

A little history

This is kind of a long post...a 'little' history might not be the right title.

My husband and I were married in April of 2007. We decided that we wanted to start a family right off the bat. So in July I went off birth control and payed a visit to my family doctor. She was excited and got me on prenatal vitamins. At that time, our only concern was that prior to going on birth control (several year earlier) I never had a regular, predictable cycle. I would go for 6 months or more without a period and never thought twice. Since I had been on birth control for so long, she was hopeful that my body had 'figured it out.' So off we went...

28 days later I started my period and everything seemed right on track. I got excited when I didn't start 28 days after that, but on day 34...there is was. And after numerous negative pregnancy tests, my heart sank when I finally started 45 days later. I'm sure you see the pattern that started. Keep in mind, we are only 4 months into trying to conceive and are already feeling defeated.

Medication #1 - Metformin - one major side effect to this medication is 'tummy troubles.' So we went with plan B.

Medication #2 - Glumetza - the objective of both of these medications is to help regulate periods by gently nudging hormone production.

So now it's December and I haven't had a period in 60 days. After a quick check with the family doctor, she prescribes...

Medication #3 - Provera - the dreaded Provera pills. My RE kindly refers to these as "the PMS pills" if that gives you any indication as to what they do. These pills manipulate the hormones to enforce shedding of the uterine lining (a.k.a. it makes you have the worst period of your life).

Due to insurance changes and ease of paying bills, I switched my PCP to the man my husband has seen for years, Dr. H. Why not go and see if he has any suggestions? His first response was that I needed to go to an OBGYN. Other than him obviously not wanting to do a female exam, he admitted that he wouldn't be able to help any more than my previous doctor. I thank him for that.

After a few phone calls, I find an OB that I think can help me, Dr. N. At visit number one she says I 'may' have PCOS (Poly Cystic Ovary Syndrome). She increases my Glumetza dose and says I'll be pregnant in no time. Keep in mind, I've now had to have another dose of Povera...fun. 3 months later, I haven't had another period, I'm not pregnant, and I'm getting pissed. Dr. N finally orders a test.

Let me interject a little here. It's been almost a year and we are having obvious problems getting pregnant. Most of my family and friends have no idea where I am emotionally and with very few exceptions, all I keep hearing is "relax, it will happen" or "it just takes a little time sometimes." This is not what a woman wants to hear when things have been going this bad for this long.

I had an HSG (hysterosalpingogram) in May 2008. Now, if you've never had one of these done, it's not fun. Where I had mine done, they didn't have OB tables in the X-ray department. It's very difficult to get in the right position on a metal table and no stirrups. They insert a catheter into the uterus, close off the end, and inject X-ray dye. Then they take a lot of X-rays to determine if the fallopian tubes are open. At least, that's what I was told.

5 days later the nurse at my OB's office called and said, "You need to make an appointment with Dr. P. Dr. N is refusing to treat you at this point." (Not the right way to say that to a patient.) After some dumbfounded pauses (from me) and a lot of questions I finally get just enough of an explanation that I can scare myself stupid. She said that the HSG relieved that I may have a bicornuate uterus and I need to see a specialist to find out what needs to be done.

Now, I'm a googler. If I don't know something, I will spend hours on end looking up as much as I possibly can on the subject. Go ahead and google "bicornuate uterus," I dare ya. This condition can range from 'bad, but probably fixable' to 'there's nothing we can do and you should never try to become pregnant because there's no way you can carry a child to term.' You see where my brain went. 2 excruciating weeks later I finally get in to see Dr. P and get some answers.

I had to wait 2 weeks to get an answer, you'll just have to wait till tomorrow. I'd hate to tell my whole story in one day.

Here we go again...

It never crossed my mind to share any of the crap my husband and I went through the first time we tried to have a baby, but this time is just seems to make sense. As of today I am off birth control and as soon as my cycle starts we will begin this journey again. I apologize now for the potential content of this blog. You will learn more than you ever wanted to know about the baby making process from a biological stand point.

My goal is to educate others on what some women have to go through to get what so many others take for granted. I'm sure there will be plenty of reflection on what I went through the first time around too...just for perspective.

I also want to say that I will not speak for my husband. If he should feel like posting on here at some point, he has full access. Men and women see infertility from very different view points and I won't even guess at everything that goes through his head at times like these. Don't get me wrong we talk ALL the time, but unless you've been there (or are on that road) you never truly know.

So, wish us luck, send us prayers, or simply think of us at some point in your day. I'll be checking in soon.