How Did We Get Here?

I married my best friend in September 2012. The hus-b (as he will henceforth be affectionately referred) and I knew we wanted a baby soon after. Initially, our plan was to not try to NOT get pregnant, enjoy our new marriage, and see what happened. Several months and trash bins full of negative pregnancy tests later, we decided to actively try. Between February and October, we tried everything from tracking my periods, to ovulation predictor kits, to iPhone apps, and everything you can imagine in between.

In November, I had my annual check up at the “lady doctor” and raised my growing concerns. Not only did my doctor not do any blood tests (relatively common and routine for a yearly), but she assured me that I was young and impatient and I should just give it time. I was defeated. When the hus-b got home that evening I relayed the information to him along with my skepticism of her (lack of a) plan. The hus-b sees things very much in black and white, and if a doctor said not to worry, then in his eyes, we shouldn’t question it. You see, he believes that someone in any given profession will certainly know more about every aspect of that field than anyone not in that profession. I see a lot of gray area. I trust my body more than I am willing to trust a doctor, and if something feels off, there is no chance of me ignoring that in favor of even an expert opinion. As with most things in our marriage, we compromised. I held off on seeking out a second opinion until January.

I had my first (and to date only) appointment with my new doctor on February 19th 2014. She was surprised and even a little concerned about the advice I had been given by my previous doctor and decide to start with a long list of blood tests. I left the office feeling a little less crazy and a lot more heard out. The results came in rather quickly and I got a phone call saying that everything had come back normal. I felt defeated once again. Luckily, that doctor didn’t believe that no news was good news and referred me to a Reproductive Endocrinologist to run further tests. She said that she would match me with an RE that accepted my insurance and they would call me to schedule an appointment.

So I waited. and waited. and waited some more. During this wait, we bought a beautiful house, moved in, decorated, and the urge to fill the extra bedrooms was almost enough to make me go crazy.  I occupied my time with planning a housewarming party and inviting my family to come and stay with us. The week before the party, I got a phone call from a number I didn’t recognize while I was at work. It was the call I had been waiting for and I sent it straight to voicemail out of habit. I weighed my options, I could wait and call when I got home, potentially miss their office hours and wait another 2 months for them to call back, or I could call form work and have one of my employees potentially hear a very private conversation. I called from home. Voicemail. Luckily it only took a few days for them to call back and we were able to schedule an appointment for the following Tuesday.

I was so excited, I immediately told the hus-b and tried to sneak in the fact that he would also need to schedule a semen analysis. He was not pumped. I agreed to go and see what they had to say and make sure it was a doctor I wanted to continue with before he had to make his appointment.

I left for my appointment an hour early, unable to sit with my nervous energy at home any longer. Upon realizing that the office was less than a mile from my house, I called the hus-b to meet me for lunch across the street. He has a pretty flexible lunch time at work, so it worked out nicely. We drove away from lunch in opposite directions and I anxiously walked toward the RE’s building. I opened the door and all I saw were couples. Shit, was I supposed to have the hus-b come with me? I didn’t get an infertility instruction manual, and I stupidly (and out-of-character-ly) didn’t google “what to expect during your first appointment with an RE, and will everyone look at me with sad eyes if I don’t bring my husband?”. My fears were confirmed when the first thing the receptionist asked was, “Will your husband be able to make it to the appointment today?” Well, lady, honestly, he would have been able to make it if I hadn’t left for my appointment an hour early and had him meet me for pizza. I politely answered that he was at work and wouldn’t be coming to this appointment. She handed me a packet of paperwork to fill out and turn into her as well as a folder to bring into the appointment. I got to work.

When the Nurse Practitioner called me in, I followed her into a room with a table and three chairs, one with a computer in front of it and two across. “Fucking pizza” was all I could think. She asked all the usual questions, “Is your cycle irregular?” Yes. “Do you have bad menstrual cramps?” TERRIBLE. “How long have you been trying to conceive?” About 18 months. And some not so usual questions, “Are you of Jewish or French Canadian descent?” uh, yeah…(No follow-up question. Still have no idea why I was asked.) She said that based on the answers and my past medical history, she didn’t think I was ovulating on my own at all. She proceeded to go through every possible course of treatment and option I had, for which I was very grateful but incredibly overwhelmed. Fortunately, she sensed that and backed up to the best first treatment option. Since I don’t ovulate on my own, the likelihood of my period arriving when I was expecting it (the following week) was slim.

Her suggestion was to start me on 200mg daily of Progesterone to induce a period, followed by 100 mg daily of Clomiphene Citrate (Clomid) on Cycle Days (CD) 3-7, then followed by 2mg daily of Estradiol (vaginally) on CD 8-12, scheduling a trans-vaginal ultrasound (u/s) on CD 12 to monitor my progress and measure any developing follicles. My heart was racing. I was so excited that not only did I have a doctor that understood my concern, but she came up with a plan of action.

That night when I explained everything to the hus-b his face went ghost white. I think in his heart of hearts he truly wanted to believe that there was nothing wrong, and for me to get prescribed so much medication, he could no longer hold on to that belief. He agreed (begrudgingly) to schedule a semen analysis. I was really nervous, I wanted so bad for GOOD news that didn’t require us to have to do any treatment on his part. I got my wish when everything that they measured came back as normal or above average. One less thing to tackle.

I started the Progesterone that night. The doctor advised me to take it before bed as its side effects include blurred vision, delirium, and dizziness. Check, check, check. If I had to do it all over again, I think I would have just waited for my period to come on its own no matter how long it took. I had every listed side-effect and then some. The added hormones had me having crazy dreams, seeing things that weren’t happening, convincing myself that the hus-b was cheating (he would NEVER and I would NEVER think that under normal circumstances), crying (SOBBING) uncontrollably, and crazy mood swings.

Luckily, that was the only medication with which I experienced such intense side-effects. I started taking the Clomid on May 5th, CD 3 as directed and by CD 9 was having a pain in my side that google led me to believe was ovulation. I spent so much time reading posts on various message boards of women with the same course of treatment as me, and I was encouraged.

By May 14th, CD12, I was excited to see a (or some) growing follicles during my u/s. This time, I was definitely going to have the hus-b with me, I didn’t care if it was “normal”, I wanted him in the room with me for support and he wanted to be there so that was that. When we got there and checked in, we discovered that the u/s was not covered by insurance and immediately had to pay the total cost. Frustrating, but my excitement to see the hopeful progression outweighed the cost annoyance. We were led back to a room and I was instructed to “get naked from the waist down” and the door was closed. I looked at the hus-b in disbelief of the lack of bedside manner, and lack of a gown to put on. There was a sheet on the table so I covered my bottom half with that and sat down. The Nurse Practitioner that came in was a woman that I had never met which added to my nerves and discomfort. As soon as she started to talk though, my fears were eased. She thoroughly explained everything that was going to take place and gave the hus-b the important job of turning out the light. It was a very weird feeling to see my own uterus on the screen of an ultrasound machine. Those types of images, in my mind, are related to pregnancy and it was a little unsettling to see my own very empty abdominal images. She measured my uterine lining, which was at a 12–apparently very good, the number they look for is anything above a 7 (I have no idea what these number measure, millimeters?)  . Unfortunately, the good news stopped there. As she pointed the wand toward my right ovary, she began to point out black circles, which she explained to be follicles. One or two follicles are great and can produce healthy eggs, which would be cause to receive a trigger shot to induce ovulation. I watched as she counted 14, while explaining that at least that ovary is Polycystic. She turned the wand toward my left ovary and found the same thing. At this point, and I swear this to be true, a fleck of mascara fell into my eye and caused it to start watering uncontrollably. While she went onto explain the next steps I frantically wiped at my right eye, causing her to ask if I was okay. I was not crying yet, just had some rogue mascara. Is it even possibly to cry out of one eye?

Going into this appointment the hus-b and I had agreed that if the Clomid cycle did not work, we would take a break and recoup. But, as the Nurse Practitioner explained that I could start a higher dose (150mg daily) of Clomid THAT night plus an added .25 mg of Dexamethasone (a steroid that would hopefully cause one follicle to take the lead instead of all over 20 of them fighting for the same hormones). We would be able to act as though that day was again CD3 and schedule another u/s for May 24th. This seemed like such a good option, and had a huge success rate when used in patients with Polycystic Ovarian Syndrome (PCOS) who do not respond to Clomid alone. A category of which I became a part moments earlier. I just agreed. The hus-b looked at me and didn’t say anything. The NP left the room and told me to schedule the u/s at the front desk on my way out and I could pick up my prescriptions that afternoon. As soon as the door closed, I looked over at the hus-b who was just making a pouty face, a relatively safe response to the news that we just got, especially given my unstable mood and emotions of late. I just kind of brushed it off and tried to focus on the fact that we had another plan in place. One that  had a high probability of success with a new diagnosis, which was also a good thing to receive.

As the receptionist scheduled my u/s she noticed my CD12 fell on a Saturday and informed us that they don’t accept payment on the weekends and we would have to pay in advance. I turned to look at the hus-b and his face was stoic. I handed over my card and prepared myself for a significantly smaller budget for the next week. We silently walked to the elevator to leave the building. We had to get to work, and go on with our day, I didn’t want to get into an argument about my snap decision and the fact that we paid a large sum of money out-of-pocket that we weren’t expecting. Let alone my new diagnosis, which came with a whole new set of questions and worries that I didn’t want to invade my brain until I had adequate time to deal with them.

It took turning out of the parking lot for the tears to start. Hot, heavy, stinging tears that I tried so desperately to rationalize back into my face. I don’t have anything less than I had on my way to the doctor. I had more, knowledge is power, right? I got to work and realized that there was no chance of making it through the day. I had a meeting at 11, and could go home after that and sit with my thoughts. So I did. The hus-b came home for lunch to a crying ball of self-pity and a lot of “Sorry I’m broken!”s. He tried to use his black and white view of the world to tell me that stress and worry would only make the situation worse, and it was definitely something we could easily tackle. Especially given the fact that we already had a game plan. In my world of gray, it was important for me to sit and stew in it, I had to give myself time to mourn the fact that I have hard evidence, a name, a thing, that would definitely make it near impossible to have children without chemical intervention (or more). So I did. For the rest of the afternoon, I cried, called my mom and my best friend, talked through my gray-world feelings, and googled (as did they, I’m sure.) By the time the hus-b got home that night, I was doing much better than the lump on the couch he left hours before. We picked up my prescriptions, got dinner and came home.

Last night was night one of my new course of treatment.

This morning I was reading through message boards and googling again, and couldn’t find anything that eased my mind about what was to come. The first message board I looked at had a list of rules for new members. I don’t want a lifetime membership to this infertility club, I just want to talk (type) through what I feel to both better understand it, and hopefully help others to as well. So here I am.

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