So it’s been awhile.

Let’s see – last post was about my new patient appointment.

After my appointment, I researched my butt off and decided to focus on losing weight and then move into fertility treatments. I started the keto diet (low carb, moderate protein, high fat), and also cut out all dairy. Thus far, I have lost about 18 pounds and I am feeling great! I am eating things I never in a million years thought I would eat – zucchini, cauliflower, beets, etc. I have already completed and lost 21.7% of my goal! (I’m trying to lose approximately 80 pounds in total) I’m hoping to get there before Christmas. I have read some wonderful stories of people with PCOS who have lost weight, and conceived naturally. Of course, I am not banking on that, but it would be nice! They say that most women only need to lose 10% of their body weight in order for their bodies to basically do a “hard reset” and start ovulating again. I am only 2.5 pounds away from 10%, so I guess we will see!

About two weeks in, I decided it was time to get the ball rolling to verify that PCOS was truly the problem. So I went in to have my blood tests done. I had two sets of blood tests to do:

  • LabCorp – came back mostly normal, except:
    • Testosterone – high (expected with PCOS)
    • Iron – low (they want to do additional testing)
  • Fertility Center – came back all normal, except:
    • Vitamin D – low (they put me on a OTC supplement)

The same day I had my bloodwork done at the fertility center, they did a quick ultrasound.

My nurse called me that afternoon to go over my results. They said that my lining was quite thick, so they were not able to get a good picture, so she wants me to start Provera in order to induce a good, heavy period to clear everything out. Which was super frustrating, because I JUST came off of an on-again-off-again six week period from hell. I attribute that nonsense to losing weight, which made my hormones go a bit whacky. I told her as such, but she insisted that she understood, but that it would be worth it because in order to get proper results from the HSG (hysterosalpingogram) they needed everything to be cleared out. So she sent the prescription over; it is a ten-day course. The medication was $0 with my insurance, so that was awesome! I am to take these once daily and call her as soon as I get a good, heavy period, and we will schedule the HSG at that time. As we speak, I am on day five currently, and have been having light bleeding for the past 2-3 days, along with some pretty severe cramping. I will call her tomorrow to give her a heads up.

In addition, she suggested that I take a powder supplement 1-2 times daily called Ovasitol. This is straight from their website: “Ovasitol is a high quality, medical-grade supplement that combines both myo and d-chiro-inositol that mimic’s the body’s own ratio. A combination of myo and d-chiro inositol has been shown to improve insulin sensitivity, restore hormone balance, improve ovulation and egg quality in women with PCOS.” So that’s cool, let’s do it. Except that it’s $80 for a three-month supply, and it is not available by prescription, so that came right out of the good ol’ bank account, and did not go towards my deductible. Oh well. If it helps, it’s worth it, right?

So as of right now, I am on the following medications daily:

  • Prenatal
  • DHA
  • Calcium
  • Vitamin D3
  • Provera
  • Ovesitol (Powder)

Another thing we have to decide. The genetic testing looks like it is going to be $300…..for each of us. Yikes. Okay so some backstory, years ago I had signed up to be an egg donor. When they did the genetic testing (10 or 12 specific genes), I came back as a carrier for spinal muscular dystrophy or atrophy – can’t remember which. This disqualified me as an egg donor, but regardless. Now, the genetic testing looks at, I believe they said, over 120 different genes? So, since I did already get flagged for one abnormality, I would like to get it done again, and I would like my husband to get it done as well. But $600 is a lot of money for some bloodwork. So we discussed it, and I am going to call Nurse Tina and ask – if the testing comes back abnormal, for either of us, what does that mean? Like, if we are both carriers for something, does the testing or the course of treatment change at all? Or does the treatment continue as normal, and now we are just aware of the possibility of the genetic issues? If the course of treatment remains the same no matter what, I cannot fathom tacking on the additional cost and anxiety…? I guess we will see about that.

As for now, my next steps are as follows:

  • Blood test at LabCorp – additional testing for the low iron
  • Blood test at Fertility Center – genetic testing (if we chose to do it)
  • Semen Analysis – STILL waiting on the call to see if hubby’s insurance covers any of this. the financial person we met with stated to give it a week and expect a call. I got off course, and called about three weeks later, and nothing had been done or submitted. this pissed me off. the woman I spoke with last week stated she would process it now, and to call a week later. I am going to call tomorrow. if it is still undone, heads are going to roll. p.s. why do I have to call YOU? shouldn’t you be calling me with this info?
  • Hysterosalpingogram – as soon as my body decides to release all this extra nonsense it seems intent on holding onto

I believe that is it for now! My main focus at the moment is the healthy living and the weight loss, since I really need to do that for me anyway, outside of the whole TTC stuff. Truthfully, I am a little scared of conceiving before I have lost “enough” weight, because I am afraid that I will gain it all back and then some and be worse off than I was when I started this. I know, there are worse things to worry about, but still.

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First Appointment – Meeting Nurse T & Financing

So next we met with our nurse, Nurse T. Just as with the doctor, Nurse T would be our point of contact through this entire process. She will be our go-to girl for any and all questions, all instructions will be provided by her, etc. She walked into the consult room, and I was instantly put at ease. She went over all of our next steps.

For me –

  1. Diagnostic Blood Work & Ultrasound – used to asses ovarian funtion (at fertility clinic)
  2. Hysterosalpingogram (HSG) – used to asses the size and shape of the uterus, as well as the opening of the fallopian tubes (at fertility clinic)
  3. Genetic Disease Screening – especially important for us, because I known from previous testing that I am a carrier for spinal muscular atrophy. The panel I did in the past checked for 12 diseases, the new panel tests for over 100! (at fertility clinic)
  4. Gyn exam and pap smear – (at my obgyn office)
  5. More Bloodwork – a basic blood panel, blood type, immunity titers, and other various tests (at labcorp)
  6. Infection Disease Bloodwork – checking for HIV, Hepatitis C, Hepatitis B, and RPR (at labcorp)
  7. Vitamins – prenatal vitamins (I was already taking them, so no problem there!), and Ovasitol (supplement to promote cycle regularity and ovarian function)
  8. then, once all of that is done, we will schedule a follow-up with Dr. B to go over all the results and our next steps.

For D –

  1. Infection Disease Bloodwork – checking for HIV, Hepatitis C, Hepatitis B, and RPR (at labcorp)
  2. Semen Analysis – (can be done at home or at the office)

 

Financing

Thankfully, I have very good insurance. Very basically, all of diagnostic testing, monitoring, and IUIs are covered at 100%. (Except a $30 copay for office visits, and a $100 copay for “surgeries”, which includes HSG and IUI) There is a note at the bottom of my insurance benefit report that states “No limits listed. May be subject to criteria of 6 attempts per live birth.” If we do have to go to IVF, unfortunately that is not covered, and that was quoted at $10,500 per cycle. So that is pretty terrifying. Hopefully, we do not get to that point, and medications or IUIs can do the trick.

First Appointment – Meeting Dr. B

So, yesterday we had our first appointment at the fertility clinic! Going in, I was completely terrified. My wonderful husband (let’s call him D) took a half day from work and met me there.

First, we checked in and handed over the mountain of paperwork, had IDs and insurance cards scanned, the usual. Then I had my vitals taken. Because of my nerves, I told the MA that my blood pressure would likely be high. It was 134/84. Not super high, but considering the environment, it was not surprising. Then back to the waiting room, where D squeezed my hand and told me everything was going to be okay.

This fertility clinic is world-known, and has many different facilities, which can leave you worried that you’ll be “just a number”. But at this practice, each couple is placed with one doctor and one nurse, and those two people are your liaisons through the entire process. I am happy about that, because I have heard horror stories about people going through fertility treatments, and not knowing who to go to with questions, and meeting someone brand new on procedure day, etc.

So our doctor, Dr. B, came out and took us back to her office for the consult. It was a clean, well-lit office. On the corner of the desk, there was a bamboo essential oil diffuser just whirring away. It was calm. Dr. B was the one who presented at the fertility seminar we attended last month, and I was hoping that she would not be our doctor – she just felt kind of harsh and sterile to me. But after talking to her I really like her. She was honest about what she thought we needed, without sugar-coating it. She was gentle and kind, but also serious. We talked for a long while about my medical history, my cycles, etc. She believes that I may have PCOS (poly-cycstic ovarian syndrome). I had somewhat self-diagnosed myself with PCOS, just judging off of my symptoms and comparing them to people who do have it. D was very involved, and asked a lot of questions, which I loved. Very basically, PCOS is a hormone imbalance that makes it so you do not ovulate at all, or ovulate very sporadically. It also has the lovely side effect of weight gain – and a wonky metabolism that does not easily allow weight loss. Makes sense, because since I met my husband, I have gained about 50 pounds, which I have not been able to lose no matter what diet or exercise regime I am on – which is also around the same time that my cycles became irregular. So Dr. B laid out our options:

  1. Target the weight / metabolism, and see if that alone will reset my body into ovulating
    • using two medications – Metformin and Myoinositol
    • takes approximately six months to see full effects
    • has a 50/50 success / failure rate
  2. Target the weight / metabolism, and target the hormone imbalace to force my body to ovulate
    • using four medications – Metformin, Myoinositol, Clomid and Femarin
    • starts regulating almost immediately

So, with those options laid out, we both kind of wondered why anyone would chose option #1. It will take six months, only has a 50% chance of working, and then we are back at square one?? No thank you! So we decided to “hit the ground running” and go all in. This is all pending bloodwork and ultrasound to see how my organs are doing their job, of course. If the medication cycles do not work, we will move onto IUI, then IVF as necessary. Of course, we are hoping that the medications alone work, but we will have to see!

Next, we would meet with our nurse.

Taking steps and making appointments.

(Photo from ShadyGroveFertility.com)

About a month ago, my husband and I attended a fertility seminar called “What to Expect When You’re Not Expecting”. The seminar went over the basics of all of the first steps in fertility planning – from initial consultation to explaining the actual treatments. At the end of the seminar, everyone in attendance filled out a registration card, and from there we would be contacted to set up our consultation appointment. We walked out into the hallway, hugged, and just kind of melted into each other. It was overwhelming, it was scary, but it was the first step.

The very next day, I had a missed call and voicemail from a patient service rep from the fertility center. I had every intention of calling back right after work, every intention of putting the wheels in motion. But when I pulled up that phone number, I froze. All of the sudden, I remembered that I did not have my insurance card in my wallet – oh darn, I would have to find it and call later. Then we had a meeting at work, when I was reminded that my insurance was going to reset on August 1st. Oh, I couldn’t schedule an appointment before then! Because my deductibile will reset then. The next week and the week after that, I was going to wait for this or that or a hundred other things.

So today I took the first step. On my lunch break today, I called the fertility center and made my initial consultation appointment. My preferred office only holds new patient appointments on Thursdays from 8:00am – 3:30pm. Which is, of course, super inconvenient for me, because I work on Thursdays from 8:00am – 6:30pm. My next choice office did have appointments that fit into my schedule. So, I scheduled one. Next Friday, July 21st at 1:00pm.

I texted my husband to see if he would be able to make it to the appointment – a long shot, since the appointment was snack dab in the middle of the day. To my supreme happiness, he immediately texted back that he would take a half-day from work so he could be there. God, I love that man.


As soon as I hung up the phone and added the appointment to my calendar, my stomach dropped and I felt nauseous. I can’t believe it’s finally come to this. I put this off for so long – because making that appointment, taking that step….it makes it all real. It means that this is our life now. Making that appointment means admitting defeat – admitting that I cannot do this on my own. It was a hard pill to swallow. And even now, twelve hours later, just writing about it is giving me that same feeling. The queasy, lump-in-your-throat, uneasy feeling. And I know I will feel the same, if not worse, at the actual appointment.

So today, I made the step; I made the appointment. And I’m trying to recognize that this is not admitting defeat, or waving the white flag. Needing help is not the end of the world or the end of our story, it’s just a new, unexpected chapter.

To Buy, Or Not To Buy?

(Photo above from Google – Pinterest)

I am an active member on several infertility facebook pages and groups. Basically, it is a safe place to commiserate with other women (& sometimes men, depending on the group). It is especially helpful in cases like mine, where no one around me seems to understand. Not only do people not understand, they don’t know what to say about it…so they say nothing. Which feels worse than saying the wrong thing – because at least they’re trying.

One of the recent posts that gained a good bit of traction was a woman asking if anyone else was already purchasing baby items, despite their struggle. She stated that her husband did not understand, and he would get upset seeing the items. There were many responses; most women stated that they purchased a onesie, blanket, or small item here and there, but nothing too crazy. Some women stated that they had not purchased anything, and would not, because seeing it in their home, sitting unused, was just another reminder of the fact that they don’t have a baby. And then there were one or two women that went above and beyond, but of course I am not one to judge and I would never tell any women that she was wrong for doing it. One woman had purchased an entire set of nursery furniture, stating that she had done so because it was on sale. Another woman had an entire room in her home dedicated to her “stockpile”; she stated that everything she had stashed away had been purchased at extreme discount, using coupons and sales wherever possible. She had furniture, decor, activity gyms, strollers, diapers, creams, multiple boppys, etc. But hey, if that is how she is choosing to cope? All the more power to her.

I, myself, have a small stash of items, squirreled away in our spare bedroom, AKA what will hopefully one day be a nursery. I will admit that I did purchase more freely early on in this journey. I am little more hesitant these days. Mostly because some days, even walking past baby section in any given store is enough to bring tears to my eye. Some days, I am perfectly fine and can peruse through, looking at items without missing a beat. I have mostly small, inexpensive items; a cute onesie that I found on clearance, three small wooden baskets that I used at our wedding as a surprise Cigar Bar for my husband (perfect now for organizing small items), a little piece of artwork and a lamp that I found at an online swap & sell, etc. Before our wedding, which is when we officially started trying to conceive, I stumbled upon an adorable little upholstered rocking chair at Home Goods. I texted my (then) fiance, and he agreed that it was cute, and that I should go ahead and purchase it. He then went to New Orleans for his bachelor party, not realizing that he was going during a large art festival – and brought home a small hand-painted canvas to hang in the baby’s room. That fantastic, wonderful gesture has now sat in that empty room for fifteen months.

I still occasionally find something that I want to purchase, but I am much more hesitant now to pull that trigger. With every item, as I hold it and run it through my fingers, I wonder how long it will sit unworn, unused, unseen. Maybe not today, and maybe not tomorrow, but one day. I know that one day, we will have a baby in our home. And I know that one day, that beautiful little human is going to use all of the wonderful things that have been purchased and loved and squirreled away, just for them.

Father’s Day.

(Photo above from Google – CrossCards)

Another Father’s Day has come and gone. The second one now, since we’ve been married. The second time I’ve wandered off in my own mind, lost track of time in the greeting card aisle, just longing to be able to pick out the perfect Father’s Day card for my husband. The 3,457th time I have felt that lump in my throat, scared to death to let that thought enter my mind, even if just for a second….what if I am never able to buy that card? What if I’m not able to do the thing that all women are built to do? What if I’m never able to make my husband a father?

No, really….what happens then? Will we drain our savings accounts, hoping and praying to get the chance at a miracle? Will we throw all that out and try to adopt? Will he go on to find someone who can add “father” to his list of accomplishments? Of course, my heart tells me that would never happen, but as each month passes, that second line never shows up, and my hope grows just a little bit dimmer.

I have always dreamed of the day that I would be able to surprise my husband with the news – “we’re pregnant!”  I have spent more time than I would care to admit watching videos of announcements, gathering ideas to squirrel away for later. But what if that moment never comes for me?

It has been nearly fifteen months since my husband and I started trying to conceive. In the back of my mind, right from the start, I was scared. I don’t know why, but I always had the feeling that this would not happen for us, at least not without some heartache. But actually living it is worse than what I could have ever imagined.

So, now we have crossed the one-year threshold after which “the experts” advise you to begin to seek fertility testing. It’s terrifying, and I feel like a complete failure. But I’m going to face my anxiety and terror head-on. Because I don’t care what I have to do, next year my husband is getting that damn card.