IVF #1: Stalled By The Cyst Monster

monster

I went to my baseline appointment bright and early this morning. I was feeling pretty pumped. My ovaries, however, were not.

Right at the beginning of the ultrasound the doctor said, “You have a cyst on your left ovary.” On the screen it looked like a gigantic monster cyst. She said it was about two inches. Ok, maybe not jumbo-sized, but that still seems kind of big to me. There was no evidence of any cysts at my ultra-sound two weeks ago. She said that cysts are normal, but this one was just had “really bad timing.” You can say that again.

In addition to the cyst issue, I only had a few follicles total. I had 20 two weeks ago. I don’t understand where they went and why they decided to peace out. I get that the cyst might have effected the follicles in one ovary, but even the cyst-less ovary only had three or so. I asked her if that was the birth control’s fault, like maybe it over suppressed my reproductive system, but I didn’t get a clear answer on that.

She said we had three options:

1. Make sure the cyst is not making estrogen. If it’s not, we could go ahead with the cycle as planned.

2. Stay on birth control pill for another couple of weeks and then reassess.

3. Stop birth control, wait another full cycle and then start again. She said there’s a possibility that she’d change my protocol and start the next round with no birth control pills.

She told me that she would least likely want to go with option 1 because I had so few follicles. She said, “Maybe this just isn’t the best cycle to start.” My heart dropped a little when I heard those words.

My bloodwork came back this afternoon and showed that the cyst wasn’t making estrogen. So I have that going for me. The plan now is to stay on birth control ’til Monday, repeat the ultrasound and then meet with the doctor afterwards to discuss what to do going forward. I’m glad we’re meeting with her again because I have a bunch of questions. But if the birth control is over-surpressing me, which it seems like it is, then things aren’t going to look any better on Monday, right? And if we have to take off another cycle, I’d really rather get started on it than delay the inevitable.

My doctor kept saying that we need to focus on the end game and not on the short term. I completely agree with her, but I was so excited to start. I know another month and change isn’t a huge deal in the long run, but I’m not getting any younger. I feel like all of this waiting is starting to pile up.

Curve balls, man. They get you every time. I was positive that this first IVF would go smoothly. I didn’t have a feeling either way on if i would get pregnant or not, but I felt strongly that the process itself would be pretty straight forward. Har-har-har, the joke was on me.

To put it mildly, I am really bummed.

Has anyone out there in the blogiverse had a cyst stop treatment, or had a lower follicle count at their baseline than they expected?. If so, please share your stories!

IVF # 1: Game On

Stitch-Therapy-I-Surrender
[image credit]

IVF is officially underway. I took my first birth control pill today (I will never get over the irony that in order to get pregnant with IVF, you need to take birth control pills), and I’ll be on those for 2.5 weeks. I also had a baseline ultrasound this morning. Apparently, I have 20 follicles total. For anyone reading that’s not a fertility nerd: follicles are the sacs that house the developing eggs. For anyone reading who’s been through IVF: Do you know if 20 follicles at baseline is an indicator that I’ll get around 20 eggs at retrieval?

On that note, I just wanted to warn my real-life friends and family reading ye olde blog that I might be getting super technical on here over the next few weeks. Here’s why: one, because I am a fertility nerd and I love the the nitty-gritty details of the process, and two, because it has been helping me to read others’ in-depth IVF experiences. So if I can help anyone who comes after me, score! Anyway, just throwing that out there. I hope you beautiful people keep reading, but if you need a break from the ovary talk, I totally get it.

I’ve been thinking a lot about the word surrender lately. Last week, as the reality of actually beginning IVF drew near, I started freaking out. I thought I was totally ready up until that point. But then, I don’t know. I started thinking, holy hell, what if I go through all of this and it doesn’t work? What then? I mean, I always knew it might not work, but as the start date got closer, it really began to sink in. I actually questioned, for the first time, if we should be doing this at all. I wondered if we should just give up instead of facing that potential disappointment.

I think at the root of all that freaking out is the fact that I have no control over this process. All I can do is take the right meds at the right time and show up for my appointments. The rest is up to God or the Universe or whatever else you believe in. If it was all up to science, IVF would work every single time the numbers were favorable and the conditions were good. But it doesn’t. Sometimes, there are perfect embryos, but no pregnancy. Sometimes a couple seems to have no chance, yet somehow, it works.

Everything in me wants to fight this lack of control. I want to take IVF and bend it to my will. I want to make it work. But I can’t. The only thing fighting will do is make me crazy.

My therapist, who is this super-spiritual hippie type, often tells me that she believes each soul chooses their path before being born because of the lessons they need to learn in that lifetime. I’m not sure what I believe about all of that, but I do find her words comforting. It makes me stop and think: What do I need to learn from this process? Even if IVF doesn’t work, how can it enrich my life, make me a better person?

And, most importantly, what can I gain by just letting go and seeing what happens? I don’t know the answer to that, but I do know that I have nothing to lose either.

So here I go.

This is me, surrendering.

Let’s Get Luteal (Visit With The Spesh: Part III)

It’s been way too long since I’ve talked about my ovaries. I know you’ve been waiting in anticipation, so I won’t leave you hanging any longer.

First things first: this visit was not as awesome as the last two. The doctor was an hour behind and rushed and short with us. I know she doesn’t need to be our best friend or anything, but since fertility is such a sensitive and intimate subject, it’s upsetting to me when doctors are anything less than friendly and focused.

I showed the doc my data for the last three-and-a-half months and all looked well. Except: the luteal phase. The luteal phase is the time between when you ovulate and when you get your period. Ideally, it should be around 14 days, but no less than 10. Mine were about 8, on average. The theory is that if your luteal phase is too short, an embryo might not have enough time to implant, even if the egg is fertilized.

Thanks to this great book called Taking Charge of Your Fertility, I had suspected this luteal phase business was a problem way back when, long before I saw the specialist. But I was hoping that since I had recently stopped taking birth control pills at the time, my body would regulate itself after a few months. Obv, it didn’t happen.

The doc gave us three options:

1. Do nothing for three more months. I could still get pregnant despite my short luteal phase.

2. Have my cycle monitored for a month to provide the doctor with more accurate data. This would require an ultrasound every other day from day 12 ’til whenever I ovulate. Then take no further action for the next two months.

3. Have my cycle monitored for a month and take a progesterone suppository for three months. Not enough progesterone after ovulation often causes short luteal phases, so the suppositories would hopefully take care of that. This third choice is the one the doctor was leaning towards.

At the end of this three-month journey, if I’m still not pregnant, she wants us to try Clomid, which is a medication that makes you ovulate earlier. It also has many side effects, including a 5-10% rate of multiple births. 10%? Um, that’s one in 10. That’s kind of a lot. And sure, twins would be sweet. But twins also mean a potentially more complicated pregnancy and that is scary stuff.

She also emphatically said to not take the herbs my acupuncturist prescribed me. I am particularly bummed about this because I really wanted to try them. In the end, though, I don’t feel comfortable going against her super-strong recommendation. She says the herbs aren’t regulated or tested, and I see her point, of course. But Chinese medicine has been around for thousands of years. It’s got to be doing something right, no?

So that about sums it up. I found myself crying in the car after this visit. Part of it was probably because of the rushed manner of the doctor, but I don’t think that’s enough to justify tears. Tim asked me if I could pinpoint why I was so upset, and at the time I really didn’t know. But now that I’ve had some time to think, I’ve arrived at this conclusion: short of doing nothing, either option we choose means I am officially starting down the scary road of fertility treatments. And even though I can get off that road whenever I want, it still feels like I’m choosing a path and I’m committing to following it.

Also, while Tim and I can talk to death about which option to choose, ultimately the final-final decision comes down to me. Because it’s my body. And right now that feels like a lonely place to be.

What will we do? I don’t know. They always say to listen to your gut on these things, but right now my gut is a jumble of confusion. They also say that doctors don’t know everything and you don’t need to listen to them all the time. And this is true, but doctors also have the benefit of knowledge and experience that I don’t, making it really tricky to know when not to follow their advice.

Should I do something or do nothing? Should I be patient or proactive? Am I starting down the road to fertility treatments too soon? And finally, do any of those other things matter if there’s a healthy baby at the end?

These are valid questions, but right now I have no answers.

Visit With the Spesh

Me with my new best friend, almonds!

Last week Tim and I went to see a fertility specialist.

I’ll go ahead and begin my very first post with some over-sharing. Prior to this specialist visit, I hadn’t gotten a period in months. Four months to be exact. This has been a source of great frustration and angst for me. Tim and I are ready to have a baby, oh, like, now, but that’s not going to happen without the ole monthly cycle. I stopped taking birth control pills in October. Since then, I’ve had a few regular periods, one very late period, and then they just disappeared altogether.

I went to see an OBGYN after a couple of months of this no-show business. The doctor ran some basic hormone tests, seriously freaked me out by saying I might be in early menopause (sayonara, dream of having children), and sent me away with a prescription called Provera. Provera is basically progesterone in pill form. You take it for five days, and once you stop, the progesterone withdrawal is supposed to bring on a period. It didn’t work. Boo.

Luckily, my hormone tests came back normal, so early menopause was out, along with a variety of other scary things (sigh of relief). But still, no period. Hence, the specialist referral.

Now, onto the visit: From the moment we stepped into the office, I knew we were in good hands. The receptionists were friendly. Friendly. This is rarity in my experience. Maybe it has something to do with living in a city, I don’t know.  When I walked back to get my blood pressure taken, etc., a woman passed by and smiled at Tim and me. A real, genuine smile. Even though she was wearing a breezy summer top and not an imposing lab coat, I knew this was our doctor, and that made me very happy. After a few minutes, we went into this woman’s office and she asked both of us a million, billion questions. The whole session felt very personal. She explained everything thoroughly and was careful and considerate of our feelings. Tim and I loved her. After a stretch of bad doctors and OBGYNs, this was a much-needed breath of fresh air.

Her diagnosis? I’m not eating enough fat.

Wait, what? You mean, it can really be as simple as that?

I had lost 20 lbs for my wedding last August and kept it off for a year (more on that in another post). She said that, even though I am a normal body weight for my height, I am being too careful about what I’m eating, and the lack of fat is causing my body to go into self-preservation mode. She ran some more blood work and instructed Tim to get a sperm analysis, but seemed confident the fat was the problem. We have another appointment with her in a couple of weeks to go over the results.

The day after the visit, I got my period. For the first time in four months. A few weeks ago, Tim and I went on vacation and I ate my face off. I came back from that vacation 6 lbs heavier. So I think it took that extra six pounds to get my body working again. Seems like pretty good evidence to support the doctor’s theory.

I’m going to continue to diligently add more fat to each and every meal. And hopefully this is the beginning of a new era, an era where my period comes every month on schedule. An era that will hopefully bring about what I want most in the world right now: a pregnancy.

Now if you’ll excuse me, I need to go eat some celebratory almonds and avocados.