Oops!

So..... my progesterone is 82.....definitely ovulated....definitely missed it.  Oops!  Good thing there's always next month.

Really No "O"

So on this higher dose of Clomid, I took longer to ovulate last month.  It didn't happen until day 19.  Which is fine, they said some people take longer to get the follicles to maturity before ovulation.  Today is day 22 and still no "o".  This is either really odd or really wrong.  I've always ovulated on my own, that hasn't ever been my problem.  And now this month I either didn't ovulate or my expensive monitor didn't work.  I don't know which is the better option.  Dr ordered more bloodwork to see what's up.  I rushed in this morning before work to get it done.  More news to come...

Merry Christmas!!!

Merry Christmas and a Happy New Year!

The Big "O"

No, not that kind of "O".....get your minds out of the gutter!  Ovulation.  Today was the last day I could ovulate and get in for an IUI before the holidays closed down the Doctors office.  So I get up this morning excited, I had some stomach pains last night and so I thought I had ovulated.  Got up and poas and there was no O.  Not yet.  So no visit to the Doctor this month.  Oh well, hopefully 2010 will be a more "productive" year for the Wolf household.  =)

Getting Some Practice

So this higher dose of clomid is definitely bringing out more of the side effects too.  In addition to the hormones going all over and making me a raging b*$@# (so sorry Tim), its also giving me morning sickness.  I have that nauseous feeling and don't know which way its going to go... or should I eat something... or will that make it worse, etc.  So I figure I'm just getting practice on how to get through it for when I do get pregnant.

Aunt Flo is Here

Enough said.  Bring on more clomid.

OMG

Got my progesterone levels back.  Dr said they want it to be over 10 and mine was.....84!!!!  Holy Cow!  I don't even know what this means.  My previous high was 34.  I don't know if it has to do with the higher clomid dose, or the longer time to ovulate or what.  I guess we'll find out in about a week.

Yucky Needles

I'm getting to be good friends with Mary, the Quest Diagnostics lady in Wentzville.  Saw her today, it had been awhile since my lab work has gone done quite a bit this month.  Had to get stuck to test my progesterone levels to show how well I ovulated.  High progesterone means good eggs floating around waiting to get this baby started.  I hadn't been pricked with a needle in about 3 weeks, it hurt a little more than I remembered.  I must be reverting back to my wussy self.

More Bloodwork

I got my bloodwork back from my Hematology visit.  My homocysteine levels are normal.  People with the MTHFR mutation don't convert homocysteine fast enough and have high levels.  Mine are normal.  Is that because even though I have the mutation, it's not effecting my blood?  That's what Odem thinks since I don't have a family history of early age stroke or deep vein thrombosis.  Or is that because all the extra folic acid I've been on up until November 5, has kept the levels low?  I'm having the test rerun in 3 months to see.  Hopefully this means I won't have to deal with all the bad issues related to MTHFR.  Still kinda sucks that I went through all the shots and extra pills and stuff all summer, when additional testing would have shown that it wasn't necessary. At least now I don't have to worry about not absorbing enough folic acid!

And now the Dreaded Two Week Wait...

Went in this morning to get my IUI done.  It took 55 minutes to drive down to their office! Thanks Hwy 40 and Forest Park Parkway construction!   My lining looks good and saw positive signs of ovulation on the ultrasound.  Next Monday I have to go in to get blood work done and then the waiting.  That's the hard part of the month, is the two weeks with nothing to do but wait to see if it worked.  Thanks for Thanksgiving to help me stay busy!

Eggs Take 18 Days to Cook

Wow!  I've been triggering to ovulate on clomid on day 15 for the past 6 months.  This month, Dr. Odem wanted me to ovulate on my own to make sure the follicles are fully mature.  I never had issues ovulating before and didn't again.  It just took 18 days to make sure they were completely cooked!  An extra 3 days!  I wonder how big of difference its going to make.  We'll find out soon...we're probably going to get squeezed in first thing tomorrow to do an IUI.

Hematology Appointment

Two out of three doctors agree, there was no reason for me to be on baby aspirin and lovenox shots prior to pregnancy and may not be necessary after becoming pregnant either.  Those two doctors also showed multiple research findings to support their answer, while the third didn't.  Great!  That was a fun experience to say I have now done.  Sounds like I'm heading in the right direction now though.  

I can't believe that the same findings can be handled so differently by different doctors.  Tim's more used to this, he knows that doctors make decisions based on research findings.  I think that's my Dr. Ahlering's treatment path was so frustrating for him.  All the pills and shots with just a basic explaination but no supporting evidence.  I've now had two different doctors show research.  MTHFR is the gene that helps homocysteine convert into amino acids, if it doesn't convert it properly there is a backup of homocysteine.  Research has shown arterial walls getting inflamed when the body has increased homocysteine, but the research doesn't show that the increased levels caused it.  Just correlated, not caused.  Research also showed that inflamed arterial walls was more common than blood clots.  So narrowing of my arteries, maybe, but still no clots.  Gotta love medicine.

November 5th, 2009

On November 5th, Tim and I had our first consultation with Dr. Odem.  Dr. Odem has been seeing infertility patients longer than I've been alive and everyone at WashU recommended him.  I had already faxed in my 36 page medical report and brought in another 14 pages his office required.  Here's what he told us...

Tim's numbers all look good, his motility is a little slower than normal, so we should keep trying with IUI's.  My MTHFR and PAI-1 are indicators that I'm more prone to these blood disorders.  But since my family has no history of stroke or deep vein thrombosis, he thought that its unlikely I actually have the disorders.  He said I shouldn't continue on the aspirin or Lovenox shots due to an OB's recommendation.  I shouldn't have an OB treat a blood disorder and should go to a Hematologist if I'm concerned.  Besides, the MTHFR increases miscarriages, not prevent pregnancy.  The blood disorder also goes with the extra folic acid pills, and he said I should just stick with a basic prenatal vitamin.  That's what he had to say about my blood results.

As for the process of IUI's at my previous OB's office, he thought it was overkill and to basically pad "their bottom line".  Dr. Odem saw that all my previous cycles didn't show enough thinning of my lining, so the estrogen shots and patches weren't doing anything.  I also have always ovulated on each cycle on my own before, he didn't understand why they forced me to ovulate by taking more hormones.  He showed research that says follicle size varies per person, sometimes as much as 1.2cm - 3.0 cm.  So my follicles may not have been done before they got triggered.  My progesterone levels were always normal also, so that test and extra hormones are out now too.  He showed that research doesn't support back-to-back IUI's being more effective than just one.  He said he could do it if I preferred but he said it would only help his bottom line.  Dr. Odem showed more research that clomid levels below 100mg are rarely effective, so even that was off.  Tim loved that he showed research to support his treatment plans, which does make more sense.  I guess I just followed the previous OB's wacky science experiment because my coworker went through the same thing and got pregnant. 

After our appointment, it was a lot to take in.  I'm glad we had driven all the way down to Forest Park Parkway together so we could talk it out on the way back home.  I was stunned to hear all that I had been doing my not have helped, maybe even hurted.  I was taking 4-5 pills and shooting injections into my stomach daily.  I averaged 7 drs appointments each month.  One at the beginning of my cycle to see my starting point (ultrasound), another to check follicle growth and get extra estrogen and HCG shots, two more visits for IUI's and another to check progesterone levels.  Now Dr. Odem, says to take clomid and come in when my ovulation monitor shows ovulation.  At that one dr's appointment, he can still check my lining, see my follicle size and do the IUI all together.  Which will be easier to schedule with work and the holidays coming up but also nice since its a 45 minute drive to the office.

So we'll see how this method of treatment goes.  I definitely have more free time without all the drs appointments.  The increase in clomid definitely made things a little more sporty around the house lately....sorry Tim.  Those chemically induced mood swings are doozies!  I still can't get over my worry about finally getting pregnant and then miscarrying due to a genetic condition I was aware of ahead of time.  I understand that the majority of miscarriages are unexplained, its hard to pinpoint what caused them.  But if I have repeated miscarriages, that is the hallmark of MTHFR and I couldn't mentally bear it.  The mental stress of this whole process will do me in way before the physical stress and pain.  So I did schedule an appointment with a Hematologist, that is later today.  Hopefully they can put my fears at ease.  It's not like I enjoyed my daily shots or the beautiful bruises they left behind, but you never know what you're willing to go through till you're there.

The Last Six Months

June 12, 2009 - This was the soonest we could get our appointment.  Had our first consultation and loved the office.  From the nurses to the doctor, they all understood that this was so frustrating.  We're both in our 20's, young, healthy with no initial tests showing any issues.  They understood that this process was so much harder emotionally than physically.  They ran additional blood tests and discovered I have MTHFR (http://www.pregnancy-info.net/mthfr.html) and PAI-1. 

This discovery started my journey on my little science experiment.  I had to start taking a prescription level prenatal vitamin, a baby aspirin, a prescription strength folic acid pill, another prescription strength folic acid and B vitamin pill each day.  Plus I had to do daily injections of the blood anticoagulant (thinner) Lovenox.  I felt like a human pin cushion and petri dish all in one.  =)

July 6th, 2009- I started a new cycle.  They had me take 25mg of clomid to make more eggs to have more luck.  This thins your uterine lining though, so I also started estrogen patches.  I got two internal ultrasounds done to monitor my progress and showed my lining did thin and got an extra shot of estrogen.  I wasn't ovulating and so I got a trigger shot of the HCG hormone to make sure I ovulated.  We wanted to try to make a baby the way "everyone" makes babies, so no IUI this time.  Got more bloodwork done to test progesterone.  Got a extra shot of progesterone, but levels came back normal.  August 5th, 2009 I started my new cycle.

Did another round of clomid, hormones, and ultrasounds.  Did an IUI on August 20 & 21.  Started my new cycle on September 4th, did another round of clomid, hormones, and ultrasounds.  Ovulated while on vacation in Washington DC, so no IUI.  Started my new cycle on October 5th.  Did another round of clomid, hormones, and ultrasounds.  Did an IUI on October 20 & 21.   Thoughout this whole time, Tim had been very cautious of everything they had me doing.  I had to throw myself into it mentally otherwise there's no way I could get up each morning and stab a needle into my belly.  Or take multiple pills a day, when I used to complain about my on vitamin a day.  So we scheduled an appointment with  a Reproductive Endocrinologist for November 5th.  RE's are OB's with years of specialized training and certifications in infertility.  All their job is to get me pregnant, then my OB takes it from there.  On November 5th, I started a new cycle....talk about timing.

Let's Start at the Very Beginning

Tim and I have been wanting to have kids for a long time.  Thankfully our siblings started before us and helped us delay our baby bug.  First we waited til Tim graduated from WashU and got his first job.  We thought that's when we would start trying, but then we got the crazy idea to be responsible.  Living for years on just one income, left a lot to be desired on the savings account.  So we decided to wait one more year so that we could build some savings.  That brings us to April 2008 and we decided it was finally time.

I was on all kinds of websites researching when was the right time of month, then waiting.  Of course, I'm still not very patient and would take an at-home pregnancy test at the earliest time possible and it would come back negative.  But then my mind would play tricks on me....maybe I tested too soon and the result wasn't accurate...let's test again.  Still negative.  For the first six months of trying I probably went through 14 tests!   Don't laugh =)  It happened.

Six months in, I called my OB and asked if it was too soon to come in.  The nurse said to come in and we could do some testing.  I scheduled an appointment and came in.  I spoke with my OB for awhile, let her know how the six months had gone.  There we no red flags on anything wrong and she said my insurance won't cover testing until 12 months of trying.  So we were sent home and I was determined to find out on my own.   I took some at home tests, bought an Ovulation Monitor, and Tim even did some tests.  Looking back...only the monitor was money well spent. 

One frustrating year of trying later, my OB started running tests.  Tim got tested and showed him in the normal ranges, but the low side of norm.  I got blood drawn and hormone levels came normal.  I had an internal ultrasound and showed that I was producing follicles (which produces eggs).  My ovulation monitor showed that I was ovulating normally.  My OB wasn't very understanding and wanted us to keep trying what we had been doing.  They thought anything else was "too aggressive".  I convinced them to do an IUI (artificial insemination).  They didn't do any monitoring or drug assistance or anything.  So of course, it didn't work.  I got my period on Mother's Day and decided to go to an OBGYN that specializes in infertility.  My coworker has infertility issues and referred us to them.