Tag Archive | Clomid

Cycle Update…or Not

It’s CD38 (or is it 39?) and things are boring. That’s the thing about taking Provera. I took my last pill yesterday and am now just waiting for my period to come. But as I did not ovulate this month, I’m not in the two-week wait. There is no teeny tiny, itty bitty hope of a BFP. At least not this week. I’m just waiting for next time.

I have spent the last ten days, every day that began by swallowing a Provera pill, indulging everything I fancy. Well, maybe not everything, but close enough. I’ve ingested way too much sugar and caffeine over the last week-plus. There is a small person inside my brain that has been screaming, Stop! You’re sabotaging your fertility! If you don’t have another baby, all the blame will be yours! And then there’s another someone who says, So what? Where has reading every nutritional label gotten you? Certainly not another pregnancy…  One thing is for sure: if I gain ten pounds this year, it will not be because of the Follistim. No. It will be entirely my fault.  But now I’m back to eating right. And I’m exercising until I can’t anymore. This week, it has been for at least ninety minutes each day to make up for all the crap I ate. I’ve even resorted to counting calories for a few days because it gives me a sense of control and quiets the mean voices in my head. Yes, my relationship with food and exercise is a bit…unhealthy. I’m pathetic really.

Like I said, things are boring. I have nothing more exciting to talk about than food and diets.  Should I write about the weather next? 🙂

There have been moments of panic recently, when I’ve had nothing to do but obsess over the future, wondering, what happens if my next cycle turns out exactly the same as this one? Because for some reason, after five months of good success with Clomid (at least when it comes to ovulating), my body decided it would not respond this month. I don’t know why. I don’t even understand how this can happen, especially when they increased the dose. It doesn’t make sense to me. And if there is no legitimate explanation, what’s to say it won’t happen again? What if even Follistim can’t help me now? I don’t know what the next step would be, what my doctor might recommend. We haven’t discussed it yet. I can only guess, but I don’t want to. I just want this to work.

And so, I wait as usual. Anxiously. Impatiently. I wish I could fast forward so I would know what the outcome will be. The unknown is the worst. But this is out of my hands. All of it. And that royally sucks too.

Waffling & Worrying

It’s hard to describe the place I’m in right now, but it’s not good. The beginning of this new year has really thrown me for a loop. I waffle between despair and limited hope on a minute-to-minute basis. On New Year’s Day, it occurred to me that I have little to look forward to in 2013 at this point, only a whole long list of things to dread: my sister’s baby shower, the birth of my niece or nephew, the birth of my cousin’s little guy, endless months of fertility treatments and BFNs. So many people I know have so much to be excited about this year, but not me. Realizing that sent me sobbing into my husband’s chest as he was trying to sleep until I finally fell asleep myself. I’ve been feeling emotional and heavy-hearted ever since. 2013 terrifies me because it feels like a make-or-break kind of year. By the next New Year’s Eve, we will either have a baby, be expecting one, or be quitting fertility treatments. I don’t want to face that.

In other news, we now have a plan for my next cycle. If I haven’t ovulated by CD35 (it’s CD27 today), I am to call the nurse to let her know and then begin Provera (well — my cheapie generic kind of progesterone) to induce a period. I really want to start this tomorrow because I don’t think I’ll be ovulating any time soon and I just want to move forward, so I may just do that. And in two weeks, when my period comes, I’ll then call and not bother to mention that I took the Provera before I was supposed to.

My RE is willing to switch me to Femara for my next cycle and try that for two cycles before adding injectables, but I have spent the last week (as I waited for a damn callback from the medical assistant) thinking all of this over. As I struggle with the concept that this year will really be the beginning or the end for us, I feel a strong urge to take action. I’m tired of standing still, or of doing the same thing over and over, expecting different results. I have pondered it, and prayed over it, intensely and I feel like the right answer is to move full-steam ahead, at least for now. We know that my body can and often does respond to Clomid. We don’t know how it will respond to Femara, and I don’t want to waste time trying to figure it out. Not now. So with that being said, we’ll try Clomid (I’m unsure if it will be 100 or 150mg) again (days 3-7), followed by Follistim injections until my body responds.

I feel like this is the best option for me, but there are three things causing me rather grave concerns in regards to this (three things that, once again, had me crying when I hung up from talking to the medical assistant):

  1. I learned that, with injectables, I will be required to do a baseline u/s on CD2 or 3…something I haven’t had to do thus far. I cannot tell you how hard it is for me to get into the city for these frequent ultrasounds. With driving time, it takes a total of four hours for a 15-minute appointment. On top of that, I have to drag my husband along with me because there is no way I can keep Cupcake quiet and occupied for 15-30 minutes while my feet are up in the stirrups (yes, it has taken 30 minutes in the past for a monitoring u/s because of stupid Lefty who likes to play hide-and-seek). I can forfeit my time, but I worry about the impact on Honey’s job and the extra $200 that yet another u/s will cost me.
  2. Follistim is not cheap, nor are the ultrasounds and, because I don’t often respond immediately to the Clomid (maybe Follistim will be different?), I often need several ultrasounds. Furthermore, I can’t really prepare for the costs because I don’t know how long I’ll have to take the Follistim for each cycle and I don’t yet know if my insurance will be covering the ultrasounds…but I’m expecting it won’t. So I’m freaking out about the expense and, even with some financial support from my mom, I am afraid we’ll get in over our heads…but what other choice do we have? Stop trying before we’re ready? I can’t let money be the be all and end all, but the thought of a huge bill at the end of each month is causing a great deal of panic.
  3. This is the least of my worries, and rather vain and petty, but I have heard the horror stories of the weight gain injectables can cause. I have struggled with weight and body image my whole life. I grew up thin and tall for my age, but gained fifty pounds in my early adolescence and it forever changed the way I look at myself. I lost that weight in college and have maintained a healthy weight ever since (ten years now!), but I still live in fear of regaining those pounds. I don’t want to be fat again.

So that’s all I know right now. I’ll be starting progesterone to bring on yet another CD1 sometime in the next week. I’m ready to take a more aggressive approach because I’m losing patience with all of this crap, but I’m terrified of the consequences of said approach. And I’m tired. I’m tired of feeling this way. I just want to have the same hope and optimism that I had when we rang in 2012. But I feel like that girl is long, long gone.

Not Good

The last few days have been hard, and disappointing.

Reason One: I have not felt well and I don’t know why and it’s odd. After a fever for five days, my temp dropped back to “normal” by medical standards…except it’s not normal for me. My BBT is in my post-ovulation range or even slightly higher, which means I either ovulated already (not likely?) or something else is going on. After my fever disappeared, though, I developed some intense nausea and bloating. Starting Christmas afternoon, the last two days have been spent feeling miserable, with me unable to do anything but sit on the sofa and beg my husband and mom to answer my call for water, or a blanket, or whatever. And on top of that, I have other suspicious symptoms: three swollen and painful lymph nodes in my neck, no energy at all, and very dark urine (even though I’m not dehydrated and normally have very pale urine). Is this a mild flu? Is it something more serious? Or is it nothing at all? It’s all very confusing and weird and I don’t know what to make of any of it. I’m going to watch my symptoms through the weekend and will call our family doc on Monday if they persist.

Reason Two: My u/s yesterday was another big fail. No progress. It was, once again, hard for them to get a good view of Lefty, but it doesn’t look like there’s any lead follicle that’s ready to go. The tech did seem confused because my lining was so nice and the one follicle she did see, she couldn’t get a solid measurement on and wondered aloud if I had already ovulated, but I highly doubt it. The RE that was in-office for the day wants to cancel this cycle and have me make another appointment to see my own doc. Which is fine, but I will definitely be asking for a phone consult versus meeting the doc in-person. There’s no reason I should waste 4-5 hours getting to and from the doc just so she can see my pretty face and tell me things that I already know and we’ve already discussed. I asked about continuing with this cycle for a few more days to see if I’ll ovulate anyways (just as I did last month) and then have my Honey give me the trigger shot when I get a positive OPK. The nurse thinks this is probably okay, but will check with Dr. Young and get back to me today.

My great fear is making a wrong decision about the next step. As far as I can see, I have three viable options: A) Should I just go forward with the 150mg of Clomid for another cycle? After all, it always takes two rounds of 100mg before my body responds. Maybe it’s the same with 150mg. But can I handle these daily headaches for another cycle? And is this too much Clomid I’m taking? I’ve been on it for so long now and I think, technically, I’m now past my “lifetime limit.”  B) Should I add Follistim after finishing my five days of Clomid? I think this is what my doctor wants, but I’m nervous about the cost and the daily injections and, whenever possible, I prefer to go the less invasive and simpler route. And there’s still concerns about frequent headaches and overdoing the Clomid with this option. C) Or should I switch to Femara and give that a go? I’m nervous about trying a new drug because I don’t know if my body will respond. What if it doesn’t and I waste a cycle (or two! or three!) trying to figure it out. We spent many cycles trying to find what dose of Clomid worked for me and I don’t want to be in the same position with Femara. At the same time, though, maybe a new drug will be just what my body needs to kick it into gear and make this thing happen. Not to mention, it’s cheaper than injectables and I may get a break from the headaches. But really…I just want to do what’s going to give me the best chance at having our next baby as soon as possible with the least amount of grief.

Guys, I’m so disappointed. I really thought I would respond well to this higher dose of Clomid. Now, with all that’s been happening in my body this week, I just feel like I don’t know anything. Everything is so far beyond my control and it leaves me shaking with fear. Please, please, please let something change in the new year.

More Odds ‘n’ Ends Brought to You by the Letter “F”

Please forgive these somewhat scattered thoughts. My head aches and I have a lot I want to cover, as quickly as I can. (But you all know me, and that’s not often quickly at all…)

Failure: That’s how I might describe this cycle, and certainly today’s CD15 ultrasound (the FIFTH medical appointment I’ve gone to in FOUR days, between my daughter and I!). Follicular progress? None. Practically no growth whatsoever. Possible shrinkage, but that left ovary is a bit shy and they have a horrible time finding and seeing her, which means measurements for the follicles on Lefty are approximate at best. Today, my largest follicles were 11.0 and 11.5. No bueno. And while I haven’t given up hope completely (see last month’s cycle for proof of what can happen), it’s hard to stay positive. And it puts a big ol’ black cloud over the upcoming Christmas festivities. I was hoping for hope and optimism this Christmas, instead I have dread and uncertainty. I return on Wednesday for one more u/s to see if there’s been any change. Really, really praying for it tonight and in the days ahead.

Frustration: I’m losing patience with Clomid. It maddens me so that my miracle drug, the one that has never caused me any grief and gave me my precious daughter and a second short-term baby to boot, is now failing me. I want to try Femara first, but my doc is already talking Follistim, which is going to cost us some mighty dough. Sigh. There are days when I am thisclose to just throwing in the towel altogether and giving up.

False Positive?: I rarely get a false positive on an OPK, and I’ve never had one this early in my cycle, but today that second line was very comparable to the control line. I’m not super confident in the accuracy of it because my urine was extraordinarily dark (from drinking, oh, one glass of water all day yesterday because I was too freaking busy), but it’s suspect. Is it wrong? Is it because of concentrated urine? Or is it that my body is preparing to release an egg before one is mature — and could that be my problem with the last four cycles as well? Is that even possible my body would do that? Or could the u/s techs just be completely wrong about my follicular measurements? So many questions! My OPK tomorrow may give some answers…I hope!

Family: For those of you who care to know, I did get to have breakfast with my family this morning. We (my mom and I) were an hour late (because of a pointless ultrasound, mind you), but we still got to spend a fantastic hour with them. Every time I see these people, I am reminded how lucky I am to have so many in my life whom I love and feel so loved by. Anthony Brandt once said “Other things may change us, but we begin and end with family,” and for me, how true that is.

Face: Mine is clearing up. It’s very weird. I had great skin in my teens, but have struggled with cystic acne through most of my 20s. And now, for the last month, I’ve had hardly any pimples at all and no cystic ones. For the last several cycles, I was breaking out especially around ovulation and my period, but didn’t see one pimple appear around CD1 two weeks ago. I love it, but still wonder, what gives? Is it that I’m just getting older (turning thirty next year!) or is something changing hormonally? Hmmm…

Fever: I’ve had a low one for the last three days, 99.5 to 100.6. No other symptoms. I went to Urgent Care last night because my GP was worried about a UTI, but everything is coming back negative so far. We’re still waiting on blood work, but the on-call doc seemed very concerned about a suspicious fever. I’m supposed to go back tomorrow if it persists, but only plan to do that if the fever is above 100.0. What really irritates me is that, even if I do ovulate at this point, I will have no solid confirmation because my BBT is already elevated. I did ask the nurse at the fertility clinic about a fever, though, and she seems unconcerned about it affecting eggs or my ability to conceive this cycle. So I guess that is one small thing for which to be thankful.

Well, I think that will do for now. Hope everyone’s last couple days have been more relaxing and less eventful than mine!

A La Dr. Young

I had a successful appointment with my RE this afternoon. I went there feeling jittery with nerves. I was expecting to leave feeling discouraged, after hearing nothing but gloom and doom and being told that our only hopes of conception are IUI or, worse, IVF. I got none of that.

We came up with a plan going forward, which I’ll get to in a minute, but first, we talked about plenty of other things. A *quick* summary:

  • Dr. Young thinks it’s probably wise to quit taking all the vitamins that we are on as they aren’t well regulated and there is not solid research proving that they are beneficial for reproduction. She thinks the only ones to continue with are the prenatal, omegas, and vitamin D (because of the climate we live in).
  • She would advise me to discontinue baby aspirin until after my BFP. I am young and healthy, so it is unlikely that I’ll develop an ulcer or bleeding issues from the aspirin, but it’s still possible and she always likes to error on the side of caution.
  • She will gladly prescribe progesterone suppositories, but she stressed the importance of taking them at the right time in my cycle. If I am being monitored and doing a trigger shot, I can take them three days after ovulation. If I am just predicting date of ovulation by OPKs, she wants me to wait a week just to be on the safe side.
  • She reviewed my 2009 2 hour glucose tolerance test. One value was abnormal and had me worried about possible insulin resistance, but she doesn’t think one abnormality is a concern. She would still recommend stopping the Metformin (I have been reluctant to thus far). She says she used to give it out like candy ten years ago, but after a study was done with Metformin and Clomid proving only a very few people benefit from it (by ovulating) in taking only Met, she thinks it’s unnecessary and worries about long-term safety.
  • Dr. Y reviewed my husband’s semen analysis with us and says his motility and count are excellent (which we already knew). The morphology is a concern and some doctors would automatically recommend IVF, but she says she’s not one of them. In a perfect world (where cost and time aren’t a consideration), she would say go with IVF w/ ICSI because it would give us our best chance. I’d probably be pregnant in a month or two, she predicted. But with the amount of money and time that must be invested in an IVF cycle, and with our prior two successes (BFPs), she doesn’t think it’s warranted yet. Nor is IUI. She wants to continue on the same road we have been.
  • She is billing my insurance under “PCOS” and “irregular periods,” but she did warn me that the insurance company can do with that information as they want. They could still deny coverage if they find out I’m taking Clomid. Fingers crossed that they don’t decide to be jerks about this!

Basically, from all of this, I got that my doctor is conservative in the drugs/supplements she encourages and describes, and likes things to be as simple as they can be. I respect that and I respect her. She’s got fantastic bedside manner, is open to all questions, and I appreciate that she seems well-read and well-informed. I truly trust her. However, that does not mean I necessarily agree with every recommendation. At this point, I’m going to continue baby aspirin and Metformin. I’m just too scared to quit right now. But I will re-evaluate the vitamins we’re taking and start with progesterone suppositories — but next cycle. This one, since I don’t have much hope for it and it’s already 9dpo, I’m just going to relax and take things easy.

And now for the plan… When my period comes, we will try 150mg (instead of 100) of Clomid in hopes that it may help my body to respond and ovulate sooner than CD20+. There is a greater chance of side effects, none of which I am particularly concerned about except possibly the elevated risk of cysts (because I’ve had them in the past) and the thinning of my lining. However, my last u/s (on CD16) showed a multi-layered lining of 11.5 (and that was after many months of Clomid), so Dr. Y is very encouraged that it may not affect me too much. And if the 150mg doesn’t work? We’ll do a combo cycle with Clomid (or Femara?) and an FSH shot.

I am pretty comfortable and happy with this plan. We’re moving forward, trying something new, but not doing anything too drastic. I’m slightly freaked out by taking Clomid for so many cycles and about the cost of the FSH and about giving myself an injection (eek!), but one day at a time, right? One step at a time. Breathe in. Breathe out.

Once Upon an RE…

As many of you know, I went to to visit an RE for my very first time on Friday. It was a frantic morning because they had to move my appointment to the 8 a.m. slot at the last minute, which meant waking my daughter an hour before she usually gets up and making an hour-and-a-half commute to get there in rush hour traffic. We had to park a block away and ran to the office (and I did not wear running shoes!). We arrived three minutes late, which I really hated and it left me feeling out of breath…which would probably explain why my blood pressure was 150/88 when the pregnant (of course!) medical assistant took it (it’s usually around 110/70). Ugh.

But the appointment went well, for the most part. My doctor, whom I will call Dr. Young because she is (late 30s? early 40s?), is straight-forward, easy to talk to, and open to questions. Since I’ve only spent an hour with her so far, it’s hard to have a real opinion, but I think I will like her and feel comfortable with her and I certainly do have confidence in her expertise. And surprisingly, she is in agreeance with much of what my OB/GYN, Dr. Smiles, already told me, which was unexpected but reassuring. We talked about a lot in the time that we spent with her, so please forgive me if this isn’t organized well. I think I’ll do it with bullet points (to at least give the illusion of organized thought):

  • PCOS: Yes, she thinks I have it. She says I am not a “classic” PCOS patient in appearance or labs, but she diagnoses PCOS through the process of elimination (every doctor has different criteria, I have found…I’ve seen four different doctors and they’ve all told me something different!). When someone has irregular periods, she rules out thyroid disorders (check!), prolactinemia (check!), and perimenopause (check!). If someone has no signs of those but doesn’t ovulate regularly, then she diagnoses PCOS. And it’s possible that the only sign of PCOS could be irregular cycles. So yeah…I guess that means I join the PCOS Club. Officially. My biggest fear in being diagnosed with PCOS was the high risk of miscarriage, but she assured me (just as my OB did) that there is no connection between the two. The studies that linked them were old and did not take into account diabetes and severe insulin resistance (which can cause miscarriage). If you exclude diabetics from the studies, the miscarriage risk would have been proven to essentially be the same as anyone else. So that was a relief to hear. I know there will be differing opinions on this, as Dr. Young reminded me there always will be, but I’m choosing to believe what she’s telling me. I need to believe for my own peace of mind.
  • Metformin: This is not a drug she prescribes, unless someone is clearly insulin resistant. Recent studies have shown that there is no proven benefit in helping with ovulation and she is hesitant to prescribe any drug that isn’t proven to be useful and has no long-term studies about it’s safety. I asked her if I should stop taking it and she says she thinks I should because, while I am lucky to suffer no GI side effects, there is the potential for liver and kidney problems…they’re rare but possible. And after thinking it over, I think she’s right. I have been taking this drug for three months and haven’t seen one bit of change in my cycles. I’m not insulin resistant, so why take a drug that I probably don’t need? Even the pharmacist told me that I was taking a very high dosage when I picked up my prescription last month. So I think it’s time to quit. I’ll wean myself off of it over the next few weeks and be done. I’m a little nervous about that because I know some do believe that Metformin can lower m/c risk, but Dr. Y doesn’t and I have to keep reminding myself that I didn’t need it while pregnant with Cupcake, so I probably don’t need it now either. Right?
  • Blood work: I successfully completed all the preliminary bloodwork through my OB and my RE doesn’t think any of it needs to be repeated at this time. Yay! This also means there won’t be any delay in starting treatment. Go me for totally being on top of this!
  • Chances of success: She reminded me that, with every cycle, there is only a 25% chance of success. I was very lucky to conceive on my first Clomid ovulation with both Cupcake and Teddy Graham, but I can’t expect it to happen every time, so this process is going to require some patience on my part. While I may be growing tired of Clomid because it’s not “working” (i.e. no BFP), it is doing it’s job and producing an ovulation. Now, it’s just a game of wait and hope.
  • Semen analysis: My husband asked about having one done. Honey had one come back as normal two years ago, but Dr. Y doesn’t think it’s a bad idea to have a recheck and we agree, so we’ll go ahead with that. Last time, my hubs got to do his business at home and take it in afterwards, but this time he’ll be doing it at the lab, which I can tell he is uber-excited about. He’s so fantastic, though, and hasn’t complained for even one second. It will cost us $110, which seems like nothing compared to everything else.
  • Short luteal phase: Dr. Y does not think this is a problem for me. She considers a luteal phase too short if it is less than 9 days. My shortest one has been 10 or 11 days and she doesn’t feel this needs any treatment. I asked why sometimes my LP is so much shorter than it is in other cycles and she said it’s just based on different hormone levels produced for that particular ovulation. Hmmm…
  • Baseline scan: I had a meet ‘n’ greet with the dildo cam at the end of our visit. It was the first time I had ever had that done during my period and can I just say…ew, gross? It was really, really gross and I’m sure much more so for my doc, but she’s used to that, right?  Anyhoo…she did conclude that my ovaries look polycystic (with 10-12 visible follicles on one side and 12-15 on the other, when the most she should see is 10 and that’s in someone much younger than myself). Also — there are no ovarian cysts or visible uterine fibroids. Good news! She also determined that my lining got plenty thick in my last cycle because, when she measured it, it was 11mm…and that was on CD2, after a full day of bleeding. So Clomid isn’t causing problems with that at this point. More good news!
  • Progesterone levels: In September, my P4 was 11.0 at 8dpo. I was less than excited about that number, but the doc doesn’t think I have a reason to worry. She says she only orders a P4 test to see if someone has indeed ovulated (anything over a 3.0) or if she is concerned about a very, very short luteal phase. She never bothers with the actual number and doesn’t monitor it in her patients because she doesn’t think it provides enough information to be worth it. Which means she doesn’t think I need progesterone supplementation of any kind at this point. She did say, though, that a trigger shot will probably help my body to produce more progesterone.  Which leads me to…
  • Treatment: I asked about switching to Femara, but for now, Dr. Y wants to stick with Clomid. She says that “they” say you shouldn’t take it more than twelve times in your lifetime, and this current cycle will be number 12 for me, but she is willing to let me go two more after this one. She really wants to do a monitored cycle and a trigger shot for this round, to see how my body responds. So I’m scheduled for a scan on day 12 (Nov 12) and we’ll go from there.  Hopefully, I’ll be ready to trigger and then we wait. If not, I’ll have to return for another scan and keep doing so until I am ready for the shot. And if this cycle doesn’t end happily, we will do two more rounds of Clomid, of which I will have to decide if I want to do monitoring or not (not recommended, but allowed).  After that, I’m a bit confused about where we go from there. There was talk of Femara, IUI, and IVF, which raised my level of anxiety and panic to unknown heights. I do know there won’t be any injectables (maybe if I beg?) because, when combined with PCOS, the risk of multiples is just too high. I have a follow-up scheduled with Dr. Y for Dec. 4, where we will create a long-term treatment plan. Which scares me to death.

So I feel pretty good about most of this, but there are a few concerns I have:

  • I felt a bit rushed at the end of the appointment and had to speed through my final questions, which was a bit irritating. I know Dr. Y had a procedure to get to (which is why my appointment had to be moved up), but I’m a new patient and have a lot to talk about…don’t I deserve her time and focus while she is with me?
  • I’m not thrilled that I won’t be getting progesterone suppositories. Dr. Y doesn’t think I need them, which is great, but what if she’s wrong? I want a safety net. One thing that will let me breathe a little easier and say, “At least I don’t have to worry about that.” So I may push her on this a bit more down the road.
  • Monitoring and especially the cost of it. One u/s scan on day 12 and a trigger shot? I think we can afford that (definitely can if my insurance picks up any of the cost). But I am fairly confident in saying that I don’t believe I’ll be ready to trigger on day 12. I normally ovulate days 19-23…a whole week (or more) earlier than this seems too optimistic to me. Which means I’ll probably have to return for another scan. And what if I’m still not ready and have to go back for another? The costs will just keep climbing and, while we can do this for one month, I’m not sure it’s something we can do over the span of several. Not to mention the exorbitant time that will be required, especially with the holidays nearly here and with a toddler in tow. It takes at least an hour to get to my RE…and an hour to get home. That’s a lot of time, especially if I have to do it more than once a week.
  • Too much too soon. In other words, taking an approach that becomes too aggressive too quickly. I am willing to stick with Clomid or Femara for a good few months and maybe do monitoring and a trigger for those cycles. But to go straight from Clomid to IUI in just three months? That’s when I start to feel my panic rise. Because I know that IUI is the end of the road. There will be no IVF for us. This is not something I’ve discussed before because I haven’t thought I would need to, and it’s something I will explain more if it comes to that, but I just know that, right now, we have drawn the line there and IUI is the last stop. And so in three months, if Dr. Y wants to move on to IUI, it will be my final and only hope and that is just too scary. I am not ready to arrive there yet.

So over the last couple days, since meeting with Dr. Y, I’ve been feeling overwhelmed. Overwhelmed by the money and time all of this will require. And overwhelmed by the possibility that none of it may work. That the bills will pile up and it won’t be worth it in the end because I won’t have another baby. But as my mom keeps reminding me, I need to take it one step and one cycle at a time. Why worry about IUI in three or six months when this very cycle could be The One? So I’m taking lots of deep breaths, praying, and just trying to balance hope with expectations. Faith with realism. Not worrying about what hasn’t happened yet, and still preparing for the worst case scenario. It’s a very fine line.

And so there you all go…the story of the day I met my RE. Fascinating and heart-warming, isn’t it? So sorry about the neverendingness of it. I do promise you that one day — one day very soon! — I will publish a post that doesn’t take me three hours to write…or you a whole hour to read.

Waiting No More

Today, the OPK was positive. Alas.

Sigh. Of. Relief.

But! (Why does there always have to be a but?) BUT it’s CD23 and I’m scared. There are three possible outcomes to this scenario and I fear every one of them:

  • OUTCOME 1: It’s a false positive and I won’t ovulate after all. I don’t doubt my ability to ovulate this late (I ovulated on CD22 with my last pregnancy), but because I have gotten a couple false positives in the past, I’m always a little doubtful. However, I’ve never gotten a false positive that was this clear — it’s always been, Is the test line as dark as the control line? Maybe. Kinda sorta. I think. That’s how it was yesterday, in fact. But today, I did not have to wonder or look at it in every sort of light to determine if it was positive. It was, no question. I also have all the other signs of ovulation, like lots of EWCM. So I’m feeling (hoping!) like this is the least likely outcome.
  • OUTCOME 2: I ovulate, but get my period in two weeks. I know I said I just wanted to ovulate and didn’t much care if I actually conceived, but let’s face it — I lied. I want a baby. I want to conceive. I want this to work. And if my period comes again, I will be sorely disappointed. Probably not like last month as I’m not hanging everything on this one cycle, but it will still suck and leave me feeling defeated. Again.
  • OUTCOME 3: I ovulate, and get a BFP in two weeks or so. This is the best-case scenario, but it scares my witless, because really, this outcome has two sub-outcomes: a) I birth a healthy baby in nine-and-a-half months, or b) I lose the baby some time down the road. To think that I could miscarry again makes me feel like I’m about to toss my cookies right this minute. I want a BFP so much, and fear it just the same.

I am most preoccupied with the last two scenarios, because I think they are most likely. I find myself especially worried about the late ovulation. With my daughter, I ovulated on CD19, still late by most standards, but it gave me a healthy baby. With our Teddy Graham, I ovulated on CD22 and lost him five weeks later. I have no way of knowing if late ovulation affected the quality of my eggs and thus caused the miscarriage, but it is something that has weighed on me ever since. And today is CD23, even one day later. There is still not a lot of difference between CD19 and CD22 or 23, but maybe it makes all the difference in the world. Maybe those three or four days are the difference between good eggs and bad eggs, between hope and loss. Someone please tell me they aren’t. That a viable pregnancy is still possible at this point in my cycle. There are plenty of happy stories on Google, but I just don’t know any IRL. Then again, I don’t know many people IRL who have fertility problems to begin with.

And if I don’t get my BFP at all? If I don’t conceive? Then what? To my friends who have experience with Clomid (or who just want to weigh in because you can), let me pose this question to you: Is there anything I can do — anything at all — to help me ovulate sooner next month? Would taking Clomid earlier in my cycle help? I currently take it on days 3-7, but I’ve heard of patients who even do it days 2-6. What about increasing the dosage, 150mg instead of 100? Would that just produce more follies or could it make me ovulate earlier? I’ve googled my brains out about it, but there are mixed opinions and I don’t know what to take away.

And yes, I know that an RE could help me with all of this. I truly do know and I have a plan in place to make that leap. But I want to give Clomid one more go before that. And I realize, too, that I’ve obsessed about all of this many times before. I’m sure every last one of you is sick of it. Forgive me? I’m just fearful and uncertain and need to get all of this out of my head. And you, my friends, are the only ones who really understand.