Round 1 of Clomid

I made it! I'm through!

I have just finished my first round of 5 pills of clomid. I had to take the Clomid once a day for 5 days from CD2-6. This little pill will help my system produce more of the hormones it needs in order to mature eggs to ovulate.

I had a fairly smooth ride with the Clomid thankfully. I have read of people having shocking headaches, nausea, hot flushes... Thankfully I only really experienced one symptom - nausea.

I didn't start to experience the nausea until CD4 (2 days into taking the Clomid). I then experienced it each day after that until the day after I finished the meds. It got worse each day culminating with the 5th day of taking the pill. I ended up with my head over a public toilet while shopping at Harbourtown! Eww! Thankfully I wasn't sick in the end but yuck it wasn't nice! I drove home with an empty shopping bag in the centre console of the car ready just in case.

So now it's on to the tests to see if I am likely to ovulate this month! Today being Monday (CD7), This is what's in store for me this week:

• Tuesday CD8 - Blood test. This is to check my hormone levels which will indicate if I am likely to ovulate and also whether it looks like I will release more than one egg. If my levels are greater than 2000 then we will be advised against trying to conceive this month as the chance of multiple pregnancy will be greater.
• Thursday CD10 - Ultrasound. This is to measure any eggs (follicles) that are present. If there are greater than 3 eggs measuring 16mm or more, then again we will be advised to avoid trying to conceive due to the risk of multiples. 

So that's what I'm doing this week. What is happening in your world?

The Clomid Cycle

I have started my first cycle of Clomid (Clomiphene).

I'm both excited and nervous about starting this journey. Clomid can give you some side effects such as nausea, breast tenderness, headaches and abdominal pain. Your body is doing some pretty significant stuff while taking this medication! Clomid works by stimulating an increase in the amount of hormone that helps to grow and release a mature egg. Basically, I have eggs but due to the hormone imbalance and other factors, my eggs just don't mature enough to release - ovulate. This medication will give it a boost of good hormones in order to make an egg mature. 

So my month is pretty much mapped out for me and detailed by my specialist. I've talked about CD's in the last post but just for a refresher - CD = Calendar Days - the amount of days since the start of my last period. 

Here is what a month of Clomid looks like:

• CD1 - Start period.
• CD2 - Start Clomid - 1 tablet/day x 5 days.
• CD8 - Blood test.
• CD10 - Ultrasound visit to the specialist.
• CD21 - Blood test.
• CD29 - Pregnancy blood test.

Phew - are you tired just looking at how much work and visits to medical facilities I have to do? They really do monitor you the whole way through the month!

Here is a breakdown of what each of these tests are looking for:

• CD8 Blood test: This blood test is to check my levels to see if it looks like I have eggs that are going to be mature enough to ovulate. If my levels are higher than 2000 then we will be advised to cancel trying to conceive that month due to a risk of multiple pregnancy!
• CD10 Ultrasound: This ultrasound is to see if there are any eggs ready to release by measuring the diameter of eggs seen on the scan. If there are more than 3 eggs measuring larger than 16mm in diameter then again, we will be advised to cancel trying to conceive. 
• CD21 Blood test: This blood test is to see how my progesterone levels are. A high progesterone level will indicate that I did indeed ovulate! Hurray!
• CD29 Blood test: To check if we are pregnant!

I am currently on CD4 (3 days of taking Clomid - 2 to go!) So far I have only had some nausea and a bit of fatigue/grumpiness. Nothing major thankfully but the smell of my favourite herbal tea this morning nearly sent me to put my head over the toilet bowl!

So - here we go!

PCOS

PCOS. What on earth does that mean?

My diagnosis of Polycystic Ovarian Syndrome makes a ton of sense. After all these years I can finally put a name to what is wrong with me.

Ever since I began my monthlies I have been irregular. I never settled down to the 4 week cycle and it bugged me to no end. With cycles anywhere between 3 weeks to 11 weeks, I always knew something wasn't right. I saw a gynecologist when I was 17 who performed a laparoscopy but had no findings.

The Encyclopedia defines PCOS as:

Endocrine (hormonal) disorder in women, characterized by high levels of male hormones (androgens) and infrequent or absent ovulation. It causes a high proportion of female infertility cases. Symptoms vary but often include increased serum concentrations of androgens,insulin resistance, hirsutism, acne, and obesity. Menstruation may be irregular, absent, or excessive. The ovaries are usually enlarged and contain cysts.
Encyclopedia

Source: womens health

It wasn't until I went back and read the symptoms of PCOS when the light bulb went off in my head and the last 13 years of my life made more sense!

SYMPTOMS:

The symptoms of PCOS can vary from woman to woman. Some of the symptoms of PCOS include:

• Infertility (not able to get pregnant) because of not ovulating. In fact, PCOS is the most common cause of female infertility. Check!
• Infrequent, absent, and/or irregular menstrual periods Check!
• Hirsutism (HER-suh-tiz-um) — increased hair growth on the face, chest, stomach, back, thumbs, or toes Thankfully no!
• Cysts on the ovaries Check!
• Acne, oily skin, or dandruff Sigh. Check.
• Weight gain or obesity, usually with extra weight around the waist *looks at latest photos of self* Check.
• Male-pattern baldness or thinning hair I don't think so?
• Patches of skin on the neck, arms, breasts, or thighs that are thick and dark brown or black  check.
• Skin tags — excess flaps of skin in the armpits or neck area a couple - check.
• Pelvic pain check.
• Anxiety or depression check - at times. I had bad Post-natal Depression with James but not sure that comes under this diagnosis.
• Sleep apnea — when breathing stops for short periods of time while asleep Hmmm will have to ask Nick if he's noticed anything...
  womenshealth.gov

I also found out that many women with PCOS go on to have a higher risk of miscarriage and pre-eclampsia (high blood pressure during pregnancy) - both of which I have had. James had to be born a couple of weeks early due to my blood pressure levels being at dangerous levels and platelet count dropping (I'd bleed out). 

Everything just makes sense now. All these things I thought weren't connected actually came from the same problem! Finally I can move on and start to work towards treating (there is no cure) what I have and working towards another baby. No wonder we weren't getting pregnant if I wasn't ovulating!

If you or someone you know has many of these symptoms, I would encourage you to catch up with your Doctor. PCOS is not just a problem if you are trying to get pregnant but can also lead to some serious problems such as diabetes, high cholesterol, heart attack, endometrial and ovarian cancer. Treatment is available and a healthy lifestyle can help. 

If you suffer from PCOS I would love to hear from you!

Trying to get some answers

James was growing and becoming a fun loving little boy. We were enjoying (almost) every minute of it! Sure there were hard nights when he wouldn't sleep, breastfeeding didn't work after 12 weeks of trying and expressing full time, and we had some hard times with reflux - but all in all it was awesome!

Around James' first birthday we decided that we were ready to start to give him a baby brother or sister. The waiting game started all over again. When we had been trying for number 2 for just over a year we went to the GP to ask for some help. I had an ultrasound done. It came back showing several cysts - 5 on one ovary and 7 on the other. I was told that I didn't have "enough" cysts (at least 10 on one ovary) to be able to be diagnosed with Polycystic Ovarian Syndrome - PCOS. We were referred to a fertility specialist in our area. I rang to make the appointment and when I was told that it was $260 for the first appointment, we decided to try to wait a bit longer. We just didn't have the money like that at the time. 

So we waited... and tried... and negative tests... and waited... and tried... and more negative tests... You can see the pattern.

We got down. We got upset. I cried many months when the tests came back negative. Nick had to pick me up again and again. When were we going to get pregnant?! Lord why are we not having another baby yet? What is wrong with me?! I can't do what a woman is meant to be able to do!

James' 2nd birthday went by. No baby. His 3rd birthday went by. No baby. It's time we have to suck it up, save money, and see the specialist. 

This was absolutely me!

September 2012 we visited the GP again who did some blood tests. They came back with Insulin Resistance and higher levels than normal of testosterone. The Dr perscribed Metformin - a drug that manages and treats insulin resistance and is often used with diabetic and PCOS patients. I was on that for a couple of months until she gave me a referral to the specialist. 

In Jan 2013 after waiting two months for an appointment we finally saw the fertility specialist. At this stage we had been trying for number 2 for 2 years and 5 months. I was so nervous about what they would find out. The specialist was so nice and put me at ease - even though he was a male looking up there! He took a couple of swabs and ordered a full slate of blood tests, an ultrasound and a test nicknamed HSG - Hysterosalpingogram. 

I had to do the blood tests in two lots as they needed to take so many different viles! I also had to do a glucose fasting test which meant no eating from the night before - get a blood test taken when I arrived at the pathology lab before drinking a horrible yucky sugar drink - sit there waiting for 1 hour and do another blood test - sit for another hour and do another blood test! My arms were aching at the end of that! I ended up with a big bruise on one arm from the sympathetic nurse taking blood in the same spot twice!

I had to do my ultrasound on CD4 (calendar day 4 of my cycle eg 4 days after I started my period). It came back with several cysts again on each ovary. The same mostly as my ultrasound a year and a half earlier. The HSG test was something I was nervous about!! I had been told by the specialist to take 3 codeine before I had the test done. A radiologist inserts a spectrum (the duck lips they use on you to open your vagina up when you have a pap smear). Then they clamp your cervix and open it in order to insert a tube into your uterus. Once the tube is in they blow up a little balloon inside to hold the tube in place and prevent it from slipping out or moving. Once everything is in place they insert a dye. If your tubes are clear the dye will show up on the xrays as filling your uterus, down through your tubes and then spill out in a cloud into your abdomen. If you have any blockages then the dye will not show up spilling out of the end of the tube.

I expected pain and yes there was some. I think perhaps there had been a small blockage as the pain occured when they pushed the dye through. I had clear tubes but the radiologist said that the pain may have been pushing some debris out of the way before it cleared the tube. This test was done on CD 8 (needs to be done between CD7-CD10). 

Last week - 18th of April 2013 - I went back to the specialist to get my results. Yes I have cysts but again not quite "enough" to be diagnosed with PCOS. The HSG showed clear tubes. The blood tests however showed more than enough data to diagnose PCOS and so the diagnosis was made. I have high levels of insulin resistance and high levels of testosterone because of it. 

I have been put on a medication called Clomid or Clomiphene. It is a common fertility drug used with PCOS patients. I will be starting this today - Tuesday 23rd of April 2013. I will detail more about this later this week and will follow through with posts about my experiences. 

I want to say a quick thank you to those of you who have written to me to express how reading our journey so far has encouraged you or someone you know who is going through fertility issues. I really hope and pray that you will get some answers for yourselves soon! I love reading your feedback and stories so please - keep them coming!

The waiting game

We left New Zealand with heavy hearts. Heavy because we were leaving friends and family behind but also heavy because we were leaving after losing our first baby. Things got a lot harder on us with two of my sister's announcing their pregnancies in close succession as we arrived in Perth - babies that would have been less than two months younger than our baby would have been. It took me a long time to be able to walk into a shop and buy them a baby gift, knowing that it would have been us needing the baby items had things been different.

We started trying again after waiting the recommended 2 months after a miscarriage and the waiting game commenced again. Nothing happened. We endured the endless questions from well meaning people "when are you going to have a baby?" responding with "We're trying!" My Mum made the joke that we should have shares in the pregnancy test business - the amount of tests we went through! It got to the point where I just didn't expect to see two little pink lines on the tests anymore.

At one year of trying after our miscarriage, we went to see the Doctor to see what was happening. He was so unhelpful and gave us our second lot of "oh you're so young, keep trying and come back in a year". Thanks. That helps.

December 2008 - we decided that we were going to really commit ourselves to praying about a baby and ... uh.... trying - A LOT. We prayed over my body that it would do what it needs to do and be able to maintain a pregnancy. We prayed over timing. We prayed over Nick's body. We prayed over the baby we were believing for - over each part of his or her body that it would be healthy and perfect. WE PRAYED!

I was due to begin my next cycle on the 23rd of December - just before Christmas. I prayed with everything in me that we would get a positive test that day. The 23rd came. Nick and I spent the day doing some last minute Christmas shopping and returned home that evening at about 8.30pm. I popped into the bathroom to do the test with such an expectant heart, inside cringing for the letdown that I had come to expect each testing time. Before the liquid had even finished covering the whole test result area we had two pink lines! I raced out of the bathroom and stopped frozen in the lounge room staring at Nick sitting on the couch.

"I'M PREGNANT!?!"

We both were shocked and kept checking over and over again the test result. I raced back in and did another one (I bought a pack of 3) and sure enough - two pink lines!! Again they were like the tests I did with our first pregnancy - a lighter pink line and a darker one. I had done so much research by this time that I knew it didn't matter how dark the lines were - just that there were two! I couldn't believe it. A baby. Finally. A BABY!

We got to share with our family our news in a way that was so memorable and special to us. We asked to be put on speaker phone when we called Nick's family in New Zealand on Christmas Day. Everyone let out excitement and it was so fun to give them a Christmas present - the news of their first grandchild / niece / nephew / great-grandchild on the way.

With my family here in Perth we shared the news while opening presents. When everyone had done with opening the presents in my parents lounge just before a big Christmas lunch, I said to my Mum "oh! I forgot! I have a card that goes with your present". I feigned disinterest in watching her read it while talking with my sister across the room. I waited and waited holding Nick's hand until she got to the end of the card

"Dear Mum and Dad,
We just wanted to thank you for everything you have done for us since we moved to Perth. You've been such a great help and we appreciate it more than you know. We wanted to give you a present to say thanks but couldn't think of a better one than to give you another grandchild - due September.
Love Ali and Nick xx"

My Mum let out a squeal and looked up at me and said "Really??!!!" I started crying and said "YES!" and we jumped up and started hugging. Everyone else in the room started asking questions about what was going on and Dad read the card and pretty soon everyone understood what was happening. It was the most perfect way I could think of to announce our news to my family and I cherish the memories.

James was born 2 weeks early via C-Section due to some complications with Pre-eclampsia. We were in shock as we had been lead to believe we were having a girl at our 20 week scan! We were overjoyed with our surprise little boy and quickly worked to replace the pink with blue. He has been such a joy for us and we love him to bits! He is now a happy, healthy, bouncing, almost 4 year old boy who makes us laugh daily. He was well worth the wait!

The beginning

Once upon a time a lovely young lady met and fell in love with a handsome young man. They married and settled down to a life filled with promise. Shortly after their first wedding anniversary they decided it was time to add another member to their small family. They fell pregnant straight away and had the 3 kids they wanted as soon as they decided they were ready for the next one. Each pregnancy and time of trying to conceive was full of joy and ease and they lived happily ever after without a care in the world....

Well, the first part of the story is true. In 2001 Nick and I met. We started dating after sharing our first kiss at our high school formal in 2002. Nick proposed Jan 15 2005 and we married Jan 14 2006. 

We decided to start trying for our first child shortly after we celebrated our first wedding anniversary. With everything you are told during your teen years - "if you have sex unprotected you will get pregnant" - "even if you have protected sex - you will probably get pregnant" - we thought it would take only one month or maybe two to fall pregnant. I guess most of what was actually taught in class went over our heads as both Nick and I had decided to remain virgins until our wedding night. We didn't need that information when it was taught and so I guess we didn't pay attention. 

We were pretty shocked then when month after month the pregnancy tests came back negative. At month 4 we went to the family planning centre in town to ask them if we could get fertility tests done and what advice we could get to help us get pregnant. We came to realise shortly into that appointment that they weren't really a family planning centre - more of a "family UN-planning centre". They didn't deal with how to plan for a family - only how to help people when they were already unwillingly pregnant and wanting to know their options. We were told to keep trying and go see a doctor if we weren't pregnant after one year. The first of the "oh you're so young, just keep trying and it will happen" pieces of advice were handed out. 

We decided to move to Perth, Australia in August of 2007 and were staying at Nick's parents house for a few weeks prior to the move. I was feeling really tired to the point where I would need a sleep every afternoon - physically not being able to stay awake. My Mum ate Marmite by the spoonful when she was pregnant with me so when I started to crave Marmite I thought that perhaps I should take a pregnancy test. It had been 9 weeks since my last cycle had started but that was nothing unusual for me. We were shocked when a pale pink line showed up next to the dark test line! After 7 months of trying - WE WERE PREGNANT!!!!

We told everyone straight away - no one told us about the "wait until you are passed the 12 week stage" rule. We wanted to tell our family and friends in person before we left for Australia. We were over the moon and so so so excited!

Three days later, I started to get a bit of a sore stomach. I didn't think much of it but went to bed and rested. The following morning I awoke to the feeling that something was very wrong. I was bleeding. With Nick already at work, I raced downstairs to his Mum and told her. With tears pouring down both of our faces, we jumped in the car and headed to the emergency room. A kindly Doctor told us that sometimes women do bleed in their first trimester and to rest and see what will happen. We headed home and I went to bed for the rest of the afternoon. I spent hours praying and crying, waiting for Nick to get home. The next morning I woke and knew that this wasn't just first trimester bleeding. Nick and I spent 11 hours at the hospital that day as I cried and cried as we lost our first baby. The humiliation of having to have a nurse come into the bathroom with you to check the 2cm thick hospital pad they make you wear to see if I had passed the baby yet. The quiet pity from doctors and nurses. The knowledge that right now you have gone from being 9 weeks pregnant to losing our already much loved baby. 

A scan the next day confirmed that we had lost the baby. Thankfully I was told that my body was doing a good job of "clearing everything out" and so I wouldn't need a D&C. We got back in the car, drove to a secluded riverside spot, and cried for 2 hours. I wondered what I had done wrong. Memories of things I had done the last 2 months came pouring back - horseback riding, spa days and trips to the sauna with the girls, eating everything that is off limits for pregnant women... I hadn't known I was pregnant until I was nearly 9 weeks. If only I had known sooner.... If only's became my thought pattern for months.

The Road to Fertility

We are often told that if you don't use contraception - you will get pregnant. For some of us this is not the case. For some of us, doing everything possible to try to get pregnant still doesn't result in a test with two little pink lines on it.

We have been very blessed with having a gorgeous son who is now 3.5 years old. It took us 2 years, 1 miscarriage, and numerous pregnancy tests to conceive him. Just before we started looking into fertility testing we got a positive test and we now have our James.

Once James reached 1 year old we decided to start trying for baby number 2. It has now been 2 years and 8 months and we have been unable to conceive yet. We have been seeing a specialist for 3 months now and finally have some answers. I am going to be posting about our TTC (trying to conceive) journey as we walk through it. I know many couples will have experienced some of what we have been through and will be going through over these next few months. Some of you will have been lucky enough to have fallen pregnant in your first month of trying. Others may be months or even years into the fertility journey. Some may be further along in the fertility track than we are and going into IVF or IUI. I hope that by sharing our story I will be able to encourage you wherever you are at on your journey.

So stay tuned and hopefully we will get to share some exciting news with you in the next few months!