Fertility Monitoring: So There I Was, Pants Around My Ankles

Whoever thought to use
oven mitts on stirrups
is a freaking genius.

View from the
ultrasound table.

Today I went in for the start of my fertility
monitoring and blood work.  Or as I like to call it "Poke and Prod"day.  The first part was the ultrasound.  My nurse greeting me with "Drop trou and take a seat on the throne!" The ultrasound went great- they check out the lining of your uterus- I was at 7.8mm- they are looking for something in between 7-10mm.  She also checked out my follicles, which also sounds like a pick-up line (follicles are responsible for releasing the egg).  She had a good count on both ovaries.  They also take blood to check estrogen levels.  Normally I'm an easy stick (heyo), but it took 4 tries and on the third try I felt a jolt through my body and radiating soreness run through my arm.  I'm not sure what happened, but I'm pretty positive I screamed something that rivaled the F-word count from "Wolf of Wall Street".

Although I was diagnosed with PCOS, I am very lucky to not have major fertility issues such as a blocked tube.  We decided to do the extra monitoring this cycle to make the most out of the try. We are investing a lot into this, financially and emotionally, so I wanted to make sure we are doing the most we can do to get it right. We are hopeful that my insurance will cover most of the monitoring, but we can't seem to get a clear answer from anyone, despite many hours sitting on hold with the insurance company. If insurance ends up not paying for me, you'll find me crying in the corner over our credit card bill. We'll keep you updated!

Another thing that happened is my grandmother passed away this morning.  I had the chance to be with her last weekend and, although she feared technology, she was up-to-date on this blog because each time I posted I would print it out and mail the latest entry to her.  She was the most southern of southern women, but was so accepting of me, Meg and the path we were taking to start a family.  She was fading last night so I called my mother who was by her side to the end.  My mom said, "I think you should tell her you're pregnant." And, while it's not the truth, I had also thought the same thing.  It would make her happy and it wasn't going to hurt anyone.  It wasn't until my mother held the phone to her ear and I struggled to say the words that this whole process, all the work, money, and blood (literally) and tears that have
that has gone into this hit me as hard as it would ever hit.  Even through the unspeakable pain that my grandmother was experiencing, my father said she raised her arms off the bed in celebration.

So.  Next steps.  My hormone levels were good- no surge detected (typically a surge of LH will happen between days 12-16).  And I'll go back in for another ultrasound and more blood work on Thursday morning.  Our  trigger shot will be arriving in the mail tomorrow so we will be ready to inject as soon as they give us the ok- this is the shot that Meg will have to inject in my behind.  I'm already preparing an arsenal of gifs for this experience.  Heh. ARSenal.

What We Wish We Could Tell Our Fertility Docs, or, Can I Keep My Underwear On?

Another member of our TTC posse sent me a link to an article by Kathryn Kefauver Goldberg (bonus points for the baller name) titled "20 Things I Couldn't Say to My Fertility Doctor When I Was Her Patient" and it is DEAD. ON.  I pulled some snippets of my favs, but for the full jam please visit her post here.

2. Any calm and charm I exude is a façade. My super-crazy side is reserved for my husband and anonymous infertility friends online. Anything casual you say about my chances of conception will be parsed for hours and days.

Interwebs,  Am I right?

3. I respect you, but I also see an acupuncturist, a hypnotist and a psychic.

5. I look at the Internet. A LOT.

6. Infertility hurts so far beyond the baby. It's about my marriage, my friendships and my ability to picture a future. It's about my body, and whether everything I've been told about personal power is true.

8. I want to feel important to you, even as I know you are successful no matter what happens in my case.

10. Part of me thinks I can solve this with wheatgrass.

13. I try to act cool about the ultrasound wand, but I'm pretty sure I have PTSD.

14. I don't understand why I have to wait for you without my underwear. I feel everything is skewed that I have to be half-naked while you get a crisp lab coat. OK, I understand, but I hate it.

15. The waiting room is a quiet, tense, darty-eyed purgatory where every minute feels like an hour.

16. It's not the shots that are hard. I would inject myself in the eyeball to get news two weeks earlier.

Goin' For the Gold, or, HcG Trigger Shots in My Rear

Well team, this cycle is starting a lot better than the past two have.  I am now becoming a firm believer in the "White Pants" theory.  Only women will understand this... For all the rest of you, here's some

education: as a female, you could guarantee a visit from your Aunt Flo by doing any of the following: planning a beach vacation, going on a date, or wearing white pants. We got our BFN on Friday the 31st and then I was still almost a week late.  Last time I went over a month without a new cycle, whichever they attributed to a cyst formed by the Clomid, and the day they told me to call if nothing had started, I called.... then bam.  She hit. This cycle I was running late again. And to my shock, to the same level of every member of the press who first saw their rooms in Sochi ( #olympics), it arrived.

For this next cycle we decided that we wanted to be a little more aggressive.  We will continue on 50mg of Clomid (starting tonight) which I had called in to a CVS while I'm visiting family in Virginia-side note: when I went to pick up the prescription at a CVS in rural Virginia I had "Di," the lesbian of all lesbians for a checkout woman. I wanted to have a secret signal that said, "My sista!", but this was the south and there's a good chance that she's actually straight. The line between butch lesbian and short haired badass southern chick is paper thin. 

We are also going to do fertility monitoring starting on day 12 of my cycle. I will go in every 2 days for an ultrasound where they will monitor the growth of my ovarian follicles.  And now I'm gonna drop a little education bomb. Typically, when a woman ovulates without fertility mess, a single follicle will raise up off the ovary.  The follicle should grow 18-24mm before it will rupture and pop out an egg.  With my having PCOS, I'm never guaranteed ovulation and last cycle the Clomid messed with the OPK test results and I question if I ovulated at all.  That experience had me more stressed out than a stage manager from "Spider-Man: The Musical".  They will also be taking

blood every other day to check estrogen levels- if my arm looks like I'm a character from "Rent" start singing 'Seasons of Love' to me and that will be our "secret handshake".

Ultrasound evaluation of follicles is even more important when fertility drugs are administered, since it

What I imagine a follicle looks like

allows the physician to determine the number and ripeness of follicles so that ovulation can be further stimulated and triggered in a safe fashion.

Also, the ultrasound can determine the thickness of the endometrial lining. The lining of the uterus must achieve a certain minimum thickness in order for there to be a good expectation that implantation will take place.

Doesn't even apply- I just love this.

Legit copied that from an old encyclopedia from my parents house.  Thanks 1998. Half of this blog's purpose is to educate. The other half is to entertain through witty remarks and painstakingly selected gifs.

After the doc identifies that that a follicle is ready I'll inject a trigger shot.  The shot contains hCG which is the chemical that triggers an egg to release. My doctor has ordered the shot which the medicine and needles will be delivered to us at our house and we will have to inject on our own.  Don't worry kids... That sucker is gonna be a blog post all on its own.

And we have to deal with what we pay out of pocket and what is covered by insurance.

We have to time things just right so we get the sperm in at the right time as frozen, thawed sperm only live 24-72 hours.  Then timing the egg release just right so they are not too premature or too old- we need them to be "Mama Bear Just Right".

That fairy tale fertility analogy just blew my mind.