Phoebe: Fertility Musings/Melatonin for Reproduction?

Now that I have quit the IVF birth control pills (wtf?) mid-cycle, I am starting to feel better.  At around 3pm on Tuesday, all of a sudden something shifted and I suddenly went “oh, right” and just started to feel better.  I think the jet lag from Asia is finally wearing off (this is the worst case of jet lag I have ever had), and the hormone roller coaster is calming down.  Between the Clomid and the birth control pills, I was on a ride I wasn’t even aware of.  Now that we are doing the varicocele repair surgery, I’m not going to lie:  I am glad I don’t have to take any more hormones, at least for a while.  That, plus gnarly jet lag, seriously f**ks one up.  In ways one never expected.  For the past couple of weeks, I have felt despairing, self-pitying, self-flaggelating and melancholy.

Another thing I realized about it all is that once we really decided to embark on this baby-making thing and not just “not try to not try,” something shifted in my identity.  I started changing from hot mama to mom.  Not that moms can’t be hot (MILFs, anyone?), but there’s a shift in mindset that begins when you start thinking about motherhood.  As a superficial example, it just so happened that right around January, my sexy, sporty manual transmission Audi was getting to that point where it was sucking up more dough than it was worth, so we decided I needed a new car.  We figured I may as well get a mom car since we are the type of people to keep cars for a long time (like ten years long).  Certainly within the next ten years, there will be baby seats in the back of that thing!  So I got a Honda CR-V.  OK, so now I am driving around the mom car, which is big and cozy with an automatic transmission.  I have the mom car, but I am not the mom.  Also, when we were in the midst of our IUI cycles, the doctor told me to stop working out so much.  I normally go four days a week; he told me to cut down to three.  So I did.  But I kept eating the same amount (which is a lot, which is why I work out so often), and started to grow a little tummy.  I was OK with it thinking, “I am preparing my body for motherhood.”  But again, mom body and no baby.  I got a “sensible” shoulder-length haircut.  Mom haircut and no baby.  We’re looking at houses and worrying about school districts.  Mom mentality and no baby.  Now that my husband is getting his surgery, we won’t be trying again for around six months.  So now I am back to working out when I want and drinking caffienated coffee and eating sushi and all that – the old me.  I know a baby will come eventually, but in the mean time it’s like I’m between identities and it’s uncomfortable!  Of course the lesson in all of this is to enjoy the present tense, no matter what it is.  A couple of days ago, feeling really down, I went to yoga and the teacher read this quote:  “Once you realize that the road is the goal and that you are always on the road, not to reach a goal, but to enjoy its beauty and its wisdom, life ceases to be a task and becomes natural and simple, in itself an ecstasy.” It was just what I needed to hear.

In other exciting news, for the past few nights, I have taken Melatonin to fall asleep and I think it’s been making me unable to wake up in the morning and has given me weird dizzy spells.  I was looking up the side effects on the internet when I came across this on the University of Maryland medical website:

Melatonin also helps control the timing and release of female reproductive hormones. It helps determine when menstruation begins, the frequency and duration of menstrual cycles, and when menstruation ends (menopause).

Anyone heard of this before?  Should I continue with it to regulate my irregular cycle while we are waiting out the results of my husband’s varicocele repair?

Also, in all of my research and whatnot and thanks to all of your fabulous comments, I have come to the conclusion one always comes to in a medical situation:  NO MATTER HOW GOOD YOUR DOCTOR IS, YOU MUST TAKE CONTROL OF YOUR OWN MEDICAL CARE.  Our doctor is very competent and a professor in Reproductive Endocrinology at UCLA, meaning he has access to all of the latest information as well as technology.  And still, without us asking the right questions and asking for a referral to a specialist, we may still have been wasting money and time doing IUI after IUI rather than getting the detailed analysis of my husband’s sperm that determined there to be a severe male factor infertility there and the IUI’s to be 100% pointless!

That’s all for now.

Drinking ‘caf and yoga-fying to my heart’s content,

Phoebe

Phoebe: Pregnancy Test Next Thursday

Normally I would just wait for my period, but I am leaving town two days before it would likely come. So my RE is having me come in for a blood pregnancy test 12 days after my procedure that will determine our next course of action. Either I’m pregnant, in which case we know what the course of action is there, or I’m not. If I’m not, then the doctor will either prescribe more Clomid or start me on injectables since the last round of Clomid only produced one egg. I don’t think we can consider IVF at this stage with me leaving town for ten days.

My husband went for a scrotal ultrasound (it was a bummer for all involved), and we are waiting for the results. His urologist’s initial thought is that he has a varicocele. Here is a definition: A varicocele is a varicose vein in the cord that connects to the testicle. (A varicose vein is one that is abnormally enlarged and twisted.) Varicoceles are found in 15% to 20% of all men and in 25% to 40% of infertile men.

It can be corrected with surgery, but that would put our reproductive efforts off for about six months, so we are not sure how to proceed there. Anyway, he got a supersonic semen analysis and the aforementioned bummer of a scrotal ultrasound, so we’ll wait for the doctor’s assessment in order to figure out where to go on that.

Meantime, every gas pang and slight cramp I feel is immediately presumed to be implantation. I’m trying not to drive myself crazy with it, but failing miserably on that front.

Just very excited to be doing this…

Woo hoo!

Phoebe

Phoebe: Day 17 and still no surge.

WTF?  Did I miss my window?  I’m taking twice the dose of Clomid this month that I did last month, and last month I had the surge on day 15.  This makes me feel powerless and out of control.

Confused and impatient and running out of sticks,

Phoebe

Phoebe: Getting Ready for IUI Numero Dos.

Quick backstory:  I have always had irregular periods.  My mom did too, and had trouble conceiving even in  her early 20’s.  In fact, I have two adoptive siblings.  So I always suspected that when it came time for me to try to conceive, it would not be one of those lickety split situations.  My husband and I got married about a year ago, and would have loved to just chill for a while baby-free.  But I am now 36 (I turn 37 in April), and knowing it might take a while, we decided to start not not trying.  In other words, Trojans aside – let ‘er rip.

Last July, I thought I might be pregnant because I experienced what I thought was implantation bleeding and didn’t have a period for a long time.  I went to the gyno for a pregnancy test, and she said not only was I not pregnant, but I was not ovulating and I should go on Clomid.  After this news, I didn’t have a period for 50 days.  The following month, on a friend’s recommendation, I read Taking Charge of Your Fertility, which is extremely enlightening.  One of the things I learned is that when you  have irregular periods, you are often not ovulating at all.  So when you finally have what you think is a period, it’s not a period at all, but what is called anovulatory bleeding.  For anyone trying to get pregnant or just wanting to know how your body works, I strongly recommend this book.  It saddens me that, until last August, I had very limited knowledge of how babies are made.  Who knew there was cervical mucous, waking temperature, ovulation predictor kits and all that good stuff?  And I can’t believe I spent the first 35 years of my life trying so hard not to get pregnant when getting pregnant is virtually impossible most days of the month!  Honestly, I don’t know how anyone has an ‘accidental’ pregnancy.  But I digress…

In January, 2009 we decided to see a fertility specialist, or RE as they seem to be called online.  After learning about my background, he suggested three rounds of IUI with Clomid.  If that didn’t work, three rounds of IUI with FSH shots.  Then if we were still not pregnant, we would regroup.  He seemed very encouraging and relatively certain, given what he knew then, that this course of action would get us pregnant. I was assigned a nurse and left the office feeling very positive.  I called several times with questions before my first procedure and my calls were not returned.  The receptionists were rude.  If it wasn’t enough frustration to have to see an RE in the first place and pay for everything out of pocket (my first visit alone was more than $950), being treated like an anonymous pest was not helping matters.

Our very expensive and invasive diagnostic tests showed my girl parts to be in proper working order except for the irregular ovulation, which could be corrected with Clomid.  My husband came in on the low end of all three semen standards:  count, motility and morphology, but not so low that the doctor went off of his initial course.  We did our first IUI on January 27th.  After the sperm wash (What’s a sperm wash?  Oh, yet another costly procedure requiring one’s husband to whack off into a cup, and then hand his nectar of life off to the lab tech who, with a smirk, takes the sample and removes all but the highest quality swimmers), we were working with 12 million of his best guys.  I got my period two weeks later like clockwork.  When we came back for the ultrasound (which is required to start another round of IUI – all of these pricy tests and doctor visits are a constant reminder of our inability to do it “the old fashioned way”), we papered the doctor with questions.

I have three friends who had one unsuccessful IUI and went straight to IVF and got pregnant.  He said, I can’t speak to their cases because everyone is different.  We asked about our chances.  The chances of getting pregnant with IUI are around 10%.  We gain a couple of percentage points with a higher dose of Clomid on the 2nd round, which would make more eggs, meaning more “targets” for the sperm.  We asked why we shouldn’t go straight to IVF, where the chances are about 50/50.  He said if money was no object, sure.  But if you’re willing to be patient, we prefer to do the less expensive and less invasive procedures first.  That seemed reasonable to me, although considering that three IUI’s costs the same as a single IVF, it is a gamble.  I mentioned to the doctor that we would also consider taking a break from IUI and just trying for a natural pregnancy and he looked at me funny.  He said our chances of getting pregnant on our own are 0-1%.  With Clomid, the chances are 0-2%.  I told him the experience was stressful and finally admitted that he was great, but his office was terrible.  He was mortified to discover how I had been treated (in addition to being unattentive, they had drawn my blood unnecessarily and sent me in for an unnecessary ultrasound) and immediately assigned me a new nurse.  I said I didn’t want to be high maintenance, but the experience was stressful enough without the office slacking too.  He said “We have high maintenance.  You are not high maintenance.”  Since then, I have been treated great.

So – now that you’re all caught up – I am on day 12 of IUI cycle #2.  Last month, I ovulated around day 16, but who knows if the Clomid will make me drop an egg earlier.  That said, the nurse said my husband should abstain for 4-5 days before the procedure (which takes place on ovulation day), so we figured last night was a good night to do the nasty.  The one good thing about conceiving medically is that it makes sex only for fun, not that mechanical ‘get pregnant’ sex that so many of my friends have complained about.  Meantime, on Wednesday my husband went to a reproductive urologist who said he may have a medical reason for the low sperm numbers:  a vein that blocks the stuff from coming out.  There is a surgery that can be done to correct it, but it would delay our reproductive efforts.  He is having one more test to determine whether the surgery is necessary.

Two months, some damaged confidence and thousands of dollars later, we have a lot more information than we started with, which is a comfort.

Peeing on sticks until next time,

Phoebe