This is going to be very long, so here's the shortlist for those who'd like the crash course.
We've been TTC for about 20 mos. I've ovulated 7 times in that span.
Problems: PCOS and hypothyroid with possible endometriosis
TREATMENTS:
Progesterone- Oral and shot to induce period many times. Suppository to support luteal phase.
Clomid - 4 rounds - all negative
acupuncture/herbs - no idea if they would have helped. Had to stop because of $$.
Femara/trigger/IUI - Chemical bfp (early miscarriage)
Femara only - bfn (big fat negative)
2nd Femara/trigger/IUI - bfn
TESTS:
LOTS of bloodwork - mainly hypothyroid
Two Hour Glucose Tolerance Test - No obvious insulin resistance
Endometrial Biopsy - all clear
Semen analysis - decent
HSG - Tubes all clear
Laparoscopy/hysteroscopy - pending
So... no more suspense. Here's my story...
My DH (Dear Husband) and I wanted to start TTC (trying to conceive) earlier than we did, but finances and job situations deemed that we wait. All my life I've been pretty sure I would have a difficult time. My cycles have never been normal in any sense of the word, and my family's reproductive history was not encouraging. Still, I believe that I thought it would all end up ok in the end.
I did however, try for 6 years to get doctors to help me figure out what was wrong. I had very long cycles, extreme fatigue often accompanied by depression and anxiety, painful, heavy periods and adult acne. They did agree to run some tests. However, their ignorance of what was normal led them to declare me "perfectly healthy" and to suggest that maybe I had SAD or something. The obgyn simply declared that bcps would fix me right up and that I should just stay on those despite my conception concerns. One of them said, "We'll worry about that when you try to conceive." Um. Ok. I still have a lot of anger about all that.
We started trying soon after I turned 28 and DH turned 30. We had been pretty careless with the birth control even before that, but we decided to get serious at that time. At first it was exhilarating! Maybe we created a life this time! No conception worries! Woo Hoo! Why I thought it would be that easy, I have no idea.
I found a popular charting website and decided to start charting my BBT (Basal Body Temperature) to determine if I was ever ovulating in my 2 and 3 month cycles. According to the software and all my physical signs, I was not. Based on this information and 6 months of trying, I went to my obgyn. She recommended waiting "just a little longer," to do anything even though I was on something like CD (cycle day) 72. That didn't cut it for very long with me. After some pushing, she decided to do some preliminary bloodwork and a "clomid challenge trial."
I took clomiphene citrate CD5-7 and waited to ovulate. If you want to know the details of clomid, a google search will work wonders, but in short, it induces ovulation by blocking estrogen receptors. She gave me NO warning of its side effects and possible dangers, and the accompanying drug info was very deceptive as well. I thought I was losing my mind! It played with my mental health so completely that I didn't know up from down. I also experienced intense cramping and tenderness in my reproductive organs, headaches, breast tenderness, frequent urination, nausea, dizziness, chest heaviness, interruption in sleep patterns, night sweats, hot flashes and intense thirst and hunger throughout the entire cycle. Her answer to this was that I was probably a little "hypoglycemic, catching a cold, and too stressed out from charting." I never went back to her again. I then found a very wonderful obgyn (Dr. P), who did his best to help me on 3 more hellish clomid rounds (one in which I almost fainted from the cramping pain which the nurse said was normal), but admitted in the end that he was out of his league with me and referred me to an RE. Lesson learned. Obgyns who say they "specialize" in infertility generally just "specialize" in prescribing clomid and running a few basic tests.
I waited 3 mos to get into the first RE. We'll call him Dr. #1. In the meantime, I began doing acupuncture and taking herbs with a wonderful Chinese Doctor. To this day, she remains the only doctor who has really seemed to care about me as an individual. Unfortunately I had to stop due to money constraints.
Dr. #1 was ok, but my personality didn't seem to jive with his. He diagnosed me with polycystic ovarian syndrome (PCOS). FINALLY! Some answers! He also ran a PCOS bloodwork panel (more needles and tests) and performed an endometrial biopsy to make sure my thick lining (3 months worth) did not show any signs of hyperplasia. I was all clear, but I had a very difficult time post-procedure. It was a full month of bleeding and pain in which I had to take multiple days off work. I did not agree with how they tried to treat the problem (my acupuncturist helped me with herbs), so got a referral to a different RE in the area. (Dr. #2). It only took a few weeks to get in to see him. I had done some research on hypothyroid by this point, and knew that I fell into the "new" (now YEARS old) guidelines for hypothyroidism since I hovered around 5. I had suspected it for a long time due to my symptoms and family history (Mom AND Grandma), but many (6 actually) had declared it to be normal. I came into the office armed to the teeth with information to prove my point, but he shocked me by putting me on synthroid right away! This office was lovely, and I was finally satisfied. :) (I felt a bit like Goldilocks by this point.)
Next, we did an HSG which showed completely clear tubes. The HSG was really cool to see because you get to see all your reproductive organs up there on the screen as the dye travels through them. I was fascinated. Shortly after that we tried our first Femara cycle with hcg trigger and an IUI (intrauterine insertion). Femara proved MUCH gentler on my body than clomid, and I still had 2 good follicles to release. The hcg trigger wasn't as fun as it's a shot you give yourself, and I had some fun side effects from it, but that was very temporary. The IUI felt very uncomfortable and impersonal. HOWEVER - success for the first time ever! We got a bfp (big fat positive) that cycle. Sadly, it ended in a very early miscarriage.
Before this happened I had been on a sort of depression roller coaster. After the miscarriage, I began to get angry... very very angry. It got especially bad after a Femara/intercourse only cycle, and another failed IUI. I'm still in that angry phase, but it's starting to ease up some as we take this next step.
In the meantime, I finally go to an office where I'm very happy with how the nurses, receptionist and phlebotamist treats me. I like the doctor, but see him rarely. My TSH is now around 2.9 and falling, and I have more energy than I have had in over 6 years. It feels amazing. It's like a new lease on life. No more sleeping for 10-12 hrs, then napping after breakfast, then napping after lunch, only to go to bed early again that night! I don't think I could EVER go back to that total exhaustion.
Now on to the lap. :-P
FCIF