Three Strikes

So, the first attempt didn’t quite go as we had anticipated.  Well, neither did the second.  Or the third.

It’s almost as though there’s a spotlight on newlyweds.  The ink hasn’t even dried on the marriage certificate and people are asking when you’re planning to start a family.  Naturally, when you’re in our position you don’t really feel like telling friends, family members, or the rude ass acquaintance that you barely know that you’ve been trying for quite some time and haven’t succeeded yet.

For three months straight we attempted IUI without success and we managed to have a family wedding right in the middle of our two week waiting game each month.  I wasn’t drinking at these weddings because I didn’t want to risk it and it seemed like everyone noticed.  It was a very uncomfortable situation to be in.  I wasn’t ready to fully go public with what my husband and I were going through, but it really didn’t matter.  People that know me know I can drink most anyone under the table, so when I’m refraining from alcohol, everyone assumed I was pregnant.  I ended up coming up with excuses such as being on antibiotics, saying it was my turn to be sober cab, anything I could come up with to get people to abandon the idea of pregnancy.  I don’t know if it actually worked, or if they’d heard all of these excuses before and figured that I was, I just wasn’t ready to tell them.  All I know is that I wanted so badly to prove their suspicions were right and yet I just couldn’t make it happen.

 

False Confidence

I was so sure that the first round of IUI was going to work, that I never actually prepared for the possibility that it wouldn’t.

I had done some research on PCOS up to that point, and after seeing all of the symptoms, I was convinced that I didn’t have it nearly as bad as most other sufferers.  Sure, depression and weight were things that I had struggled with for years, but I had Metformin on my side now.

Metformin is a drug used to control blood sugar in diabetes patients.  It’s also used in conjunction to treat PCOS, as it helps to combat insulin resistance.  I immediately lost 15 pounds on Metformin, so I was feeling better than I had in a few years.  Even before I lost the weight, I wasn’t THAT overweight.  I had been flirting with the BMI charts line between overweight and obese for a few years, but if I ever stepped over the line into obesity, I was back in overweight land within a few days.  I was convinced that those 15 pounds would make the difference.  And losing the 15 pounds made me happier, so I felt like the depression was a bay.  Plus, as I stated in my previous post, I had just celebrated my first wedding anniversary.  The powers that be would have to reward us with a positive pregnancy test, right?

I treated the day of the test as if it was any other day.  I work up early, went in for the blood test and went to work.  I found it hard to concentrate as I waited for the call.  I wondered what I was going to do when I got confirmation that we were expecting.  When my phone rang, I hopped up and headed towards an empty office to answer the phone.

I knew it was negative the minute the nurse said my name.  There was just something about the tone of her voice.  Not quite pity, but not far from it.  I tried to hold back the tears as she told me to stop taking the estrogen and progesterone I had been prescribed to make sure my body was ready for a baby.  My voice started to crack with each confirmation I gave to all of the information she was giving me. “Okay. Okay. Okay.”  I was informed that I would most likely be getting my period shortly, and to call within the first three days of menstruation if we wanted to try IUI again.

I tried to compose myself so I could go back to work and finish out my day.  I sat back down at my desk, but the tears wouldn’t stop.  I looked up, hoping that nobody had noticed the complete wreck of a human I was at that moment.  My boss was in a meeting, and I didn’t want to interrupt it, but I also knew I couldn’t be there anymore.  I walked in on the meeting, and as my boss looked up, his face dropped.

“It didn’t work.  I have to go.  I can’t be here, ” was the last thing I said before I became completely inconsolable.  I gathered my things, called my husband on my way home and drank myself into an afternoon stupor.

I took the next day off to regroup.  It was a Friday, so I figured a nice three day weekend would be just what I needed to get my mind centered around trying again.  My husband and I decided that a second time couldn’t hurt.  I vowed to take even better care of myself for the second round.  Not a drop of alcohol, no caffeine.  Nothing that pregnant women are supposed to stray away from.  Surely, the first time was just a practice run.  The second time it would produce a positive pregnancy test.

It had to.

 

IUI

After we got the PCOS diagnosis,  our doctor decided that it might be helpful to try a round of IUI.  IUI, or intrauterine insemination, is the process of placing the sperm inside the uterus in order to help with implantation.  It’s considerably less expensive than IVF, but not as successful.  It tends to be successful for many couples with PCOS or other unexplained infertility issues and our doctor thought that we would be good candidates.

We embarked on our first attempt at IUI shortly before our first wedding anniversary.  The process for IUI is quite regimented.  It actually starts about 6 weeks before the insemination.  I was put on one cycle of birth control to regulate my ovulation schedule.  Once I got my period, I called to schedule what’s called a baseline ultrasound.  Performed within the first 3 days of menstruation, the baseline ultrasound is typically performed on people with known issues such as yours truly.  They perform the ultrasound to make sure that the uterus has mellowed out enough to start the IUI cycle.  More specifically, they’re checking for cysts.  If there are cysts present, they are looking to make sure that the cysts are too small to affect the cycle.

Once my uterus was deemed calm enough to start the cycle, I was put on Letrozole, a drug that inhibits the production of estrogen.  Seems crazy, right?  You would think that extra estrogen would be a good thing as a woman trying to get pregnant!  In fact, Letrozole suppresses ovulation which then tricks the brain and pituitary gland in to creating more FSH, or follicle stimulating hormone.  The increase in FSH helps to develop follicles on the ovary that will mature to produce an egg.  Letrozole is taken for 5 days to help the follicles mature.  At that point, another ultrasound is performed to track follicle growth.  Once the follicles reach about 12-13 millimeters, ovulation will be induced via one shot of HCG (human chorionic gonadotropin).  HCG stimulates the ovaries to release an egg (or multiple in the case of multiple follicles.  The insemination takes place roughly 36 hours later.

The insemination is a tag team effort between husband and wife.  The husband goes in for his appointment first.  There, he will be escorted to a room with a chair and a couch, a TV and VCR and a variety of assorted “reading materials”.  Once he’s made his deposit (and yes, that’s what they call it), he’s done.  The sperm is then examined for volume, count, structure and motility.  The sperm is “washed”, meaning that the sperm is separated from the seminal fluid.  At that point, any abnormal or immotile sperm are removed from the sample.  My doctor aims for 2 million motile sperm per IUI.  They will do the procedure if there are less, however, 2 million or more is optimal.

Once my uterus was deemed calm enough to start the cycle, I was put on Letrozole, a drug that inhibits the production of estrogen.  Seems crazy, right?  You would think that extra estrogen would be a good thing as a woman trying to get pregnant!  In fact, Letrozole suppresses ovulation which then tricks the brain and pituitary gland in to creating more FSH, or follicle stimulating hormone.  The increase in FSH helps to develop follicles on the ovary that will mature to produce an egg.  Letrozole is taken for 5 days to help the follicles mature.  At that point, another ultrasound is performed to track follicle growth.  Once the follicles reach about 12-13 millimeters, ovulation will be induced via one shot of HCG (human chorionic gonadotropin).  HCG stimulates the ovaries to release an egg (or multiple in the case of multiple follicles.  The insemination takes place roughly 36 hours later.

The insemination is a tag team effort between husband and wife.  The husband goes in for his appointment first.  There, he will be escorted to a room with a chair and a couch, a TV and VCR and a variety of assorted “reading materials”.  Once he’s made his deposit (and yes, that’s what they call it), he’s done.  The sperm is then examined for volume, count, structure and motility.  The sperm is “washed”, meaning that the sperm is separated from the seminal fluid.  At that point, any abnormal or immotile sperm are removed from the sample.  My doctor aims for 2 million motile sperm per IUI.  They will do the procedure if there are less, however, 2 million or more is optimal.

Guys don’t get to have all the fun, though!  Their female counterpart gets to experience a fun, papsmear-esque prodedure.  I’m talking, naked from the waist down, feet in stirrups, butt hanging off the end of the exam table fun.  A catheter with the sperm sample is inserted in to the uterus and that’s that.  The procedure itself takes less than 5 minutes and then you’re on your way.  Sounds pretty easy, but the worst part of the process is just beginning:  The two week waiting game.

There’s really nothing you can do to make the process more successful.  I mean, it would probably be frowned upon if you did a keg stand immediately following the procedure, but there aren’t any steps you can take to make sure it works.  You just have to be patient.  Well, I suck at being patient.  Yes, patience is a virtue and blah, blah, blah.  I don’t have it.  Never have.  And I probably won’t develop it until I’m forced to for the sake of my children.

So the two week waiting game begins, and I do my best to maintain my composure.

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Polycystic Ovarian Syndrome: What is it?

Polycystic Ovarian Syndrome, also known as PCOS is a disorder caused by a hormone imbalance.  This imbalance can cause problems with ovulation, irregular periods and is the leading cause of female fertility problems.

It’s estimated that 1 in 10 women have PCOS, so chances are you know someone that is affected.  Symptoms include:

  • Acne
  • Weight Gain (often due to insulin resistance)
  • Trouble Losing Weight (also due to insulin resistance)
  • Extra Body Hair (known as Hirsutism)
  • Thinning Hair
  • Irregular Periods
  • Darkening of Skin
  • Skin Tags
  • Depression
  • High Blood Pressure
  • High Cholesterol

While the exact cause of PCOS is unknown, it is believed that genetics play a factor.

For more information on Polycystic Ovarian Syndrome visit:

https://www.womenshealth.gov/publications/our-publications/fact-sheet/polycystic-ovary-syndrome.html

My Body is an Asshole: A Love/Hate Story

I always knew there was something wrong with me.  It took years for me to get actual proof, but I could just feel it.  Call it woman’s intuition if you will.

I got my first period at the ripe old age of 10.  Seriously.  10 years old.  I don’t care how many programs you sit through in your elementary gym class, nothing truly prepares you for your first period at the age of 10.  You know what else it didn’t prepare me for?
Mind- numbingly painful, want-to-rip-your-uterus-out, praying-for-death-because-anything-is-better-than-this-hell menstrual cramps.  Thus, the love/hate relationship with my body was born.

As I got older, my menstrual cycle issues got worse.  Uterine cramps, back cramps, heavy cycles, nausea and the occasional bout of vomiting have become commonplace.  I took these concerns to my doctors at every annual appointment and they always got dismissed.  There was no discussion about what could be at the root of all of these problems.  It wasn’t until I was in my 30s that I even had a doctor mention Endometriosis or PCOS.  That’s what pisses me off the most, I think.  Had my concerns been validated in my teens or twenties, I might not feel as desperate as I do now.

It wasn’t confirmed until I was 33 years old that I had PCOS, or Polycystic Ovarian Syndrome.  By that time, my husband and I had been unsuccessfully attempting to start a family for close to a year.  Before that, we hadn’t been trying, but hadn’t necessarily been preventing.  I was secretly hoping for a happy accident, I suppose.  Knowing deep down that this wasn’t going to be an easy road ahead for me, I kind of hoped that if I only half-tried but didn’t think about it, I would be rewarded.  Well, years of trying and not trying didn’t produce a thing.  Not even a scare.

I spent almost 22 years with a syndrome that went undiagnosed, so I think it’s safe to say that it’s going to take a while for me to fully come to terms with how much it’s fucked up my life.  And yet, all of this anguish could have been avoided with a simple blood test.  That’s the most fucked up part of all.

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PCOS Pity Party: Coming to terms with Polycystic Ovarian Syndrome

If you’re reading this, it means I’m finally feeling comfortable enough to share my struggle with the world.  That’s not an easy feat for someone like me, who prides themselves on keeping things close.  But the thing I find most frustrating about what I’m going through right now, is that I can’t find anyone that shares in my pain.

I’ve found blogs posted by other women and some of them are wonderfully uplifting.  I’m not in that place yet.  I’m not going to “Let go and let God”.  I don’t know that I believe God exists.  And if he/she does, why would so many deserving people have such a problem building a family and so many shitty parents seem to have no problem?  The news is constantly littered with stories of child abuse and neglect.  Why do those parents get rewarded with one of the most beautiful gifts in life, one that they clearly take for granted?  It’s not fair and that fucking sucks.

The point of this blog is to share the journey as my husband and I navigate through IUI and IVF in an attempt to start a family together.  I hope you’re able to take something away from my story; whether it hits home or close to it, I hope that it will provide insight into what some couples go through to build their happily ever after.