CD 13, Early Trigger Shot, and the TWW

In two weeks, I’ll know if this cycle amounted to anything other than $1000 in medical bills. I have a strange feeling in my heart this cycle is going to work (no reason other than I will be testing on my birthday and I want that to be my birthday gift) — but I’ve also been reading a lot about the super-high rate of miscarriages amongst women with PCOS and I’m now more concerned about getting pregnant and losing the pregnancy than getting pregnant to begin with.

There’s a little logic behind this. Not much. But my logic is that I seem to be a prime candidate for infertility treatments. Unless I have more tubal issues than we think, my only issue / reason for not getting pregnant, as far as we know thus far, is not ovulating. Well, with the Femera I’m producing 1-2 mature follicles each cycle — and they seem to be releasing properly when using a trigger shot to force ovulation. Assuming nothing else is wrong, we have a 15-20% chance each cycle of conceiving using this method.

Yet, the chances for women with PCOS to miscarry are 30%-50%, or even higher, according to numerous studies. I’m quite concerned that even if I can get pregnant, I won’t be able to stay pregnant. This is all personal hypothesis at this point — my eggs could be of horrible quality, or my tubes could be blocked, or something else could be wrong making it impossible for me to even get pregnant. Or, maybe my body isn’t set up like a typical woman with PCOS and I won’t have any issues with miscarriage.

I just like to plan ahead for these things so I’m emotionally prepared. I’ve been fairly sure my whole life I won’t be able to have children – or it would be very, very hard to get pregnant. So as much as I’m saddened over this, I’ve dealt with it a while ago. But – if I DO get pregnant and then lose the child, it’s going to be a whole new emotional ballgame.

I’ve been reading all of these horrible stories about miscarriage and I just think about how awful it is for all the women who have been through this. It’s actually fairly common, even for perfectly healthy expecting mothers. Most miscarriages happen in the first 12 weeks, but some happen later. I just worry about getting my hopes up — and also, actually I worry about worrying every day that the fetus might not make it to another day… not to mention reading those horrifying stories about miscarrying at work (I can’t even imagine!) Well, here’s to hoping this cycle is my ticket to pregnancy and I won’t have to experience miscarriage. But, I prepare for the worst… and hope for the best.


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.





What if I can’t have kids?

Growing up, I wasn’t the type of girl who dreamt of being a mother. While I didn’t imagine what it would be like to have kids, I always assumed I would have them – one day. I know plenty of women don’t have children by choice, and this makes them happy. I thought I might be one of those women.

But now, on the verge of turning 34, I realize that there’s nothing I want more in life than children. I can’t explain exactly why as the feeling isn’t logical. I’d probably be better off without kids. I could continue to live in a one bedroom apartment with my husband. It would certainly be cheaper in the long term. I’d be able to travel when I want and if I eventually get up the courage to go back to school and change careers entirely, it won’t be such a big deal. There are a lot of benefits to *not* having kids.

So why am I so obsessed with having children? I haven’t the foggiest if I’ll be a good mother (and all signs point to I’d be pretty bad at it, at least the project management part of the job) – but I want kid(s) and I know I’ll be extremely sad if I can’t have them. Yes, I can adopt (though that’s hard too), but selfishly I want my own.

I want to (try to) raise children that are healthy, happy (within reason) and mentally stable. I want to be a mother – I really can’t explain it. I guess it’s biological. For me, anyway. I want to nurture a kid or kids. I want to be there when things go wrong and when they go great. I want to learn from the stresses of parenting and grow from them. I want to see my children grow up and turn into adults, and see where those lives lead. I want to be openminded and kind and supportive for anything that life might throw their way.

I’ve been asked “what if I can’t have children” and I don’t want to think about it. Not yet. The prospect of spending a small fortune on IVF and it not working is bad enough, let alone the realization that there is only so much money — and so much time — that one has until she no longer can possibly have kids. Outside of the money, time isn’t on my side. I’m turning 34 in two months and once I turn 35 my “fertility” will drop rapidly. That means even with all the expensive tricks and science it will be less likely to work.

This also means I have one year to manage to make my body work. I’m cautiously optimistic. I’m most afraid of getting pregnant and having a miscarriage. Women with PCOS are so much more likely to have a miscarriage that it’s almost something you have to just assume will happen to you. I know that will be really hard for me. Yes, it would be a good sign that I was able to get pregnant at all, but I’m sure that won’t help in the moment.

Right now my biggest focus is getting to a healthy BMI and getting my blood sugars stable, along with supplementing for potential nutritional deficiencies. I’m down 20lbs from my highest–BUT–I still have to lose another 35 pounds minimum before I’m at a healthy BMI. At five pounds a month, that will take six months of constantly eating healthy and exercising. It’s very doable with this goal in mind, but it’s not easy.

I can’t help but think about my second child — which seems so silly since I haven’t managed to have one yet. But child #2, assuming my body does decide to function, will be something I’ll want to accomplish by 37. That means that, if the stars align once and I’m pregnant by mid 34 (say, by June), and I give birth at 35, I’ll have about a year (or less) before I start trying again for my second. Which seems all sorts of crazy, but I guess I’ll cross that road when I get there.

It’s certainly a lonely journey now–one that can’t really be understood unless you’ve been there yourself, and for a substantial amount of time. I know IVF can work and I still have my faith in that if needed, but that is when it will become an even more emotional process and I don’t know if I can mentally handle it. Maybe IVF will work the first time. Maybe I can get my body ready for it through all of my healthy eating and exercise plans and my body will be so ready to accept the embryo and love it for nine months until a baby is ready to meet the world. I hope so. I really hope so.