Wednesday, June 28, 2006
Preparing for my wedding was very stressful. It was a formal affair and I was all about the details. About a week before the wedding, I prayed for Grace. I continued to pray for this with all of my heart, because I realized that I had done everything in my control to make it a perfect day, but I need a little help from above to be at peace on the big day.
The morning of the day was crazy. Loads of fun, as I was treated like a princess surrounded by my very best girlfriends and family. I was still nervous over the day. Not about getting married, but the day's events. I continued to pray for Grace.
As I walked into the church, I felt like this is it. I started to walk down the isle with both of my parents and I started to cry. Not over sadness, but the immense love I felt for all that surrounded us.
Once I got to the alter. I took my husband's hand, looked into his eyes, and felt Grace.
It was so distinct to me. Never had I felt the power of God so close. Like there was no other place that I should be or no other person that I should be with.
It felt right.
1. Progesterone - The ovaries produce significant amounts of progesterone during the 2 weeks or so that follow ovulation. Progesterone thickens the nutrient-rich endometrium in preparation to receive a fertilized egg. It also acts on the breasts to prepare them for milk production (lactation).
2. Estrogen – Estrogen is produced in increasing quantities prior to ovulation, helps the uterus rebuild its lining (or endometrium) after menstruation. In addition, estrogen and progesterone also act as feedback controls on the brain hormones LH and FSH. In other words, these sex hormones travel to the brain to increase or decrease LH and FSH production. This feedback mechanism helps to regulate the timing and the events of the menstrual cycle.
3. Estrogen and progesterone are both made primarily in the ovaries from cholesterol. Initially, the ovaries use cholesterol to derive progesterone and the male sex hormone testosterone. Then the ovaries convert a good portion of the progesterone and almost all of the testosterone into estrogen. After ovulation occurs, more progesterone is made than can be converted; consequently, significant amounts of progesterone are secreted only during the latter half of the cycle.
4. LH- The LH surge is initiated by a dramatic rise of estradiol produced by the preovulatory follicle. The LH surge occurs 34 to 36 hours prior to ovulation and is a relatively precise predictor for timing ovulation. The LH surge stimulates luteinization and stimulates the synthesis of progesterone responsible for the mid cycle FSH surge. Also, the LH surge stimulates resumption of meiosis and release of ovum.
5. FSH- Estradiol levels fall dramatically immediately prior to the LH peak. Elevated FSH levels at this time are thought to free the ovum from the follicular attachments. Progesterone is responsible for stimulating the mid cycle rise in FSH. The mechanism causing the postovulatory fall in LH is unknown. The decline in LH may be due to the loss of the positive feedback effect of estrogen, due to the increasing inhibitory feedback effect of progesterone, or due to a depletion of LH content of the pituitary from downregulation of GnRH receptors.
Find out what is ovulation and what are the physical signs of ovulation.
This test is done by:
1. Obtaining a day 3 FSH and estradiol
2. The woman takes two tablets of clomiphene (100 mg) on days 5-9 of the cycle
3. Repeat an FSH level on day 10 of the cycle
The normal test would show a low FSH on day 3, a low estradiol on day 3 and also a low FSH on day 10.
Cut off values for the day 3 and the day 10 FSH values are very lab dependent and must be determined by experience with the laboratory being used. In other words, only your infertility specialist can interpret your results.
Tuesday, June 27, 2006
Feels good to have that one out of the way.
Also spoke to the nurse in more detail about the blood work. It seems that the majority of it has been completed except for the genetic and insulin resistant tests. All of the others are normal except for the testosterone.
Tomorrow is my day 10 labs.
Tonight is also the last night for the Clomid.
Feeling good. Progress, that is what I am feeling. We are very close to naming it. Once it is named, than we move on and tackle it with knowledge and overcome the obstacles. Yes, this is an excellent feeling.
Monday, June 26, 2006
Other than the information that I have shared below, the other thing that I've found is what high testosterone does. Basically, when your testosterone is low, the LH hormone increases to increase the testosterone. Since my body has too much testosterone, it isn't producing the LH hormone. The LH hormone is fairly important because it is the hormone that triggers ovulation. Basically, my eggs never mature because of the hormone imbalance.
Also the information that I have found come back to PCOS.
Most would consider a level above 50 to be somewhat elevated.
Some information. Thank you WebMD in advance. Please note that I have deleted all references to males, because I am female and this is my unprofessional investigation into myself.
A testosterone test measures the level of this male hormone (androgen) in the blood. Testosterone affects sexual features and development. In both men and women, testosterone is also produced in small amounts by the adrenal glands; and, in women, by the ovaries.
The release of testosterone is controlled by a hormone called luteinizing hormone, or LH, which is produced by the pituitary gland (see an illustration of the pituitary gland). When the testosterone level is low, the pituitary gland releases LH, which increases the amount of testosterone produced by the testicles.
Most of the testosterone in the blood is attached to a protein called sex hormone binding globulin (SHBG). A small amount is attached to albumin. The unattached, or "free," testosterone may be measured when conditions that can increase SHBG (such as obesity or hyperthyroidism) are present. Free testosterone can also be calculated from SHBG and albumin levels. Usually this is done only at large medical centers.
Why It Is Done
A test to measure testosterone can be done to:
Evaluate why a woman is developing male features, such as excessive facial and body hair (hirsutism) and a deep voice.
Evaluate irregular menstrual periods in women.
How To Prepare
No special preparation is required before having this test. Your health professional may recommend a morning blood test, when testosterone levels are highest.
A testosterone test measures the level of this male hormone (androgen) in the blood.
Normal values may vary from lab to lab.
less than 100 ng/dL
less than 10 pg/mL
In women, a high level of testosterone may indicate a tumor of the ovaries or adrenal glands or polycystic ovary syndrome.
What To Think About
Most of the testosterone in the blood is attached to a protein called sex hormone binding globulin (SHBG). The unattached, or "free," testosterone may be measured when conditions that can increase SHBG (such as obesity or hyperthyroidism) are present. Usually this is done only at large medical centers.
A low LH level and an abnormally low or high testosterone level may indicate a problem with the pituitary gland.
Author Jan Nissl, RN, BS
Editor Susan Van Houten, RN, BSN, MBA
Associate Editor Lila Havens
Primary Medical Reviewer Caroline S. Rhoads, MD
- Internal Medicine
Specialist Medical Reviewer Alan C. Dalkin, MD
Last Updated July 2, 2004
Well, let me attempt to explain.
For example, two weekends ago, I went shopping. I entered a store and I saw five dresses that I loved. I need a dress for my friend’s wedding in September, so it would make sense to try some on, especially because when I start looking for one in August, they won’t have any. Nope, I refuse too.
You ask why?
I’m crazy. I refuse to purchase clothing three months ahead of anything, because I may get pregnant. OFCOURSE!
Yes, this is sad. But, it is also funny. If you think how crazy I am, you’ll laugh too!
After that I felt better and finished getting ready. Called the doctor's office to find out what I needed to do. The nurse called me back , basically told me to take it on a full stomach, not a small meal such as directions.
Got to the car and noticed that my right front tire was only half full with air. Took it to the mechanic up the street. He looked at all 4 of my tires and told me that they were bald. Also, he took the right front tire off and checked it for leaks etc. He couldn't find anything wrong. Filled it with air and sent me on my way.
Called the dealer since my car isn't even 3 years old and only has 38K miles. Turns out that the tires/warranty are only 40K mile tires. So, simply put, I am out of luck.
FYI, my afternoon is much better.
Thursday, June 22, 2006
Likelihood of Pregnancy in Fertile Women -
How long should it take?
Age - Probability of conception per month - Average time to conception - Probability w/in a yr.
Late thirties - 8.3 - 12 - 65
Early thirties - 10 - 10 - 72
Late twenties - 15 - 6.7 - 86
Mid twenties - 20 - 5 - 93
Early twenties - 25 - 4 - 97
I asked her about three of my maternal great aunts. (They never had any children.) They all were married later in life. Their childless status was based on this and not the thyroid disease that all three of them had later in life.
Early last year, I got this checked. Wanted to rule it as soon as possible. Although the blood work recently done also checks this out, so maybe? Sorry, I'll get back to my story.
We continue to chat. Turns out that my cousin needs blood transfusions. I tell my Aunt that I can't donate because I am A-. She starts to say, oh I have B's blood type, B+.
Now, this triggers my interest.
I ask how can you have B+, when my Mom has A-, Uncle C has AB-, and Uncle A has A-?
She tells me that my Grandfather has B+, my Grandmother had A-.
Her next statement, your Grandmother had a miscarriage after me.
My mouth drops. Why is this astonishing?
Well, genetically, this is a minor miracle that my Mom, Uncle C and Uncle A were all born with Rh-. Rh- factor is only in 15% of the world's population. It is very rare because the Rh+ is the dominate trait. The fact that my Grandmother had three children with Rh- blood, which allowed her to have her fourth with Rh+ is a miracle. These people, my Mom, Uncles, and Aunt, were meant to live.
Hence why, despite nature, I believe God works his miracles to allow for children to be born.
Then why is it that I don't let him take care of this situation. I also think that he rather use those miracles on other things that cannot be fixed by human hands.
See my Grandmother conceived and gave birth under no medical surpervision. She gave birth during the late 40's and 50's in Azores, Portugal. There was no hospital on her island. She didn't have access to the shot required for all Rh- women. The islands only received access to electricity in the 80's. Therefore God had to take things into his own hands.
I have other venues, his hands will also have to work his magic on me, but I must do my leg work first. Because I also think he takes into consideration the desire he has put in my heart. He knows that I won't give up easily and when I feel like I want to give up; he gives me my husband, friends, and family to push me on.
It seems to be a good idea, and excellent way to live. To letting him guide me, every day. For me, I struggle with this idea of giving up total control. After all, I am lover of history. I know about the Crusades and it really didn't work for them.
Therefore, my conclusion that there must be a balance. I must do everything in my power and ultimately let God take care of it. Yes, this is more me.
What does that mean?
1. I go to the reproductive endocrinologist. (CHECK)
2. I undergo whatever is needed to be diagnosed. (IN PROCESS OF COMPLETION)
3. Consider all medical procedures that reproductive endocrinologist suggests and make an educated decision. (Waiting for diagnosis.)
4. Do everything in my power.
OK, this doesn't sound like I am Letting Go or Letting God. Let me explain the thought process.
I believe that God gives us opportunities, pathways to finding what we need to sustain us. In my case, what I need is to get pregnant and have a healthy baby. This is my goal. He knows me well enough to know that I am not doing this out of bad intentions and that I am pure of heart with this goal, therefore I think that he will open my eyes to the correct path.
He has made me aware of the reproductive endocrinologist and I should take full advantage of her knowledge that she has gained through God. (See, yes there is a connection there too, he has given her the power and the desire to learn these things and process the knowledge she has to aid women such as me.)
God has also allowed Medical Science to be. It holds the mystery of what nature has incorrectly done with in me. Therefore, undergoing testing, is also productive.
Once the diagnosis occurs, I must make the decision of procedures. Well, to be honest, I haven't really contemplated too much on how far I am willing to go. If the procedure only effects me, I am more than willing to do it. Anything, that means medication and surgery. I am willing to try the knowledge that God has given to the Medical World.
Ultimately, whatever happens, it will still be in God's hands.
If the IUI occurs, yes it provides a 31% chance, but it is not a guarantee. Neither does any other procedure. The baby will still be a miracle of God. So, I guess, I do live: Let Go and Let God.
Wednesday, June 21, 2006
Also, day 10 labs consist of the same tests completed for day 3. At least for those, my period shouldn't be around.
Oh boy, where is T with my burger.
Just because you have PCOS does not mean that you are infertile. Many women with PCOS fall pregnant naturally, whereas others require some level of medical assistance to help ovulation to occur regularly. You can have polycystic ovaries without having PCOS.
Getting A Diagnosis: PCOS is normally diagnosed through an ultrasound and/or blood tests.
Polycystic ovaries tend to have a string of many small cysts around their edges, which show up on an ultrasound.
You may have any of the following blood tests:
· Full blood count, to check that you are not anaemic
· Thyroid function
· Testosterone, as many women with PCOS have a raised level of testosterone
· Luteinsing Hormone (LH) which can be raised in PCOS sufferers
· Follicle Stimulating Hormone (FSH). You might also be offered an oral glucose tolerance test as many women with PCOS have raised levels of the hormone insulin and have a tendency towards insulin resistance
Treatments: Some GPs offer women the birth control pill as a treatment for PCOS and the brand Dianette is often offered to women who have problems with acne or excessive body hair.
Clomid or Clomiphene Citrate is often offered to women who are not ovulating and who wish to become pregnant. If Clomid does not work, then injectable hormones may be used which stimulate the ovary to produce eggs.
Metformin is another drug, which can be used either alone or together with Clomid. It improves insulin sensitivity and can also help with weight loss and help ovulation. It can have side effects such as nausea, vomiting, diarrhoea, and abdominal bloating.
Laparoscopic Ovarian Diathermy (Ovarian Drilling) is another treatment, which is more suitable for women who are close to their ideal body weight. It involves a laparoscopy with a general anaesthetic and is performed as day surgery. Small holes are made in the cysts of the ovary using a probe or laser. It can restore ovulation and make the ovary more sensitive to hormones.
Helping Yourself: Weight loss is the first and most effective treatment for PCOS. A weight loss of 10% is usually enough to re-start periods or make them regular and ovular. Women with PCOS who are significantly overweight are more likely to have difficulty conceiving, are more likely to miscarry and more likely to develop gestational diabetes in pregnancy and maturity-onset diabetes (Type II) in later life.
A low-fat, high fibre diet is most effective for aiding weight loss in PCOS, but sufferers must be patient and persistent, as safe and permanent weight loss can be slow and difficult to achieve.
Many women have found that their symptoms are reduced by eating healthily, drinking more water, reducing alcohol consumption, giving up smoking and taking regular exercise.
Alternative Therapies: Some women have found the following alternative therapies helpful; acupuncture, aromatherapy, herbal medicine, homeopathy and reflexology.
Thanks again, iVillage, you have most informative.
It is normally taken between days 2 and 6 of your cycle, although some doctors suggest taking it on slightly different days. The lowest dose is normally 50 mg a day. This can be increased if your body does not respond appropriately.
Clomid stimulates your hormone system into helping an egg grow. It tricks your body into producing more follicle stimulating hormone (FSH) because it is an anti-oestrogen. At high doses the anti-oestrogenic effects may affect cervical mucus (making it thicker and stickier) or the endometrium (making it thinner and less receptive).
Some women experience side effects such as breast tenderness, hot flushes, minor abdominal discomfort and moodiness. If you have very bad nausea, vomiting, abdominal bloating, pain or problems with your sight, you should see your GP. There is a slightly increased risk of multiple pregnancies when on Clomid (10 percent).
You will normally be offered a Cycle Day 21 blood test, to check that ovulation has occurred. Some clinics will offer you an ultrasound scan a few days after you have finished the treatment to see how your follicles are developing. Some studies have suggested that prolonged usage of Clomid may increase the risk of developing ovarian cancer later in life, but this may be because women who are anovular and do not conceive are at a higher risk of ovarian cancer anyway.
Thank you again, iVillage.
You will be asked to undress and put on a gown. Take a sanitary towel with you, for use after the examination. You will be asked to lie on your back on an examination table. The doctor may perform a quick internal examination of your vagina to check the position of your cervix before inserting a speculum into your vagina. This is the same instrument that is used when you have a smear test and allows the doctor to see the cervix.
A small plastic tube is inserted into your vagina, through your cervix and into your womb. You may feel slightly uncomfortable as this happens. A colourless liquid, which shows up on x-rays is flushed into the fallopian tubes and then spills out into the abdominal cavity. X-ray pictures are taken while the dye is flowing through the organs. Some women feel a sharp pain, similar to period pains as the liquid travels into each fallopian tube.
You may be able to watch what is happening on a TV screen. The doctor may tell you the result of your HSG immediately, or you may have to wait for a follow up appointment. After the examination you may feel period like pains and have some discharge, which contains the dye and also some blood.
Thank you iVillage.
Tuesday, June 20, 2006
I have thought that I might be pregnant three times. Yes, I know that sounds pathetic. But, three times with in almost two years is not a heck of lot of times. So, I remember them distinctly.
The weird coincidence is that, come to find out recently, that I have two friends that have been pregnant or are pregnant that coincidentally occurred during my questioning of conception. (I know this, because, sad fact to admit, is one of the things I do when I am in the two week wait, I check to see when the possible child will be born. Yes, not proud, but I do it.)
Also, during recent obsessing, I found in twoweekwait.com (I love that site.) that my symptoms were indeed pregnancy symptoms. So, I've also included that information from the other women, abridged, because I don't think anyone wants to know about EWCW, unless they are TTC.
The first, December 2004 /January 2005, only three months into the trying to conceive saga. I believed I conceived had the following symptoms: extreme thirst, excess saliva, tingling feeling in ovaries and uterus, gas, fatigue, high sense of smell. Due Date: October 2005.
The 2ww description:
3DPO - Tingle feeling in uterus. Small cramps. High sense of smell. Breaking out EVERYWHERE. Very sore boobs and very tired.
Reality: 8 negative home pregnancy tests and 1 beta, I was convinced that I wasn't.
The second, January 2006, a year later. I confirmed ovulation, we took advantage and I had the following symptoms: extreme thirst and slight twinges in ovaries area. Due Date: October 2006.
The 2ww description:
7dpo - Slight twinges in ovaries area
Reality: 4 negative home pregnancy tests, I was convinced that I wasn't.
The third, May 2006. I believed that I ovulated, HA that was funny, it was also my first cycle on Clomid. The following symptoms: crampy, tightening feeling above my public line, fatigue, slight twinges in ovaries area, high sense of smell. Due Date: February 2006.
The 2ww description:
5-7 dpo irritable and fatigued
6 dpo-present crampy, tightening feeling above my pubic line, tender bb's, fatigue getting stronger and stronger
Reality: 4 negative home pregnancy tests and a website that stated that Clomid can cause pregnancy symptoms.
Now, my title.
Why is this weird? I realized today, that New Mom was pregnant when I thought that I was, my first questioning period. The second, I found out yesterday that a friend is five months along and due in October. The last, New Mom is pregnant and due around that time frame.
Yes, it could be a weird ESP or coincidence, but it is still a weird coincidence. Felt that it deserved noting.
"Some People come into our lives and quickly go.
Some People stay awhile and we are never the same."
My friends are the latter. I will never be the same with them in my lives, for this I am grateful.
I have two groups of friends. My Real friends and my Vent friends.
(Please note that the names I have come up with are no reflection of anything, except my inability to be more creative. Real, only because I will see my real friends in real life. My Vent friends are in the cyber world, more than likely, I will never meet them in person. Doesn't mean they are any less my friends.)
My Real friends, I have known forever, a minimum of twelve years. They know me inside and out. They listen, they try to help, and they know where I am coming from. During my trying to conceive saga, they have done all these things, but something was missing. This was no reflection of them, it was me.
In January of this year, in desperation, I found my Vent friends. These are women all experiencing the trying to conceive saga. Some for as long as I, some for longer, some have completed many more procedures than I, and some have gone through less. But, they all are going/have been through the same thing. They listen, sometimes have advice, other times, they send there cyber hugs and words of encouragement.
I realized today, that God has blessed me with both of my groups of friends. They both help me daily. They listen, encourage, push me on, and for all of that, I am grateful.
For both groups, I feel: joyous for their victories, sad for their disappointments, devastated for life's unfairness, and ecstatic for life's blessings.
Why is that I must separate the two?
For my Real friends, I pray that they never experience infertility. They are able to get pregnant if and when they want to, that they experience a healthy pregnancy, birth, and child.
For my Vent friends, I pray that we are blessed to experience mother hood through a healthy pregnancy, birth and child, soon.
This is why I must separate my blessings, I need different blessings for them.
I always thought that I was good at languages. I can speak several. Well, I had no choice but to learn a few of them.
My first language is Portuguese, granted at this point I speak English the best. But, Portuguese was the first. If I wanted to be listened too, this was the language I needed to learn. When I get angry, this is actually the language I resort to. :)
My second language is English. If I wanted to get by in the world, at least in the US, I had no choice to learn it. Glad I did :).
My third and fourth, well they were taught to me in school. The third is technically French. But, since I really can't remember any of it, I don't generally count it. The fourth is Spanish. I can get by, I call it a working knowledge of Spanish. At times, I think I am giving myself too much credit on that one.
The fifth, you are asking? Well, the fifth is trying to conceive language. It has taken me several months to learn it, some of it I still don't fully grasp, but I am muddling through.
I thought I'd share it with you.
The site that I use is care of BabyCenter, http://www.babycenter.com/general/1145946.html
This is the short list of items they provide:
AF: Aunt Flo — menstruation/period
BBL: be back later
BBT: basal body temperature
BC: because, or birth control, or before children
BCPS: birth control pills
BD: baby dance (sex)
BFN: big fat negative (pregnancy test)
BFP: big fat positive (pregnancy test)
BRB: be right back
BTDT: been there, done that
BTW: by the way
CD: cycle day
CF: cervical fluid
CIO: cry it out
CM: cervical mucus
DPO: days past ovulation
EWCM: egg white cervical mucus
HPT: home pregnancy test
IC: incompetent cervix
IUI: intrauterine insemination
IVF: in vitro fertilization
LP: luteal phase
MC or M/C: miscarriage
OPK: ovulation predictor kit
PG: pregnant, or pregnancy
RE: reproductive endocrinologist
TTC: trying to conceive
US or U/S: ultrasound
I count it. Wouldn't you?
The latest conversation:
Me: "Yay, T.'s Mom wants to get together next weekend, but I'll be on the crazy pill (Clomid) at a higher dosage and I'm not sure how I'll be. I think we will have you all over some time in July."
Mom: "OK, so maybe I won't call you this weekend. Why are you taking that stuff?"
Me: Shaking my head, I have no patience, but at least I am in an EXCELLENT mood. After all I am taking the BULL BY THE HORNS. "I was on it last month and you had no idea. The only issue that I had was that I couldn't remember anything for about two weeks. Besides, you don't want grandchildren?"
Mom: "Make sure that you write things down. I'll be fine without them."
Me: Laugh out loud. "I do write things down. You know that a few months ago you told me that I would be a failure as a daughter if I didn't give you grandchildren, right? You do remember this conversation."
Mom: "I didn't say that, I wouldn't say that."
Me: Laugh harder. "Yeah, you did." Laugh harder. "No worries, I luckly don't take you seriously." I also think to myself that I KNOW that you are slightly off your rocker.
Perty much the end of the conversation. My Mom, I love her. I know that she loves me, but she is the QUEEN of the insensitive statement. SHE CRACKS ME UP! On most days, the others she can bring me to tears or make me so angry that T tells me to hang up the phone. But, most of the time, I can laugh at her.
The funniest part is, that she did say it. I remember it exactly. I was trying to talk to her about things in November, while ironning clothing. Trying to have a supportive conversation, and I got that response. Literally hung up the phone on her and called my sister. We both agreed, SHE IS NUTS! Then we started to laugh, while I cried and laughed, uncontrollably.
But, the Wicked Witch (also known as: Aunt Flow, Tia Maria (Portuguese), My Period) started yesterday! YIPPPEEE! (Another small miracle.)
So, the schedule:
1. Day 3 Blood work tomorrow morning. According to my research, they are checking for:
- Follicle Stimulating Hormone (FSH): FSH is often used as a gauge of ovarian reserve. In general, under 6 is excellent, 6-9 is good, 9-10 fair, 10-13 diminished reserve, 13+ very hard to stimulate. In PCOS testing, the LH:FSH ratio may be used in the diagnosis. The ratio is usually close to 1:1, but if the LH is higher, it is one possible indication of PCOS.
- Estradiol (E2): 25-75 pg/ml Levels on the lower end tend to be better for stimulating. Abnormally high levels on day 3 may indicate existence of a functional cyst or diminished ovarian reserve.
- Luteinizing Hormone (LH): <>
- Prolactin: <>
- Progesterone (P4): <>
- Thyroid Stimulating Hormone (TSH): .4-4 uIU/ml Mid-range normal in most labs is about 1.7. A high level of TSH combined with a low or normal T4 level generally indicates hypo-thyroidism, which can have an effect on fertility.
- Free Triiodothyronine (T3): 1.4-4.4 pg/ml Sometimes the diseased thyroid gland will start producing very high levels of T3 but still produce normal levels of T4. Therefore measurement of both hormones provides an even more accurate evaluation of thyroid function.
- Free Thyroxine (T4): .8-2 ng/dl A low level may indicate a diseased thyroid gland or may indicate a non-functioning pituitary gland which is not stimulating the thyroid to produce T4. If the T4 is low and the TSH is normal, that is more likely to indicate a problem with the pituitary.
- Total Testosterone: 6-86 ng/dl. Testosterone is secreted from the adrenal gland and the ovaries. Most would consider a level above 50 to be somewhat elevated.
- Free Testosterone: .7-3.6 pg/ml
- Dehydroepi-androsterone Sulfate (DHEAS): 335-430 ug/dl.
- Androstenedione: .7-3.1 ng/ml
- Sex Hormone Binding Globulin (SHBG): 18 — 114 nmol/l, Increased androgen production often leads to lower SHBG
- Fasting Insulin: 8-16 hours fasting, <>
2. Clomid Challenge test starts Friday and goes on until Tuesday. Cycle days 5-9, 100mg. (Increased from last Clomid cycle of 50mg.) Also may involve more blood work, will know later.
3. HSG scheduled for Tuesday at 1:00 PM. HSG: An x-ray of the pelvic organs in which a radio-opaque dye is injected through the cervix into the uterus and fallopian tubes. This test checks for malformations of the uterus and blockage of the faloipian tubes.
4. Day 10 blood work next Wednesday. Not sure what that involves, must ask. My research hasn't triggered any key information.
5. Day 12, June 30, start to use Ovulation Predictor Kits. When a surge occurs, trying to stay positive, must contact the nurses again to schedule the IUI.
I'm taking the bull by the HORNS!!!!
Sunday, June 18, 2006
Turning 20, this small mile stone birthday, bothered me tremendously. I had finished my Sophomore year of college and I thought of my teens being over and it bothered me. Mostly because I had changed a great deal and many people didn't recognize it.
Just like a butterfly, I wanted it to be recognized. (OK, minus the cocoon, etc.)
I wanted to represent that in some way. It was my acknowledgement of change. So, as many 20 year olds, I got a tattoo. Yup, straight laced me. No one expected it. No one thought I would go through with it. But I was determined. So, in July of 1996, almost ten years ago precisely, I got a tattoo of a butterfly on my lower back.
This is where it started, my alter ego of flutter. :)
Now, as time has had its effect, it has another meaning. It too changes. It now means/represents, the hope of experiencing the flutter of new life within me.
Self-Insured Group Health Plans. Plans set up by employers who set aside funds to pay their employees’ health claims. Because employers often hire insurance companies to run these plans, they may look to you just like fully insured plans. Employers must disclose in your benefits information whether an insurer is responsible for funding, or for only administering the plan. If the insurer is only administering the plan, it is self-insured. Self-insured plans are regulated by the U.S. Department of Labor, not by Massachusetts.
Friday, June 16, 2006
Spoke to a woman at the Infertility Case Management and Education with my insurance, lets call her Godsend. She didn't tell me to go take a hike. She was nice, compassionate, informative, and someone who I could KISS at this moment.
Godsend provided clear directions how to navigate my insurance. She told me that the insurance would cover ALL of my blood work. I am doing a happy dance. Yes, how sad that this makes me this happy. *Including the daily blood work for the Clomid challenge test! YUP, that is a big one.
Also, she told me that if the RE is able to find what is wrong with me, than the insurance will pay to fix the problem. PLEASE OH PLEASE LET IT NOT BE UNEXPLAINED INFERTILITY. If it is, they won't pay for anything to fix the problem.
(I doubt this is the issue, afterall it is clearly a hormonal imbalance of some sort. Ask anyone who knows me, it must be a hormonal imbalance! Also, please do not let it be something with FSH, I'm not sure what it is, but they have another crazy exclusion for that too.)
Side tracked, sorry.
The only down side, they will not pay for IUIs or IVF. Nothing to get us pregnant, which includes fertility drugs. No worries, I already found this out when I paid out of pocket for the Clomid. No problems, one fish to fry at a time. Heck, I found out how useful the AAA card is, they do provide a discount on Clomid. Imagine that!
Also found out that state mandates only apply to "fully insured." Need to do some research on what that means, Godsend didn't know. But she did know that we are "self insured."
The funniest statement "the customer service people are a little dodgy on the topic of infertility." You think? I laughed out loud at that one. Couldn't help it!
OK, at the moment, saying silent prayer for my minor miracle. See I told you they happen :).
Now, granted it is very early for me to say this, after all I am still waiting to find out what is WRONG with me. But, yet I believe that I grieved over the thought of my fertility in October, November, and December of last year.
In October, I felt at a loss. It had taken me several months to finally get a doctor's appointment with my primary care. She is a busy woman, she has three boys! (Please note that I'm not sarcastic about the boys, I'm sarcastic that she can't get her schedule together!) The initial appointment was made three months in advance. It was cancelled on me for two months later. Hence the feeling of loss, there was nothing more I could do to take things into my control. Another issue I have.
In November, when she said "Well you are obviously having an issue. We (Meaning: myself, her, and another doctor. Little did she know that should also include a reproductive endocrinologist.) will find out what is wrong and in a few months, you'll be back here pregnant. Really, well, can you please put that in writting.
She gave me a ton of blood work and arranged for the consultation with the gynecologist a week later. Maybe she felt bad for cancelling on me.
I went to the gynecologist appointment. Well see below for how useless that was, but after this appointment I felt at a loss. On my own. Yes, she did not make me feel taken care of. Despite of the words she said to me, she did not make me hopeful. She gave me some words of encouragement. Told me to find a specialist (mind you on her description it states infertility) and try clomid. No referrals. No supervision while on the clomid. See the door on your left and don't let it hit you on your ass.
I cried after this appointment. I wasn't being taken care of. This was not going to bring me closer to "our" dream. It left me feeling hopeless and also sad that my thoughts and suspisions were true. I was indeed infertile.
How weird to admit this, I like to think I am a realist. However, on this day, I was the furthest thing from that category of people. What I really wanted was for my primary care and gynecologist to tell me I was making a moutain out of a molehill. I didn't have a problem and all I needed to do was bed on ______ and be done with it.
What I got was the truth, what had been lurking in the back of my mind for so long. Instead of just trying and praying for the best. I was entering the world of the infertile.
Now, this may sound dramatic. But it is.
For me that has meant that I must take control of an uncontrollable situation. I must pee on a stick on a almost daily basis. It means that I must assume the best at all times, so no heavy drinking and watching what I eat. It means that I check my cervical mucus and cervical position. It means that I will start having blood work on certain cycle days. It means that I will have to start going through medical procedures with the first being the HSG. It means that T and I have to decide about IUI. It means that a beautiful thing of trying to conceive has turned into a science project.
Yes, I grieve for the simple idea of making a baby. For having the thought that it should be easy and happen right away. Magically like it happens for so many others without any special effort or confusion.
In November, a very special woman told me of her story. She told me how she and her husband have "unexplained infertility." (This category should be, we just can't figure it out infertility so we need to call it something and we don't feel comfortable saying we don't know.) How she and her husband don't have anything serious that the medical communuity can name. How she and her husband went through countless tests, attempts and it never happened. How they decided it was better for them to be together childless than to continuously pursue the unattainable baby.
Yes, I grieve for the thought that this too can happen to me. For I am not any better than she. I can see how this may happen.
In December, a friend of mine, (the one that is all ready pregnant with her second), came home with her daughter. (Further refered to her as New Mom.) Myself and another friend came with me to visit. At first, I didn't want to play with the baby. After all it is the one thing that I may not want to give back once I have in my arms. But, I breakdown, and she and I play.
The comments come naturally, "Oh, your so good with her. When do you think it will happen for you and T?" She is a close enough friend. I don't have the energy to deny or to placate the situation especially right now, I am grieving. I say, "I just don't know if it will."
I play and chat for the rest of the day. As New Mom, my friend is discussing breast feeding and day care. My other friend is playing in the fantasy game. I'm listening, but not participating in the conversation. New Mom says, "What do you think?" I answer, "I don't. I don't know if it will happen, so I don't."
I know that she doesn't know what to say to me. My other friend knows more of what is going on in my head, that I have been depressed. How I really am grieving, how I don't know what the future brings, and how I must come to grips with it soon.
We leave. Before we do, New Mom's sister innocently gives me "Little Earthquakes" by Jennifer Weinner. I take it with no intention of reading it. Unless we have a miracle. It is still in the back of my driver's seat.
I part ways from my friend.
I start to drive home. Must get away from my friend before I start to cry.
I cry in uncontrollable sobs. I grieve. I remind myself that isn't a good idea on a busy highway, but I cry anyway.
I get home. I wipe the tears, because my husband, God love him, doesn't know what to do with me when I cry.
I recover. Spend a few hours with him that night chatting about nothing and then I go to bed. I cry myself to sleep while he is watching TV in the livingroom.
Yes, I grieve for the innocence of trying to conceive.
Thursday, June 15, 2006
Go To:Next SectionPrevious SectionChapter Table of ContentsMGL Search Page General Court Home Mass.gov
PART I. ADMINISTRATION OF THE GOVERNMENT
TITLE XXII. CORPORATIONS
CHAPTER 175. INSURANCE
PROVISIONS RESPECTING DOMESTIC COMPANIES
Chapter 175: Section 47H. Infertility, pregnancy-related benefits
Section 47H. Any blanket or general policy of insurance, except a blanket or general policy of insurance which provides supplemental coverage to medicare or other governmental programs, described in subdivisions (A), (C) or (D) of section one hundred and ten which provides hospital expense or surgical expense insurance which includes pregnancy-related benefits and which is issued or subsequently renewed by agreement between the insurer and the policyholder, within or without the commonwealth, while this provision is effective, or any policy of accident and sickness insurance as described in section one hundred and eight which provides hospital expense or surgical expense insurance which includes pregnancy-related benefits and which is delivered or issued for delivery or subsequently renewed by agreement between the insurer and the policyholder in the commonwealth while this provision is effective, or any employees’ health and welfare fund which provides hospital expense and surgical expense benefits which includes pregnancy-related benefits and which is promulgated or renewed to any person or group of persons in the commonwealth while this provision is effective shall provide, to the same extent that benefits are provided for other pregnancy-related procedures, coverage for medically necessary expenses of diagnosis and treatment of infertility to persons residing within the commonwealth. For purposes of this section, “infertility” shall mean the condition of a presumably healthy individual who is unable to conceive or produce conception during a period of one year. "
This is the Massachusetts law regarding infertility treatment.
Now, I 've been expecting to have to go through infertility treatment for some time. After all, my husband and I have been trying to conceive (TTC) for 22 months. Yes, it was inkling that this may pertain to me.
In November of 2005, approximately seven months ago, I went to my primary care for my yearly physical. I went armed with a chart of my then cycles. Please see below that chart with additional information.
No. Length Menses Ovulation
1 37 days 3 days Unknown
2 48 days 3 days Unknown
3 119 days 6 days Unknown
4 81 days 8 days Unknown
5 85 days 7 days Unknown
6 30 days 6 days Unknown
7 41 days 8 days Unknown
8 33 days 6 days Unknown
9 50 days 5 days O 14/15 – HF 16
10 30 days 4 days HF 10-25 – O N/A
11 43 days 8 days HF 12-27 – O N/A
12 5 days Clomid/PRO – 30-38
FM – N/A
She suggested that I talk to someone, maybe a gynecologist. She really didn't know what I had, that I had some symptoms of PCOS, as I clearly questioned on my own. But, that none of my symptoms were as drastic as PCOS usually requires them to be.
One week later, I went to the gynecologist. Let me preface this, I had gone to this gynecologist about eleven years before. At the time, I was suffering from irregular cycles, big surprise there, and she fixed it. She put me on the pill and my cycles were like clock work. They were beautiful. But, I was on the pill. Obviously counterproductive to what I want to get done now!
Back to November of 2005. I go to the gynecologist. Now, I admit my primary care didn't know what was going on with me, but I will give her credit. She put me through a heck of a lot blood work. She also gave me my yearly physical and PAP smear. Loads of fun, but she did what was medically necessary.
I go to the gynecologist and I am expecting more of the same. Do something! We talk. She comes to the same conclusion that I have come to, I may not be ovulating and that I have irregular periods. GENIUS! Heck, look at the chart. I think ANYONE can figure this out, I did.
She tells me to give it a few months. Looks like my cycles may be regulating and that I should just give it a few more months to see if this continues. Also, take the clomid to see if it helps and to make an appointment with a reproductive endocrinologist in several months.
OK. I left this appointment, confused, frustrated, helpless, and hopeless. Not good. Cried at my desk when I got to work. Definitely not a great day. What could make it better?
I called the insurance to find out about infertility treatments and what they covered?
The answer nothing to help you get pregnant! Only diagnostic testing.
WHAT?!?! WHAT DO I PAY YOU FOR?!?!?!
Luckily, I didn't say that out loud. I asked her to send me the information in writing.
So, I go about my business. In November and December I have two more regular cycles. Heck, I think, maybe the gynecologist is right and I am becoming regular.
In late December, I buy the expensive fertility monitor. At $187 for the machine and $49 for the sticks, it is not a cheap endeavor. But, after finding out my infertility coverage, why not?
In January, the little monitor says I ovulated. YIPPPEEE! My husband and I take full advantage. I go online to find out when to take the home pregnancy test. What find out is that I'm not pregnant and a FABULOUS group of women that know exactly where I'm coming from. It was a very productive month!
More confusion comes because a friend from the board posts this http://sharedjourney.com/articles/mand.html
It is an article about state mandates to cover infertility treatment. Mind boggling. It states:
Massachusetts:Massachusetts law requires those HMOs and insurance companies covering pregnancy benefits to cover those medically-necessary costs of fertility treatment. This covers IVF, IUI, GIFT, ZIFT, and sperm and egg retrieval. This mandate does not include experimental procedures or the cryopreservation of eggs.
This leads me to the MA state law, see above.
So, now the confusion has hit. But, I am not sure what to do yet. It sinks in, diagnostic testing. But, the law also states that the insurance must pay for the treatment of infertility. OK, to me that means getting me pregnant, but I see how that may mean everything but getting me pregnant.
Fast forward, it is now June, my husband and I go to our first appointment with the RE. She starts talking about IUIs. I say to her. Our insurance only covers diagnostic. She looks at me puzzled. She says, I thought it was required by law. I said, I looked at the law and it is ambiguous. She also suggests that I talk to the woman in her office who deals with insurance.
She calls me back, after five days of playing phone tag, she told me what I thought, just diagnostic testing. But, she goes on to say that I should talk to the benefits manager at my husband's company.
So, I send my husband to the benefits manager. Are you getting frustrated yet? Do you wonder why I am blogging?
He brings home the plan summary. I read it. After an hour of laughing out loud about the fact it doesn't pay for infertility, but it will pay for sex enhancing drugs. (I'm still chuckling over that one.)
I find a glimmer of hope.
There is a section about "Infertility Case Management and Education." Why would an insurance company that doesn't cover infertility treatments need this service?
I called today, and I'm waiting for a call back. Yes, I am fully expecting them to tell me "Sorry, but we don't cover infertility treatments. We are here to tell you that for the third time. We are sorry that the first two times didn't work. Have a good day!"
The meaning of contradiction Mr. Webster:
1 : a fact or condition incompatible with another : OPPOSITE -- usually used with the
OK, contradiction was not in the dictionary, but contrary was and contradiction is a derivative of the word, therefore I feel fine using the definition.
Back to my thought process, I am a contradiction. Since I have been experiencing a hormonal imbalance, at this point I don't have a more direct description of it, I am a contradiction.
I pray to get pregnant. I pray to get my period. Yes, they are a contradiction. This is where I have lived for several years.
Why do I pray to get pregnant and then also pray to get my period, you ask?
Well, because you can't get pregnant without first having your period. If you realize that you didn't conceive during that cycle, like I do, because after all it is day 40. You originally believed that you had ovulated on cycle day 13, and you later find out from your RE that you ovulated between cycle day 31 and 38. You start to pray for your period.
Hence, I feel like a living, walking, talking contradiction. Mr. Webster, you can put my picture next to that definition.
I have decided to instead to pray that I have intercourse on a day that I ovulate.
*More to come on this realization :). Yes, there is more to the story.
Wednesday, June 14, 2006
On June 5th, after approximately 21 months of trying to conceive and only 11 cycles, my husband and I went to visit a reproductive endocrinologist (RE). We are finally "taking the bull by the horns."
The doctor was 45 minutes late. My husband was about ready to hurt someone. Patience is not a virtue that he has, but I cut him off and placate the wait. Keep in mind that this is the ONLY RE in our insurance network. Another story for another day.
We enter her office. She looks over my charts and comes up with a plan. Most of the tests are for me. Only one my husband to do. He of course is freaking out about this test. (But I warned him a long time before and he has come to the conclusion that he has no choice in that matter.) I'm told that I will have to go a barrage of blood work, a HSG, Clomid Challenge Test, etc. Instead of being put off by all the testing, I'm excited to start the testing! BRING IT ON!
Yes, I am sick.
Then she says, "All of these tests must start on certain days of your cycle. You need to call me at cycle day 1 or call me on Monday. If it doesn't seem like you will be getting your period on your own, I will induce it."
That day, they checked my progesterone, to determine where I was in my cycle, if I ovulated etc. It was at 2. Right in the middle. Higher than four means that you ovulated, lower means that you are getting your period. Mind you I on cycle day 31.
I call on Monday, June 12th. I still don't have my period. No worries, this is completely usual for me, hence the RE. I'm told to come back in for more blood work.
I go yesterday. Turns out that my progesterone is now at 23, on cycle day 38. This means I ovulated last week. Yah, my body has a sense of humor. So now, since I did ovulate, I have to wait patiently for my period. Yes, this is causing issues because I want it NOW. I'm ready to take the bull by the horns!
*Keep in mind that I've seen this actually done in a bull fight, it doesn't seem to be a smart thing to do. But just like the matador, I must do it!
During my teens, I knew this amazing person. She was terminally ill with cystic fibrosis. I say she was amazing because despite the knowledge of her impending death, she choose to live and fight for as many days as she could and excel while doing it. In her final months of life is when I started to pray.
Now, I admit that I had prayed before, but never with a clear purpose such as for my friend's life to be saved. That is what I prayed for, that she be saved. To be pain free and to be saved.
Well, she and I got the pain free :S. Heck, if you think about it, she also got to be saved.
This is when my first trials and tribulations in faith started.
Soon after, within a month of each other, I had another friend, age 20, find out that he had a tumor in his knee and a cousin, age 10, find out that he had a brain tumor.
Now, my prayers had graduated. I prayed for their lives to be saved, so that we, insignificant mortals, have a little while longer with them here on Earth. (I got a reprieve with the first before he died two years later. Luckily, my cousin has been fighting an amazing eleven year battle and continues to win. I pray for him daily.)
So, the book talks about nature and how it causes the bad things, but in and of its self, it is not a bad thing, but neutral.
As a Catholic, I am taught that all things are controlled by God.
Now, how am I to interpret this, nature; genes, illness, natural disasters are responsible for all the bad things that happen. (I'm leaving human choice out of the equation at this point, way too much to think about.) So, you can't blame God. He is there to give us strength in living through the ordeals.
Yes, I believe this....but why is it that I still pray for my cousin to be saved and for myself to be given a chance at conceiving despite of all the evidence that this may never happen.
Miracles.....yes, I pray for them too.
The book does say that they happen. Miracles do happen everyday. I agree with this too. It goes on to say that miracles are sometimes so small that you cannot see them immediately. I agree with this too.
So, what is my problem with the book?
My problem is, than who do you blame? Yes, I feel like I need a responsible individual. Who do you yell at? Who do you demand answers from?
Tuesday, June 13, 2006
I was volunteering with the youth group and was asked to join the retreat program to be trained as retreat leader.
I said yes.
He was assigned to train me :).
First we go through retreat training. There weren't any real immediate sparks during the training sessions. At least we never admitted to them :).
Then, retreat. I gave my talk which is my personal account of how I came to believe in God. My sister was a retreat participant. Her contact slipped and her eyes were watering during my talk. I noticed. I thought she was crying because of what I was saying. (Talk about self-importance.) It made me catch my breath and I kind of lost it myself. Mostly because my sister is six years my junior and I never shared all of it with her.
So, my husband is watching this occur.
Now, he was suppose to recap my talk and explain how if fits in with the thread of the weekend. He didn't say anything, and just told everyone to go into small group.
Later in the day, I notice him. You know that notice that you usually have at initial contact with someone that you may be interested in. He was playing with a group of kids. Wow, he is really great with these teens. (Snap - relationships that start on retreats are started in a retreat world. This was my opinion at the time, obviously things change.)
So, fast forward. My friend was trying to hint that he might like me. I told her of my theory. She let it drop :).
On the second day, my husband and I are having a quiet moment. Honestly, on retreat, they are far in between. I ask him how he thinks the retreat is going. He says, "I always have a "WOW" moment." So, again I don't think before I ask my next question. "What was your WOW moment for this retreat?" He said, "You were..."
Well after a month of pursuing me, I caved and we started to date. It was the best thing I ever did :).
I keep the anger bottled up and for the most part it passes. Today, someone made a comment that sent me through the roof. But, I bit my lip. It was during an email conversation that went like this....
I am really upset. I could CRY. The nurse just called me back to tell me that my progesterone was 23, which means that I ovulated in the last week because the blood work from early last week showed that I was at 2. My body is really out of whack considering I'm at cycle day 38 and the first blood test was done on cycle day 30.
I'm feeling really upset, I think that I'm PMSing.
The person replies, How do you know if your are PMSing.....obviously your hormones are all over the place. You blame being angry so many times on being premenstrual....but how can you be. Just admit that you are angry, disappointed, frustrated.
This is when I bit my lip.
My first response was like this:
I appreciate all you have done for me. You have been incredibly supportive, especially when you went on line to learn about the various things I would be going through for testing etc. However, progesterone is one of the hormones that causes PMS, the other one is estrogen. So, if my levels went up, I feel like I don't fit in my own skin, and that I could hit you right now, I'm guessing that I am experiencing PMS.
What I sent was:
I appreciate all you have done. Yes, I am angry.
My hormones are out of whack people. Half the time, I don't know what is going on with my body. For the most part I feel broken. Uncapable of doing what most female bodies do so naturally. But, I believe that I still have the right to say I am PMSing. Heck, I think that I have even more right than most! ERRRR......I am still angry.
Thanks Mr. Webster, yes that is indeed how I felt on Friday. Friday was my birthday. Overall a great day. My husband made dinner for me and several friends. The food was fantastic, shrimp cocktail, caprese, roast beef, carrots, and mashed potatoes.
One of the couples is from out of town. I noticed that she wasn't drinking. (Thought to myself that is odd...I know she is breast feeding but, she could have at least one. Instead of following the thought process through.) I ask, "Are you pregnant?" (Wow, I didn't think this through, because I definitely did not want to hear the answer in the affirmative. It is one of the first rules, you NEVER ask a question that you don't want to hear the answer to.) She responds guiltily, "Yes!" I say, "YIPPPEEE!"
What was I suppose to say? "What about me?" or "When is it going to be my turn?" or "You have one beautiful little one, couldn't you be happy with her for a little while longer so that there would be more souls for God to give me one?"
OK, I am a mean person. I am a selfish person that only wants things for herself. BUT, I AM REALLY NOT!
Ultimately, I am thrilled for her and her husband.
But, I am envious.
I dream of that little one that my husband and I can call our own. He/she has his big blue eyes. My curly eyelashes. His black hair with my curls. His great quick wit and my love for reading. The little one can't sing, but neither can we. But most of all, the little one has our love to laugh!
Yes, I have thought of the unattainable child more than I care to admit. He/she comes into my dreams. I wake up hugging a pillow with a sense of desperation and grief.
So yes, I am envious.
Very often I have thoughts and feelings that I cannot fully express. I usually resort to writing a letter to sort everything out. It is usually to a person. Heck, my issues are usually with a person. But, I haven't been able to direct my anger, frustration, exasperation, to just one person. See my issues are with so many: myself, God, the health care system, uncaring doctors, family, friends, and strangers. I feel that I must bite my lip. I can't anymore, this is where I can say what I'm thinking.
Really, I am a positive person, however reading my first entries you may doubt my truthfulness. It is just that after two years of trying to conceive I think that I've reached the critical point of explosion.
I have a wonderful husband, family, and friends. However none of them completely understand. Not that they could because they aren't me. My thoughts are contradictory so many times that I often wish that I could turn them off. (One minute I am optimistic and the next pessimistic....ahhh.....but that could be that I'm a Gemini and its part of my complex self. HA!)
So I rarely talk about the situation as much as I think about it. :).
Mostly because of my theory that if you say it OUT LOUD than it's real. I'm affraid of saying so many things OUT LOUD because I don't want them to be real. Here is my attempt at finding peace while saying things OUT LOUD......BOOM!