December 29, 2012 – A New Chapter

I am sorry for the tardiness of my update.  The holidays were a whirlwind for us!  On the 24^th we met with the fertility doctor.  He was nice, really smart, and talked really fast.  I am hoping he was talking so quickly because he knew Doc could follow and that isn’t how he talks to everyone, because not everyone has had biochem and understands neurochemistry.  If it had been just me he would have had to go slower.  If your doctor ever says things you don’t understand feel free to interrupt and make them explain.  Doctors spend time with other doctors and they tend to forget that not everyone knows the Latin name for everything.  Doc is a big fan of the big words and I regularly make him explain things in simpler terms, because I am afraid he forgets when he speaks with patients. 

We did learn a ton.  For one thing: Clomid actually stays in the body for 35 days.  That is the reason it lengthens cycles.  Clomid initially tricks the brain into thinking you have too little estrogen, so it sends a signal to the ovaries telling them to ramp up production.  This increase causes hyper ovulation; which is why Clomid is a great fertility drug (although they initially thought it would be birth control.  Being part of that study must have sucked.)  However, when you use Clomid for several months your brain gets a little confused because you start taking more Clomid before the previous treatment has worn off.  Eventually it leaves you with excess estrogen building up.  This build up confuses your brain into thinking you have too many estrogen receptors and can actually cause depletion in the number of estrogen receptors available.  This is not a good thing to have happen when you are trying to get pregnant because you need estrogen receptors in order to get the signal to ovulate!  The doctor told me it was probably a good thing that I took myself off of it last month.  I am feeling very grateful that I listened to my body and gave myself a break when I most needed it. 

The doctor also said Clomid sucks.  It has horrible side effects and makes people feel terrible.  I really didn’t learn that, but it was nice to know I am not completely insane for struggling with the side effects. 

This cycle will be the last cycle where I take Clomid.  Ever!  J The only reason I am still on it this month is because I started it 2 days before seeing the new doctor.  Next month we will switch to Femara.  He said it will have fewer side effects but accomplish the same thing. 

He did recommend that we move to IUI (intrauterine insemination).  He explained that there are 2 challenges we humans face in getting pregnant.  The first is ovulating a viable egg and the second is getting a healthy sperm to that egg.  We increase the number of eggs I ovulate with the drugs in hopes of producing a healthy one.  The lab will wash Doc’s sperm so that we are left with the healthy fellas.  They then thread a catheter through the cervix and deposit the sperm at the back of the uterus during ovulation so that they have the best chance to reach the egg.  The shorter distance to the egg also means my body has less time to fight the swimmers off.  The doctor said that using this method 2/3rds of his patients become pregnant within 6 sessions.  The sessions aren’t cheap though, so we don’t know if we will be able to do 6.  Certainly not 6 in a row which would be more than $2,400!  Infertility isn’t cheap. 

We are starting this month. J I have to start taking a ClearBlue Easy fertility test every morning starting on Monday.  As soon as I have my LH surge I call the clinic and schedule an appointment for the following day.  Doc has to give his sample and then an hour later I have the IUI done.  It sounds pretty easy and hopefully it is.  J

Just a product note for those of you trying: I had previously been using First Response ovulation tests but the doctor recommended I switch to the ClearBlue Easy.  I have both this month because I already had the First Response kit at home, but the CBE kit is MUCH better.  First, it gives you a smiley face when you ovulate and a circle when you don’t which I find to be more rewarding than the daily NO I get from FR.  Second, if you don’t use all of your CBE tests (they come with 20) you can use them again next month.  FR’s version shuts itself off after you get a YES, so it can’t be used again which is very wasteful and since the kits are $35 a pop I will go with the one that I can use all of the sticks on!  Finally CBE packages the sticks separately so they can store for a month.  FR has them all in bag with warnings about exposure to moisture ruining them.  CBE wins hands down; I can see why he recommended it!  I like doctors that research products to recommend to patients.  Doc does that with formula brands and other baby items, so of course I think it is brilliant! 

December 04, 2012 – Another Opinion

We are at a fork in the road.  We can keep doing what we have been doing or we can try intrauterine insemination (IUI, AKA: artificial insemination).  Either way I am back on Clomid just before Christmas.  If we keep going the way we have been it means that Doc has to be available for intercourse every other day for about 2 weeks.  This wouldn’t be a problem if he had chosen any other profession.  It turns out working with sick and dying kids isn’t super great for the sex drive.  Not only does he work crazy long hours, but the things he is exposed to during that time isn’t exactly helping maintain a sex drive.  For example, right now he just admitted a set of twins into the NICU and was on call to admit another set.  That is 4 sick newly born babies he will work on just before coming home.  Not exactly a turn on.  Not to mention the stress of working on sick children every day. 

Our other option is IUI.  If we choose IUI Doc has to be available to give a sample 1 day, but we don’t get to choose the day.  When my hormones surge I call the clinic and they set up an appointment within 24 hours to do the insemination.  Doc would need to be able to go to the clinic and produce a sample.  It sounds like a no-brainer; 1 day vs. 14?  Trouble is that he has no control over his schedule and he can’t request time off to go masturbate.  Shocking, I know.  Regardless of our choice it adds stress to his life because I need him to be home and the hospital needs him to be there.  I also still have to take Clomid or possibly take injectable drugs (a terrifying thing for me) in order to continue.  Doing that without knowing whether or not Doc will actually be available to provide the sperm is not an easy thing. 

We will be discussing all of this with a new doctor.  We are not changing doctors; we are just adding a fertility expert to the team, because my doctor doesn’t perform IUI in his office.  On Christmas eve we have our first meeting with him at the fertility clinic.  We plan on talking about all of our options with him.  I will let everyone know how it goes.