Hormones

Lately my hormones have been feeling all over the place. I've had 2 periods since the girls were born. I have no idea the length of my first cycle and my second one was 51 days long. I'm currently on day 60 with no period in sight. I feel so irritable and have little patience and I've am having issues with insomnia for the first time in my life. I am still breastfeeding and know that that can affect hormone levels. 

Recently I purchased ovulation tests to try to see what my body was doing. We're not trying to get pregnant, I just wanted to see if I was ovulating, and if so, on what day of my cycle. I never really used them consistently and always heard they aren't reliable with PCOS. I will have to agree. I didn't really take too many but I got 2 clear positives this current cycle. This tells me that my body is having LH surges but likely not ovulating= more ovarian cysts. 

I realized I needed to make an appointment to see some kind of dr, but just wasn't sure what kind. My ob? A regular endocrinologist? A reproductive endocrinologist since it's related to my reproductive health and hormones? I feel like a RE is the most appropriate person, yet most are just focused on fertility treatments and getting women pregnant. That's not my goal right now.

So, I have an appointment scheduled with my ob for next week. I emailed Dr. B last night just to get his input. He suggested taking progesterone every 3 months to get a period. I read more about progesterone to help manage PCOS and that seemed like a popular treatment. 

The thing is, I'm wondering if there are ways to restore regular cycles (ovulation) and minimize the PCOS symptoms without birth control pills. Due to blood clotting issues I was told I shouldn't ever use an estrogen based birth control because it will increase my chances of developing a blood clot. I'm currently taking 1500-2000 mg a day of Metformin, more often the 1500 since I have a hard time tolerating the full dose. I also don't want to go on birth control. We've both talked about it and we'd be fine with a spontaneous pregnancy. In fact, I'd love it if we got pregnant on our own. 

I know I have to do something. Having 50+ day cycles isn't healthy or normal and I feel like my mood and patience aren't in a great place. So, we'll see what my ob says next week and what he suggests. Has anyone else regulated their PCOS without birth control pills? Any suggestions or ideas?

Roadblock

I'm glad I went for another ultrasound before doing the transfer. Yesterday afternoon I had another ultrasound followed by an appointment with Dr. S. The ultrasound revealed the same amount of fluid plus traces of additional fluid next to it. 

I then met with Dr. S. He pointed out the trace fluid and gave me three options. 1) Go ahead with the transfer despite there being more fluid 2) Cancel the transfer and do an endometrial biopsy, 3) Cancel the transfer and do nothing. 

We talked for a while and I asked for his best recommendation. He said none of those situations are ideal, but since we know a FET is less successful than a fresh transfer, it would be best to eliminate any other variables that may reduce the chances of implantation. He also said he would hate for it to not work and look back and say we should have waited. He looked at the ultrasound and my trial transfer and tried to determine if he could avoid the fluid. It was possible, but not the ideal placement for them. He was planning to place the embryos where the new fluid appeared. He doesn't know why the fluid keeps reappearing since I don't have a hydrosalpinx and there is no possible reason at this time. He recently rechecked my testosterone levels and they were normal (thanks Metformin!)  He's not sure we will be able to avoid this happening in the future, but it is probably best to wait and see what happens in subsequent cycles. It's not a problem I had doing IUI's or on anything ultrasound until last month. 

I opted for choice number 2. He did the biopsy right then and it was not fun. I wasn't able to take anything prior so there was a lot of cramping, but nothing horrible. It felt similar to an IUI but with much more cramping. I saw the tissue he removed and it was a decent amount. 

After the biopsy I went back into his office to get my prescription and paperwork to bring to the receptionist. At first he wrote me a prescription for oral progesterone and told me to take it for a week and then would start the protocol for the FET once I get my period. He then informed me that he is going to be out of town from Sep 1-11. We looked at a calendar and determined that if I took the progesterone and we started another cycle, the next time we would do the transfer would fall during that time he was away. He offered that the other RE in the office could do it, but I've never even met the guy. So, after some discussing with the nurse he decided to put me on birth control pills and keep me on them until he is back. That way he will be there to make any decisions and not have to communicate over the phone with the office during my cycle. 

In a sense I feel relief. I know this is the best decision and gives me the best chances for the future. I'm not sure why this fluid started appearing and has now become a chronic problem. I'm hoping giving my body a break for a month will help and the fluid won't reoccur in the future. 

I had the cyst and surgery and wasn't able to start trying until January. Once January hit we did the IVF that got cancelled because I got pregnant, a miscarriage in Feb followed by a D&C and laparopscopy #2. March was spent waiting for my cycle to start again after the miscarriage, I tried Clomid + IUI in April, injectables + IUI in May, Lupron started for IVF in June, IVF cycle in July was cancelled at the time of the transfer due to fluid, and a cancelled FET cycle in August. I need to step away and take a month off, forced or not. 

At the same time I am disappointed. Disappointed that this has been so difficult, disappointed that my body won't cooperate, and disappointed that I will be in limbo for another month. I need to step back from infertility and distract myself. I need to live life outside of trying to get pregnant and just be. This is going to be hard, but it is something I know I have to do. At this point I don't know how to not focus on TTC. We shall see how the next month pans out. As I left the office my RE apologized that we had to cancel the transfer again. My response, "I'm learning how to be patient." 

When it all started

When I would think about getting pregnant, I though it would be easy. I thought we would be one of those lucky couples who would get pregnant the first month they tried. In all fairness, we've only tried one month so far, but have been on a roller coaster ride that started in June.

My husband and I got married on October of 2009. We knew we wanted children and disagreed some on when we should start trying. He was still finishing his education and didn't want the added stress of trying to start a family at the same time as finishing graduate school. 

Finally in June (after being married 8 months) I broke him down and he said we could start preparing to get pregnant (cutting down of coffee, exercising more, eating healthier, getting a pre-conception check-up, etc.)

I had actually ditched my birth control pill about a year prior  in hopes I would drop a few pounds before our wedding. I had been on the pill for the past 7 years consistently. During the year I was off the pill and we weren't trying, we used condoms and the occasional "pull-out" method. There were a few months where I started to get nervous after no period for 34-35 days. I had one cycle where I didn't get my period for 38 (it might have even been 40) days. But each month I got my period, although sometimes just a little late. During the year I was off the pill, I got my period each month (albeit a long month.)

When we talked about getting pregnant I started to research good books that I could read. I found "Taking Charge of Your Fertility" and started reading. This is where I read it is a good idea to get a pre-conception check-up with your gynecologist. I booked an appointment, excited we could start taking steps towards getting pregnant. In this book I read that sometimes a woman may have longer cycles due to a hormone imbalance. I decided to ask about this at my appointment. The nurse practitioner decided to draw some blood and check my hormone levels. I left the office hopeful that I could convince my hubby to start trying in July. 

Less than a week later I got a call about my blood work. I was not able to take the call at the time and the NP left a message on a Friday afternoon. By the time I got it, it was too late to call the office back since they were closed. She said she would be back in her office on Tuesday. On the message she said that things were "just a little bit off" with my testosterone levels. She said to call her back and we could talk about it. I'm pretty sure I still have this message saved on my voicemail of my cell phone.

I spent all weekend worrying and looking up high testosterone in women on Google. The most common search result: Polycystic Ovarian Syndrome (PCOS). Reading about it I didn't think I really matched most of the criteria. Although I had always been a little hairier than other friends and I had difficulty losing weight around my mid-section, I was by no means obese, growing a beard, diabetic, etc.

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When I finally talked with my doctor on Tuesday she explained the numbers and said that PCOS was a definite possibility. My testosterone was off, as well as my DHEAS. She wanted to refer me to a endocrinologist.