Cysts and Super Sperm

Fertility treatment is a roller coaster. One month you’re up. One month you’re down. It’s physically and emotionally draining. And, just when you let yourself get your hopes up… another cyst.

Last month, I went to our new clinic to get an ultrasound and blood work. It was day two of my period, which is a very awkward time to get a transvaginal ultrasound. During the ultrasound, the nurse discovered a cyst on my left ovary that was too large for me to safely continue treatment that month. In hindsight this was actually a very good thing. It meant my back injury from a recent car accident would have more time to heal before I start growing something in my uterus adding extra weight and stress to my sore lower back. But, at the time, it felt devastating.

In order to rid my body of the cyst, I was prescribed a one month cycle of birth control, and told to come back for another ultrasound day two of my next period. As it turns out, that day is today. So, this morning, I went back to the clinic with fingers crossed that my ovaries would be cyst free. When the sonographer looked at my uterine lining, it looked wonderful. And, when she looked at my ovaries she said, “Your ovaries look beautiful today!” Maybe that isn’t your typical compliment, but it meant everything in that moment to me. My left ovary has a small follicle that was collapsing, but not enough to worry about, so we are moving forward.

Tomorrow I will start our third round of Clomid treatment. (The first at this clinic.) I will be taking four pills a day (two in the morning and two in the evening). This is a higher dose than I took last time. Since I have successfully ovulated on Clomid before, there is a good chance that I will do it again. Plus, this clinic actually has me on a 31-day plan. I will be monitored every step of the way. In fact, next week I will return to the clinic for another ultrasound, and a HCG trigger shot to induce ovulation. I will have two more “mini shots” of HCG to help maintain a pregnancy, as well as two estrogen supplements at the end of the cycle.

We were given an option with this cycle to choose Intrauterine Insemination (IUI), or sexual intercourse. IUI holds a price tag and sex is free (not to mention a lot of fun), so we were hoping to do this the good old fashion way (you know, besides the ovulation stimulating medication). But, in order to give sex a try, my husband had to get a semen analysis test. To me, this is one of the most humiliating things you can do in a doctor’s office, but my husband is a trooper. Although we did not discuss the details of his “sample donation”, I know he did it. Later that day, I got a phone call from the clinic with his results. His sperm count was above average, and the sperm’s mobility is also very high. My husband has often joked that he knows he can get me pregnant, because he has super sperm. As it turns out, he’s right! These results do not guarantee pregnancy, of course, and we may need to try IUI some time, but this month is not that time.

Next week, my husband and I will be celebrating our two year wedding anniversary. We planned a long weekend getaway to Hot Springs, AK. We are both praying that that time will be the last that we are alone.

Brighter Days

            On Monday of this week we had our first visit to our new doctor! If you are regular reader of this blog, you know that we have not had the best luck with our last fertility specialist. He is a very unpleasant man, with a serious lack of bedside manner. After he told us we were wasting our money seeing him, I booked an appointment at a new clinic. The clinic is called CORM, and is so close to our house that I cannot believe we were driving on the other side of Houston before. Anyway, one of the best parts about this new clinic is that our specialist is a female. Don’t get me wrong, I don’t necessarily think women make better doctors, but when it comes to dealing with my most intimate regions, I would prefer a woman to a man.

            Dr. Schnell is one of two doctors in the practice, and she really is very sweet. Although, we waited in her office a long time to see her, when we were with her she was thorough, professional, and very good at answering all of our questions. She did a physical exam and ultrasound on me, and talked to my husband and me at length about our treatment options. During the ultrasound, she confirmed that I did, in fact, ovulate this last cycle. But, I was not pregnant, a fact I knew because I had just finished my period. I told her about the pain I had during my last cycle, and she agreed that it was most likely due to overstimulation from having two cycles of Clomid back to back without a period in between.

            We learned a lot from this visit. I knew that PCOS made up the majority of female related infertility, but I had no idea that 40% of infertility patients are due to male infertility, caused from slow swimmers to low sperm count and everything in between. My husband has not had a semen analysis done yet, but he will be having one soon. We don’t really have a reason to believe he has issues with his sperm, but you never know. Incidentally, he’s not really looking forward to this test, because, as you can imagine, it is awkward to produce a sperm sample in a doctor’s office.

After my exam, Dr. Schnell spoke with us again about another test she wanted to conduct on me. The test is called a Hysterosalpingogram (HSG). Basically, an HSG is an x-ray conducted after dye is injected into the uterus through a catheter to check if the fallopian tubes are open. This test is usually a test given early in treatment between days 5-10 of a cycle. I had asked for this test repeatedly when we were seeing Dr. Smith. And, although it is normally one of the first and most basic tests, he told me that I did not need it. After seeing Dr. Schnell one time, she ordered the test, and I had it done yesterday. Amazing how much faster things work when you know what you’re doing! I was given a Valium for the test in order to relax the uterus and lessen some of the pain. The test isn’t painful, but it’s uncomfortable. A catheter is thread past the cervix into the uterus where a small balloon is inflated to prevent the dye from leaking out. The balloon is the most uncomfortable part of all of it. The pain is like a normal menstrual cramp. I actually got to watch the dye fill my uterus and flow through both fallopian tubes on the screen. The entire procedure probably took 10 mins, at most. And, the results… ALL CLEAR! This means that when I ovulate, the egg has a clear path to the uterus.

But, the successful HSG isn’t even the most exciting thing to come out of our visit with our new doctor. The best thing is that SHE HAS A PLAN! Every time we saw Dr. Smith, the plan was always to wait and see. There was no clear path. But, Dr. Schnell has a 31 day pregnancy plan. We will go back to see her on May 8^th to start a new cycle. First, I will take a medicine to induce a period (not Provera, which I hate). Then, on day three of my cycle I will start Clomid. She is increasing my dose to four pills instead of three, and I am starting the pills two days before Dr. Smith had me start them. On day 11, I will have an ultrasound, begin taking an estrogen supplement, and receive an HCG trigger shot. Over days 13-15, my husband and I are to have sex, or if his semen analysis is not so great we can opt to do IUI (artificial insemination) with his sample. (The IUI is more effective because it forgoes the sperm traveling through the cervix in order to reach the egg.) Here’s where things get really tricky, I will have another ultrasound, another oral estrogen pill, and two more HSG shots between days 18-31. The extra two trigger shots are smaller doses than the one that forces ovulation. They are used to maintain the egg growth, so that I have a greater chance of not miscarrying early in the pregnancy. HSG is the pregnancy hormone; it is what causes the home tests to give you a positive, so it is not harmful to the baby. After this entire process has concluded, if we are still not pregnant, we will revise the plan and try a more aggressive treatment.

I am happy to report that Dr. Schnell only took me off one medication Dr. Smith had me on, the estrogen supplement. According to Dr. Schnell, if you take this pill daily, it makes it more difficult to get pregnant. It is best to take a higher dose for a few days during the cycle. Since the estrogen I was taking was only available from a pharmacy that did not take my insurance, my husband and I were both pleased to not need it anymore.

In general, things are looking up. I really have a good feeling that we will get pregnant before the end of this year. This new clinic is professional, friendly, and technologically advanced. (They use computers- a concept that Dr. Smith never got.) I’m looking forward to our next visit with Dr. Schnell, and if the worst part is the long wait times in her waiting room, then I would still say she is worth it.

Ice Cream Is Essential When You're Wasting Money

     Since my last post, a lot has happened, but it was really difficult for me to find the words to express how I was truly feeling, so I let my blog rest on a cliffhanger. Let me begin with three weeks ago.
     We went back to our doctor to follow-up on my egg situation. The hCG shot was supposed to force ovulation, so there was a chance I was pregnant. I took a home pregnancy test before scheduling my appointment, and it was negative, so I didn't really have high hopes that I was pregnant. However, I had every symptom you can imagine, literally. I woke up with a sore throat one day, a symptom I didn't even know existed. I also had an egg white discharge, which kind of freaked me out at first, because I didn't realize that was also a normal symptom. The problem is that despite all these symptoms, I wasn't pregnant. The trigger shot made my body behave pregnant, and my heart was just along for the bumpy ride. At our doctor's visit, I assumed our doctor would do blood work, because he ALWAYS does blood work. But, he didn't. He told me that I was unlikely pregnant, and that my testosterone levels had gone back up in the blood work he had taken last time. He also said that while it was possible that the presence of follicles at the last visit could have caused the hormone change he doubted it. But, he didn't do ANY blood work to confirm, even after I asked/ told him he should. The whole situation really pissed me off! My husband and I live about an hour away from his office and we waited 30 mins to see him, and HE DID NOTHING!
     I haven't really trusted Dr. Smith since he said I was closer to a daddy than a mommy, but this visit was the last straw. In fact, his new treatment plan seemed so poorly thought out, I was a little embarrassed to tell people for fear they would judge me for sticking with a bad doctor. His plan was to wait a few days, take another home test, and start another round of Clomid (with an increased dosage) without having a period. I knew from the ultrasound the last time that I had a uterine lining build up, which needed to be cleared out for my own safety, but the doc told me, "Your body doesn't follow the normal rules, so it will be fine". I was pissed.
     My husband and I really don't fight a lot. We disagree, discuss, move on, but fight... we just don't. But, that day, it was brutal. I told my husband that I didn't want to continue with our doctor, because I didn't trust him, and I was scared for my body to build up this lining and not shed it, because it can be toxic. My husband is normally fully on my side, but this time he wasn't. He thought I was trying to change doctors so that I could move to a more aggressive treatment too soon, which he didn't think was a good plan at all. I agree that moving faster than normal through procedures was a bad plan, but that was not what I was doing. After, literally three hours discussing it, my husband agreed that a second opinion wasn't a bad idea, especially since I was actually willing to postpone treatments altogether to ensure that what our doctor was prescribing was the best. We agreed to look at another clinic in April if round two of Clomid failed.
     Fast forward to this week... After five days on Clomid, and 14 days of waiting, we had another follow-up. While on Clomid this time, I had the same side effects as the first time, light cramping and mood swings. But, this time, I had a significant temperature drop (the first sign of ovulation) right on schedule! A few days later (Tuesday of this week), I had the same white discharge, which can also signify ovulation is starting. Then, on Wednesday I was sitting at my desk at work, when out of nowhere, a blinding pain hit both sides of my ovaries. It hurt so bad I thought I would throw up. And, the pain did not dissipate for over two hours. After the first hour, I called the doctor. I didn't hear back until much, much later, after the pain had subsided to a dull ache. His nurse said to take some Aleve, but since our appointment was the next day there really wasn't much else to do.
     At our appointment yesterday, Dr. Smith looked at my temperature chart, which featured another significant drop from that very morning, and said he didn't think we needed to do an ultrasound, because he didn't think there was anything going on. I sort of insisted that we do the ultrasound, since that was really the only way to be sure, and since I was still in a little pain it would be nice to know why. The ultrasound revealed that I had a lot of small follicles, and two large ones (one on each side), but it also revealed that the large one on the left had ruptured, and was caving in on itself. This was the pain I felt. There is no real way to tell if the ruptured follicle contained an ovum/ egg, or if it was just filled with liquid, but there was liquid present, which was a good sign that something was actually happening in my ovaries. The follicle on the right side, may or may not rupture to leak the ovum or liquid out this weekend. There's really no telling. So, he ordered some blood work to check my estrogen and progesterone levels, which would be a clearer view of ovulation. I won't have those results until Monday, but the doctor had some advice for us. He feels as though Clomid may not work for us, because there is a chance that my ovaries have a thick "shell" built up on them, which is common with PCOS. He also feels that the best way to treat it is to drill holes in my ovaries to make a path for the eggs to escape from. The procedure has had poor results, and he doesn't know a doctor in all of Houston that does it. So, this was less than helpful, to say the least. Our other options could be to move to IVF, but he doesn't think my body will produce viable eggs, despite the fact that Clomid is producing follicles that are the right size and shape. He concluded his recommendation by saying, "I feel like I'm wasting your money". And, in that moment, my world shattered. HE HAS GIVEN UP! I am grasping at straws of tiny successes, and he is throwing in the towel. It was all too much to handle, so this time I did cry in his office. And, I didn't stop crying for nearly the whole hour drive home.
     As is our routine, my husband and I discussed the visit on the way home. He said he doesn't think Dr. Smith is right, and he wants the second opinion. While I was hurt, my husband was angry. He couldn't believe our doctor would give up when there was literally proof that my body was responding to treatment even in the slightest. When I suggested maybe we should explore adoption, something we have not done, because we weren't ready to quit trying yet, my husband said we could look into it, but he still wasn't ready to give up. We are so early in the process that it doesn't make sense. Plus, there is a chance I am ovulating right this very moment. My husband was right. It isn't time to give up. I told him that I do not want to have my ovaries drilled, but, if we have to move to IVF, then we should start saving.
     Today, I feel awful. I have dull, achy cramps on both ovaries that feel sort of like someone poked them repeatedly with a stick, which is pretty accurate, I guess. I'm writing this while drugged up on Aleve and resting on a heating pad. But, the second I hit "Publish Post", I am calling the fertility clinic we chose for a second opinion.

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.

Almost a Daddy or How Dr. Smith Broke My Heart

Friday, my husband and I went back to the doctor to have follow-up blood work completed after three weeks on the estrogen treatments. I have learned not to get my hopes up too much before we head to Dr. Smith’s downtown Houston office. His office has become menacing. It is a large, skyscraper-esque building, complete with lots of traffic and a large parking garage. The building has changed for me. I used to see a bright building full of hope, but each visit the building has grown darker and darker. It is no longer a place of hope. It is a place of fleeting dreams. A place of heartbreak. A place of hurt. And, I feel all of these things before we have even had a chance to try a single fertility treatment. So far, Dr. Smith has been focusing on my “crazy hormone levels”, because at this point my body will not respond to treatment. I respect and support this treatment approach, but he doesn’t always exhibit the best bedside manner. He is a man of jokes, and I am a fragile girl who cannot handle them. Since this visit was to be short, only long enough to discuss that I have not had any side effects on the estrogen, I didn’t expect much in the way of a new treatment plan. There can be no plan until he has read my test results sometime this week. I didn’t even want to ask him what was next. But, I ended by saying what I usually do, “I’m really praying this works, because I really want to be a mommy.” Dr. Smith laughed and said, “With testosterone levels like yours, you’re almost a daddy.” My mouth fell open, and my heart sank. I held it together enough not to cry at that moment. My husband wrapped his arms around my and whispered in my ear, “I love you.” This is always his answer when things get me down. It used to feel like it was a copout, but lately it’s the only thing that gets me through. He loves me enough to hold me when the world falls apart, which is something that happens more frequently than not with fertility treatment.

But, Dr. Smith’s one sentence sent me into a downward spiral of despair the entire weekend, not a good thing considering we had company from out of state, and I was appearing in a Christmas play. Who would not have been hurt by those words? If you read my blog regularly, you know that the high testosterone levels have begun to make me feel like less of a woman. I questioned everything about my life. Am I not a girly girl, because I have too many boy hormones? Can people tell that I have high testosterone? Will my hips ever pear-shape like a woman’s should? Will I have less of a sex-drive when the testosterone levels come down? This weekend, it took everything in me to hide how I was really feeling in order to perform in a play, and be a good host to my friend. It was exhausting. And, I didn’t do a very good job at it. For someone that has ridiculously high testosterone levels, I am pretty damn emotional. The worst part is that since there was so much happening over the weekend, my husband and I really haven’t had a chance to process the new information, however little there was.

The current plan, as I understand it is to wait and see how my test results come out. If it looks as though there is some balance, we will probably start Clomid after taking Provera to induce a period. If there isn’t… there is no current plan in place. I am a planner, and the waiting, not knowing, uncertainty is killing me. I wonder if it would be a good idea for us to begin the process to adopt. My husband says that he isn’t ready to give up on my body yet. And, that isn’t because he doesn’t believe in adoption. In fact, we both believe adoption saves lives. He doesn’t want to give up on my body, because he knows that I selfishly want to carry a child. I have two friends who were adopted, and I believe their lives were better because of it. I know I’m being selfish by wanting to exhaust all our options for treatments first. I know we run the risk of extreme stress on our marriage as sex becomes a chore prescribed by a doctor, and as doctor’s bills go unpaid by our government issued insurance. I know that there is a better way to spend the kind of money we could be paying out in the end, but I am selfish enough to not care about any of it. At least my husband is supportive, and I am very appreciative. But, I wonder if his role will become passive as mine becomes pregnant by any means necessary. Will he resent me? Will he resent our child?

On a related note, my life has been consumed with fertility talk. I enjoy writing this blog, because it is free therapy for me, cathartic. But, people ask me about it a lot in my personal life, and I can’t seem to not bring it up in relatively every conversation. I am a woman obsessed. I fear it will become a draining burden on everyone around me. I am a Debbie Downer. And, I really don’t want to be. So, I am hereby granting permission to change the subject. Just because my life is consumed by fertility overload, doesn’t mean the lives of all my friends has to be too.

I swear I didn't mean for it to feel like this, like every inch of me is bruised.

It seems as though every time my husband and I have a glimmer of hope, we get knocked down so low that it is hard to remember that our doctor hasn’t given up on us yet.

I was so excited as I started this week. Monday was the last day I was taking Provera, which meant a period later this week, and the start of our first round of Clomid. On Monday afternoon, Dr. Smith’s nurse called me to deliver my test results. I had completely forgotten that he had ordered blood work before I left his office two weeks ago. Since I was told not to wait for the results, the tests seemed meaningless. I didn’t even remember what he ordered, and I assumed it was just the standard routine that I have drawn nearly every visit. The results were not good, to say the least. You see, my biggest complication with PCOS is that I have unusually high testosterone levels, which is a major symptom of the disorder. However, mine are the highest my doctor has EVER seen. And, despite the fact that they were in normal range a month ago, they have once again skyrocketed to levels that prevent Clomid (or really anything else) from working. Basically, he wanted to see us the next day (yesterday) in his office to discuss a new plan.

            After I hung up the phone, I cried. Mostly, I felt defeated in a battle that I didn’t even get the chance to suit up for. But, it also hurt my heart to hear that my testosterone levels were high again, because the very idea of it makes me feel like less of a woman. I consider myself to be an intelligent person, and my mind KNOWS that this is not my fault. I even KNOW that I am actually pretty lucky that I don’t take more after my Hungarian roots, because the symptoms would be more visual. But, my heart… my heart feels pain, hurt, anguish that I am defective. It makes me feel like I am not a woman. Sure, I have breast and a vagina, but my ovaries make more testosterone than they should, and my brain doesn’t know how to turn it off. Essentially, my body appears female, but behaves male. It is a major identity crisis. I feel like my husband married a woman, but didn’t get one. I irrationally worry that my body will somehow find a way to change shape and grow a penis. I KNOW these things can’t happen, but I cannot change how I feel. I feel manly, and no woman ever wants to feel that way. We are conditioned from birth to grow up as beautiful woman. We wear make-up, color our hair, bat our eyes, and sway our hips. And, I feel like my body has forgotten those things, choosing instead to spit, scratch, and grunt. I am defective. If I were an electronic, I would have been traded in under factory warranty. I am broken.

            After stewing in these thoughts for a full day, my husband and I made the long trek to Dr. Smith’s office. I wanted to believe I had prepared myself for the worst, but if I were really honest with myself, I hadn’t. Dr. Smith had a plan, though, which was a little reassuring. My cycles, the way my body will respond to treatment, it’s all a guessing game at this point. While Dr. Smith couldn’t answer all of our questions with more than, “I don’t know yet”, he did explain in detail what he would like to try in order to get my body in gear. Since my testosterone went down with birth control, we know I do not have a tumor, and we know that there is a window of opportunity that could produce ovulation. So, I will now be taking three weeks of estrogen treatments once I finish my period sometime next week. These treatments are the same ones given to women who are going through menopause, which I am not. Dr. Smith is certain I am not going through early menopause, because my levels would be more than double what they are, which I guess was supposed to make me feel better, but really didn’t. After I have taken three weeks of estrogen, I will be given another blood test and then “smacked” with Clomid. Basically, I will be on the highest dose of Clomid Dr. Smith is comfortable with. Though, that doesn’t mean I will ovulate. Like I said before, it’s all a guessing game now.

            Maybe I am crazy for putting my body through this. Maybe it will work too well, and we’ll end up with a litter instead of just one healthy baby. Maybe it won’t work at all. But, I have to try. I think the worst part about the uncertainty of infertility is the guessing, waiting, praying for a positive result. Being that I am what Dr. Smith calls a “toughy”, it makes it even worse. I can no longer rely on the statistics that surround the medication, because I do not fit the mold of the women who usually take them. I am thankful that Dr. Smith is still willing to try pills before exploring other options, because our insurance won’t cover anything beyond that, and the other procedures can be painful and invasive. But, I wish it were all over. I have dreamt of holding a baby my whole life. Since I have known my husband that baby has a face; features similar to his crooked smile and brown/ green eyes. I want to hold OUR child. I believe in adoption, and I would never love an adopted child less than I would love one I carried for nine months, but I want the chance to be pregnant. I want to help God grow a miracle. I want to feel that baby grow, kick, move. I want to feel the pains of birth, and hear our child cry for the first time. And, I don’t think these things are selfish. I am not motivated by greed, hate, destruction; I am motivated by love. What can be more pure than that?