This story unfolded in waves, with each cycle teaching me a new struggle I would have with my body and mind, so I shall write in that way. Apologize for length – there is a lot to go through. I want to start with a disclaimer – adoption is not our second choice. I’ll share more later, but adoption has been part of our plan for years before our fertility adventures. This is not a back-up kid for us. That being said, over the past 15 months I have learned one thing: My brain and my ovaries are not friends.
Stage 1: Problems Loom (AKA Warning Signs)
I knew pretty quickly that fertility was going to be a struggle for me. Many of my friends have been pregnant after only a few cycles, and when it didn’t happen for me I started to investigate. I read the Fertility Bible and soon realized that my cycles were not regular for many reasons. To give a brief overview of fertility:
A typical cycle is 28 days (day 1 being the first day of a period). In the beginning of a cycle, estrogen and progesterone levels are low, which stimulate pituitary glands (in your brain) to release Follicle Stimulating Hormone (FSH) which matures the eggs in the ovaries. Mid-way through a cycle, as estrogen surges, the pituitary gland releases lutenizing hormone, which tells the ovary to release the egg for (hopeful) conception. The estrogen also helps the body make super cervical fluid to help the sperm swim. If intercourse is timed right, the sperm and the egg meet up in the fallopian tube, do a happy dance, and move their way on down to the uterus to get comfortable and grow a baby. If this does not happen, Aunt Flow debuts.
To promote conception we did the following:
- Tracked cycle days on an app
- Peed on an ovulation predictor kit (OPK) for 1-2 weeks looking for when the surge occurs to time intercourse
- Checked out the mucus (yes, it is as awkward as you think)
As things still didn’t progress, we upped our game:
- My cycles were ~35 days, a week longer than typical. Continued tracking.
- We noticed that I had multiple positive OPKs, which probably meant that at times my brain sent a signal to my ovary and it said “solid pass” on releasing an egg – and then it would have to send the signal again a week later. That means a lot more pee sticks.
- We began temping — taking your temperature at the same exact time every day. Your body temperature will rise by ~.5 degrees if you actually ovulated, so this helps confirm ovulation, but also means 6 AM wake-ups on Saturdays.
Then it happened: Anovulation.
This is when an egg never comes out of the socket and, thus, you don’t have a period because the right signals aren’t happening. The first time this happened it was a 50 day cycle. The next time, 70 days. That means 120 days “trying” for a baby, but being stuck at the start gate because your engine isn’t running. It is as infuriating as it sounds.
Stage 2: Preliminary Testing (AKA Appointments Begin to Increase)
I am fortunate my doctor agreed to start the investigation process early given the above info. She ran some blood work (all normal). Honestly, so much blood work. Every time you finish a sentence just assume I got blood work. Ok, that was dramatic, but for the past year I’ve had a lot of blood work.
Next, Rob got the swimmers checked out – normal.
Then I had an a hysterosalpingogram (to the tune of supercalifragi…). This is where you lay in an xray machine and they squirt dye inside of you to check and see if your uterus to fallopian pathways are open. It was AWFUL. When the radiologist told me to breathe I gritted my teeth and was like “I KNOW!” Six hours of pain on the couch to reveal that my tubes are (wait for it…) normal. Good news, but no direction.
Stage 3: Medication (AKA The Time I Lost My Mind)
My doctor started me on a medication called Clomid for 5 days per cycle. This is a common medication used to promote ovulation by blocking the estrogen receptors in the hypothalamus to help release the FSH and the LH. The hypothalamus is the hub for hormones, including what regulates temperature, thirst, hunger, and emotions. This drug makes you cray cray.
I had hot flashes ALL DAY. Trying to do therapy when your insides unpredictably start burning from the inside out will make you think you are nutty. There’s nothing like looking around the dinner table and being close to tears as people say “No, it’s not hot in here.”
Besides that, I think I was a gem — but my man says I may have been moody… jury out J
Spoiler…after 3 months, no baby.
Stage 4: Referral to the Reproductive Specialist AKA Bring in the Science!
Rob and I met with a very nice doctor who wrote down everything above and asked about our medical histories. He seemed pretty confident as he laid out the next plan. He also told me to throw out my app and thermometer. It was like he could tell that I was a Type A planner, because he leaned in close, made eye contact and said “I’m serious, I don’t want to know a single temperature.” Big breath. The new plan we embarked on:
New Medication: I began a medication called Femara which is an off-label medication used for breast cancer. It has had better results with significantly less side effects – just a few headaches and fatigue for me. I do not miss hot flashes.
New Stimulation 1: I also began coming to his office for ovary ultrasounds. This means poking an ultrasound wand up your Va-jay-jay and pushing hard on your ovaries to count the follicles. He tracks the size of them and predicts when you have one ready to go. This sometimes means last minute appointments and 2 ultrasounds per month to get it right.
New Stimulation 2: Things get technical here. As we approach ovulation, Rob injects Pregnyl in my arm which helps trigger that ovary to let go of the follicle (because my brain typically forgets to tell it) in almost exactly 36 hours. You can time intercourse down to the hour from there. #Science
Stage 5: More Science (AKA This is Where it Gets Weird)
After the first two cycles of this, we were still not pregnant. The doctor also noticed my progesterone numbers weren’t quite adequate. While this would not mean as much for stimulating ovulation, progesterone levels keep the uterine lining thick to give the fertilized egg a good thick cushion to implant and make a home in. So another medication would be added to the regimen. I was like “fine, load me up.”
Then I called the nurse.
“Ok, you are going to take this medication twice per day (morning and night) vaginally for 10 days.”
Come again?!
“Where?”
She repeats.
“Where?”
She repeats. As you can guess I have 1.5 million questions.
And thus here I am, twice per day, throwing some progesterone up my V. If I do get pregnant, I will be doing this for the first trimester to help keep a baby in there. Wowza.
Stage 6: To Be Determined
After this cycle we will be meeting with the physician to talk about how my brain and my ovaries must have had a super big fall out somewhere along the way in my life, because the science is not making them friends! It has been 16 months. There are still some interesting options to try – but at times I feel overwhelmed and want to hit pause. Here’s to the next conversation and making decisions…
Seriously Fun 