5.06.2014

Journey to Pregnancy: Second Six Months of Trying

Click here for the first six months.

June 2013
This month I had my annual physical with my new OB/GYN. I finally got to discuss what had been going on the past seven months - our failure to conceive, my incident in April, and how I've noticed that my cycles were getting longer each month.

Much to my surprise, my doctor was immediately on the ball about things. From everything I had read, doctors don't really become proactive about infertility until after a year of being unsuccessful. She ordered blood work for the next cycle. And assured me I'd be pregnant by the end of the year.

July 2013
This was the month that the reality of infertility set in. This was the first month I cried about it all.

My first round of blood work was on day three of my cycle. It tested follicle stimulating hormone (FSH) which is responsible for ovarian follicular growth - basically my egg supply. I do not remember my exact number; however, I do remember the nurse telling me that that my particular number was great. I was ecstatic to hear positive news and I foolishly convinced myself - all these tests are going to come back perfect and we were just dealing with a timing issue.

Then the second blood test came a little later in the cycle. Progesterone. Just because your ovarian follicular growth is good great doesn't mean you actually ovulate those eggs. A good progesterone level is 10-12ng/ml. Mine was 1.2. I was in shock when she told me what numbers they wanted and what my number was; I don't even remember reacting. All I heard was you're not ovulating. Which created extreme confusion for me because a.) I obviously didn't ovulate this month, but b.) I obviously did ovulate back in April. I was devastated that as a woman, my body isn't (at least not consistently) doing what it should be doing. So I was prescribed Clomid for he next cycle (If you're wondering about Clomid, I have a whole post dedicated to it coming in the future).

Thankfully, I had that friend I mentioned in the last post that had been through this exact same thing. Low progesterone, not ovulating, and having to use Clomid. Although I was in tears telling her the news, she was so positive and helped me to see the positive in the situation. No, I'm not ovulating, but now we know that and thankfully there's a drug that has a pretty high success rate in helping with anovulation. So after a few days of crying with Chris and some close friends, I was ready to accept it and move forward. I was excited again.

August 2013
So now that we knew what was going on with me, my doctor wanted to make sure that this was our only barrier - so she ordered my husband to have a specimen analysis. His sperm count was fantastic (above and beyond what was needed) and his morphology was normal (no sperm with two heads), but his rapid motility (the ones that typically get down the fallopian tubes and to the egg) was only about half of what it should be.

So we both have issues going on - issues that are pretty vital to conception. An egg needs to be released and sperm need to get to that egg. Without these two things there is no conception.

My doctor's nurse informed me that while it is possible to get pregnant with his low rapid motility, we may need to look at possible IUI if nothing happens in about three months.

I started my first round of Clomid this month. When you start on Clomid, a progesterone 21-day test is ordered to make sure your prescribed dosage is working (re: you ovulate). If not, they up the dosage. Thankfully for me, Clomid turns me into a Ovulating Rock Star. Remember back in July my progesterone was 1.2? My first month on Clomid my progesterone was 52. Yeah, 52. And although that number was amazing, nothing happened. 29 day cycle. 

September 2013
Since Clomid worked so well for me, my doctor wanted me to continue with taking it. Progesterone this month was 47 - still amazing. But nothing happened. 29 day cycle. 

October 2013
My third month on Clomid. Since I was ovulating with Clomid and it was possible that we could get pregnant (but haven't the past two cycles), my doctor ordered me to have a hysterosalpingogram (HSG). This test looks at the uterus and fallopian tubes to make sure there isn't a blockage of any kind within the tubes; they need to be clear for both the egg and sperm to travel. I'll be posting a separate post about the HSG a little later (it deserves its own post). Ultimately, there was no blockage (thank the Lord!). So I did Clomid and I did the HSG, but still nothing happened. 30 day cycle. 

November 2013
After three cycles on Clomid and no baby, it was time for the first IUI. I was prescribed Clomid for the fourth month. Told to start taking OPKs immediately after my last Clomid pill and call the office once the OPK is positive and they'd schedule an IUI the next day.

Unfortunately, we were unable to have the IUI this month. The week I ovulated, we ended up driving to North Carolina as my grandmother unexpectedly passed away.

Even though we'd been working towards conception and pregnancy for almost a year at this point, I wasn't upset with having to miss the IUI. I know the Lord works in mysterious ways; ways we can't see and sometimes can't even understand, but I can't help but think that we missed that IUI for a reason. Maybe the IUI is going to work perfectly for our situation, but it just was not time. I don't know. Nothing happened. 30 day cycle. 

December 2013
When I started my cycle in December, I was already exhausted. We'd gone through four round of Clomid and been unsuccessful and I'd unexpectedly lost my only grandparent. I just felt heavy and worn down. I really wasn't looking forward to another month of trying.

If you've battled with infertility, you know that it's easy to become consumed with planning and timing. For December I had calculated my cycle and looked ahead to around the time I would most likely ovulate if we did another round of Clomid (since I'd been fairly consistent in the past). Ovulation was going to happen right on or around Christmas Eve. Because of this and pure exhaustion, we decided not to spend our Christmas holiday focused on anything besides Christmas. We both needed a break.

I spoke with my OB/GYN, we discussed the fact that the Clomid is working perfectly - I'm definitely ovulating, but we're still not getting pregnant. And I didn't want to do another month on the Clomid without being able to do an IUI (and since ovulation was going to be around Christmas, the offices would be closed anyway) and since we needed a break, we decided not to do Clomid this month. No IUI. Nothing. We will resume Clomid and hopefully be able to schedule our first IUI in January 2014. What a great way to start a new year!

It was a liberating month. Wanting a child and not being able to conceive weighs down on you - so December was a blessing. I felt like me again. I made a point to not pay attention to my body at all. It was hard and I'd be lying if I said I didn't, but it was the least I'd thought about it in over a year and it was wonderful.

2 comments:

Bethany said...

I'm currently going through this, I commented before (trying for over a year, two miscarriages) - reading this I am surprised the word "infertility" came up at all only 7 months in and that your doctor would do those tests that soon! How lucky you are, honestly. I was only able to get this type of testing started at the one year mark, despite the fact I had miscarried twice. Very frustrating. And my doctor hasn't even tested my hormone levels! He said the normal range is so large it isn't worth it. He did a thyroid/prolactin test, and an ultrasound, said everything looked fine and prescribed Clomid (even though I am ovulating on my own). He's going to give me progesterone supplements next time I get pregnant, but since he never tested my progesterone, I wonder why, and how he would know how much to give me? :/ All I wanted to say is that I'm so sorry you're going through this, I know how painful it is. It's a very, very long emotional drain. It sounds like you have a great doc though, I might need to switch to an specialist if things don't go well next time.

Linley said...

Bethany,

I was pretty shocked as well that my regular OB/GYN (not a specialist) would be willing to start some blood work and medication only seven months into the process. I was extremely grateful for sure!

Unfortunately, this was the extent of the testing for the next few months. Like I mentioned, following that visit I took Clomid and had progesterone tested regularly and it still wasn't working - but nothing else was being done.

That's great that the thyroid was WNL - that has a huge effect on irregular cycles and miscarriages.

I would push for some more extensive test. And I'm not sure why you'd get prescribed Clomid if you're already ovulating? Maybe you need a stronger ovulation? I would ask more about that.

A specialist is a great idea - especially if it's been over a year and you're having recurrent miscarriages. We recently saw one - I'll post about that soon, but I will say it was amazing how aggressive they were on the FIRST visit!

It is extremely painful and draining at times (heck, most of the time), but hearing from you all has been wonderful!

I keep you all in my prayers on a regular basis.