Tag Archives: Clomid

It’s the same old song

Every morning, en route to my office, my bus drives right by Grant Park, a beautiful lakefront park in downtown Chicago. Hubs and I will be there baking under the steamy August sun this Sunday, as we are every first weekend in August, listening to our fave bands and discovering new ones at Lollapalooza.

This weekend is also the one-year anniversary of the first home pregnancy test I ever took. (I’ve only taken four since then, all because Clinic #1 required them.) It had been weeks and weeks since I’d been off birth control and while I was 90% sure I hadn’t ovulated and wasn’t pregnant (I’ve never ever ever had a symptom, remember?), I wanted to make absolutely sure before indulging in some beers at the the concert. I remember standing in my bathroom early that Saturday morning, hopping from one foot to the other, waiting to see. UP popped the control line, in a flash. And of course, that was all there was. One lonely line. Hubs gave me a hug, then I took a walk around my neighborhood and thought and thought about my next steps. I knew something was wrong.

I was fine afterwards, it wasn’t a shock or anything. But late that night, after a couple of beers were in my system, tears began rolling down my cheeks while hubs and I watched the Fleet Foxes play an aftershow at a bar. It was this endless well of emotion that I didn’t even know was inside me, and I was tapping it for the very first time.

I wish I could go back in time and give that woman a hug. She had NO idea what was in store for her and how tough her year would be. Provera. TSH test. Referred to RE. Consult with Dr. C. The Clomid bust months. The crazy-thin lining. The HSG. Second consult with Dr. C. The cysts. Consult with Dr. K. The hours and hours and hours of Googling.  The bench months. The early morning monitoring appointments. The blood draws. The canceled cycles. The injectables. The failed IUI. Consult with Dr. A. The second failed IUI. The third IUI. The jealousy. The fear. The anger. The regret. The frustration. The guilt. The shame. The heart-crushing longing to see two lines. So many tears.

And now I can’t help but wonder, as I look forward to my weekend at Lolla….do I need a hug now? The truth is, I STILL have idea what’s in store for me. Will I ever get to move forward, and leave this purgatory?

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The compromise

This post is too long and all over the place (aren’t you dying to read it now? haha), but so are my thoughts so here goes….

We had a great consult with Dr. Awesome at the new clinic yesterday morning. The only downer: I went into the appointment with the mentality that Dr. A was/is our new RE. Apparently hubs missed the memo….for him, it was an exploratory meeting.  Dr. A is smart and mellow and aggressive and honest and chillaxed and positive. I’m hyper and type-A and a little gloom & doom and prone to freakouts and Dr. A’s qualities are an antidote to my crazy. I am ready for a fresh start and some more urgency with my treatment.

Hubs really likes Dr. A, too, but he (hubs) is being all academic and reasonable about the decision to switch doctors. He feels like my reasons for wanting to switch are “emotional and reactionary.” Is that possible? Ummm, yes. But geeeeez. I have been with clinic #1 for 9 months and spent 6 of them sidelined. I took Clomid three times even though it wreaked such havoc on my lining that I couldn’t have supported a pregnancy even if we’d gotten an eggie to meet up with a swimmer. The word surrogacy was uttered at a very premature stage! So. Yeah. I’m over them. And I have been for a long time.

Here’s what I like about Dr. A, aside from his demeanor that exudes confidence/mellowness.

  • He does not automatically bench patients with cysts. He considers each one (size, number, whether or not they’re secreting E2) and then either 1) lets you cycle through it, 2) watches it with monitoring every 7 days so you can jump back in if it goes down, or 3) tries to get it to burst (and maybe even release an eggie if it’s a viable follie) with an HCG shot. For someone like me who is SO PRONE to cysts, this is a pretty huge deal. It would theoretically eliminate a lot of my bench time. (And my friendly cyst would NOT have benched me this month. Sigh. Another lost month.)
  • He does not cancel injection cycles for too many follies. He lets the patient decide when the multiples risk is too high. He might strongly recommend canceling, but ultimately it’s up to the patient.
  • He gives patients the option of converting to IVF if they produce too many follies during injects.
  • While he does not employ it often, he thinks I’m a good candidate for a “step up” protocol…which basically means he’s open to tweaking the injects dose to a higher level if the response isn’t great at a lower level. (Clinic #1, as a rule, only lowers the dose. To me that suggests cycles could be a bust, like when I was on too low a dose of Clomid?)
  • He is the only doctor at the clinic, which means that he is ALWAYS the one making the decisions about treatment. (It bothers me that Dr. K is “my” RE at clinic #1, but two other docs are often making the decisions when she’s teaching or not on call.)
  • He has the best IVF success rates in town.

Aside from those differences, his thoughts about my protocol are pretty similar to clinic #1. He’d stick with the Gonal-F, starting with a lower dose and potentially building over the course of stims. He’s not a big fan of the Luveris, and doesn’t think it’s a big deal that I have trace amounts of LH. So he’d probably nix that part of the stimming. He also wants to repeat hubs’s sperm analysis, because he didn’t love the morphology number from the one back in October. He has a test methodology he likes better than the one clinic #1 used, which will shed more light on that subject. (I really believe it will be fine.) If it turns out morphology is an issue, he’d recommend we move onto IVF sooner rather than later.

Whew! Right?

So, over dinner last night, we hashed out our course of action. We will move forward with all of the testing Dr. A has suggested. (A new SA for hubs, bloodwork for me, including a metabolic panel, androgens, AMH and re-testing my TSH.) While all of those tests are being run and the results come back and Dr. A tweaks our protocol, we will do one more IUI with Dr. K. Hubs feels like she has learned a lot about my body and we should give it one more shot. He reminds me that both of us were sick on IUI-day last time, and maybe this one will go better. Even Dr. A concedes that my last injects cycle “looked great,” so it’s not like we’re wasting a chance by sticking with clinic #1. Plus, hubs feels like it’ll be easier on me to go to them this month…because I know the monitoring drill, I know the nurses, etc etc. And if it doesn’t work, I can jump over to Dr. A on CD3 and potentially not have to be benched as long next cycle since he will manage my cyst differently.

As you all know, I’m ready to pull the plug with clinic #1 rightthisverysecond, but I have been convinced that hubs does have valid points. Plus, it could take a little while for hubs’s SA results to come back and I’d like to move into the next cycle ASAP. It might take a couple more weeks to get the ball rolling at clinic #2. When you’ve been on the bench as much as I have, waiting a couple more weeks is just….ouch.

What do you think? Would you be frustrated that we’re not doing IUI #2 with Dr. A? Or do you see the benefits of sticking with Dr. K for one more go-round? And, isn’t it fun how my TTC life is finally heating up a little? 🙂

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CD8 *updated*

I am now in the hard part of the cycle. The part that has gone badly, so badly, two out of the three times I’ve cycled. Today I am determined to keep a positive attitude. I am tired of being heartbroken and scared and disappointed on monitoring days. Here’s the deal: After five nights of Gonal-F, I went in for CD8 monitoring this morning. No follies over 10 and lining is 4mm. There are two follies on the left that are close to 10mm.

Now is when I focus on the positives! I know most folks would not be happy with their lining at 4mm (heck, most people start a cycle with that kind of lining!), but for me it’s a good number for CD8. Back in December, in my one Clomid/ovulatory cycle, my lining was 3.2mm on trigger day (CD13). So, this is definitely improvement. And considering my follies are all small, I’m hoping there’s going to be more fluffing as they begin to grow and spew estrogen. Because they WILL GROW. Right……?

I know that they like to see follies above 10mm at this point, because the nurse gently explained that so far my response is “less than ideal.” But, the upside is that they can tweak my meds. Maybe Dr. K will want to add in the Luveris now? Maybe she’ll amp up my small dose of Gonal-F? I’ll find out this afternoon. I am feeling so fragile right now….like I’m in a rocking boat and I’m desperate to keep my balance. To find my Zen place. All morning I’ve been giving myself little pep talks. Everything is fine! Slow and steady is the way to go! It only takes one good egg! They’ll tweak the meds and the next monitoring appointment will go better! I want so badly to believe all of this is true.

P.S. NYC was awesome. Great weather, great parties, great shopping, great running, great friends, great family. We had an amazing time. 🙂

*Monitoring update*

My E2 is 103, LH is 1.9, no measurable follicles. Not a great day of monitoring. The infamous Dr. Old is on call and has….wait for it….made NO CHANGE to my Gonal-F dose. Sigh. I remember from WTH consults #2 and #3 that Dr. Old is anti-upping dosing mid-cycle. Awesome. And Dr. New is out of the office today and Wednesday (when I go back), so I have to do whatever he says. Despite my attempts to connect with a doc who cares about my response and is willing to treat me as an individual, I still have Dr. Old calling my shots (literally).

Because my LH is so incredibly low he has (SHOCKER!) instructed me to take a half dose of Luveris. A half dose? I have no follie action! Shouldn’t we be a little more aggressive? Good lord.

Despite all of my attempts to be positive and Zen and chill, I find myself slipping toward negativity.

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Very very interesting

Remember how I wanted my estrogen to fall? It did not. It rose from 305 to 410. My LH is up a bit, too. And my lining grew from 3mm to 4mm since Friday.

Remember how I wanted my cyst to get smaller? It did not. It grew by 1mm.

Remember how I said this is the weirdest, lightest period of my entire life? Dr. K has a theory about that.

She’s the attending doc, who’s on call for two weeks while Dr. C is on vaca. She thinks my body may not be ready to call this cycle off. I had a mini-consult with her during this morning’s ultrasound and spoke to her on the phone this afternoon after my blood work came back. She thinks this might be a viable follicle—a slow-grower leftover from the Clomid. She’s having me come back on Tuesday for more monitoring to see if my estrogen and LH continue to rise. If they do, she wants me to take the HCG trigger. And then IUI. And then take progesterone. She said this is extremely unusual. And that implantation would be a long shot with my thin lining (which the Provera didn’t help, but didn’t hurt much either). She wants to check it out.

She also has a theory on my thin lining….that I’m estrogen deficient and that it’s possibly due to endurance-level exercise in my past. (I have majorly chilled out on exercise after a decade of marathons and triathlons.) For that reason she might recommend a different injectable (Menopur instead of Gonal-F, since my LH is chronically low and Gonal-F is an FSH-only drug while Menopur has both FSH and LH). I asked her if it would make her or Dr. C uncomfortable if she looked at my medical and TTC history and met with me and hubs for a consult in April. She said it would be perfectly fine and she thinks it’s a great idea.

No matter what Tuesday brings, I think this is what we’d call, a bone. 🙂 Right my friends? A doctor who is looking at my case with fresh eyes. One who has a plan. And who thinks outside the box (potentially trigger on CD30 to salvage the wonkiest cycle ever?! Awesome!).

So, for 36 hours, I have hope again. (Is that okay? Am I setting myself up for another crash on Tuesday afternoon?) How amazing would it be if I could trigger and IUI for the first time? C’mon estrogen & LH….RISE!

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Throw me a bone! *updated*

Okay, so after Googling IF counselors and reading your extremely supportive and awesome comments yesterday afternoon (thank you!), I got a nice surprise. MY PERIOD! I almost posted right then but something told me not to count my chickens before they’d hatched. So to speak.

And that something turned out to be a big 22mm leftover follie/cyst at this morning’s baseline monitoring this morning. ARE YOU FREAKING KIDDING ME? Can someone throw me a bone here, please? Please? PLEASE?!?!?!

My heart sank as the u/s tech measured it. I felt like shouting, Where the F- was that guy when I needed it, during my cycle? Geez. Also, if my ovaries were stagnant (remember, ZERO follies over 10mm) and the cycle was canceled on CD16 how the heck did I develop this big follicle? Is it possible I had a semi-mature one last week that was missed in the monitoring? I’m so confused. And frustrated. This is a final F-YOU to Clomid. I really tried to be your friend. We are finished, this is the last time you’ll hurt me!

I know what happens now. The nurse calls or leaves a message on the lab line at 2pm trying to gently explain that I have  a cyst and Dr. C (or whoever is on call) wants me to wait a month and she’ll call in my Provera Rx because she knows I don’t ovulate or get my period. And then I’ll call back and ask WTF is going on, how the heck do I have this cyst and she’ll say, “It happens. Cysts are a side effect of Clomid. I don’t know what else to tell you.”And then I’ll tell her I’m not taking my chances that it’s going to grow (like it did in January, sigh) and that I’m starting BCPs. And she’ll say, “Okaaaaaay. Bye hon.” BYE!

I should’ve been on the 100mg dose this past cycle. If I’m going to get a cyst anyways, why not actually give me a shot at ovulating? Every cycle I find things we should’ve done differently. I know, I know, hindsight is 20/20 or whatever, but seriously. I kept saying I thought we needed the 100mg dose. Whatever, it doesn’t matter: My lining sucked so regardless of ovulating the cycle was destined to be a bust. It just really blows that it also busted April.

So after the appointment I headed to the gym (monitoring was so early I had time to kill before work) and sweated on the StairClimber, lifted weights. Then I showered up and stopped into Starbucks, where I ordered a grande coffee and a calorie-bomb of a glazed donut. Because why the hell not? Now I’m hopped up on caffeine and sugar (groooooss, I’m regretting that horribly unhealthy breakfast) trying to think of all silver lining, because I can’t bear to leave you all with yet another DOWNER EGG post. There have been so many lately!

1. The cyst/follie is on my right ovary. First time I have EVER seen action from rightie. It’s nice to know she’s alive and well. I do wish she had not picked this moment to wake up, but this is my silver lining part of the post so I’m just going to be grateful she has the power to produce follies.

2. My lining was 3mm. This is still thin for most women, but considering my lining is usually in the 1-2mm range at baseline, I am impressed. However, today is only CD2 so perhaps I’m just catching it before it gets super thing from bleeding. Oh wait, this is silver lining time. Yay, that is a good number for me! If I can start there next time I have a better shot at a decently thick lining when I ovulate. (Yeah, I’m going to freaking ovulate next time I get to cycle. You have no choice in the matter, body. We are MOVING FORWARD.)

3. We have an out of town wedding the weekend of April 10. I was getting nervous about squeezing in an IUI before hubs leaves town. I guess we will not have to worry about that now. Unfortunately, there is another wedding the weekend of April 30. I have already calculated what three weeks of BCPs does to my timeline and it isn’t pretty. I’ll probably have to stay on them longer to ensure we’re not in the middle of injects when we go to NYC at the end of April. But, silver lining, I can control my period better with BCPs than I can with Provera.

4. Back to the lining. I guess this gives my body more time to clear Evil Clomid out of its system. That can only be good.

I think that’s about it. Whew. I will take my bone any time now….is someone up there listening?

**********Update************

A different nurse called me this afternoon. A really nice one. The news was not nice: Estrogen-producing cyst. Typical! I hate to say it, but I was pretty sure that’s how the convo would go. She has no explanation for why I grew a big follie in a canceled cycle. BUT, because I only started bleeding late yesterday, they are going to re-test my Estrogen level on Sunday morning. My level is currently a sky-high 305. They want it to be 75-ish or lower. And if it goes down, they’ll let me cycle through this. I guess there’s a chance it could be artificially high because it was too early to test me. I don’t know. This period is pretty weird. I’s EVEN lighter than it has been since I went off the Pill. Like, I’m bleeding, but so little that I don’t even need a pad. Or a panty-liner. And as I’ve remarked a few times to hubs since last night at 7pm, I have no cramping. None. It’s unusual. (He chalks it up to my daily dose of Vitamin E supps, which would be a nifty side-effect of that supplement!) But still, I’m bleeding…so it’s my period, right? Right, said the nurse.

I really can’t decide how I feel about this. I guess perked up just a bit to have some hope for the next 36 hours. But really you guys, you have seen my body’s history (look to the Long & Short Of It sidebar to the right), it has an amazing ability to develop all of the worst side effects of fertility meds. Right now, so frustrated, I feel like I watch people get good news or at least green-light news month after month, while I sit here spinning my wheels and switching between cheering everyone else on and shouting for help. (I do love cheering you guys on, I hope you know that!)

Sunday would be a GREAT time for that bone…

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Welcome to my world

Hi ICLWers! Thank you so much for stopping by; I’m happy you’re here!

To get you up to speed, here’s a quickie version of my TTC history….

After 10 years of BCPs I went off them and never got my period. I was prescribed Provera a few times to kickstart it: I’d get it but then weeks and weeks would pass sans period. Finally in October I began seeing an RE. Diagnoses: anovulatory.

We have tried three cycles of Clomid since October, taking breaks in between the first two due to cysts. In December I ovulated for the first time since TTC. (Yip!) But my lining was so thin (3.2mm) that even if I had conceived, there was no chance of it sticking. My most recent cycle was canceled on CD16: no follies over 10mm. But worse, my lining only got to 4.4mm. Yes, I do know that happens to a lot of women on Clomid—however, I was also taking Estrogen suppositories, so I really ought to have had great lining.

That seemed slightly worrisome, but became slightly crushing. Last week we met with our RE for a third consult and he informed us that my lack of response to Estrogen is a serious concern. He’s hoping I magically fluff up on injectables, but he warned us we’re nearing the end of the road if my lining doesn’t improve. (You can always try new and different meds to improve follicles and trigger ovulation; but without decent lining, you can’t get pregnant.) It was a pretty devastating conversation.

We are hoping with all of our hearts that injects do indeed improve my lining, even though I don’t respond to Estrogen. But if they don’t, we will seek a second opinion from an RE who’s willing to try alternative therapies on my lining. Or we’ll take a break. Or possibly both. That makes this upcoming injects cycle pretty important. Of course my heart physically yearns for a BFP. But above all else, I need my lining to get better. Otherwise, we will be heading down a new rabbit hole…

Now onto the more fun parts of my world: hubs, running, writing and cooking. I’ve gotten to enjoy them all today.

7am Suit up for a 5-mile race.

9:30am Finally cross the start line and run through downtown Chicago on a blustery, gray, frigid but awesome morning. Hubs runs it, too—the longest distance he’s completed. He ROCKED it! 🙂

11am Hubs and I relax with big cups of java in a coffee shop to warm up and then take a cab home.

12pm We prepare The World’s Best Pancakes with maple syrup–butter to celebrate his longest-ever race. And drink mugs of spicy hot coca.

1pm I work on some freelance assignments in front of the TV while hubs watches basketball. (I’m KU fan; my ‘hawks lost last night—so sad! Fortunately, hubs’s team, University of Kentucky, is still in the tourney and looking great.)

Up next Bottling hubs’s latest batch of beer (a Saison), cooking din, more freelancing…and injects training in the a.m.!

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My heart is breaking

Injects consult 10am this morning: Dr. C said it’s a huge problem that I don’t respond to the Estrogen. 😦 Like, super HUGE. I said, “Do you still think I can get pregnant?” And he said, “I really don’t know.” And then he said that if my lining doesn’t thicken on the injects, then we have to think about a surrogate. He wasn’t being fatalistic, he was telling us the truth. Lining is pretty much a deal-breaker. They can always give you more meds for bigger, better follies. But if your lining is thin, game over.

I am dying inside. This nightmare just gets worse and worse. I may not be able to get pregnant.

This cycle is officially canceled. I can start Provera next week. We’re going to injects class at 8am on Monday. I have no idea if lining will thicken with injects. Dr C doesn’t know either. Hubs just seems numb. (Please, someone, anyone, tell me a story about how your lining was in the 3mm range on Clomid and thickened up past 7mm with injects.) I teared up in the meeting, and now I’m barely holding it together. I  asked about Viagra and acupuncture to thicken lining. He said there’s no evidence that either one works, but I can do acu to de-stress.

How can I be so healthy and yet so totally f-ed?  My hormones are all normal. I’ve never had a problem with light periods until I went off BC and began TTC. I don’t have fibroids. I don’t have scar tissue. I don’t understand why my body is like this.

My heart is breaking.

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