Eggs before Easter

Wednesday, we went back to the doctor to follow-up. I had taken the Clomid, and given it two weeks to work its magic. The hope was that in that time, I would have produced follicles and ovulated. I had absolutely no desire to visit our doctor this week, because I knew in my heart that it hadn’t worked, and I really didn’t want to face the disappointment. I took home ovulation tests to check for an LH surge signifying the start of ovulation. Nothing happened. And, although my temperature had dropped, another early sign of ovulation, I really knew my body didn’t respond to the treatments. My always encouraging husband grabbed my hand and reassured me that if we didn’t go to the doctor, we wouldn’t know for sure, and we couldn’t really start over. He was right, so I reluctantly gathered my things, and we drove the 45 minutes to the doctor.

I had a lot of side effects on Clomid, including pain in my lower abdomen where I assume my ovaries are located. The pain was worse on the left side than the right, and in both cases was more like a dull, achy pulsing than a sharp pain. I didn’t want to tell Dr. Smith about the pain, because I figured he wouldn’t want to let me try again on Clomid. But, I also knew it was important for my care. The doctor told me that in some cases this sort of pain is normal, and a good sign that something is stirring in the ovaries. He suggested we do a physical exam before my blood work.

The exam showed that my body was producing cervical mucus, which is a good sign that ovulation is possible. And, that once ovulation occurs, pregnancy is possible. After, he suggested we do an ultrasound to check out my ovaries. I got dressed, changed rooms, and another doctor (Dr. Rodriguez) met us there to conduct the ultrasound. The first picture was of my uterus. The first ultrasound Dr. Rodriguez did on my uterus, last summer, showed absolutely no lining build-up, which was kind of a blessing, because I hadn’t had my period in about three months at that point. But, this ultrasound showed a lining ready to be a womb. Both doctors, my husband, and I celebrated the small victory. Then Dr. Rodriguez moved to my right ovary, which contained one follicle. The follicle wasn’t quite big enough to produce an ovulation resulting in pregnancy. So, he moved to the left ovary. As soon as we could see it on the screen, both doctors yelled out, “There you go!” And, there on the screen, was a follicle perfect in size and shape waiting to be coerced down my fallopian tubes! I looked at my husband and we just smiled! It was amazing. The Clomid had produced one, possibly two, follicles!

Dr. Rodriguez looked at us and said, “No triplets this round,” as he exited the room. My husband and I just laughed, because my mother is so convinced we will have triplets; a fact we have never discussed with either doctor. Then, my husband gave me the “I told you so look” as we sat back down with Dr. Smith to talk about what’s next. Since my body was able to produce a follicle, but not actually ovulate it, I had to get a shot of hCG. hCG is a hormone found during pregnancy. It is actually what home pregnancy tests are looking for. But, it has been proven to force ovulation in women. But, I HATE NEEDLES!!! I am such a baby about it, and the thought of having my husband push medicine into my arm terrified me a bit. I keep reminding myself the endgame is worth it. The hCG has the potential to push the egg (or both eggs) out within 36 hours. If it worked we’ll know in several weeks, because I will either be pregnant or have my period. If it didn’t work, we’ll probably repeat the same steps again next month. With the Clomid and hCG, we still only have a 30% chance of becoming pregnant.

The truth is, even if this month we do not get pregnant, I am still praising God that my body produced even one healthy follicle. I was so convinced it wouldn’t work on that dose. But, it did! I am asking for continuous prayers, because it’s still a long journey. I thank all of you who read this blog and pray for my family, because God is moving mountains right now in my body.

And I'll be awful sometimes. Weakened to my knees. But, I'll learn to get by on the little victories.

Today, I started taking Clomid. It feels like a long time coming, considering that my husband and I have been seeing a fertility specialist since November 2010, and have been seeing our current doctor for just under a year. But, here we are. I feel a little hesitant to write an entry today, because I didn’t want to give people false hope. I guess, the truth is, I really don’t want to give myself false hope. Clomid has a 35% success rate. This is actually the same percentage a fertile-aged couple with no signs of infertility has of getting pregnant each time they are sexual active during ovulation. It seems so low to me, but those are the odds. Since my hormones are balanced (or at least they were at my last appointment), we now have the same chance as any other couple with the help of Clomid. That’s pretty amazing to me. But, 35%? How does anyone get pregnant with those odds? I feel like we just climbed the first peak of Everest, only to look up, and realize there are many, many more miles to go. I believe this will work for us (I believe, help my unbelief.- Mark 9:24), but how many tries will it take? What is the right dosage for my body? These things are so subjective, and not even my doctor can answer for sure. Fertility medicine is all trial and error. And, that is scary as hell to me. My body is exhausted from just the past three weeks of preparing to take the Clomid.

On January 13^th, I started Provera. Provera is a drug that induces a period. Gynecologists believe that it is unhealthy for the female body to go longer than three months without a period (except obviously during pregnancy), so they frequently put irregular woman on birth control to produce a period each month. If you are trying to get pregnant, then birth control is obviously a poor choice, so the other option is Provera. I HATE Provera. The drug makes me feel awful! I have premenstrual cramps for the whole 10 day cycle, plus the 10 days in between before my period starts. And, I am so nauseous that I don’t really want to eat. This time, it actual made me vomit. I feel fatigued, weak, unmotivated, and irritable. It is really not a fun medication. Plus, when my period does come the cramps are so bad that I feel nauseous again. So basically, I have felt like absolute crap for a month.

In the past when I have taken Provera, my period is weak flowing, but painful. This time it was less painful and heavier. Maybe I am looking too much into this, but I think that was a good sign. When I have taken the medication before, I had low levels of estrogen, and the doc was trying just to clean me out, because a lining build up can be dangerous. But, I know from my previous ultrasounds that my lining doesn’t really build up on its own because the hormones that make that happen are too low to do their job. This period more closely resembled those I had on birth control when there was a higher level of estrogen present in my body. I am chalking this up to a small victory that the estrogen supplements are causing my body to produce a lining, but not ovulation. Enter the Clomid.

Clomid’s job is to stimulate the ovaries to create follicles and induce ovulation. It increases your chance of twins by 50%, but is not really known to produce higher sets of multiples (though it has happened). The beginning dose is 50mg once daily for five days. The dose is increased if it is unsuccessful the first time. Dr. Smith started me on 100mg for five days. Essentially, we skipped step one. Typically, if a patient takes 200mg and uses the “trigger shot” of hCG hormone with no successful ovulation then Clomid will not work for the woman. (Note- hCG “trigger shots” are given during the third step of trying Clomid.) Since there are so many trial and error steps even this medication can be a long process, depending on how persistent the doctor is with the medication. Since today was day one for me, I will go back to the doctor in two weeks. At that appointment, he will run lots of blood work to check for ovulation and/ or pregnancy, perform a physical exam to check for signs of a thickening cervix, and discuss what the results mean. We obviously won’t know the blood work results the same day, but usually the physical exam is enough to determine pregnancy. The blood work will confirm if the Clomid induced ovulation even if we are not pregnant.

I plan to use the home ovulation tests to better time sex, but we have been instructed to be intimate every other day from now until our appointment. And, I will say, I am happy that although we will be having sex on a schedule, neither of us feels negatively about it. We both know that a lot of couples sort of get bitter in these situations, usually because the female is looking only to get pregnant and it can deplete the intimacy of sex. I love my husband very much, and sex is a very active part of our marriage. I want to get pregnant, but I don’t want him any less.