Just Waiting...

CD 17 - Waiting to Ovulate - 100mg Clomid

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Sooooo.... not much happening over here. I'm CD 17 already and, if I had a regular cycle, would be in my TWW by now. Of course, I'm nowhere near normal, so instead I think I'll most likely ovulate in the next week or so. I don't even have any pre O symptoms so I have no concrete clues. With my new job time seems to be passing very quickly, and yet not quickly enough. I've put my sweet husband on notice for lots of romantic time in the next week or so in hopes of catching my fertile window. There's no such thing as too much sex when you're TTC!

That being said, I have no idea if I will even ovulate this month. I did manage to ovulate last month thanks to Clomid, but it's not a sure thing yet. I'm still not counting on it - can you really count on anything when you have PCOS and endometriosis and a history of many (MANY!) anovulatory cycles. Without my constant monitoring by ultrasound and blood tests, I have no idea whether I have any follicles or not. Because I do monitor my temperature, at least I will know if I HAVE ovulated or not due to a sustained temperature rise. So every morning at 6 I check my temp and hope to see a spike - nothing's happened so far!

And every day, I try to just keep living my life, just keep pushing on. One foot in front of the other, one step at a time, one breath then another. I try not to think too hard or too long about it all, it only makes my heart ache and feel empty all at once. I just booked a trip to Croatia for a week of sun and relaxation. If all works out, I'll be in my TWW by then and it will help the time zip by. I'm really looking forward to the trip - lots of beaches, wine, and culture - but of course, as always, I'd rather be pregnant. Sigh.   

Until that time, I'll try to spend my time living, not just waiting. 

Clomid Round Two at 100 mg

Well, I promised an update so here I am. As you may have noticed from the title, I'm on my second Clomid cycle (at 100mg) but my third Clomid cycle overall. This worries me a bit, as doctors normally only allow you to try six Clomid cycles before they move on to stronger drugs. My doctor has noted that we'll move on to injectibles - and I hate needles.

By now you've deduced that my last Clomid cycle ended without any positive results. I did manage to hold off testing, but I was thoroughly disappointed when my period started. I had hoped that all the signs were pointing to pregnancy! At least now I know what my PMS signs look like, as I think this is only my second natural ovulation in a year. All I can do now is look forward to this next cycle and do everything I can to make it work. Hubby and I don't have any plans to be apart this time, so at least that timing works.

I guess I shouldn't be too disappointed, as this was my first real chance of pregnancy in 13 months, it's not much a surprise that it didn't work. Any normal couple (without any infertility issues) only has a 1 in 5 of getting pregnant in any one cycle. Who knows what other issues I have lurking around the corner? 

So today I start Clomid, and I've decided to take it at night in hopes that the side effects will be less drastic, or occurring during my sleep so I don't notice them as much. I'm trying to keep my stress levels down, although with my new job that might be quite difficult. I'm even more grateful that I accepted this job as it provides a perfect 10 months of distraction. 

Not much else to update on just now. CD 3 is both depressing and exciting - depressing because it means the last cycle was unsuccessful, but exciting because it means there is a new cycle starting. I'm hoping to ovulate earlier than CD 22, and the nurse at the Fertility Clinic was concerned by my 'long cycle' last month. At 35 days, my last cycle was the shortest cycles I've had since we started TTC (the next shortest was 41 days!), so I can't even imagine having the normal, 28 day cycle! Anything shorter than 112 days is pretty great for me - I think most women with PCOS can agree. I wonder what they'll do if this is another 'long cycle'? Add more meds? I'll do pretty much anything at this point!

The Two Week Wait

Well, I'm officially 10 dpo and nothing interesting has happened. I've had so few legit two week waits (TWW) that I've almost forgotten how awful they are. The days crawl by at the slowest, almost incomprehensible rate. Every moment I wonder if I'm pregnant, if I'm not, and what I'll do next.

I've just been offered the most amazing job, which of course, I accepted. You can't let this baby making business take over you entire life! If I'm preggers this cycle, I'll make it work, if I'm not, then I'll make that work too, no worries. 

I'm trying my best not to symptom spot, but anyone actively trying to get pregnant understands what I'm going though. My nipples are pointing different ways! Let me google that and see if that means I'm pregnant! I had a slightly weird tugging motion in my lower abdomen, I must be pregnant! It's almost like a disease, this TTC! I'm attempting to not be so crazy, but let me tell you, it's hard work. 

I'm even going to attempt not testing with a real test (digital) until I'm 14 dpo (we all know how well that worked before!) in hopes of avoiding another stark-white negative test. I promise to update here as things go along. Until then, I'm excited about this new life opportunity. Keep living you life, keep building on your dreams, you never know what tomorrow will hold!

Clomid Round 2 at 100mg and Raging Side Effects

Cycle Day 11, Second Clomid Cycle (days 3-7) at 100mg

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I feel like it's been far too long since I've done any updating, but then again there wasn't much to say. I had to wait for the last cycle to end (63 days!) with the help of Provera and then to take Clomid for this cycle. Since the last round did nothing but create more cysts, the doctors have upped my dosage. 

I noticed an immediate difference from the last Clomid round to this one. My temperature was much higher while taking it, and I had some of the often-talked about side effects - moodiness, headaches, hot flashes, and crazy dreams. I'm hoping this is a good sign, and that it means the meds will actually work this time (but I'm not holding my breath!)

The mood swings side effect was the one that surprised me most, and surprised my sweet husband as well! We had friends flying all the way in from Canada to visit us that day, and I had just gotten home from a trip to Prague. I was desperately trying to make a shopping list and plan meals so I could get to the store before they arrived. As I scoured Pinterest for a child-friendly, vegetarian-friendly meal, my hubby walked in. I asked if he though baked ziti was a good idea for the first dinner and he gave me a blank stare. "What's ziti?" he asked. And that's when the explosion of angry screaming from me started, mostly about how he was being so unhelpful and trying to frustrate me and why couldn't he just make something easier?!! Why couldn't he just tell me that was the perfect meal?!!

I realized after he backed out of the room that maybe I was being a bit unreasonable. Hormones can sure make you do crazy things! Needless to say after the eruption I went to find my husband and apologize for the pulsing anger that seemed to come from nowhere. I am so lucky I got a guy that understands me and knows that something like that is so out of character that we can just blame the drugs and move on.

The crazy dreams are also very surprising, as usually my dreams fade immediately after I wake up. This time, however, my first fantastical dream was so real I had to do some fact checking after I woke up just to make sure it wasn't true! Every night has been like that since I started the pills, and now that I've finished with them I hope they will stop soon. 

Tomorrow morning I have my first monitoring appointment for this Clomid cycle. I am trying not to think about it, or get anxious about it, because the last few visits have been so disappointing. My ovaries just don't do their job! On top of all that, I leave on Thursday for a half-ironman race in France. I signed up for this back in March, praying by now I would be pregnant so I wouldn't have to complete it. Alas, here we are 6 months later and no closer to being pregnant, so I've got to at least attempt it. This all means that around my O date, I won't be near the clinic to get a trigger shot, and I'll have quite a lot of stress hormones coursing through my system. I'm half hoping my ovulation is delayed like many other PCOS-ers, and that it doesn't happen until I'm back from France but there is nothing I can count on. I'll just have to go in tomorrow, give some blood, deal with the dildo-cam, and take it from there. 

The only thing I have to cling on to is that if this cycle doesn't work, then I will be able to attend my best friend's wedding next May. I'm her maid of honor, so I REALLY want to go but she knows that if something good happens this month then I will only be attending via Skype. Her wedding date is 9 months from when I'm due to ovulate this cycle, so it's good/bad timing. That's the life of TTC, always counting ahead to the next cycle, the next possible due date, the next appointment...

Now only time will tell... if you're reading this, wish me luck tomorrow!

Reactions, Positivity, and Understanding

While visiting my friends and family in America (some with children, some with grandchildren, some without any), it was interesting to see people's reactions, responses, and comments if I chose to share my current struggle with infertility. I wasn't sure how I was going to deal with this situation - A bottle of wine in each hand? Mimosas every day at breakfast? How do you respond to a topic that consumes you when you're home but that is so difficult to discuss?

As I had guessed most people brought up the topic with me quite quickly. With more than five years of marriage, a new home and low-stress job, it looks like the perfect set-up for a family. As they eyed my very full wine glass, they would inquire, "So, are you thinking about starting a family?" and I would choose my response carefully. Usually something like, "Yep, we are trying pretty hard, but no luck so far!" Humor can make any topic seem normal. 

I had expected some of the normal responses for someone who is trying-but-not-succeeding: At least you're young! It'll happen when the time's right! Maybe you should adopt! You know all the ones I'm talking about. I had prepared myself for them as well, and mostly let them slide right over me without taking them to heart. No one is trying to be hurtful with their comments. People don't know how to react to a situation they have never encountered. They want to give advice, they want to give hope, they want you to be happy and positive and make THEM feel comfortable. And I get it - infertility is a pretty uncomfortable topic. Society has made it very taboo to talk about reproduction, and I also believe the explicit details of my journey are a private topic for trusted close friends and family (except, apparently, on this all-too-public blog, but that's something else entirely).  

So for a lot of my interactions with friends and family while on my visit to America, I lied. Instead of sharing how I really feel most of the time (hopeless, frustrated, angry, inadequate, and more...), I pulled on my brave-face mask and echo their sentiments and hide my real thoughts.  For the most part, people don't want to hear that you are not okay. They want the easy, comfortable, sanitized version. They want me to be positive and joyful like I normally am towards difficult situations in life. I can't really blame them, everyone has enough of their own troubles in their life - why do they need mine too?

One friend, however, really surprised me. Instead of a cliché comment, advice, reassurance, or positivity, she offered support and understanding. Instead of rushing to tell me how, "I would get there someday," or "It would all be alright," or telling me about her roommate's cousin's sister with PCOS who miraculously had a baby - she commiserated with me. 

"You must be so frustrated"
"It might never happen, I'm so sorry."
"I know what it's like to go through something difficult. I'm here if you ever need to talk about it"

And for that moment, I didn't feel like I was hiding behind a mask or pretending to be the sunny, positive, shiny me. I could just share my real thoughts and put everything out there on the table. I felt so free for the moment. When we said goodbye I gave her several big hugs. I don't think she even realized how important that conversation was for me. 

Everyone deals with infertility in their own way, and I don't think there is one right way to do it. I just know showing understanding and compassion instead of rushing to slap on a band-aid can do wonders for someone like me. And if you're reading this and struggling too - I understand, and I'm sorry for your frustration and difficulty. 

The Beer Trigger

With no temperature change, no response to medication, and now no husband (I left him behind this trip!), you would think I could move on and enjoy this vacation I'm taking while I visit so many friends and family. And most of the time, that's true. Between trying to get my work done, completing my training schedule, and seeing everyone, I am busier than ever. It's the quiet moments that catch me by surprise and have the ability to pull me down into the dark spiral of 'What ifs' and negative thoughts. 

Just yesterday I was flying from Chicago to LAX, when I looked at the beer I was drinking and nearly broke down sobbing. I don't WANT to be able to drink beer - I want to be pregnant! And sober! And bloated! And throwing up with morning sickness! And running to the bathroom every 5 minutes because there's a BABY sitting on my bladder! The thing I wanted the least was to be able to drink that beer. But I was on a plane full of people, and wailing and crying in a confined space is never a good idea, so I bit my lip, and (as is my new habit) pushed those feelings and thoughts back as deep in as they could go. They've tried to rise back to the surface a few times since, and I try to push them deeper still. How long can I keep ignoring them and distracting myself so I don't have to feel it? I guess only time will tell.

I had hoped this trip would be so busy I would never have a free minute to think about how long this process is taking and how long it might continue to take. But wherever you go, there you are - you can't run (or take a vacation!) from your thoughts and feelings, because they are always there with you. Instead I'm going to try to acknowledge them and just keep moving forward, one second, minute, hour, and day at a time. Because what else can I do?

Second Clomid Cycle On Its Way

With my first disappointing cycle behind me and another 50+ day cycle continuing on, I finally had the chance to visit the fertility clinic. My time during my travel in America made the days pass, thankfully, quite quickly but this next cycle was always in the back of my mind. I was always anxious, always waiting for the days to tick on.

The visit to the clinic was very brief - no more than 5 minutes. They determined I still hadn't ovulated (and most likely wouldn't), and prescribed me Provera (to bring on a period) and then Clomid 100mg for days 3-7 in hopes of making me ovulate.

I'm now on day 2 out of 7 of Provera, and I've seen my temperature increase already. More than anything I am just anxious to get on with it and have a real chance. We're back to a different kind of waiting - waiting for the end of this cycle and the start of the next one without any happy TWW maybe-I'm-pregnant-maybe-I'm-not guessing and hoping in-between.

Part of me is optimistic that something will finally happen this time around. Most of me doesn't believe that anything will. Maybe that's just a bit of self-preservation. Every time I hope, I set myself up for failure. But if I already think it's not going to work (and by some miracle it does) then I will be surprised and ecstatic. 

Only time will tell - and of course I'll be updating here as it goes along. If you're reading this, will you say a prayer and cross your fingers and think positive thoughts my way? I need all the good vibes I can get.

First Clomid Cycle (non) Update

Well I have to say, I have almost been purposefully avoiding this blog. Mostly because thinking about it just made things worse. Like sobbing, wailing, crying worse. Usually writing is extremely cathartic for me - I write it down and it lets me release my feelings and helps me return to normal.

But this time, every time I thought about it my chest got tight and I found it hard to breathe. So I took a step back, closed my laptop and just threw myself into the rest of my life. I hoped that would let me forget everything for a while and allow time for my heart to heal so I could come back a bit better.

And it is, luckily, a bit better. So what has made me so upset? Last Friday I went back to the clinic for my third monitoring session. After the bust on Monday, I prepared myself for the same news - no follicles, no estrogen surge, no nothing. When I arrived at the clinic, there was a different doctor than normal (this isn't particularly concerning), so I followed the usual routine of giving a bit of blood and then went in for my scan. With the dildo-cam inserted, the doctor searched one ovary, and then the other. My lining still looks great, but only one slightly larger (but nowhere near actually matured) follicle was present. I quarried the new doctor about if we would still take the next steps my doctor had outlined on Monday. I explained that she had said if nothing was happening on Friday, then I would start Provera and a larger dose of Clomid in order to be ready when I returned from the U.S. to start my next round. 

The doctor pursed his lips and said that no, he would not prescribe Provera or the next round of Clomid yet. Because I wouldn't be around to be monitored and MAYBE I might have a teeny tiny chance of of ovulating on my own, that I would just have to wait and see for the rest of July. When I came back, we'd do another scan and see where to go from there. I was in shock, and instead of pushing for the medication I just let them shoo me out of the office. 

I'm sure you won't be surprised when I say I cried all the way home from the hospital. There might have been a little bit of door slamming and swearing as well. How can they make me wait another f***ing month! As if I haven't waited enough already! And I'm already on cycle day 23 and nothing is happening and NOTHING IS GOING TO HAPPEN. And even if I ovulate in July, I won't be with my husband so it's a total waste!

As tears dripped down my face I navigated my car home, doing the calculations. You know the ones - where you see when each part of the next cycle will take place. My next monitoring appointment would be July 28, where they would see that I (still) hadn't responded to 50mg of Clomid. That means they would start me on Provera the next day, July 29. You take Provera for 7 days (August 4), I get my period 10 days later (August 14), take Clomid days 3-7 (August 16-20) and start monitoring on cycle day 12 (August 25) and maybe I won't even respond to that dosage. The whole process takes another month where I can't do anything. It feels like it's a never ending process that takes so much time and energy and it just makes me so frustrated I want to scream, or pull out my hair or punch something. 

Someone who is not actively trying to conceive might read this and think I'm crazy. It's just another month, they'll say. It's just a drop in the bucket compared to the rest of your life. You won't even notice. It'll just fly right by. Enjoy yourself! Have fun! Drink wine! 

Those of you who are trying (and failing) to conceive will understand, and most likely want to punch those well meaning people in the face. Just kidding, I'm not the violent type. But we aren't getting any younger and when it takes two months just to get one chance, it makes me think that the long and windy road ahead of me is even longer than I had anticipated. It's like a Disneyland line - you think you're almost to the ride then the line turns and you've got another 3 hours of waiting in front of you. Only in this case, it's 3 years. 

Sigh. Maybe I haven't allowed enough time to pass between my appointment and now. I can feel myself getting all angry and wound up, but I suppose that's better than sporadically bursting into tears. 

With nothing to do, I am only temping (although goodness knows why I even bother), and now just counting down the days until my next chance - only 45 days to go!

Second Monitoring Appointment (CD 19)

I woke up this morning with that nervous, excited anticipation that you get before a blind date or first day of school. The one where you can't wait to get where you're going, but also worried about what is going to come from getting there. It was my second monitoring appointment for this first Clomid cycle, and I was hoping (praying really), that my two, slightly larger follicles have grown and responded to the 50mg of Clomid. 

I got to the fertility clinic early, sending up a silent prayer for the clinic not being in the same area as the maternity ward, and so not being filled with pregnant, happy women. I wrote my name down on the sign-in sheet and waited no more than 5 minutes before I was called in by a kind, chatty nurse to get my blood drawn. Next was the dildo-cam, and at this point my stomach was doing flips and I just kept thinking to myself, over and over, "Please, please, please show that my follicles have grown! Please, please, please!" I waited a few minutes more on the awkward, spread-your-legs chair before the doctor and assistant came in to start the ultrasound. The dildo-cam was quickly inserted and started with my uterus. "Oh, very nice, thick lining!" the doctor exclaimed as she measured it and called out the numbers to her assistant. Well this was a good start! I thought to myself. Then she pivoted the dildo-cam to the side to check out the main feature, my ovaries. She pushed this way and that, trying (and maybe hoping too?) to find a dominant follicle. She found one slightly larger than the rest, but after measuring it she realized it had shrunk from my last visit a week ago. Switching to the other side, she searched in vain for something that might pass for a follicle. Zip, zero, nada. She didn't even bother to measure anything on the other side, it was so obvious how small the follicles were.  

I could see it on her face before she said anything. A kind smile, but also a tiny bit sad. She explained that it didn't look as if I had responded to 50mg of Clomid, and that we'd need to up the dosage for the next cycle. She asked me to come in again on Friday for one last check before they prescribed Provera again. I swallowed the lump in my throat as they left the room to let me get dressed again. I managed to make it out of the clinic before I started crying.

Rationally, I knew this might happen. It may take a few cycles to find the right dosage of Clomid, and because of the side-effects they always start with a low dose then work their way up. But my body had been showing signs of imminent ovulation - egg-white cervical mucus (EWCM) a high, open cervix, and an increased sex-drive. Even with all these signs, from the scans we can see there is no chance I'll be ovulating any time soon. I'm so angry at my body, for letting me down again and for tricking me into thinking something good was coming. Since I'll be away traveling for 3 weeks, I know that I won't have a chance in July, so our next shot is in August. It may not seem far away, but it's another 2 months down the line. It feels like no matter what I do, I'm always waiting - and even when I do all this waiting, I don't even have a fighting chance. 

When I came home from my appointment and the drive/cry home, my lovely hubby was up waiting for me to see how it went. I just asked for a hug, knowing I couldn't trust myself to explain it yet. I left myself just stay there for a while, let myself be hugged and tried to calm myself down. Then I got a lot of hugs and cuddles and kisses as I explained the appointment and results. I am so grateful to have such a loving, supportive husband, someone who I am so happy to be with, even after five years of marriage. 

So now I haven't got much choice but to keep moving on and looking forward to my future plans. I've realized there isn't a chance I'll be pregnant by the end of August, so my training for my half-ironman is in full swing (and boy can my muscles feel it!). I've got plenty of things to keep me busy and to look forward to, so I just have to push away this dark cloud, hide it in a closet or cupboard, and keep pushing forward, one step at a time. Why dwell on something you can't change? Why worry about the future when, "worrying is as effective as trying to solve an algebra equation by chewing bubble gum" (a quote from the graduation speech "Wear Sunscreen".).

Deep breath in. Deep breath out. Try not to get caught up in this moment right now. Try to see the long game, try to enjoy what you can while you can. Wine, sushi, sleeping in late, travel, spontaneity, beer, margaritas, gin & tonic... and deep breath in, deep breath out. 

First Clomid Monitoring Appointment

This morning was my much anticipated visit to the fertility clinic to see if I've responded to the Clinic. The way it works here is I show up any time between 8-8:45, write my name on a paper, and then wait until I'm called. It's first come, first serve, so getting in early is the key to not waiting too long.

Well I managed to arrive at about 8:30 (not exactly early), but there was no one else on the list above me who was still waiting to be seen. Within a few minutes they called me back to have my blood drawn. I explained to the nurse that it was my first time having a monitored cycle, and that I wanted to know what to expect. She explained that I would get my blood drawn, have a quick scan, then they would tell me when I should come back. She was helpful, friendly, and knowledgable and that definitely put me at ease. I had blood drawn (I give so much blood, it's a wonder there's any left!), and then went back to the waiting room to be called in for my scan.

I had been warned there was a bit of a line for the scan room, so I wasn't surprised when they called me in nearly 20 minutes later. It was the usual, get half undressed, cover yourself with a blanket, and wait awkwardly in the stirrups deal. Still, I find this infinitely better than my gynecologist in Switzerland who had you undress in the same room, then walk over to the seat, hop on and spread 'em (without a blanket or anything!). Anyways, I digress.

The fun dildo-wand (or if you're being technical, internal ultrasound wand), quickly inserted and the scan began. First they checked my lining - the doctor said it was a bit on the thin side, but nothing to be worried about. Next they checked each ovary - once again I could see the characteristic "string of pearls" a.k.a. cysts, cluttering up my ovaries. There was one follicle slightly larger than the others, and the doctor measured it, calling out the numbers to her assistant. She moved onto my other ovary, again checking all of the smaller cysts before finding the slightly larger one. She repeated the measurement, pulled out the wand, then told me they'd like me back in on Friday to see if these follicles are developing, or are just slightly larger cysts that will stall like all the others. 

After slipping back on my clothes I made my way home from the clinic, a little apprehensive but feeling overall positive. They could have looked at my ovaries and not seen ANY larger follicles, so this was good news!

My positive outlook only lasted until early afternoon, when we missed a call from the office and were instructed to call back. They had run my blood analysis and my estrogen and FSH levels hadn't increased in any way that suggested imminent ovulation, so they wanted to push my next visit back until next Monday. I know it's only 3 days later, but I feel quite disappointed. Only having to wait until Friday wasn't too bad - but now I had to wait a whole week to see if I've responded to the medication. And my trip to America is coming up - I don't want this to take so long that I ovulate when I'm away from my darling husband! 

I suppose there is nothing I can do until next Monday except wait, and hope, and baby-dance just in case. So if you're reading this, cross your fingers that next Monday will have better news and this cycle will offer me my first real chance of pregnancy!

That Room

You know the one I'm talking about. When you were looking at moving into that house (or apartment), you thought it was perfect. It gave you room to grow. That special place that you imagined crib, a colorful mobile, and maybe a rocking chair. Where you would arrange tiny socks and shirts and pants into tiny drawers. Where you would sing soft songs and read good-night stories and rock-a-bye-baby. The meant-to-be room that's all too silent; the room that should be filled with laughing and giggles and smiles, and yes, lots of crying too.

That room that feels so empty, and yet you can't quite bear to do anything else useful with it. Maybe if you just sparsely furnish it, you think to yourself, it won't be so painful. Maybe if you leave room for that crib and changing table, then you know there's still space. You're not giving up on the nursery you've dreamed of, just making the most of today and using the space you have.

You push those feelings back, thinking of when you first saw that room and how excited you were to fill it with happiness, joy, shining eyes and chubby little cheeks. It will happen someday, you tell yourself. It might take longer than you planned, but it will happen. You try to be hopeful, try to ignore that room - or avoid going in it altogether. 

But that room is always there, silent, empty, and a constant reminder of what you don't have.  

First Clomid Cycle (CD3)

Today marks a new day in my TTC journey. Let's do a little recap: My last cycle was only 51 days, which is less than half of the cycle before. Technically it was a short cycle, but still - 51 days is a long time to be doing nothing. The only reason this cycle was only 51 days was that Provera worked its magic and brought on a period that would have never arrived otherwise. I have never been so overjoyed for Aunt Flo to arrive, because of everything she brings with her. 

For those of you who are interested in Provera (and I was when I was taking it!) I was prescribed two tablets a day for 7 days. The nurse said I should get my period 7-10 days after the LAST pill was taken, but that some ladies had their periods come much earlier (like 2-3 days after). Anxiously, I waited and hoped for my period to arrive early (how often does that happen when you're TTC?). Spoiler alert: It didn't! At that point I was googling nearly everything, including "What if my period doesn't come after Provera?" and "Could I be pregnant even if I took Provera and didn't have sex?" (you get the idea, right?). Turns out all this baby making sometimes makes me a bit mental. Then, 10 days after my last pill I FINALLY started spotting, and the next day my period started in full force. *Insert nervous laugh*. I don't know why I was acting so crazy, I always knew my period would come!

And that, my friends, brings us to today. Completely relieved, that is how I feel. Relieved and excited and nervous to finally, for the first time, REALLY be trying with a real chance at getting pregnant. Because today is my Cycle Day 3 (CD3) = FIRST DAY OF CLOMID!

I know Clomid might cause all kinds of crazy symptoms (headache, hot flashes, emotional swings, general craziness, etc.), but if it gets me a baby, I'm happy to take all of them. I'll come back tomorrow and see if I have been one of the unlucky ones to get the side effects. Until then, I'm enjoying a relaxing weekend with my hubby in a beautiful city and eating raw fish and drinking alcohol. Because here's hoping next month I'll be pregnant and this is my last fun hurrah! You gotta be hopeful sometime, right?

The Waiting Game

In order to start my first real round of "trying" with medical intervention, I need this cycle to end. My doctor prescribed Provera, which is a synthetic version of the progesterone that a woman's body naturally produces after ovulation. The gist is you take the pills for a certain number of days (I took mine for a week), then your body is tricked into thinking you've ovulated, and your period comes. The nurse told me my period could arrive a few days after the last pill, or up to two weeks after. 

Well it's only been 6 days and already it feels like an eternity. It's like the most tortuous two week wait, because nothing good is going to come from it (definitely no pregnancy!). And I have to say, I am beginning to get very impatient again. This cycle has only been 48 days (so far) and I know compared to my last cycle, that isn't too bad. But that's still about 20 days longer than a normal cycle, and I just want to get moving. I am so tired of waiting around for my body to do something normal. I feel like it never cooperates or makes things easy on me. 

And there is nothing I can do besides get through one day, then another, waiting for my period, and Day 3 of my cycle to start Clomid. Will it be this week? Or next week? Or will Provera even work for me? 

Until then all I can do is cross my fingers and wait and hope that something will go according to plan... 

Saying Congratulations! (Without a Breakdown)

When you're struggling with your own infertility, one of the hardest moments is finding out a friend is pregnant. This is likely to happen over and over again, since your friends are normally a similar age to you. The longer you struggle with infertility, the more of your friends and acquaintances will seem to fall pregnant around you - they will be everywhere. For me, I've had 7 close friends announce their baby news in the last 9 months, and countless more acquaintances. 

The second hardest moment is saying, "Congratulations, I'm so happy for you!" without breaking down into tears. 

I think one of the reasons this is so difficult to deal with is the fact that very few people share their baby-making plans, their struggles, their disappointments, their frustration, and their sadness. So many women who are trying to fall pregnant wear a mask on the outside, and keep these personal details to themselves. I completely understand - deciding to start a family and then the actual trying is quite personal. It might look like I'm being very open about my struggle through this blog, but keep in mind that I haven't shared the link here to any of my "real life" friends. If you're reading this, chances are we've never met each other. So yes, I'm sharing, but anonymously, because writing helps me work through my emotions.

Because people are so quiet about their struggles, it might seem that everyone becomes pregnant so easily, without trying, without intervention, without pain or loss. This is not always the case - remember 1 in 8 couples face infertility. That's a lot of people out there that it didn't just happen for.

One of my friends just called me this morning to let me know her happy news before I arrived for my visit. I managed to say the "Congratulations!" without crying (go me!), and I really did mean it. I remember years ago speaking with her about having kids, and she wasn't sure she's be able to have them due to her age. On the phone she confided that they had been trying for years, had suffered through a miscarriage, and were about to take the next steps with medical intervention when they got their miracle baby. If she hadn't shared this information, it would have been easy to view her as just another pregnant friend. Instead, she helped take a bit of the sting out of her announcement and I am truly happy she is on her way to motherhood after everything she's gone through. I wish I had known sooner so I could have offered her support.

Remembering that everyone has their own struggles can help ease the pain of finding out yet another friend is pregnant. It's a long, hard road we are walking, and we are not alone.  

There's Never a Good Moment

As I wait anxiously to be able to start Provera to bring on a period and then actually start my first medicated cycle with Clomid, so much has been happening in life. The most exciting event is that I am visiting Switzerland in a few days to see all my old friends, colleagues and students. Just planning for that is mind-boggling, trying to piece each friend into this slot or that. Since I'm not pregnant, I figure I might as well enjoy the all-you-can-drink wine event happening that weekend. There have to be some advantages of not being knocked up, right?

The school I work for (online) is expanding, and I have been offered several travel opportunities in the near future. I might be able to visit North Carolina for a few weeks to help with an opening of a new branch of our school. Then maybe, some time in the future, I could travel to China for a teacher exchange! Both of these options sound amazing (I love to travel!), but a part of me feels like I shouldn't even consider it. These next few months are already so packed - Switzerland; an anniversary getaway; Amsterdam for a long weekend; two weeks in America; August back-to-back full of visitors - how can I even think about adding more on my plate along with the baby-making plans? 

But as a lovely friend of mine pointed out, there is never a good moment to start a family. For me, having a baby is #1 on my list. I want it more than I could even begin to describe. Unfortunately, trying to conceive with PCOS and endometriosis is so uncertain that it could take years - or it could happen tomorrow - or it may never happen. As I explored in a previous post, if you don't keep living your life and planning for the future, this process of trying to become pregnant can destroy you. Alternately, I don't want to miss any chances of falling pregnant just because I was so busy living. Sigh. Is there any right answer?

Unfortunately, I can't just "try" every few weeks in a relaxed and natural way. I need pills to start a period, pills to cause follicle maturation, constant monitoring and blood draws, and injections to force ovulation, then more monitoring and blood draws. With that in mind, trying to get pregnant can easily be equated to staying at home and doing nothing except attending doctor's appointments. It can be hard to continue enjoying life when that might be all your future holds for you.

Or maybe I'm over thinking it and my first Clomid cycle will be successful and BAM, it'll be baby time. 

The uncertainty is killing me. I'm a planner and I can't plan ANYTHING. But I suppose, as long as I remember that it will never be a good time, I can just do the best I can as things come my way. 

What do the next few weeks hold for me? Only time will tell!

What Not To Say

Since starting our TTC journey in August 2014, and going through emotion after emotion and test after test, I can most definitely tell you the things NOT to say to someone with PCOS who is wishing for their rainbow baby. You might think you are being helpful or kind, but some of these comments are frustrating, hurtful, or upsetting. And most of the time we know you are just trying to be nice, and trying to find a way to make us feel better - especially if you happen to fall pregnant very easily - because you don't really know what to say. Because it was just infertility awareness week, Huff Post did an article about 27 Things People Struggling with Infertility Want You to Know. It's pretty comprehensive, so you can read women's thoughts there too. But really, it's better not to even think these phrases:

1) So when are you two planning on starting a family?
Well meaning grandmas, cousins, extended family and friends love this question. Especially if you've been with your partner for a while and all of your friends/siblings/cousins/neighbors are having their first (or second!) kid. But this question is so hard to answer, because we WANT a family now, but it's not happening. I can't just order a baby and have it arrive. And every time you ask me about kids, I feel like a failure and my heart rips a little bit more. And then I just try to hid all the feelings and smile and say, "We're trying now, it's just taking a while". You probably don't want to hear about my fertility woes, so keep this question to yourself.

2) Just relax and stop trying, it will happen soon.
Do you really think that "not trying" is the answer? Do you know anything about how someone gets pregnant? Apparently not...

3) You're so young, there's no reason to worry!
Every day you get older, your fertility decreases. So yes, I am worried. I'm worried that nearly a year ago when we started (and I was younger and more fertile) I couldn't get pregnant. So now that I'm older and I continue to get older I shouldn't worry just because in your eyes I'm "young"? Yeah. Thanks for that. 

4) You have lots of time! You practically just started trying!
In women with PCOS, we don't get 12 chances a year. With long cycles and unpredictable ovulation, we may only have a chance or two if we're lucky. Every year. Think about that probability. Does it seem like we have a lot of time?

5) Just adopt, you'll get pregnant!
Often said in a joking way, I hate this one. First, it assumes that adopting will magically make everything okay. Second, because people forget how long it takes to adopt. You might get pregnant while adopting. You might not. If you've been trying 5 years and it takes 2 more years to adopt, that's still 7 years so you might have gotten pregnant anyways. Adopting is not a magic fix-all solution. It's a wonderful one for many people, but it won't just make you pregnant.

6) It's just not your time yet, but it will be.
Is there a magic number of women who are allowed to get pregnant each month? So the quota was full this month? ARGH! But some month you assume I will, in fact, get pregnant. Can you promise me that?

7) If you stress about it, you won't get pregnant. Just enjoy it!
As one of my TTC buddies stated, all the Zen in the world is not going to regulate my hormones! Women with PCOS often can't ovulate on their own. No ovulation = no egg = no babies. I can meditate all day long, but it's not going to affect my fertility. Studies have shown acute stress might delay ovulation for a day or two, but it will not stop a woman from ovulating completely. The stress thing is just a myth, so stop repeating it!

8) You're so lucky you don't have kids yet! Enjoy "you" time/time with your husband/time to travel/sleeping in/a clean house/ etc.
When you say something like this you are telling me that I'm lucky that I don't have the one thing I long for the most. It makes me angry because it feels like you aren't grateful for what you have (even though you probably are), and that you don't understand that I already KNOW kids are a challenge and change your life completely. But I WANT that challenge and change more than anything! So no, I'm not "lucky" that I don't have kids yet (but YES I am guzzling the wine, because it dulls the pain a little!).

9) You're trying too hard! You don't need to see a doctor or get any treatment. 
Some people might worry needlessly about getting pregnant after trying for a few months. Most women without complications will fall pregnant within the first year of trying. But women with PCOS should begin intervention sooner rather than later. I'm not saying we should jump right to IVF, but you should find out what works, what doesn't and then take steps forward to make it happen. Sure, some women with PCOS might get pregnant on their own, but most won't. We need help and waiting a whole year to seek help isn't going to increase our chances of getting pregnant. 

10) My husband just looks at me and *BAM* I'm pregnant OR I was so excited I got pregnant the first month! It was so easy!
First, I'm very happy for you. I love babies and if you got the baby you wanted, that's amazing. Really. I promise I'm happy for you. But also I'm angry and jealous and frustrated. Not at you, but at the world for making it so easy for some and so difficult for others. You certainly don't need to rub more salt in my aching wound. 

So what can you say? Instead of offering advice, or telling us it will be okay, just listen. We probably need someone to talk to, someone who can just lend a sympathetic ear. Often we bombard our partners with our feelings, thoughts, hopes and dreams, but hide them from everyone else because infertility isn't something you are supposed to talk about. But we are bursting to share about it, because honestly, it is the biggest thing in our lives and we need all the support we can get. 

Any other PCOS ladies out there want to chime in with comments I've missed?

Rubella and A Break

After meeting with our fertility doctor, he mentioned that the results from my blood tests showed that I was not immune to Rubella. I found this strange, as I had the Measles/Mumps/Rubella (MMR) vaccine as an infant, then the booster as a child. This is a problem because if you are not immune and fall pregnant, then contract Rubella, the consequences are severe - including miscarriage, stillbirth, or birth defects. Before we can start with our great big plan of attack at the fertility clinic, I would need another Rubella vaccination. 

Now I am all for protecting any future babies, so of course I called my local medical practice right up to make an appointment. The problem with the Rubella vaccine is that, because it is a weakened live version of the virus, you cannot attempt pregnancy for at least a month afterwards. 

So this month we are officially forced to take "a break". Next month is when the whole circus will start, so I guess it's a nice little recuperation time for us. I've oscillated between being grateful to be less focused on my temperature, cervical mucus (cm) and the ever present "am I, aren't I" ovulating question, and feeling really frustrated that we're missing another opportunity and chance to make something special. Then, because there is nothing I can do about it, I let it go.

I do have a lot going on in the next few weeks, with a trip planned to visit friends, wine tasting, date nights, anniversary getaways, I guess the timing couldn't be much better. I know my husband feels a certain sense of relief at no longer being called on in a moment's notice whenever I show the slightest hint of ovulation. Four months straight of being "on call" with no end in sight was exhausting, I know. Hopefully when next month comes and we need timed intercourse (to go along with our trigger), he and I will be ready and refreshed and it will be mentally easier for both of us. With the near-daily ultrasounds and constant monitoring I'll have, at least a lot of the unknowns will be removed from the equation. 

So that's our latest update - with the vaccine already in me, I've got two weeks until I start Provera to bring on a period, then I can begin Clomid on days 3-7 of my cycle, and then we wait and watch for maturing follicles and trigger the release of an egg! A month seems long, but I'm hoping this one will speed by and get us closer to our next chance of our rainbow baby. 

All the Options

Today, sitting around recovering from my laparoscopic surgery and being a completely useless lump, I stumbled from one website to another to try to pass the time. I've found my pain meds make me spacey, so I'm taking off a bit of time for work. Free time = too much thinking = too much internet searching = depressing. 

At first I was just looking to find success stories from other ladies who had both PCOS and endometriosis. Let me tell you, the results were not very promising. Then one click lead to another (you know how the internet is), and I was reading an article about what three women did when faced with infertility.

The first woman decided treatment wasn't for her, and she made peace with never being a mother. I know that this is something that will never be okay with me.

The second woman decided to say no to invasive treatments due to recurrent miscarriages, and miraculously ended up pregnant on her own. Hurray! Success for someone!

The third woman decided to opt for adoption, and fell pregnant two more times after. This helps reinforce that myth that if you want to be pregnant, just adopt!

These stories got me on to thinking how far down the rabbit hole I want to go with this whole infertility deal. Am I up for being poked and prodded and stuffed full of drugs? And then after all of that, it may not work? I guess for now, my answer is yes - I am willing to try everything: up to and including IVF. Becoming a mom has always been a dream of mine, right up there with finding the love of my life (check), becoming a teacher (check), and traveling the world (check). 

And then my mind went on to the "what if...?" How many years am I going to try drugs and treatments and invasive surgeries? How many years should you hold on to hope and keep trying? At what point do you decide, "This isn't going to happen"? After all, our chances get worse every year as egg quality declines - how much torture should we subject ourselves to?

I'm not going to lie, a small part of me is absolutely terrified by the "what ifs". I have to remember that maybe everything will be okay before I have to face most of these options. But then again, maybe it won't be okay. In life, nothing is guaranteed. 

Since I want more than anything to be a mom, is adoption ever going to be an answer for me? I know it is a wonderful thing to offer a child a home, but it isn't a cure-all bandaid for infertility. I can't just adopt a child and pretend like I never wanted to grow a baby in my tummy, to create a child that's half me and half my husband. How do people even make this decision, I asked myself. And would my husband ever want to adopt? Adopting a child is a decision two have to make, and it's a pretty big decision that also says, "We gave up."

And then, because I'm clearly trying to make my life as miserable as possible, I started looking up adoption protocol in Scotland. Approval times (long), home visits (many), matching (stressful), it could all take years and still might end in heartbreak. The chances of getting a baby are extremely slim, and at the risk of sounding selfish, I really want a baby. I don't want my first time as a mommy to start with a four-year-old who can already walk and talk. I always kept adoption in the back of my mind as an option, but now - I'm just not so sure. 

One of the things that has kept me sane for the last few months was knowing there were more options out there for me. So I'm going to pull back from the adoption option for a while and look at all the wonderful miraculous options that science has to offer those of us who struggle with infertility.

• Surgery - Depending on the need, some women undergo laparscopic surgery to fix known or suspected problems. A woman with PCOS may undergo ovarian drilling - when your cysts are popped and drained. Or if you are suspected to have adhesions, blocked tubes, or endometriosis, the doctors may go in to clear the way and dispose of any problems they find. Some women claim that after laparascopy and an HSG you are "superfertile" because everything is free and clear for the sperm to meet egg. This hasn't been proven in any medical journals of course, but I'll take positive news wherever I can get it.  
• Drugs - Usually the first step after tests confirm whatever fertility issue you have, because they are the least invasive. For PCOS, many women are prescribed metformin (Glucophage) which regulates the amount of glucose in your blood and seems to help shorten cycles. Then Clomid (clomiphene) is often prescribed to induce ovulation. Sometimes this requires monitoring through ultrasounds and blood tests to confirm ovulation. It seems the general consensus is to find the lowest dosage that results in ovulation, and only try for 6 cycles. Some women do not ovulate on Clomid, and so Femara (letrozole) can be tried. This seems to be the end of the road for the simple, oral fertility drugs. 
• Injections - There are a range of different injectable drugs (Gonal-F, GnRH, HcG, and many more), each stimulating something different. The doctors choose the right cocktail of drugs for your situation, but in general they affect your levels of LH and FSH to induce ovulation. Some doctors avoid injectables because of the higher chance of multiple births and their high cost. It seems success rates are similar to oral drugs, but injectables might be successful where oral medication was not.
• Intrauterine Insemination (IUI) - Commonly used for unexplained fertility or mild known infertility factors, and often in conjunction with either oral medication or injections, an IUI is the placement of washed and concentrated semen directly into the uterus. Timing is important, and the rates of pregnancy aren't spectacular, but it is an affordable option. 
• IVF - Often the last stop on the infertility train, IVF ranks quite high in cost, invasiveness, and success. Some clinics boast as high a success rate as 60% live births per cycle! This is a process involving drugs to stimulate egg production, then egg retrieval, then the actual injection of a sperm into an egg (or allowing sperm to penetrate egg in a petri dish), then the placement of the embryo (or embryos) back into the woman. I am lucky in that the NHS covers three rounds of IVF for a woman without any children in cases of infertility. 

Even though sometimes I feel like I will never be able to fall pregnant, I am so grateful that there is an entire list of options that I haven't tried yet. I'm just at the beginning of the road, and although some of the options seem big and scary, at least I have options. PCOS and endometriosis can be daunting, but at least I know what I'm dealing with and I can charge straight at it head on. I don't know what the future will bring, but today I'm feeling cautiously optimistic and I'm holding on tightly to that little ball of hope inside. 

It's two days until my meeting at the fertility clinic, and armed with my piles of research, only good things can come. It's a long dark road ahead of me, but I think I might just be able to see some light at the end of it.

No Rainbows, Just Rain

When you think of Scotland, what do you imagine? Castles? Kilts? Bagpipes? Most people think of the weather - cold, grey, and rainy. I have to say, most of the time that isn't true. I've had so many beautiful, blue sky days since moving here and the rain seems to only appear overnight and disappear in the day.

Today is an exception. It's raining outside just the way you'd expect from a country this far north. As I sipped my cup of tea this morning and thought about where I am in this journey, I wondered if the weather was mirroring how I felt.

First and foremost, I feel sadness. The kind of deep, immeasurable sadness that wells up when you're not expecting it. The diagnosis of endometriosis still has me reeling. The fact that there is no way to stop it and only surgery or pregnancy to treat it has added new layers of stress to my already gigantic pile. Isn't having PCOS enough for one person? I can't ovulate properly, but now I get to have constant abdominal pain that will interfere with falling pregnant and staying pregnant? 

Then I think - what else is wrong with me?

And the rain falls steadily, inside and outside. Hovering, menacing, iron-grey clouds hang over me. I try to push it back down, cover the sadness with my list.

Every day I make a list of the things I am grateful for. It reminds me of everything I have now and keeps me focused on the positives. The list is seemingly endless; I'm thankful for my house, my neighborhood, my neighbors, my job, my family, my friends, my (mostly) strong and healthy body, my past experiences, my travel, clean water, good food, interesting books, my education... I could just keep writing. Sometimes I even go through my friends and family one by one, thinking of how each person has brought joy and happiness into my life. 

And this list pushes back down the sadness and the darkness for a small while. It reminds me there is more to me and my life than just trying to fall pregnant. It's enough for me to catch my breath and try ignore that deep pain. 

If you're struggling with infertility too, you know the pain. I don't need to describe it to you, because you know and feel this pain everyday. If you aren't struggling with infertility, the words could never describe it. I'm not trying to belittle other types of pain - there is a whole buffet of pain out there, all with its own flavors and subtleties and none necessarily easier to bear than others. But the pain from infertility can only be understood by those experiencing it and it's a club I never intended to join.

Howling wind screeches past my window as the harsh pounding of raindrops continues. I'm in the stormy part of my journey, I tell myself. Intervention (and hopefully success), will be here someday, but isn't here yet. It's something I have to tell myself over and over to keep my hope up. Because in infertility, there are no guarantees. It might rain and rain and rain and rain... with no rainbows. 

It's a healing, waiting, hoping game for now. As the rain drives down, ever more forceful, I just have to remember that without the rain there wouldn't even be a chance of rainbows. And that little bit of hope is enough for now as I sit here, wishing for my rainbow.

One Inch At A Time

In a "normal" woman's cycle, which lasts an average of 28 days, ovulation occurs on day 14 and then you cross your fingers for 2 weeks while you wait to find out if you were successful that round. If it's positive, GREAT! If it's negative, oh well, you only have to wait two more weeks to try again.

Now I have yet to meet someone with a perfectly "normal" cycle, but I would say the majority of women fit into this basic pattern. I, sadly, am not one of them. Instead of ovulating every 28 days, my body gears up to ovulate several times, but never quite succeeds due to a lack in the proper hormones (estrogen and progesterone) and an overproduction of the wrong hormones (androgens). This is a two-fold whammy. First, it leads to delayed ovulation and incredibly long cycles. I don't mean a 35-40 day cycle. I mean more in the 90-120 day cycles - 3 to 4 months worth of waiting. The second problem is that each time an egg is not released, it decreases in quality. This means that when it is, in fact, released, it is less likely to result in pregnancy. And then women with PCOS have a higher chance of miscarriage, gestational diabetes, preeclampsia, and premature diabetes. Well isn't PCOS just filled with sunshine and butterflies and rainbows of good news?

My doctor recommend I decrease my BMI from 25 to 22, as losing weight and eating healthy are two of the best lifestyle changes to increase the chance of ovulation. I have been exercising more and eating very healthy, so now it's just going to take time to see the changes. As I said before, I am a "lean PCOS" because my BMI is in the normal range but I still may have too much insulin in my body, making it difficult to lose weight and causes even more problems. But my recent decrease in weight means...

... I was lucky enough to *finally* ovulate on my own on April 8. My temperatures increased and stayed increased for 13 days before AF arrived. This is great news for two reasons:

1) I am actually, in fact, ovulating (even if it is very very late)
2) My luteal phase (LP), the second part of the cycle, is long enough to sustain a pregnancy

For us PCOS girls, ovulating on your own is a cause for celebration in itself. Most women end up needing treatment to cause their cycles to end, but I was lucky enough to start a new cycle myself. Hurray! (popping a bottle of champagne now!)

So after celebrating my ovulation, I had that tortuous "two week wait" - the time between ovulating and testing. I even had a slew of symptoms, like most women do, which could by PMS or pregnancy. I threw up several times for no apparent reason, so I was very hopeful. Unfortunately, this cycle was not the one but for now I'm enjoying little victories. And the throwing up? Hubby and I both have some kind of stomach bug and neither of us have felt well for over a week, so that explains that.

The best news now is that I have had a pre-op appointment and have just been scheduled for my actual surgery on Tuesday. Yay! That's months before I expected to be fit in, moving things along nicely. The doctors will be doing an HSG, which is where dye is squirted through your tubes to check if they are open. If they aren't the doctors go in to remove any blockages. With my history of torsions, it is quite likely they are blocked, so even if I ovulate on my own, it couldn't get through to be fertilized. They are also going in laparoscopically to check out the condition and location of my ovaries. My left ovary is still riddled with cysts, but my right ovary is cyst-free and smaller than they think it should be. This could be from my previous surgery when they had to cut through my ovary to take out the cyst. Either way, I should come out of the surgery with more answers and at the very least information for my fertility clinic appointment - which is in just two weeks! 

Although I am disappointed with not falling pregnant after the last never-ending cycle, at least something is happening. We aren't just sitting around, twiddling our thumbs, waiting for my hormones to magically regulate themselves. I am so grateful for the NHS, my doctors, and the treatment I have been receiving. I appreciate being proactive and moving forward, one inch at a time.