IUI #1

I really hope the count on this doesn’t go too high.

In the end, it was a rather simple procedure. It’s not even done by the doctor (which surprised me at the time but in retrospect I suppose it makes sense). It’s not exactly comfy but then neither is a PAP smear. The worst was actually the trigger shot. How do single women manage? The instructions on it were so confusing between mixing and changing needles and positioning. I ended up asking a friend who’s a doctor to give it to me (which was really useful). The best is getting instructions to cut out anything strenuous for the next two weeks (this includes yoga and laundry and walking). Walking’s rather extreme but anything that gets me out of housework, I’m all for! Also, no caffeine. I’m not a coffee or tea drinker but ever since being banned, I’ve been craving them like crazy. So weird.

I’m pretty sure I ovulated – I’ve observed my cycle enough now that I can tell. But I suppose its much to early to tell anything else. Doesn’t mean that I’m not antsy and impatient about it!

I think the waiting in this whole process is the most anxiety inducing. I’m in the process of job hunting as well so that’s just more waiting. Can I fast-forward to.. oh, I don’t know, March maybe?

Eggs be growing..

i.e. clomid works. Sometimes I wonder if I ever ovulate normally on my own – I mean, at least half of my periods are non-induced. But no one’s ever told me whether “if you get a period, then you have ovulated” is true while I’m pretty sure the converse is true.

Anyways, lining is good and while there’s only one follicle at a good enough size, one is all it takes. *cross fingers*

Finally starting!

I’m finally starting my first IUI cycle (and second medicated one). Yay! I’m nervous (do we really know how to be parents?) and excited (finally!) all at once. I’m also worried — what if my thyroid numbers could have been better? What if I get gestational diabetes? But I will cross those bridges when I come to it – it’s not like I can do anything else anyways.

I had a few scares about not starting the cycle (because honestly, this whole process seems like one delay after another). My endo wanted to test my sugar levels and it’s borderline. So he wanted me to tell my RE in case they chose to go with metformin rather than clomid+IUI. My RE eventually said, this is fine, let’s go ahead with clomid. And then right after my day 3 blood tests + ultrasound, turns out that I didn’t have insurance approval. Even though I had it two months ago. And I had called (both my clinic and insurance) to explicitly ask. Apparently it expired (which is weird when I didn’t even use it). So I ended up starting clomid a day late but that seems to be a standard protocol too.

I don’t know if it’s the extra hormones or just the general stress but I’ve been feeling more.. raw lately.

For instance, I went to the pharmacy to pick up my meds. They gave me one packet with the clomid and then three more. As far as I knew, I needed only 1 more – the HCG trigger shot. And then had to ask for clarification (the remaining turned out to be the needles and syringes). I asked the pharmacist how to administer them and they were just “well, we don’t know, the doctor usually does it.” So no help there. The instructions also seem non-trivial – there’s a couple of different vials and they have to be mixed and then there are strong admonitions about bubbles. I’m just asking a friend to do it (she’s a doctor). But this is the type of situation where I wished I had more guidance with the day to day stuff. On top of it, the whole way home, I just felt like crying. I mean, I’m glad that I have access and opportunities to medical advancements but oh, I really wish I didn’t need it.

Yesterday threw another curveball – one of our close friends announced their pregnancy. For various reasons, I guess I just didn’t expect it. At least they told us by text first so I had time to compose myself before a skype call. It’s not that I’m not happy for them. But I just couldn’t not cry. I ended up sobbing all the way home. We ended up taking a ‘mental health’ evening – bought takeout and watched a chick flick. It’s just hard to take when for some people things come so easily. Meanwhile, we’re hitting 2 years of trying and no progress.

I think each announcement of our friends breaks my heart just a bit more. For some, I know I’ve become a worse friend. It’s shitty of me but I feel that’s the price I needed to pay to protect myself – by just cutting myself off from certain friends. I had a blowout with my mom a while back when I said that I just don’t want to know anything about my cousins kids. I don’t wish them harm. I just don’t want to know anything – not that they’re expecting, not that they had a girl/boy, not that the kid is walking – nothing.

Some part of me can’t help but think this is karma. So many other things in life came easily to me – I was always a good student and loved learning, I have a good job, I found my life partner so young and frankly, with minimal drama, I have a wonderful family and great friends. Maybe this is my payback for that.

One last end-of-year kick in the pants

That elevated HCG level — mostly a chemical pregnancy. And so I’m sending off a tumultuous year with one last negative. And hopefully, my work and life paths for 2017 are smoother.

It’s seems like such a matter of fact thing – it’s so common that most people don’t even know it’s happening. But some part of my wants to take a little time to cry and mourn. But work beckons and other commitments await.

Still waiting…

I haven’t updated in months. Why? Because there was nothing to update about. The last several months have just been this huge back and forth between my endocrinologist and my RE about the thyroid. My endo is fine with my starting treatments as long as I’m taking synthroid. RE is super particular about TSH levels. And all this was complicated by some really strange results where my TSH levels doubled in two weeks (which I’ve yet to find a convincing explanation for).

Anyways, I finally got the go ahead for treatments (yay!). And wouldn’t you know, thats just when my PCOS kicks in again. I’m now several weeks late but of course before inducing anything, they wanted to run HCG levels. And it was slightly elevated. Not enough to confirm anything but not low enough to rule it out either. So now I’m waiting. Again. (Personally, I think it’s negative. Me being me, I spent the next several days scouring the research on what these HCG levels mean and frankly, it seems to be much too low to be indicative of a pregnancy. Low enough that I don’t even know why they want to retest).

I wish someone would have told me how slow this whole process is. Any of my other friends who’ve gone through infertility seem to have had a relatively easy time – 1 month testing, a couple of cycles of treatment and boom! they’re pregnant. Not to mention my countless friends who just went off birth control and a couple of months later, surprise! But my story has just been.. slow. I’ve been seeing a doctor for more than a year now. And with all that, I have almost no new information at the end of a year (I mean, how many times do I need to get tested for PCOS), and only 1 treated cycle. Anyways, I really do hope that a new year will bring with it new possibilities.

I hate waiting..

I finally had my RE appointment. There’s good and bad news. On the plus side, the only issue is the PCOS (other hormones are normal, including sugar; no physical issues). So at least it’s only one bug to troubleshoot (and the computer science nerd in me comes out).

The bad is that the RE won’t start treatments until my TSH levels come down (normal is <4.5 but for fertility purposes, they aim for <2.5 or so). And while mine is normal, it’s significantly above the 2.5 threshold. Ordinarily, this is a simple case of just taking synthroid for a month or two but since I had a weird reaction, off to the (non-reproductive) endocrinologist I go. And of course, there wasn’t any open appointment so we’re waiting (again) to meet the endocrinologist to then have more thyroid tests and then start meds again. I’m a little worried that this is indicative of a more serious issue but common sense tells me to calm down and that it’s probably nothing.

Still, I have to say, I like this RE. He’s pretty aggressive in treatment – at least compared to my obgyn (understandably). The plan: start with clomid+IUI and then if that doesn’t work after a while, go straight to IVF. Since we already know that I have a good reaction to clomid, chances are that I won’t have to go to the stronger meds to induce ovulation. And I guess IUI adds a few percentage points probability to each cycle (I’ll take what I get). Based on the probabilities he was quoting, there seems to be ~60% chance of getting pregnant with first line treatments. Still, it doesn’t really matter what the chances are if you’re on the wrong side of that probability.

Mostly, I’m trying to take a step back and internalize that a few months delay waiting for the thyroid to stability isn’t really a big deal. It screws up my ideal maternity leave plans but honestly, most of the this country functions without good leave so there’s no reason to think I can’t figure out something. I guess, given all the effort I’m putting into making this baby, I’d rather have the time to spend with the baby once he/she is here.

Tests and more tests..

I haven’t updated in a while mostly because there hasn’t been a whole lot to update about. July wasn’t a particularly productive cycle – I went in for the entire set of tests that REs dump on you. The list is not for the faint: blood tests for thyroid hormones, sugar, all teh reproductive hormones, STDs, genetics (I think I refused this) and a few others that I probably forgot; ultrasound; sonogram. Not fun at all. The fasting glucose test especially sucks – I almost fainted and had to get myself pushed up in the queue because I really really need my breakfast. I was thinking of updating when I had some results but apparently only the doctor can tell you anything. And that appointment’s only next week.

The thing that’s frustrating me the most at my RE’s clinic is that they’re so busy. I suppose, on one hand, that’s a good sign that they’re good at their jobs. On the other, I could only get an appointment with him a month after my tests. And in the meantime, there goes another cycle. This one is especially frustrating because having a medicated/monitored cycle in August would have been relatively easy – I don’t have to travel for work and my work is relatively flexible (if busy). Now, September is going to be a pain to try and schedule ultrasounds and such around travel. Sigh. I should try to see if they’ll start me on something without an in-person visit.

The only medication that I actually did try was a synthetic thyroid to try and get my TSH levels down a little more (so apparently for the ttc population, normal levels don’t cut it. They have to be really good for the doctors to be happy with it). I lasted 2 weeks before deciding that the resultant trouble swallowing/lump in my throat was not normal. Let’s see what the doctor says at my appointment.


What’s in the water?

I’ve apparently hit the age where suddenly, all of my friends are pregnant. I don’t know why I didn’t expect this – I guess I expected some of them to wait longer; others to take more time. It’s not that I’m not happy for them. But at the fifth pregnant person of the day (baby shower season) and the tenth facebook friend of the month to announce, well, mostly I wonder ‘why not me?’

Talking about it more has brought a level of normalcy to infertility. But.. it’s still a lonely path. That most don’t understand. With each passing cycle, I worry that more of my eggs have gone to die. Then again, if I’m not ovulating.. does that bode well for my egg count?

I hate how people don’t talk about the issues. Suddenly, everyone’s comparing notes about morning sickness and tests and plans. And.. I feel left out. And lost. And while clearly that’s not the reason I want a baby, it does make me feel even more lonely along my path. It’s hard to even muster up the cheerfulness to congratulate people anymore on their news. And I’ve been knitting baby things for many of my friends who have had babies but with this round.. I just don’t know if I can do it.

Yet another induced cycle

First order of business when I got home was to call my RE and get a prescription for progesterone. The second was to start tackling the mountain of laundry. 40+ days into the cycle and no sign of a period. It was expected and I managed to wait till the last day before I took a pregnancy test (-ve).

Taking the provera dose this time was oddly depressing. I think with each induced cycle, I’m completely paranoid about harming a potentially healthy pregnancy. Of course, this is all ridiculous – I’ve taken too many tests/confirmed in multiple ways that there isn’t a pregnancy but some small part of me is eternally hopeful that this one is the one that worked. Well, I never said that I was being rational.

I don’t know if it was all the travel or the provera but I’ve been so tired. Like fall asleep at promptly at 8pm, right after dinner. And even after sleeping 9+hrs being tired. Not sleepy really, just tired. I felt the same thing with another progesterone formulation (prometrium), so I wonder if this is similar?

Since moving to our apartment, I’ve started a little indoor garden. I’m historically incredibly bad at maintaining plants – I’ve even killed a spider plant which is notoriously hard to kill. I’m going to fault the lack of enough light because, this time, many of my plants are thriving. I’ve found myself ridiculously pleased with their success. Even though my body is failing at growing a baby, at least, I’m capable of growing something successfully.

During all the travel, one of the books I read was Nia Vardalos’s “Instant Mom”. It was a wonderful read, but maybe not the best travel book. So much of her emotions and experiences resonated and I kept tearing up. I wonder what my fellow passengers thought. It did make me think more about this journey – how long we want to try, what happens if we can’t conceive, whether we would consider adoption and from where.A lot of this is premature, I know, but I’d rather have mental plans than be completely blindsided.

A break

The last few weeks have been crazy – a lot of work travel between my husband and myself, all at once. And a little bit of fun travel because, why not? It was definitely an adventure and I got to see beautiful parts of the world and I’ve totally loved it (even as a homebody who hates being away from my own home). Of course, my low-carb diet went out the window – as a vegetarian, the choices in that part of the world are carbs. And some fats. And maybe an occasional glance at a vegetable. I was so relieved to get back to the US and have a nice solid salad!

How does this affect the parts of life relevant to this blog? Well, next on the list is a workup with my (new) RE. As with everything, tests are timed with my cycle. Which has disappeared. Again. I expected that, given the results of my last ultrasound (which didn’t show any growing follicles). So timing might work out after all – I’ll induce as soon as I get home and then go in for testing.

Of all things, I’m proud of the fact that I (still) haven’t taken a pregnancy test. It’s day 40 or so. Mostly, I wanted to prove to myself that I can back off if needed. And that I can think about other things and not go crazy obsessing over fertility. It helps that I had a ton to think about and be busy with – some of my research got some great publicity, so that’s been kinda cool and exciting.