The Details, Part One

Thank you all for your sweet comments on my last post. I've been anxious to share my news in cyberspace, so I'm glad that it's finally out there!

I'm 12 weeks along today, so we've known and been keeping quiet for a while. Easier said than done :-).

I do plan on doing weekly pregnancy updates - complete with belly pics - starting next week. They were pretty tedious to do every week when I was pregnant with Brenson, but I really enjoy looking back on them now. I didn't do them every week while I was pregnant with Brianna, and I wish that I would have. As a quick 12 week update, I'll say that I have been a little less fatigued this week and less nauseous in general. Hopefully, I'm coming out of that zone. I'm about 1.5 pounds down in the weight department, and even though I am starting to show a bit, I haven't unpacked any maternity clothes yet. I think I'll work on getting them unpacked and washed next week because I know I'm going to need the pants sooner rather than later. I had been experiencing serious lack of appetite, but that has also been better this week.

Okay, so now for the story of the pregnancy. Or at least part of it anyway . . . it's a long one :-).

Many of you know that I have a condition called Polycystic Ovarian Syndrome (PCOS), originally diagnosed back in 2006 then confirmed by my Reproductive Endocrinologist (RE) Dr. P in 2008. My case was pretty severe when I first began seeing Dr. P, so he preformed surgery on my ovaries in early 2008. Although that improved my condition for a while, I began experiencing PCOS flare-ups not long before becoming pregnant with Brianna in June of 2009. While I was pregnant with Brianna and for her first six months of life while I was nursing her, I had no problems with my PCOS at all. While a woman is nursing, her hormones tend to be suppressed and this was great for me! With suppressed hormones, my PCOS was under control and I felt better than I had in years. However, as soon as I weaned Brianna, I had a major flare-up. I immediately gained almost 15 pounds, had zero energy, was in pain, and my skin looked like it belonged on a 13 year old. I also experienced what felt like a delayed postpartum type depression. Now, what I should have done was immediately go see Dr. P, but that's not what I did. I waited over 6 months before seeing him again. When I did finally see him (when Brianna was about 13 months old), my PCOS was back with a vengeance and it took Dr. P a couple months to get things under control again.

After becoming pregnant with Brenson in June of 2011, I saw Dr. P for the first 10 weeks of my pregnancy. Before releasing me to my regular OB, Dr. P gave me specific instructions that I was to be back in his office no more than 8 weeks postpartum. He wanted to make sure that the PCOS didn't have a chance to flare up this time.

Fast forward to April 2012 (8 weeks postpartum). I meet with Dr. P who puts me on Metformin to help keep the cysts dormant. I am still nursing Brenson at this time, so I'm feeling great and not having any PCOS related issues. I see Dr. P for a check up again in July 2012 (everything still looks great), and then in September 2012.

As a side-note, I began seeing a chiropractor in June 2012. During my initial meeting with my chiropractor, she looked at my x-rays and pointed out the various areas of my spine that have problems. One of my biggest areas of concern was in my lower back. My chiropractor pointed out to me that the specific vertebrae that was most out of place was directly linked to the reproductive system. She then asked me if I've ever had problems in that area. I almost laughed out loud! I mean, when I have not had problems in that area??? She then tells me that after we get my back problems under control, she wouldn't be surprised to see improvements with my reproductive issues as well. Interesting.

Okay, so this past September - exactly two days after Brenson was fully weaned - I had an appointment with Dr. P. I knew that he would want me to go on birth control now that I was finished nursing in order to help keep the PCOS suppressed. However, Chris and I had decided that we were ready to start trying for baby number 3. We had always said that we wanted a "big" family, and even after infertility totally threw a kink in those plans, we knew we still wanted to do treatments for at least 3 babies. So, during this appointment, I shared with Dr. P that we were ready to cycle again, and he seriously got SO excited! It's fun to watch a doctor who is truly passionate about his job :-). He immediately whipped out his prescription pad and began writing scripts. He wrote a script for a Z-pack for both Chris and me (just in case we had any infections that could affect the treatments), he wrote a script for Provera for me (to get me cycling on his schedule), and he wrote me a script for Femara to take during cycle days 3 through 7 (to tell my ovaries to produce follicles). He also ordered us both to have lab work done, and for us to complete our patient education class (basically, a class where we learn about the meds, sign our lives away in paperwork, and learn to give injections . . . we have already taken this twice, but my clinic requires all patients to take it before cycling for each child). I left his office feeling so excited and hopeful.

Timing wise, everything worked out perfectly as cycle day 1 fell on October 1st. I had been feeling pretty crummy on the meds (Provera does that to me), and we had been having an extremely busy stretch of time. I felt horrible during our little weekend getaway to OKC, but tried hard to put on a happy face. Can you tell?

I went in to Dr. P's office on October 3rd for my baseline ultrasound. My fertility coordinator, Hannah, performed the ultrasound and actually said, "Your ovaries look great!" to which I responded, "Wow, really? That's not something I've ever heard before!" She quickly clarified that she meant great "for me" but that was still really, really good news. Such good news in fact, that Dr. P cut my Femara dosage in half (from 5mg to 2.5mg daily). I was shocked. This was the 6th injection cycle that we had done with Dr. P, and I hadn't been on 2.5 mg of Femara since our very first injection cycle that was cancelled due to poor response. In other words, it wasn't enough medicine to convince my ovaries to work. They are very lazy, those ovaries of mine :-).

I wasn't thrilled about this. I trust my doctor, but at the same time I didn't want to waste time and money. Each cycle costs us about $2500 out of pocket, so we want every single one to count. I was also worried that I wouldn't respond as well since I'm getting older. Cutting the meds just didn't make sense to me.

Regardless, I didn't really have a choice. Dr. P had decided that he wanted to try a lower dosage so that's what we did. On cycle day 8, I began the Follistim injections to tell the follicles (that had hopefully produced due to the Femara) to grow, grow, grow. Dr. P had also lowered my Follistim dose from 100 IUs to 75 IUs.  I wasn't at all sure what to expect when I went in on cycle day 11 for an ultrasound, but to my surprise I had 2 follicles growing! The one on my right side was measuring 13mm and the one on my left side was measuring 7mm. While those certainly aren't great measurements for cycle day 11, they are EXACTLY what I would have expected on the higher doses of meds. I really couldn't believe it! My follicles are just super slow growers, even with the Follistim helping them along.

I continued the 75 IUs of Follistim injections until cycle day 15 (also, October 15th), when I went back in for another ultrasound. This ultrasound found that I had one good follicle on my right side, measuring 23mm. That's actually the biggest one I've ever had, so I was pumped! We did a trigger shot that night (Pregnyl - another first for me, I've only ever used Novarel or Ovidrel in the past), and had an IUI on October 17th. Then, of course, it was time to wait.

For the majority of the two week wait, we were in New Orleans which worked out kind of perfectly. It was a great distraction! However, towards the end of our New Orleans trip, I told Chris that this cycle didn't work. I had ZERO symptoms of pregnancy. With Brenson, I began having symptoms about 5 days after the IUI (read about them here). I was very disappointed, but we had spent a lot of time in prayer over this matter, so I was determined to trust in God's timing.

The day before beta day, I was feeling very at peace with everything. I was scheduled to have my blood drawn at 8:00am on Halloween (a full two weeks after the IUI). Even though I was already pretty sure the answer was no this time, I tested at home the night before my beta. I used a digital home pregnancy test and a regular home pregnancy test.

Both results were negative.



To be continued . . .