Monday, June 8, 2015

TTC: CHART 15 (12/12/14-1/18/15)



I start 50mg of Clomid after 14 months of mostly anovulatory cycles. Clomid ups the chance of multiples by 8-10% and has other potential side effects, including ovarian hyper-stimulation syndrome (OHSS) and miscarriages. I am not advised to remain on the drug for long, so if one natural round does not work, we move on to Inter-Uterine Insemination (IUI). In this procedure, they insert a small, pliable catheter through my cervical opening and inject pre-washed sperm straight into my uterus, which gives the sperm a shorter swim to meet the egg, plus no Cervix Police to stop the ambitious little guys, who hone in to the ripe egg with their built-in GPS. My husband has to take a mandatory blood test before we could do IUI, and braving that is a hurdle. I await the results with a Cycle Day 13 ultrasound to get a peek inside, a luxury I did not have with natural cycles. I find myself researching IVF, an option I would not have considered before. Reading about all these procedures doesn't seem as intimidating and overwhelming as it once was.

They say a woman becomes a mother when she learns she's pregnant, but a man doesn't become a father until after the birth of his baby. We women are already attached to and romanticized by the idea of a baby before we even conceive. I swallow daily prenatal pills and vitamins for over a year without barely skipping a day, get weekly acupuncture religiously and arranging my life and schedule around it, track my temps, buy lube, pee on sticks daily (to continuously negative OPKs that just demoralize me further), and drive myself to clinics to weather invasive tests alone.

I brace myself for the side effects I have been hearing about on Clomid, but aside from some mild sensations in my abdomen and a few hot flashes, I feel fine. I’m happy to not have out-of-control side effects, but at the same time, I wonder if the pills are doing the trick. On Christmas Eve, when people prepare to open their presents with loved ones, I go in for my follicle ultrasound. A few follicles are found on the left, some more on the right, but the biggest at around 12mm is nowhere near maturity yet (they look for closer to 20mm before triggering). The OB hopes I'll be a late ovulator again this month as I usually ovulate around CD18-20, so at CD13, it is still early, but it gives her a baseline without having to worry about missing ovulation. We're upping my Clomid dose to 100mg next month, and I become disappointed in my own body; even with science to help, it seems like I can’t get off first base.

I continue testing with OPKs to hopefully catch my surge. As if by some divine sign from the universe, a brand new box of Clearblue Digital OPKs keeps registering error messages on the test sticks. New Year’s Eve, and their Customer Support center is closed. It’s so hard to control the variables of your environment to make sure there are control factors for when you take your temperature. In winter, having the heat constantly running turns me into a prune, so I sleep with a warm mist humidifier. Is that why my temps have gone up? Or maybe due to the weather getting warmer, or because I hit the gym again after my two weeks' holiday break sloth. You know you’ve reached a new level of TTC Crazy when you tear the customer reps at Clearblue a new one for faulty technology and cheap service. They mail me a replacement box after I call about the test stick errors, but it is a box of 7 test sticks instead of my original box of 20. I get put on hold for a good 20 minutes on the phone, and the customer rep today says they sent me a box of 7 since I said I have some leftover sticks from my defective box of 20 that I can use with the new reader. I tell them, Oh hell no, you are replacing what I paid for--it's not the reader, but the rest of the test sticks in this old box are crap, and I'm not using them to be misled in a new cycle again! She gets the point real quick and says she'll send out some more test sticks to make up for it. Usually I'm cordial over the phone, but I totally flip the switch on that one. Desperate TTC’er at work.

At the end of the Two Week Wait, I fluctuate.  It’s a fine line we walk between hope and despair. My temperature has stayed up to reflect a somewhat healthy LP; a bit of spotting can indicate implantation bleeding; I have a headache and feel bloated and icky, which can all be signs of PMS. Clomid does help with ovulation after all, albeit late. I line up my steps for the next cycle: 100mg of Clomid, HSG test, CD13-15 follicle ultrasound, possible IUI. These monitored cycles feel like such a rush on CD1 to get everything in place.

Takeaways: Estradiol (E2) is a suppository that can be prescribed to help plump up a thinned-out endometrium lining. Progesterone suppositories are prescribed to sustain progesterone during a woman’s LP if she happens to fall deficient too soon in the cycle. Both can be taken orally or vaginally for absorption. Progesterone in Oil (PIO) must be taken as an injection into a muscle, typically the butt. A healthy LP is considered anything above 10 days; mine is 13-14 days. A woman’s LP does not naturally vary more than 1-2 days. A fertilized egg implanting in the uterus usually happens 7-10 DPO.

SES = Secondary Estrogen Surge, also called a Fallback Rise, and not to be confused with implantation dip (which is indicated on a BBT chart by the time a fertilized egg implants in the uterus). SES can occur anytime during a LP and is characterized by a dip, and then a rise in temps.

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