Part 2… Round 1

April 12, 2018January 21, 2018 / Hilary / Leave a comment

Here we go… round 1 with CCRM.

Blood Draw

Before Dr. G can prescribe the Letrozole, I have to go in for a blood draw to confirm I’m not pregnant. I find that to be ironic or funny.

A piece of me hopes that I am, that we don’t have to go through another round.

Wouldn’t that be amazing to receive the news that they can’t prescribe the medication because I’m already pregnant!

A girl can dream.

Confirmed: not pregnant

Ultra Sound

I then need to go in for an ultrasound to ensure I don’t have any cyst that would ‘eat’ the medication.

Confirmed: no cysts

Side comment: the technician did ask if I’ve heard of PCOS before because I have cystic-type ovaries.

… Funny.

Letrozole

Here we go!

Medication: prescribed

Dose: begin taking 2 pills daily for 7 days.

I understand the side effects to be different than Clomid and am hoping that my face doesn’t break out like a pizza and my skin doesn’t hurt like a stuffed sausage.

That was painful and uncomfortable.

Intrigued by the hope of Dr. G, I proceed with hopeful caution.

Hubby is a bit more skeptical as he recalls our OBGYN being just as optimistic.

I guess I just can’t get stuck in the weeds of the ‘what ifs’ and will choose to take it one day at a time, one dose of medication at a time.

Day 6-

The medication hasn’t been too terrible. Actually, I haven’t seen too much of a change except my energy level is a bit low. Praise God that’s all it’s been.

I’m a bit nervous that the medication hasn’t done anything for me because I haven’t had cramps or pains in my lower abdomen and just hope and pray that things are still reacting even though I can’t feel it.

We will wait until day 9 to visit the doctor for a second ultrasound. This will be the indicator as to the reaction to the medication and also where we will learn our next steps.

I am grateful Dr. G has not outlined every step for us as I was too caught up in counting days and plotting out our next moves.

I literally can’t do that this time around. I just get to live in this day, this moment.

God, I trust you and believe you know the timing for our growing family.

And the Dr. Says…

April 9, 2018April 9, 2018 / Hilary / Leave a comment

Unfortunate timing as our doctor was out of the office for a week after our lab-work and then booked the following.

…. so after a much-anticipated wait (haven’t I heard somewhere that patience is a virtue?), we have had our follow-up appointment with Dr. G. to find out more about our lab results and hear what he thinks our next steps are for treatment.

No surprise, Hubby’s swimmers look great and the anti-sperm antibodies are negative. No issues on his end and I’m extremely grateful for that.

As for me, here’s the list I can recall-

THS- normal
Uterus- normal
Egg quality/ quantity- normal
FSH- normal
LH- REALLY HIGH
Estrogen- normal

DRUM ROLL….

Conclusion: NOT hypothalamic amenorrhea CB064019 and NOT PCOS (although some of the symptoms and criteria fit with PCOS such as high LH, my testosterone levels are not elevated).

Is this good news?

For the most part, it is. Grateful not to have either of the two but where does that leave me? Somewhere in the middle, Dr. G says.

Diagnosis: Anovulation, not otherwise specified

Treatment: Get me to ovulate!

Dr. G. pretty much nailed my concern. Regardless of what we call my ‘condition’, the bottom line is we just need to get me to ovulate and Dr. G feels all the rest will come together.

He’s positive because I should respond to the medication because I don’t have hypothalamic amenorrhea and because I responded to the Clomid over the past several months.

I’m feeling pretty good about all this news. There isn’t anything major going ‘wrong’ in me, it’s just a matter of helping my bodywork.

What about the Heart shaped uterus?

Dr. G isn’t concerned. Wait, what? That’s great news.

Although on the HSG it looked like a septum, the 3D ultrasound, which is much more accurate, shows a mild arch and nothing needs to be removed)

No surgery necessary!

Wahoo! Grateful, grateful, grateful.

Treatment-

Begin on Letrozole. This will be used to make more FSH (to increase eggs)
Start with the midway dose which will mean I will take it for 7 days
Look at follicles and lining and then trigger
timed intercourse (IUI won’t be necessary at this point, Hubby’s happy)
Test for progesterone levels (add suppository if necessary)
Add estrogen towards the end of cycle, if needed to thicken the lining

Dr. G wants to do this with 3 successful ovulatory cycles. If we are not pregnant, he will then up the dose and add IUI.

Breath of fresh air… this is good news!

Lab Rats

March 19, 2018 / Hilary / 2 Comments

It feels as though we are lab rats.

Hubby and I both went to CCRM for a morning of tests that will give Dr. G more information about the two of us and what might be the best course of action to take.

Starting with a urine sample to ensure I am not pregnant, I sort of thought it would be such a fun surprise if they came out and said, “well, we have bad news and good news. The bad news is that we will not be able to do any testing this morning and the good news is you’re pregnant!”

They didn’t.

I proceeded to have a Baseline Ultrasound ($400) where everything looked better than I expected. My uterine lining is thicker than normal and I had 7 follicles in one ovary and 8 in the other! The technician thought I was mid-cycle, pretty cool!

Not sure what that means for us though.

I then was pricked for a blood draw to test: ($555).

Hubby went for his test to see if he has any sperm antibodies that might be hindering the “egg search” ($117).

Then I was taken for my HSG, where they shoot dye up into my uterus and see it move through the fallopian tubes into the ovaries and then out into the body. I was able to see it on the screen as the dye was being injected and sure enough, it spread throughout just as it is supposed to. It was not as painful as the FemVue (the bubbles) I had done 6 months ago, just uncomfortable with minor cramping.

Here’s what I learned:

The uterus flips and flops on a regular basis and so today mine was tiled upside down essentially. The technician was not concerned as she sees them flip and flop almost daily.
I have a heart-shaped uterus (either a partial septate or bicornate uterus). Today it looks more like a “Y”. This is a bit more concerning.
If Dr. G feels it’s too deep of a “Y” then there may need to be a surgical procedure before moving forward with any medication. A normal uterus is more of a triangle shape at the top with a stick coming out the bottom.

So either:

We move forward with medication as Dr. G is not concerned
Dr. G will want a closer look through a hysteroscopy (where he looks through a microscopic camera) to get a better look at what’s causing the “Y”.

It could be the way my uterus is formed, increased cells gathering or some mass resting on that part of the wall. With a Bicornate uterus, there are greater chances of miscarriage, breech birth, higher deformities and disruptions in the in-uterine development, and possible automatic C-section during birth.

Yuck, I do not like this news.

I am not going to get too wrapped up in the facts and details until I talk with Dr. G. Although it would stink to have to go in for another test procedure, I’d rather know what we are dealing with to ensure a healthy, safe home for our baby to grow.

Today, I go in for my annual OB-GYN appointment and get a full head-to-toe exam plus some more cell gathering and an additional blood draw.

Our follow-up appointment with Dr. G. to understand what’s going and the next steps won’t be for another few weeks (busy man), but I’m ok with that. Give me a chance to work on other things in my life and practice faith in God and what He’s doing and trusting in His timing.

Besides, I need a break from all this prodding and poking!

CCRM Consult

March 9, 2018December 23, 2017 / Hilary / Leave a comment

We had the pleasure of meeting with Dr. Gustofson at the Colorado Center for Reproductive Medicine (CCRM) for our fertility consult. He was an absolute delight. We first were welcomed by the front desk helper, who was very cheery and escorted back by a nurse who was kind. Dr. G walked in with a spring in his step and an energy that enabled me to feel comfortable and welcomed.

We talked small-talk for a little bit, getting a feel for his personality which was a delight. Dr. G comes highly recommended by a couple of my friends, so I threw their names out there to make more of a connection.

Funny enough, the friend who told Daniel about me is also a patient of his so the connection feels a little more complete. He was personable and engaging. I immediately felt as though I was in good hands.

He opened a binder of labs and records, all which looked as though they had been combed through with flags coming off the sides of the pages.

Then he asked me to share a bit of my history. I laid it all out for him, starting back when I was 11 years old until now. He listened intently while writing keywords intensely. He then asked some questions to fill in the holes and moved his focus to Hubby to share.

After a quick assessment of our stories coupled with the information he gathered from our records and labs, he offered his thoughts plus some next steps.

Diagnosis: Hypothalamic Amenorrhea

Essentially my body is not engaging in a normal cycle because my brain is not properly communicating with my ovaries.

Dr. G believes this may have started when I was going through puberty. Since I hadn’t ever had regular cycles, he is not sure if this condition was present prior to my exercise bulimia or because of it, but either way, the exercise bulimia, and addictive eating did not help my body to grow into a healthy reproductive state of being. (Thank you God for FA to help me be healthier in my body for the past 11 years!)

Dr. G is quite hopeful for our situation because my body did respond to the Clomid (which many people who are full into the Hypothalamic Amenorrhea do not respond). This is good news. Unfortunately, he did say that the Clomid was probably not the best course of action to take with my situation and believes that with a few changes to the course of action over the next 3 cycles, we will have a positive outcome with a baby.

This is encouraging.

Recommendations:

There are a few labs that he still wants to run just to be sure everything is accounted for.
A full body OBGYN appointment to make sure everything is okay.
I will have to go through an HSG test (where radiographic contrast –dye- is injected into the uterine cavity) to see that the fallopian tubes are open. I already did a FemVue (where they shot bubbles up) but Dr. G wants to see the dye.

Bummer, we should have gone the dye route the first time. This was NOT a pleasant experience and am not looking forward to it.

Hubby has to get checked again too to make sure his swimmers don’t have the antisperm antibody which would essentially ‘blind’ the sperm so that even if a sperm were next to the egg, the sperm wouldn’t be able to detect it.

Fascinating.

Treatment:

Dr. G does not see the need to force a period and (supposing everything goes well with the labs) will start me on Letrozole for days 3-7 of my made-up cycle start. He asks that we do an intrauterine insemination (IUI) to help with the process and will prescribe a progesterone suppository to help improve the receptivity of the uterine lining, enhancing the chances of implantation of a fertilized egg. Yuck, but okay.

Next stop: Billing

How much is all of this going to cost? We will have to call the office next week to find out.

Our insurance (which is a health cost-sharing program) will not cover any of this so we need to be wise with how we move forward.

Continuing to gather all the information to be able to make a decision on what our next right action will be. Praying God will provide the means to do this if this is what we are supposed to try next.

It’s All About the Trust

February 20, 2018 / Hilary / Leave a comment

It’s here, finally! I have been looking forward this day (and a little worried I would start my period before this day arrived). The build-up of this day has gotten to be too great. I am enjoying being in this space of hopeful anticipation because it means there is still a possibility I am pregnant. By now, the HCG from the trigger shot should be out of my system and I am two days past the day I would start my next cycle (if I was in a normal rhythm). I have not gotten my period yet so there is a chance that when I look at the pregnancy test, I will have two lines staring back at me. If not, then I will have to accept that this is not our time and wait for next steps.

Here I go…. wish me luck!

After waiting 3 minutes, the test came back with only one line on the strip. Bummer! I even wait a couple more minutes and then checked again, still not pregnant.

My heart just sank. I was really hoping this would be the one and although am not as let down as I have been in the past, still have a sadness that I can only chalk up to be a normal reaction to an anticipated outcome.

We will not do another round of Clomid at this time. I need a break from all the hormones and we need to take my OBGYN’s recommendation to visit with a fertility specialist as being our next guided step.

The consult is in just over two weeks and I have been putting off the completion of the paperwork in hopes of a positive pregnancy test.

I begin the paperwork and have Hubby fill out his portion.

As I complete the answers, I see how incredibly healthy I am. No smoking, drinking, caffeine, drugs, mental or health history that would prevent pregnancy. From all aspects, I appear to be a healthy candidate for a successful pregnancy. I am hopeful of what these specialists might find inside of me that would be preventing pregnancy.

At this point, I really don’t care how bad the ‘thing’ is that I have going on in me, I just want to know so there can be an answer for all these empty attempts.

Maybe I won’t ever have an answer. I need to be ok with this reality too.

My goal before the consult is to get back into a healthy routine for my body. Getting lots of rest, working out consistently and continuing to eat healthily. This is what I can control.

So for the next few weeks, I will rest and take care of myself. Get into a workout routine that supports my mental health and take action on the things I can do for my body.

I will take my much-desired naps and spend time with God. I do trust him. I trust in the wait and know it will all make sense when I look back on it. I don’t know what is ahead of me in the next year of life. God does. I know that rejection is God’s protection. He knows what he’s doing and I get to sit back and trust it all will come together as it is supposed to.

Until then, I get to enjoy the life I have today. All the wonderful riches of this day. Thank you God!