Letrozole is a newer drug used for infertility. Statistically,
Clomid has a longer history of success for non-ovulatory women. Because
Letrozole is also used to treat breast cancer, health insurance companies will
scrutinize a prescription for infertility. I need to get a doctor’s prior authorization before I can get my hands on the drug.
Otherwise, it’s $55 for 5 pills. HOWEVER, if I have my prescription sent to
Costco’s pharmacy, they charge $6 for the prescription out-of-pocket without
having to go through my insurance. It comes in a bottle with all these warning
stickers affixed to it; no wonder insurance companies are freaked out:
"Do not take if pregnant or planning to become
pregnant."
"For use to treat breast cancer in women after
menopause."
"Shown to cause harm in the human fetus."
It is still safe to use, though, as it has a very
fast half-life, meaning it does its job and disappears from my system long
before fertilization occurs after I take the last pill.
I switch from 100mg of Clomid to the starting dose
of 2.5mg of Letrozole. I’m apprehensive whether starting a new drug will help
me ovulate at a decent time in my cycle, but I hope to go 3 for 3, which is
some kind of PCOS world record. My “treat” for starting a new cycle is
indulging in something healthy for my body—I’d run on the treadmill and succumb
to abs- and high-aerobic workouts that I don’t dare to perform while in the
TWW. I miss aikido like hell, but it doesn’t make sense to sporadically go back
on and drop off during the TWW. Our date nights are not going out to watch 50 Shades of Grey but, being as how we
met through martial arts and enjoy watching a good fight, we go to see the UFC
match between Ronda Rousey and Cat Zingano. Rousey’s got a bit of an attitude
and is definitely not the nicest or friendliest gal you'll find in the ring. She's
definitely got beef with some of her opponents, but the girl's got skillz. I
also like her philosophy of self-reliance and not expecting anything to come
easy for her; it’s like you need to harness her headstrong martial spirit to
make it through the rough journey of TTC.
Now that I’ve mastered going without alcohol, in an
effort to wean myself off caffeine, I switch to peppermint tea, which is also
supposed to have a “warming” effect on the uterus. It’s an acquired taste, and to
me it feels like I accidentally swallowed warm toothpaste water, but I’ve been
through the Chinese herbal teas, so now I can get through anything. Bring on
the peppermint tea, Clomid, and Letrozole. A coworker sees me brewing tea in
the Break Room, and she asks why cutting out caffeine is a trend lately. I make
an excuse that I personally am sensitive to caffeine and am trying alternatives
to even green tea. She then asks if I drink alcohol, and I say not for the past
3 months. In retrospect, I should've just responded with a vague "No,"
but immediately she cocks her eyebrow and blurts out, "Are you
pregnant?" I grit my teeth and say no, just trying to be healthy.
I get so excited about my follicle ultrasound days
that I'm like a giggly schoolgirl finding it hard to sleep. My OPK turns
positive this cycle before I even trigger, and at the ultrasound appointment,
they find a follicle on my left side measuring at 25mm, perfectly ripe. They
decide to do the Ovidrel trigger shot right away. I'm performing great on the
Letrozole--textbook ovulation near CD13, and my endometrium this time measures
at a cushy 10mm when they look for a minimum of 7mm.
Most people aren’t advised to take Clomid or
Letrozole beyond five cycles as the chances of success don't improve much
beyond then. Timing is huge for IUI cycles as after the sperm wash (which is
necessary to prevent bacteria from getting past the cervix, thereby causing an
infection), sperm end up not living as long (they live for up to five days in ideal Cervical Fluid if "released" naturally). Trigger shots usually cause women
to ovulate 36 hours afterward, and for that reason, the IUI is scheduled for
1-2 days after the trigger shot is administered. An egg usually lives 48 hours
after ovulation. On March 4th 2015, we go in for our second IUI. This
time, my OB has to employ the tenaculum to hold the cervix in place for the
catheter insertion, along with the speculum.
Nearing the end of the TWW for this cycle, I can’t help
but fall into a despondence despite my best efforts to remain optimistic. Maybe
the financial and emotional investment of an IUI and the thought of having to
do it again and having fewer chances of success after the third round is really
getting to me. I can't help thinking, "What if an IUI doesn't work for
us?" I get moody at slow and stupid people I encounter in public and think,
“Tazing idiots in public should be fully legalized.”
March 17th 2015, I take another HPT test
(I lost count of how many by now) to see yet another negative. I’m ready to get
off the Crazy rollercoaster. I become so dejected that I break down and lose my
will to go to work. I can't push away these thoughts of, "I CAN'T do
it." I can't get pregnant. I can be the first of my father's family to
finish college, I can score a career and excel, I can become one of the
youngest promoted female managers, I can plan a wedding and find a man I love
and want to share my life with, I can buy a house, I can travel the world, I can
be responsible for another living being by adopting dogs...but I can't get
pregnant. It is morally defeating, and I'm not sure I've learned how to deal
with working so hard for something I haven't yet achieved. I drag myself to the
warm comfort of the bed, secretly put a pillow on my tummy just to see what
it's like to have it grow, and grieve.
Takeaways:
There are reflexology points near your ankles and at the webs of your hands
that can bring on uterine contractions. TTC’ers and pregnant women should avoid
massages around these regions. When at the dentist, pregnant women should try
to avoid or use more caution if getting x-rays and make sure their dentist uses
a pregnancy-safe anesthetic if needed as some can raise a patient’s heart rate.
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