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Posts Tagged ‘clomid’

During my first medicated Clomid cycle, at the CD11 ultrasound, the doctor saw a 5mm polyp. At the time, he said that anything under 1cm was not really significant and therefore not worth removing. Since then no one has mentioned ever seeing it again so I was hoping it went away on its own. Well it popped up again during the saline sonogram today. It measured 7mm at the longest end so it’s still what the doctors would consider “very small” but the doctor who conducted my sonogram told me that she would recommend getting it removed via hysteroscopy. If you’re gonna spend the time and effort doing IVF, you might as well try to go into it in as good of shape as possible, right? So this is likely going to delay the starting of my IVF cycle and it’ll probably also make me have to take some time off work (on a new job!!! yikes) so not really happy about that, but I’ll do whatever the doctor tells me to do because I’m too tired to try and come up with my own ideas. On a positive note, I did not have Ashermans syndrome, fibroids or any other issues. Lets get rid of this polyp already.

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I am going to think out aloud here because I want to have this conversation with my RE at our consultation. I’m going to ask him about laparoscopy and he’s going to tell me it’s “elective” and that it’s up to me if I want to have the procedure done. So I want to think this through knowing where I am at right now.

So the whole fertility treatment process for “unexplained” infertility is a basic elimination process. As follows:

Clomid/Femara combined with IUI

The IUI procedure effectively eliminates any issues with sperm not getting through the cervix and allows a larger amount of higher quality sperm to get closer to the egg(s). Multiple eggs obviously increases the chances of conception. But it doesn’t eliminate egg quality problems, sperm/egg interaction problems or implantation problems. This is where I am in the process now and it hasn’t worked out so far.

Injectables combine with IUI

This is plan B for superovulation and IUI. Injectables are more stimulating and I suppose that’s supposed to further increase your chances of conception. But the issues listed above are not eliminated.

IVF

Because the egg and the sperm are brought together on a cute little petri dish, IVF eliminates the need for the sperm to find it’s way to the egg at all. Also visible now and possibly prevented are any sperm/egg interaction issues, i.e. any issues with the sperm not being able to penetrate the egg, too many sperm penetrating the egg etc because the technician makes that magic happen in the lab. It also has the added benefit of giving you some idea of the quality of your eggs. But IVF doesn’t eliminate implantation problems because after transfer, the blastocyte still needs to be able to “hatch” and embed itself in the uterine lining and many other steps for it to become a viable pregnancy.

The thing is…none of these procedures address implantation issues. If you’ve got that, it appears that you are totally fucked. And while Laparoscopy can help diagnose endometriosis and it’s an opportunity to clean up cysts, scar tissue and address inflammation which could interfere with follicle development and a fertilized egg traveling through the fallopian tube, apart from removing fibroids, does it do anything to help with implantation? My thoughts from all this is that, if you’ve made the decision to proceed with IVF, the only thing that I can see a lap helping with is improving follicle/egg development IF you have issues around that. (Of course if you’ve had an ectopic pregnancy then there is a medical need to get in there and do a lap so that’s a separate issue). And when you weigh the benefits of having a lap and then having to do a 2-3 month “break” afterwards, with what issues you can eliminate with the IVF procedure, the pros are not that great for someone who doesn’t feel like they have a whole lot of time on their hands. And I’m thinking that’s why my doctor and so many other doctors don’t require patients to do a laparoscopy, unless there is a visible cyst or a medical reason to do so.

Please someone correct me if there is a flaw in my thinking or if there is something that is missing but based on this, I feel like maybe the right time for me to do a lap is if the first IVF fails to give the IVF elimination plan a chance to eliminate some of the obstacles. But then again IVF is expensive and physically intense and I would love to give the first IVF it’s best shot at working with a cleaned out inside. Maybe even a clean slate for when I get to injectables/IUI! See now I’m faltering again…I wish there were ANSWERS!

I’m not even at IVF yet and I’m jumping the gun but sometimes the act of planning my shit out helps me relax and take back control. Would love to hear others thoughts on this and please point out the flaws in my thinking. I am just pulling this out of my ass and trying to distract myself from the latest failure.

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So far, Femara seems to be better than Clomid. I haven’t gotten the headaches that Clomid gave me and I don’t feel as agitated when I’m going about my normal business, but when I start talking about something that annoys me – the anger! It burst out of me! Also, yesterday, I wanted to go to IKEA and my husband didn’t want to, and I had a melt down. I took a shower, I climbed into bed and cried. It was so stupid. And you are probably reading this thinking…and Clomid made you even more of a bitch than this? The answer is…hell yes it did. I hopefully will not yell at my co-worker this time and say things like “What the FUCK is wrong with you!!!!!” or anything like that. I am very curiously awaiting my CD10 ultrasound. Friday could not come soon enough. I want to know what is going on in there. I’ve had some mild cramps today which is kind of weird and makes me nervous. I also want to know what is going on with the polyp. I’m praying that it went away (or hasn’t gotten bigger). One more full day of taking this Femara stuff and then we wait for Friday. GROW FOLLICLES GROW!

So what annoyed me yesterday was this girl who is the wife of a friend. She found out that we are having problems conceiving and she approached me at a party last week and said “I heard about what you’re going through. We have SO much in common, unfortunately.” So we made a date and met up to talk. She asked me to tell her my story and so I gave her the quick run down – not too much detail as I don’t know her that well. And I ask her how long they have been trying and she says, oh since November 2008. WTF! November 2008? Isn’t that like…FOUR months ago? How do we have anything in common? I’ve been trying for FOURTEEN months. So I politely said, oh. well, I’m way ahead in the process than you. And she says, “yeah but not by much”. Are you fucking kidding me? It takes the average person at least 9 months to get pregnant (some sources say 18 months). And she’s been trying only four. I felt so tricked into telling her my story. I felt so annoyed that she’s this upset about not getting pregnant after 4 months that she wanted to consult me, the only other infertile she knows, on it. I just couldn’t sympathize…until my husband, sweetly reminded me that I too, was frustrated at 4 months. Call it a woman’s sense. I just KNEW that something was wrong. And maybe she does too.

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femara It’s CD2 and my doctor has made a decision to switch me to Femara or Letrozole as it’s also called. The first pill is sitting in front of me as I’m typing. I need to get a glass of water to down it with. Femara is weird. It’s primary use is for breast cancer treatment. Its similar to Clomid in effect and it acts as a superovulation agent but it wasn’t designed to be used for fertility and the pharmaceutical company that makes it has never done the testing for it to market it as a fertility drug. I wonder if a bunch of women who were getting treated for breast cancer started getting pregnant with twins and they were like oh. sweet. it’s a fertility drug too. Anyway, the plastic pill bottle says: Do not use this medicine if you are pregnant or plan to become pregnant. Ummmmmmmmmmmm. There are studies that show that Femara actually causes birth defects in women who are taking it DURING pregnancy but not necessarily BEFORE pregnant. It’s still scary. I hate hate hate any drugs. You just don’t know what they are doing to you. It freaks me out to no end.

The reason for the switch is that he felt that the lining of my uterus was too thin when we did the ultrasound at CD10 last month when I was on Clomid. I had thought that Clomid was something that over time thinned the lining, not immediately. I suggested maybe taking progesterone with Clomid but he just said it was ok to switch to Femara. Why do I constantly feel like I’m suggesting things to my RE? And then when he says ok, I feel weird because me, the non-expert, had made the suggestion and so it’s like I’m prescribing my own treatment. It’s not that great of a feeling. I would love to hear more from other people that have been on Femara. I am going to go on a blog search now.

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Ugh. I am depressed.
I went in for the CD11 ultrasound today and found out that:

a) i have a 22mm follicle (but i’ve got only ONE follicle!)
b) i have a 5mm polyp in my uterus

WTF! I am so fucking pissed off. I’ve never had a problem ovulating so if all clomid is going to do is give me the same ONE egg and then on top of that give me a fucking polyp which I’ve never had before, this is bullshit! The Dr who did my ultrasound said that it probably wasn’t a big deal but she would send a message to my doctor about the polyp. PROBABLY not a big deal…but possibly maybe a big deal? From what I’ve read online, polyps are common but they can affect your fertility. 5mm is not terribly big in polyp standards but still…what wasn’t there before is now there and I blame the clomid! It doesn’t look like I’ll be able to do the IUI this month as I’m leaving for Mexico on Thursday so this will be a timed intercourse cycle. But with the same old single egg and a polyp, the chances of pregnancy have only decreased from a non-clomid cycle. Frustrated does not begin to describe what I’m feeling right now.

Update: read somewhere that 22mm follicle is a mature follicle and that clomid doesn’t necessarily produce MORE follicles but helps with producing bigger and BETTER follies. so fingers crossed that this single 22mm sucker is a superb follie.

Newer Update: The IUI coordinator called and said that I have two follicles that we are shooting to get mature. They are each at 13mm and 14mm right now so she wants to give them a few more days to “ripen” and then wants me to take the HCG shot tomorrow night. Apparently the larger 22mm follicle is considered to be too large and of no hope. I’m not sure why the u/s technician and the IUI coordinator are telling me different things but I like what the IUI coordinator is telling me better! Unfortunately the IUI needs to be scheduled for Thursday but we are leaving town then so it’s definitely going to be a timed intercourse cycle unfortunately.

Newest Update: My RE says that he thinks that I really did only have one mature follicle. Which is it motherfuckers! Stop telling me different things!

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yesterday was our first appointment with the reproductive endocrinologist. a friend asked me if i was excited and i really wasn’t sure. i guess i felt “excited” in the sense that we’re doing something about the issue and being active about it makes me feel better. but then again, who knew that i would have to be paying someone money to help me have a baby?

our doctor was really nice and my husband and i both liked him immediately. he looked at our tests and did a review of our history and said, well what we have here is a case of “unexplained infertility”. in other words, we both look good on paper but the magic just ain’t happenin’. his advice? get started on a dose of 100mg of clomid and then try 3-4 round of IUIs.

we’re now letting the information marinate and are in discussions on when to get started on the IUIs. my friend who is a naturopathic doctor told me to do all my tests (and find out that we’re both fine) and then just forget about it for 6 months. SIX MONTHS! thinking about all this actually really stressed me out last night. i can’t imagine another year going by without successfully getting pregnant, so trying again naturally for another six months seems impossible. i think it will break me. some of my friends will start trying for their second kids this year and others will get married this year and have a baby before me. even though i’m happy for everyone who gets to have a baby, every time i’m told that someone else is newly pregnant, it kills me inside – because life is not fair and i’m not sure why it’s not happening for me.

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