Day 1; IUI Cycle 1

And here we are again....good old Aunt Flo (she really needs to take a LONG hike...off a cliff.) Day one was yesterday, and now I need to start giving myself injections. Yeesh. Not something I ever thought I would have to do, but here we are. I'll be doing 75 IU of Follistim every night for a few days, then will have monitoring done to see when I should trigger for my first IUI. I'm a bit nervous, but if these are the things we have to do to have kids, I will do them.

SNOW!

Today sucked. Shmuel and I were supposed to meet with Dr. Glatstein at the office to discuss next steps if this cycle didn't work, and because of a predicted snow storm we didn't make it there. See, what happened is that everyone was so freaked out about the snow that everyone left work at the same time. Gridlock was absolutely unreal. It took us HOURS to do what should have taken minutes. And we had taken two cars since I was supposed to go to work after, but that didn't happen - the store closed because of the impending snow. Well that was nice, but it still didn't get me to the doctor's office on time. Luckily, we were able to change from an in person to a phone appointment, so we didn't lose out entirely.

Anyway, if we're not pregnant this cycle, then we're going to start in on IUIs with injectable meds next month. Hopefully we won't have to go that route, but at least we have a plan for something new.

Almost Ovulation Time!

That 14mm follicle from the other day has now blossomed into a 19mm follicle that's getting ready to go! My estradiol is now up to 263 pg/mL and my LH at 11.8 mIU/mL. My endometrium is over-achieving and is up to 13.7mm. Whew! Looks like a great environment for a baby to grow in, so hopefully this will be our month! I'm going to be doing ovulation predictors for the next few days, and then start progesterone a few days after ovulation. No more monitoring needed for this cycle. Yay! Fingers crossed!

Cycle Day 11

Things are growing! I've got a 14mm follicle on the left side, my endometrium is up to 8.3, and my estradiol is holding steady at 126 pg/mL. My LH is also holding at 13 mIU/mL and my progesterone is still low at 0.319 ng/mL - that's to be expected, since I haven't ovulated  yet. Next monitoring visit is in 2 days, and we'll see how things are going then. Hopefully ovulate within a few days after that visit.

Monitoring Day

I got my results back from day 8 monitoring and things are looking good. My estradiol is at 110 pg/mL and my LH is at 18.4 mIU/mL. No huge follicles yet, which is to be expected. But I have a bunch ready to go on either side, and my endometrium is starting to grow and is now at 6.4mm. I'll go back in for more monitoring in a few days and will update then!

#2 Down the Drain

Aaaaaand Clomid cycle #2 comes to an end. *sigh* This cycle we're back home and will be monitoring again. But first off will be 25mg of Clomid from days 3-7 once again. I'll go in for monitoring on day 8, which will be 12/2. Fingers crossed for something good this month!

Progesterone Test

I got my surge this month on the 8th, which was on day 17 of my cycle. Not great, but not too bad either. So, I went in for another progesterone test today, and it came back as 13.3 ng/ml. The doctor is going to be starting me on progesterone suppositories even though this level is ok. I also did restart Metformin on the 30th. It probably didn't help me ovulate any earlier this month, but maybe it will do something for me next month if I'm not pregnant now.

They also did a fasting insulin level, which was 4.75. That's actually slightly lower than normal, but no one seems to be worried about it.

No Go

Well, Clomid cycle #1 was a bust, so we're on to cycle #2. We'll be doing 25mg of Clomid again from days 3-7 of my cycle, and I'm thinking about restarting Metformin as well. Maybe it could help? Who knows...

Since I'll be out of town, I won't have any monitoring this cycle or do a trigger shot. I'll be testing for my LH surge, so we'll see how quick it comes this month. I'm also curious about my progesterone level and hopefully will have that checked after I ovulate. We'll see!

Even More Bloowork

So, here are our CD 14 results:

1 follicle on the left ovary at 22.5mm
endometrium at 12.9mm
Estradiol at 392 pg/ml
LH at 18.1 mIU/ml

These are all normal and it shows that I'm at the beginning of the LH surge!! This means that I do the hCG trigger shot tonight and then we just wait...

Test Results

So, here we are again. I got another prolactin level and it came back as 2.2 ng/ml, so we can see that the Dostinex is keeping that under control (yay!) and my estradiol level at CD10 was 99 pg/ml (which I was told is normal as well). I had 1 follicle at 13.5mm and my endometrium was 8.5mm (which are both normal--they want to see at least one follicle over 10 mm and the endometrium over 8mm) I am going back for CD 14 testing to see if it's time for my hCG trigger shot so that I can ovulate! I will update when I get the results!

Pregnancy Plan

So, we saw the RE today and here is the plan. First, I have already started taking Dostinex to lower my prolactin level and I will continue on that med until I get pregnant. Second, I'm going to start on 25mg of Clomid next month and they will monitor my endometrium to make sure it is not too thin. I'll also have an HCG shot to force my body to ovulate once my egg(s) and endometrium are ready. If that doesn't work or if it makes my endometrium do bad things, then we'll go for the injectibles and possibly IUI as well. Hopefully I'll be pregnant this cycle and won't have to do Clomid! (Wouldn't that be awesome?!?)

More Bloodwork

I had my repeat prolactin test today and it came back with a level of 28.7 ng/ml, which means that it's still elevated (even though it's less than last time). So, my doctor has put me on Dostinex to get my prolactin level down (which will hopefully help me get pregnant really fast!!) :-) Also, I had an ultrasound which showed a 14mm follicle and a 9.2mm endometrial lining. Those both are normal for CD10!! YAY!

Bloodwork

Here are some more test results!

Today I had my CD3 blood tests and here's what I got:

Estradiol: 36.8 pg/ml (normal = between 25-75 pg/ml)
FSH: 6.08 mIU/ml (normal = 3-20 mIU/ml; best is under 10 mIU/ml)
TSH: 3 uIU/ml (normal = .4-4 uIU/ml)
Prolactin: 43.3 ng/ml (normal = < 24 ng/ml)

So, from here we see that my prolactin level is way out of line! :-) I have to go in for a repeat prolactin test next week to see if this was accurate. It would actually make a lot of sense if it is elevated because I have read that elevated prolactin levels can cause irregular cycles with late ovulation and light/short periods. I have both!! :-) So, I think we have our answer of why my body can't get pregnant--I have too much prolactin! Hopefully my RE will have a solution for us when we see him next week.

S/A Results

Here are the S/A results:

Volume: 2.3ml (normal = more than 2ml)
Concentration: 95.2 million (normal = more than 20 million; best = more than 90 million)
Motility: 59% (normal = more than 50%; best = more than 60%)
Morphology: 40% abnormal (normal = less than 70% abnormal)

They say that it's best to have at least 8 million normal, forward-moving sperm per ml, and, if you do the math, my DH has at least 33.7 million per ml. :-) GO HUBBY!

My Rabbi ROCKS!

So, I had an appointment with a new RE (who is totally amazing) at the beginning of the week. This is someone who my Rabbi trusts. The doctor ordered some more tests for us and said that we do need to get a semen analysis. Then we just had to wait for him to speak with the Rabbi...and then...today my Rabbi gave the ok for us to make the appointment for the S/A!!! So, that's going to be done on Tuesday and I'll update here with the results when we get them. Until then, I'm in the TWW and hoping that I'm pregnant now. :-)

Progesterone Test

I got my progesterone test results back today and my level was 11 (which means I definitely ovulated and is within the normal range). So, this is good news! I don't have a progesterone deficiency and there's no medical reason why I haven't gotten pregnant yet. Next step is to find out if my husband has the ability get me pregnant. I'm going to have a chat with my rabbi next week and hopefully he'll give us the go-ahead to get a semen analysis soon.

HSG

So, I had my HSG today and everything looks great. There were no blockages or scar tissue that the Radiologist or my OB/Gyn could see. I scheduled a follow up with my OB/Gyn for September. Hopefully I'll be pregnant by then! :-)

OB/Gyn Follow Up

I went to my OB/Gyn today for my 3 month followup, and since I'm still not pregnant she scheduled me for an HSG two days from now and I'm supposed to get my progesterone levels tested around 5 or 6 DPO. I'll keep you updated!

Reproductive Endocinology

I had my first visit with a reproductive endocrinologist on February 1st. Even though it has only been about 6 months of TTC, my OB/Gyn diagnosed me with PCOS a few months ago and my periods have been very irregular. He had me do some blood work at that point to see if I really do have PCOS and we met with him again yesterday where he did an ultrasound. Here is what he found:

My right ovary seems to have the classic PCOS look (ring of pearls). It also appears that I ovulated recently. YAY! Based on my symptoms, blood work and this ultrasound, he confirmed that I do have mild PCOS and should continue taking Metformin as I had been prescribed by my OB/Gyn. We decided to keep trying on our own for a few months, but we can always go back if we're not successful soon.

And here are the results of my blood work:

• FSH - 7.51
• Estrogen - 38.7
• LH - 17.8 (this is high from PCOS, because I was only CD 7 when it was drawn and not close to ovulation)
• Progesterone - 0.673
• Prolactin - 10.2
• TSH - 1.83
• Free T4 - 1.53
• Total testosterone - 85.3 (anything above 82 is high, and this is down from 111 in December, so it looks like the Metformin is working)
• DHEA-S - 391

Hopefully the Metformin will continue to bring down my testosterone levels and will help me to get pregnant soon!

RE Follow Up

I had a follow up appointment with my RE today (my first appointment was background and getting bloodwork done so I didn't post about it). We did an ultrasound which showed that my right ovary has signs of PCOS and my left ovary showed that I ovulated. :-D The ultrasound coupled with my bloodwork points to very mild PCOS. Since I'm ovulating relatively normally, the doctor says that I can stay on metformin once or twice a day and that I have the option to do clomid if I feel I need to. Also, if I'm not pregnant in a few months he can do monitored cycles as well.