Category / femera

by adena

Cycle 3, Day 5. Femera, Over.

I just finished taking the 5 days of Letrozole (5mg a day) to wake up my ovaries yet again to try to develop  a viable egg for this cycle. I’ve also been taking 500 mg of metformin, which I think is giving me bad headaches – but I’m going to keep taking it all cycle to see if it helps with conceiving. It certainly can’t hurt.

On Monday, I go in for my ultrasound to see if any of the follicles are growing. Since I’ve only really been through this process once (with monitoring and Femera), I don’t know if my first time was a fluke (in terms  of two follicles growing to full size) OR if Femera will work every time. I did take Femera once unmonitored, and I believe I ovulated that cycle based on my BBT (basal body temperature), but I’m not sure.

The hope is that on Monday they see my follicles are growing and there are 1-2 dominant follicles. I don’t know if I’ll have to go back for another ultrasound (another $500) or if they’ll let me trigger without a second monitoring appointment. The other clinic I went to required two ultrasounds… one on CD9 and then another on CD11 to make sure I was ready to trigger.

I still have to order the Novarel (trigger shot) for this cycle — if they say I’m ready to trigger. I really hope this cycle is a “go” because I’m hopeful to get 2 more tries in before the end of the year. Less tries, less odds this is going to work. At all.

Next year, we may switch to Kaiser – which, according to very unclear benefits documentation, covers 50% of infertility treatments (however, not IVF, unsuprisingly – though they do not make this clear at all.) If they cover 50% of the monitoring appointments and IUI (which we’ll likely try next year if femera/trigger/TI doesn’t work), then that could be a big cost savings. Of course, that means we have to go to Kaiser for our treatments… and I’m worried about appointment times being impossible to manage with my job. At least the private clinic has super early morning appointments.

I’m starting to save up for IVF as well. I think if we’re not pregnant by… say, June/July (assuming we’ve had 6-8 real attempts where I’ve ovulated), we’ll move on to IVF. Maybe we’ll move onto it sooner – I just want to give this lower cost, slightly more natural way a bit of a chance to work first. BUT – that’s $8000 down the drain that could be put towards our first IVF cycle. I guess I’ll see what the doctor thinks and go from there. They recommended 3 more cycles this way… so, that’s ~ $3000, and we’ll see what happens. Or I switch insurance and maybe it won’t be $3000 – which would be ideal, though then I’m stuck with Kaiser for all my healthcare including, if I get pregnant, my actual pregnancy and delivery. I’ve read mixed things about Kaiser, so I’m concerned… but some people really like them. Maybe it would be fine.

First of all, I need to actually get pregnant. That’s task #1. I have little control over that other than trying to destress, eat healthy, exercise (all things I’m not doing well at the moment) and just hope that something sticks at some point in the next 14 months. I’d really like to be pregnant before I turn 35. I still can’t believe I’m turning 35 in a year (that’s besides the point) but we’re definitely going to move onto IVF if we aren’t pregnant by the time I’m 35.

by adena

Cycle #3 – Femera, Trigger & TI with BC

We thought we were going to have to skip this cycle due to our travel schedule, but a new clinic we’re trying out suggested that I take the birth control pill for two weeks to clear out my system, which pushes off the timeline of everything enough that both I and my man will be back in town in time for ovulation (which is still a requirement for this making babies process.) Phew.

I haven’t been enjoying being on the monophonic birth control pills, but I’m glad it’s only for two weeks. Mostly, I’ve had some stomach issues which may or may not have to do with the pill. I stopped taking the pill years ago because I don’t like the idea of permanently pumping hormones into my body, in case it would mess with my chances of getting pregnant, so being on it in order to get pregnant is kind of ironic.

This cycle I would have preferred not to take the BC pill, since I actually had a clean 35 day cycle previously, which is better than the 45-100 day cycles of my past. But the nurse also mentioned that BC is good to level hormones and clear out my system before the cycle, which sounds good, so I’m pumping my body full of Estrogen and such for a short while. Tonight, I stop taking the pill and then I get to experience a system-emptying bleed for the next week (nothing like timing this perfectly with the first week of my new job, oy… here’s to hoping the cramps are no worse than a normal period.)

Once this happens, I will take Femera for 5 days, like the last cycles. I really only had one clean cycle previously since one was a Femera only with no trigger, not approved by doctor but accidentally administered since I was out of town when I needed to go to my appointment. But, given some people take Femera without monitoring and trigger, I’m counting that as a failed cycle. This time around is cycle #3. Lucky #3.

I believe I ovulated in my last cycle with Femera with no trigger shot based on my BBT tracking. That makes me quite hopeful. This time around will be basically like the first cycle – except I don’t know yet if the first cycle with my two fully-grown follicles was a fluke, or if Femera always works for me (at least to grow the follicles large enough so I can ovulate.)

Another concern, TBD, is if my eggs are of low quality. Apparently with PCOS having a lot of eggs is not an issue, but quality often is. I’m still waiting for the moment (since I’m a pessimist) when I’ll be told all of my eggs are unviable. Until then, though, I should assume that my eggs are ok and the only problem is timing and standard monthly odds.

I did have a test last week that looked at my uterus and my tubes. It mostly looked at my uterus to see if it was a good candidate for IVF (it is) but it also checked if saline pumped in would come out my tubes, to see if there are any blockages. The nurse gave me a kind of mixed explanation of my tube quality. She said – some saline came through, which means at least one is at least a little open… but she also made it sound like the amount of saline that came through was very little, leaving her to believe that there may be tubal issues in one or both of my tubes. The only way to know which one is to do an HSG – and this clinic doesn’t do HSGs. My other clinic does, so I may go back to them for the HSG… or I may change health insurance to Kaiser (another post on this soon) which may cover the HSG fully. It’s concerning that there might be a tubal issue, identified but the $500 test, but in order to identify if it’s really an issue I need another $750 test. :/

The tests also supposedly push through anything blocking the follicles (if it’s movable) so sometimes people get pregnant after these tests due to that, if nothing else is wrong. Maybe I just had a little piece of dust in my tube and this test will do the trick. Infertility treatment is so weird because every month you’re playing the odds – but you don’t really know for sure what’s wrong in most cases. You just keep going until they figure “well if you didn’t have THAT problem you’d be pregnant by now” and then they move you on to the next treatment. Except every month costs $1000+++ that you’re paying out of pocket…

This month, with the hydrosonogram, bloodwork, monitoring and trigger shot we’ll be paying about $2000. I know kids cost a lot when they’re born, but it sure sucks to be spending down my childcare fund prior to conception. But so goes life. I’m still terrified of going the IVF route, spending $50,000 or more, and still having no child in the end. It’s a real possibility, and it makes me go back and forth on whether IVF is something we should seriously consider. But that’s for another post at another time.

For now, I’m hopeful, sort of, that this cycle will work. We’ve cleaned out my system with the birth control pills, and I’m a fresh slate of baby-making material. I’m having no side effects with the Femera other than ovarian cramping, and I’m feeling good about this cycle. The way the timing works out, if I happen to get pregnant this cycle, I will be finding out on my 34th birthday. I think that would be fabulous. Odds are still very slim, but it could happen.

 

 

 

 

by adena

Getting Pregnant Attempt Updates…

I’m not pregnant (yet/still.) This cycle I was traveling when AF came, and I had my Femera prescription with me, so I took it, hoping that I wouldn’t ovulate before I got back to the west coast and, you know, near the other person I need in order to get pregnant (my husband, not my doctor.)

I also ordered a too-expensive bluetooth-enabled thermometer and started charting with the Kindara app, despite knowing that with PCOS charting is pretty much a hopeless cause. I guess, in my delusion, I’m hoping with the eating healthy and weight loss (plus the Femera) my body will just WORK for once, and then charting might make some sense.

My chart so far this month actually looks fairly healthy, although I only had EWCM for one day vs the 4-5 days that the internet says is normal. I did have a temperature spike, but it’s hard to say if that’s because on the east coast my temp was lower and then on the west coast it was higher… I flew to west coast on CD 15 sooooo… it could just be due to that.

I really wasn’t supposed to take the Femera this cycle, as my RE prescribed it with the expectation I would come in for two ultrasounds ($700) and then get my trigger shot (~$100) but I wasn’t here in time for any of that, and I didn’t want to waste the cycle since AF came early (on time) due to having taken the Femera with Trigger shot the cycle before. I never have 28-day cycles (I think my ‘normal’ is 35 but sometimes it can be 3-5 months before a period comes, though it’s been getting more regular lately.) It’s hard to know if I’m actually ovulating — with the Femera and Trigger shot last month I supposedly did, but I don’t trust my doctor yet.

I’m on a waiting list for a well-regarded IVF clinic, and I should be off that waiting list early next year. My HOPE is to be pregnant by then, but that’s going to be tough given I’m traveling too much. That’s my fault. But my husband and I are going on a trip *together* for our very belated honeymoon. I’ll be charting during the trip and maybe I can ovulate on my own – TBD if my RE will prescribe me Femera if I tell them I won’t be around for those ultrasounds.

And… there is the chance I could be pregnant right now. Super slim chance, since I didn’t actually see my husband until late CD15 and based on the chart I think I ovulated on CD14 – since the egg lasts 12-24 hours and sperm takes 6 hours to get to the egg, if my observations are accurate about CD14 then it’s impossible I’m pregnant right now. However, I’ve read mixed things about the EWCM – if it’s supposed to happen WHILE you ovulate, or in the days leading up to ovulation when you’re most fertile. Given I only had EWCM one day, I have no idea what it means, if anything.

The picture below is my current chart. Sorry it’s so blurry, but basically what it is showing is that based on my past cycles they expect me to ovulate between CD23-CD26, but that isn’t accurate since I took Femera this cycle so all bets are off. The noticeable change is the temperature, but as noted above up to CD 15 I was on the east coast, and then CD16 started temping on west coast, so that could explain the change. I’m also getting used to the temping in the am so the first few days I did get up before taking my temp, which should make my temp recording higher than it actually is — so that makes me think the temp increase on CD16 might be significant.

The other notable element of my charting is that my cheapo ovulation strips had a medium-shaded line on CD13 & CD14. The more expensive OPK did not give me any positive results on either of those days, using the same sample at the same time. Women with PCOS supposedly have high levels of LH to begin with so these tests are also not very accurate, but I’m hopeful with the Femera this could mean something. Then again, if it does, I likely ovulated on CD13 or CD14, which was too early given I was still a country away from my husband! But it’s definitely good news if I was able to ovulate with the Femera alone. It has me thinking maybe I should have went to a OB/GYN before RE and possibly tried that, since OB/GYN are not making all their $$ from infertility treatments they’re less likely to suggest expensive treatment until it’s necessary. I’m turning 34 in 2 months, so all of this may very well be necessary… but maybe I don’t need $700 ultrasounds and $100 trigger shots every month. Maybe the cheapo Femera and charting and eating healthy will work.

On CD13 and CD14 I definitely felt cramping in left ovary (I felt that last month too on the Femera, but that could be eggs growing, not necessarily releasing.) So maybe I did ovulate on the 13/14. Maybe I ovulated on the 15 because LH rises before you ovulate, and maybe I’m pregnant right now. Wishful thinking.

OR maybe I haven’t ovulated yet. The early temps could all be wrong, and I could see another spike in temp later in this cycle. My hope, if I’m not pregnant, is that I get my period on Wednesday, which would mean that I probably ovulated without the trigger shot “on time” with the Femera alone, which I could report to my RE and request for another Femera cycle without the expensive ultrasounds.

I wish some/any of this were covered by insurance. I know what I’m doing right now is so much cheaper than IVF will be, if we have to go that route, but it still is so much money. $800 a month for ultrasounds and trigger shot. It will be about $1500 if we do IUI. And I probably should get an HSG test which is – I don’t know yet – but I think another $1000. It adds up fast. Yes, I want kids and yes, I’m at the point in my life when I’m running out of options (especially if I want to have two.) I’m trying to remain optimistic but once my husband and I return from our honeymoon, we really have to get serious about this and that means seriously ready to pay whatever it takes to have a child.

In the meantime, I’m really focused on weight loss. I can’t say I’m super healthy as I haven’t been exercising (but our honeymoon will be composed mostly of hikes and lots of walking and healthy-ish eating every day) — BUT after going to a health resort in August I’ve lost 10 pounds, and I’m down 20 from my highest last year. I’m still ~30 pounds over a healthy BMI at 135, and I feel like if I can get there in a healthy, keep by blood sugars stable and eat 3 balanced meals a day sort of way, I can do this all naturally. I just have to heal my body. I’m not into holistic health BS but I know my body, and eating healthy and getting the right nutrition is legit.

At this point, I’m aiming for 5 pounds loss per month (hoping honeymoon really is going to be a loss month!) — 165 now, 160 by October, 155 by November and 150 by Jan 1. I can lose more than that (at the health resort I lost 5 pounds in one week!) but I’m trying to be realistic and take this slow. I’ll deal with figuring out the exercise routine when I’m back. I’m going to heal my body through treating it right, eating real foods, and getting the right nutrients through eating a lot of vegetables, lean meats and complex carbs. Simple. Maybe that will save me $50k of IVF/baby-making costs. I hope so.

by adena

Not Pregnant, Not Surprised.

When there were two beautiful properly-sized follicles on my first ultrasound post starting Femera, I had this surge of optimism in my mind that I maybe would be lucky and this try would take. I knew, scientifically, that even in the perfect setup odds of getting pregnant any cycle are less than 1-in-5, so I *shouldn’t* get my hopes up… but odds are still odds, and they’re not impossible.

When I felt cramps in my ovaries and could almost feel my eggs releasing, I thought maybe they were the ones. When I had a strange cramping sensation a few days before I was supposed to get my period, I thought maybe something took… but then a few days later, in unfortunate perfect timing, came the standard setup of cramps and bleeding. No dice.

Due to travels this summer, it’s going to be challenging to find time to try another cycle that works for the doctors and my husband and I. It’s hard to time these things since my period is so irregular anyway, and I need to be available for an ultrasound on the 9th day of my cycle along with the 11th day, and to be able to complete triggering and the following required acts for the few days following. This time I’m traveling internationally so I have to skip this cycle. Each missed cycle feels like a lost roll of the dice – will I look back in a few years and wish I just never left my area until I managed to get pregnant?

I’m not doing myself any favors by being out of town so much — I’m pretty much committed to traveling through October and then heads down and really focusing on getting pregnant (since I’ll be 34 somehow in November.) Thirty-four will be the year when I’ll be stabbing myself with tons of hormones, spending my savings on IVF, and maybe, if I’m lucky, being able to enjoy the wonders of pregnancy and having a child. My doctor says I need 2 more tries with the Femera and Trigger shot alone before we do anything else (though I can opt for a tube test to make sure they aren’t blocked… which I’ll have to do before IUI or IVF… but everything I’ve read about that test makes me cringe (sounds painful) so I’m avoiding… so far we know my (major) problem is that I don’t ovulate, and Femera seemed to “Fix” that, so maybe that’s all that needs to be fixed. Why believe something else is wrong with me for no reason other than being completely unlucky?

So I haven’t written here in a while because I was hoping if I didn’t think about it or write about it I’d be pregnant. That didn’t work. I’m not. On to cycle two… eventually…