Must remember to breathe.

As with most things with this infertility crap, something is going wrong. As most of you know, the insurance has been approved. I received my first bill of at least six in the mail yesterday – and it was higher than expected. The insurance cards should be arriving soon, but the bill includes my insurance number. So, I should be good to go, right?

Well, we are also going into my busy few weeks. I work for a company with foreign subsidiaries. And two of the more demanding foreign subsidiaries – because of antiquated laws – require actual board meetings. Which in themselves aren’t bad but when you need to coordinate VERY busy people’s schedules, it makes your life miserable. So, in my latest attempt of being proactive, organized, and to keep my job; I called the REs office, because I will also need to coordinate monitoring with the VERY busy people’s schedules. Can we say crap!

Since, November – saying this may jinx everything but – I’ve had somewhat normal cycles. I’ve actually ovulated every cycle since October. So, I ovulated this cycle as well. And I expect my cycle to start early next week. (The only reason I can come up with is that the clomid kick started my ovaries or that the clomid is still in my system and stimulating the ovaries. I hardly believe this will be a continuous situation.) The cycles themselves are hardly "normal", but I am not complaining, anything less than 60 days is a minor miracle.

I called the REs office, I wanted to know when I will be monitored etc. Get this one – the IUIs were to be unmonitored. WHAT THE FUCK!!!! Excuse me? So, I kindly spoke to the nurse and made the following points in a – listen to me, I am not effing around kind of way.

1. I absolutely insist in a MONITORED cycle.
2. Because we have no idea what kind of ovulation I’m currently having. If it is producing a worthwhile mature follicle or how many.
3. I have a limited time on this secondary insurance and therefore a limited amount of procedures.

The response, the nurse thought I was demanding that she change it immediately to a monitored cycle. I told her, I am not unreasonable. I was making my point to find out the best way to proceed with the doctor to change her stance of monitored versus unmonitored. She said she would talk to the doctor on Monday and I should call back then.

Realizing that my blood pressure is through the rough right now and I also know that my doctor is a reasonable person and if she relays the information accurately – she will agree to monitored IUIs. But, at this exact moment, I feel if it isn’t one thing it is another.

Oh – and in completely unrelated infertility news – did I tell you I am my sister’s matron-of-honor. Currently planning my sister’s bridal shower with six other women. The task of getting more than one woman to agree on anything – well it is hurting my head. Than add to the mix – mind you I am writing up 154 save the date invitations in Calligraphy, outside envelopes for the save the dates, bridal shower invitations and wedding invitations – and her list of invitees sucks! I called her to provide me more information and she tells me that she doesn’t know and that I am on my own. Again, what the fuck?

So, I sent the list to the groom’s sister, begging for help. She sent me an email about how she and her mom were very disappointed in the list. I tell her, believe me, I understand and that I absolutely need this list to be perfect, because I will be referring to it for the next six months constantly! Totally want to get it right. So, now, I am meeting her and her mother on either Monday or Tuesday to do my sister's list.

Not to mention, I have another bridesmaid, who is our cousin, and she is all ready complaining about the financial obligations. Crap, the most we will need to contribute is $200 each– which includes the gift! And I doubt it will be that much. Why, because my parents are paying for the location and food – it is what they did for me and they want to do it for their other daughter.

Now, this is why it is bugging me so much – my sister and I were in my cousin’s sister’s wedding a few years back. The bridesmaids paid for EVERYTHING – cost about $600 a piece – there were six of us. And they spared no expense – they had it at that same place T and I got married – it was expensive for a shower. Her reasoning – just graduating don’t have job. Well, my sister was in high school and I had just graduated and was working for below minimum wage. Nope, did not have the money to spend. But I found it, and my parents paid for my sister. So, I am extremely tempted to say, “Suck it up. You shouldn’t of said yes. You knew the time frame, and you also knew that you would need to fork money up.”

The funniest part is that I was just talking to my sister’s future sister-in-law saying that these girls did not have any money to spend. That she and I were the most established in our lives. One is starting her own business. The other three are just graduating from college, in Vet school, and in Grad school. In other words, we must find a way to keep costs down.

All right, I think I’m done. If you actually read this bitch session, thank you. I feel better. Err…why can’t life go smoothly?

Cycle 15, Month 24

As we start cycle 15, I feel numb.

When I purchased my last round of Clomid this afternoon, I was reminded by the pharmacist that it was "the last refill on the prescription." I responded with, "I am all too aware."

The last cycle of Clomid only marks the end of the less evasive measures to get us pregnant. After this, the RE has recommended three injectible medicated IUIs. In other words, the beginning of the journey into A.R.T. (assisted reproductive technologies).

Today, I decided it was time to pursue our insurance again. This time, the women told me in not so many words, they can't help us. They have done what they can. They paid for the diagnosis and if the diagnosis is a problem that cannot be fixed by an operation you are on your own.

I knew that this was more than likely their response. Yet, I find myself close to tears.

It only means the beginning of another battle in finding a secondary insurance plan which I knew would be in the future. But, for some reason, I hoped that the information I gathered was going to change the answer.

Frustration, exhaustion, and emotional turmoil is knocking on the door. I need a vacation.

Progesterone Result

The number, well it isn't exact, but I was happy with the inexact number I was given.

"Twenty something, you definitely ovulated."

YIPPEEE!

And the number is high for 9 DPO which allows me and T to hope. (Sigh of relief.)

Now, must wait for Monday for blood test. (The RE said Monday, even if the nurse said Wednesday. I like Monday better.)

Who knows, a HPT maybe in my future? If only I could quit POAS. :) I think it would be better for my mental stability.

Progesterone Levels

Thank you FertilityPlus.

Progesterone in Pregnancy
When
Normal Values
What Level Means

Mid-Luteal Phase
5+ ng/ml
As mentioned above, a level of 5 indicates some kind of ovulatory activity, though most doctors want to see a level over 10 on unmedicated cycles, and over 15 with medications. There is no mid-luteal level that predicts pregnancy.

First Trimester
10-90 ng/ml
Average is about 20 at 4 weeks LMP, and 40 at 14 weeks LMP. It is important to note that while a higher progesterone level corresponds with higher pregnancy success rates, one cannot fully predict outcome based on progesterone levels. Progesterone supplementation is unlikely to help if started after a positive pregnancy test.

Second Trimester
25-90 ng/ml
Average is 40 at beginning, 90 at end.

Third Trimester
49-423 ng/ml
Usually peaks at about 175.

Excellent graph at http://repro-med.net/papers/progest.html.

Findings

Well, the RE appointment was this morning. She spent an hour reviewing all of my tests, and kept me in the waiting room while she did so. When she came to get me from the waiting room, she had made her medical mind up, and only spent 10 minutes explaining her findings.

I have. Drum roll, please. I have an "indication of PCOS because of my high testosterone." But, I don't have any of the other symptoms and all of my other tests came back normal.

OK, so not as cut and dry as I hoped. Like you definitely have PCOS. But, relief that I don't have any tumors. Actually, she was the one who said it. (For this reason, I really like my RE becuase she goes along with my crazy thoughts before I say them out loud.)

There is nothing to fix my testosterone imbalance. It is the way I was made. GO NATURE, please note, sarcasm has been added.

The plan for the next six months is the following. Three months of Clomid at 100 mg and good old fashioned s*x. If this doesn't work, I move onto Clomid or injectibles for three months with IUI. If this doesn't work, we reevalutate.

My homework is to look into supplemental fertility insurance to cover IUIs. She likes to give me homework.

Also, she checked my progesterone. The results should be here tomorrow. If they are low or non-existent, that means negative on the pregnancy this cycle, but that the Wicked Witch will be coming. If high, I should keep my fingers crossed. Hoping for the second :).

Monday!

YIPPEEE! The RE appointment is Monday. Only 70 hours away. I will be going sans T. But, I am so excited to find out what is wrong with me or the next test, that I am OK going without him.

(Yes, it is confirmed that I am nuts, since I am more concerned with naming the problem than the potential aftermath of finding out what is wrong with me. One step at a time.)

CD 26, DPO 6, and still optimistic. Everything is good. And it is Friday!

Therapists' top ten tips for coping with fertility problems

Thank you, BabyCenter editorial staff this is truly a helpful article. I've decided to see if I use these in my TTC saga.

The pressure to raise a family can be enormous, and the thought of not being able to can make many people feel something is wrong with them. We talked to respected psychologists who work with couples with fertility problems to find out which coping strategies really work.

Recognize that a fertility problem is a crisis. A fertility problem may be one of the most difficult things you'll ever face. Acknowledging this is a key to coping, says Kate Marosek, who's counseled couples with fertility problems in the Washington, D.C., area for more than ten years. "It's normal to feel a monumental sense of loss, to feel stressed, sad, or overwhelmed. Don't chastise yourself for feeling these ways." Facing and accepting your emotions can help you move beyond them.

Check.

Don't blame yourself. Resist the temptation to blame yourself or to listen to the little voice in your head that may be saying, "I shouldn't have waited; I'm being punished for having that abortion; I should have lost more weight or taken better care of my health; I shouldn't have assumed that I could have children when I wanted," or whatever.

People can get caught in negative-thinking patterns that only make things worse, says Yakov M. Epstein, a psychologist at Rutgers University and co-author of Getting Pregnant When You Thought You Couldn't: "Instead of berating yourself, look forward to how you and your partner are going to manage the situation." When you start feeling like you "should have" or "could have," remind yourself that your fertility problem is not your fault. Even if you could have made different decisions in the past, they're behind you. Concentrate on your future.

Is considering yourself broken, blaming? But I don't think it was anything I've done. Must contemplate.

Work as a team with your partner. You and your partner should help each other through this time (and definitely not blame each other for your difficulty getting pregnant). This doesn't mean you need to feel the same thing at the same time — that's one of the most common pitfalls for couples facing fertility problems. It does mean paying attention to what your partner's going through. "If you're taking care of each other emotionally, you can unite to fight the problem," says Marosek.

Work together to find practical ways to share the burden, too. If you're undergoing treatment, he can take care of the insurance papers. Or if he needs injected therapy, you can administer the shots.

Check. We take turns in freaking out. He and I have united in many ways. Coming to agreement in definitions. Realizing that most of this freaks him out and that he is in a need to know phase. But, he has been very good about going to his HR, coming to appointments, taking me to appointments, etc. He did over book himself and now he can't make it to the 17th appointment. I think there is room for improvement.

Educate yourself about fertility problems. Read as much as you can about fertility problems, and ask your doctor and other couples in your same situation questions. This is especially important when you're dealing with a fertility problem because the technologies behind the treatments are complicated and change quickly. "You've got to understand what's happening medically," says Epstein, "or you won't be able to make informed choices."

See our resource guide for a list of books, Web sites, and organizations that can help, or learn the basics by starting at the beginning of our Fertility Problems area.

Check. Have you read my blog? This isn't half of what I've learned in the short time that I've been trying to read everything I can find.

Set limits on how long you're willing to try. Some couples decide from the get-go that they won't go to extreme measures to have a baby. Others spend years and thousands of dollars trying out all their treatment options. No one can tell you when to stop trying to conceive — that's a decision you need to make with your partner and doctor — but you'll feel more in control of your life if you start thinking in advance about how far you're willing to go to get pregnant.

Start by discussing your medical odds of getting pregnant, which treatments you're not willing to try, and your end goal. (For more help making this decision, see Making the decision to end fertility treatment)

Have not done this, but it is yet premature considering we don't know what is wrong with me or what the best course of action will be. Need to know more information before we can decide.

Decide how much you're willing to pay. With in vitro fertilization (IVF) averaging $10,000 to $17,000 a cycle, it's no wonder couples feel anxious about money, especially since women often need to go through multiple cycles before becoming pregnant. To cope with the anxiety caused by the high costs of treatment, sit down and develop a financial plan. Start with your insurance: Find out exactly what it does and doesn't cover. If it covers some or all of your treatments, decide whether you or your partner will monitor the paperwork and negotiate with the insurance company. Then look at all your assets and determine how much you can spend and on which treatments. "You should always have a plan B," says Alice Domar, a Harvard University Medical School psychologist who specializes in helping couples with fertility problems. "Because nothing, especially with fertility treatments, is certain."

Again need to know more information before we can determine this, however it does seem wrong in a way. How much is a baby worth?

Get support from professionals or others with fertility problems. Society often fails to recognize the grief caused by fertility problems, so those denied parenthood tend to hide their sorrow, which only increases their feelings of shame and isolation. "Finding other people who are going through the same thing can help you see that fertility problems are widespread and your disappointment is understandable," says Linda Klempner, a clinical psychologist and mental health consultant at the Diamond Institute for Infertility and Menopause in Millburn, New Jersey. Connect with others who can relate on one of our Fertility Issues bulletin boards.

If you'd like to talk to a therapist, look for one who understands fertility problems. "Fertility problems are very complex, and if a therapist does not understand the medical issues he or she won't be able to help," says Epstein. Ask RESOLVE for a referral or check out the InterNational Council on Infertility Information's list of therapists.

Not at this point yet. My T, blogging, my friends, and crochet are my therapy for now.

Just say no to baby-focused activities. If certain gatherings or celebrations are too painful for you — all your siblings had babies in the last two years, say, or you keep getting invited to baby showers — give yourself permission to avoid them or at least to have a good cry afterward. To avoid hurt feelings, send a gift, but send children's books to save yourself a troubling trip to the toy store or baby boutique.

Not at this point yet. There not fun, but I can still manage without breaking down at them, I can wait until I get into the car.

Balance optimism and realism. "You need to be optimistic to go through a procedure," says Epstein, "but if you're too hopeful, if your hope is unrealistic, you'll be setting yourself up for a huge fall." By keeping up to date on the technology and your diagnosis, you can get a good handle on what chance of success you have with each treatment.The array of medical technologies available today leads many couples to keep trying month after month, year after year. But about a third of couples treated for fertility problems won't go on to have a biological child, and often they must make peace with that before they can move on with their lives. Staying realistic can help you make smart choices as you work your way through the emotional minefield of treatment.

Check. I do believe that I do do this one. For the most part I am a realist. After 22 months of TTC, 13 menstrual cycles, and only two confirmed ovulations. Yes, I am cautiously optimistic. This is one of those all too few times, so I will enjoy it as long as possible.

Take care of yourself by pursuing other interests. Being treated for a fertility problem can feel like a full- or at least part-time job, so it's important to keep up with some of the activities or hobbies that bring you pleasure. "It won't be easy," says Marosek, "especially if you're doing something like going in for a blood test every other day, but look for ways to take care of yourself." She recommends that people get a massage, have a manicure — anything that can give them relief from the focus on fertility treatment.

If your old activities are painful — maybe all your friends are parents now — look for new diversions. If hiking is your thing, do that. Or take a class — painting, dance, or something else that's always tempted you. And remember, laughter is one of the best healers. See a funny movie, head out to a comedy club, and re-read your favorite funny novel.

This one, I have tried. But it is very hard to do. Especially when the things I want to do don't exist in my area (cooking classes or book clubs) or are really expensive (yoga and pilates classes). After spending $80 on fertility monitor sticks and ovulation predictors, saving for potential IUIs that cost $750, etc.; there is very little left.

OK. Not bad. Four checks and five needs improvement/not applicable at this point. Everyone has to start somewhere.

CD 22, DPO 2

Not feeling completely obsessive yet. Yes, this is a small accomplishment. But, it should be noted.

Feeling very content that we have a chance this cycle. An opportunity that it could happen. Yes, this makes me feel happy.

T is exhausted, if I am to be truthful, so am I. A marathon is work, despite how pleasing it is!

Also talked to the nurse at the RE's office about the weekend surge, turns out that I could have just called and come in on Sunday and Monday for the IUIs. But, she agreed that since we haven't had our review of our exams it may be more productive to wait. (After all it will be coming out of our pocket.) I asked if I needed a progesterone test to determine if my fertility machine and ovulation predictor were correct. (Yes, I realize how obsessive that sounds.) She said that it would be a good thing to ask the RE, with my history, at my appointment. Also, if the Wicked Witch doesn't show by the 25th, I am to call for a pregnancy test on the 26th. Little does she now, that if the Wicked Witch showed that soon, cycle day 38, I would have a minor heart attack!

So, I must wait seven days, Monday to get my medical diagnosis. And, 16 days for the all important pregnancy test.

The wait is the killer. Oh boy, what will I do with my time. The same thing I always do. No worries, I will fill you in soon. :)

Ovulation Please

Yes, I am waiting patiently to ovulate. (Sarcasm) What fun!

I pee on a stick (POAS) in the morning for the fertility monitor and on a ovulation predictor at night. There is hardly a chance that I will miss the surge. At least this is what I tell myself. After all if I don't detect the surge, than there definitely will not be an IUI or exactly timed intercourse, and I can't let this happen.

I've used the monitor since January. It only detected a surge once in that entire time. It has no problem in detecting my estrogen increase. The estrogen has been detected every cycle except for one. However, since I can ovulate between cycle day 13 and 38. The monitor directs me to stop POAS on or about cycle day 28. I've learned that I must continue to use the ovulation predictors basically until I see the Wicked Witch. Also, since the monitor is only used in the morning and many people experience the surges in the afternoon, I am also forced to test at night as well by using the ovulation predictors.

The estrogen elevations are also interesting. Mostly because it never detected a spike during my first cycle of Clomid at 50 mg. However, during this cycle of Clomid at 100 mg, it has detected my elevated estrogen levels since cycle day 12 which gives me some hope that I may ovulate this cycle in a timely manner.

So say it with me. PLEASE, OH PLEASE, LET ME OVULATE IN THE NEXT FEW DAYS. I will leave out the part about me and T having s*x on that day too.

The Hormones in action when a woman ovulates.

When a woman ovulates, various hormones in her body are synchronized to prepare her for ovulation, fertilization and implantation. Ovulation occurs approximately 10-12 hours after the LH peak. Here are the primary hormones involved in ovulation in women:

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.

Clomid/Clomiphene Challenge Test

A clomiphene challenge test is a dynamic type of test that can discover some cases of poor ovarian reserve that are still showing a normal day 3 FSH.

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.

HSG and Miscellaneous

The HSG is done! It went really well. All of the reproductive organs are in order. The tubes are clear and the uterus is normal. Thank God for the doctor, he was great. Kept me talking the whole time so I didn't notice what he was doing. Then he went through each of the x-rays to explain them to me.

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.

The Afternoon

The rest of the day was fine. A nurse from the RE's office called and only gave me partial information on the bloodwork. For the most part it was good news. My FSH was only in the 5 range. Anything under 10 is good, the insurance requires that it be lower than 13. So, very good. My LH hormone was slighlty higher than the FSH, but not that much. The only thing that was of note was my testosterone. So, like myself, I have begun the investigation.

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.

More later.

Testosterone

Per my blood work, I have high testosterone at 88.7. The norm, for day 3, is 6-86 ng/dl
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.

Testosterone

Test Overview

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
Normal values may vary from lab to lab.

Women:
less than 100 ng/dL

Women:
less than 10 pg/mL


High values

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.

Credits

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

- Endocrinology
Last Updated July 2, 2004

My Morning

This morning got up, feeling fine. I take the antibiotic. Start to get ready for the day. Brush my teeth and start to gag. OK, not good. So, I eat some crackers to try and settle my stomach. I get in the shower. Get out, the stomach is not feeling right. So, I go back into the kitchen, because I remember we have gingerale. I don't even get to the gingerale, before I gag again. This time, I couldn't stop myself. Vomited, luckily I did make it to the toilet.

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.

Day 3 Labs - Done

Eleven vials later, day 3 labs are done. I will be just fine with a little patience and iron riched foods.

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.

WHAT THE RE THINKS I HAVE

Polycystic Ovary Syndrome is a common disease, which can cause symptoms such as irregular periods, excessive facial or body hair, acne, infertility, irregular spotting and obesity.

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.

WHAT IS CLOMID?

Clomid or Clomiphene Citrate is often prescribed to women who are having problems ovulating. It is unusual to be prescribed Clomid for over 6 months, although some women use it for up to 12 months. Some women are prescribed Clomid to help regulate their cycles, even though they may already be ovulating.

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.

WHAT HAPPENS WHEN I HAVE A HYSTEROSALPINOGRAM (HSG)?

A hysterosalpinogram (HSG) is an x-ray examination of the fallopian tubes and uterus, which checks to see if the cavity of the uterus is normal and whether the tubes are open. It is normally performed between day 7 and 10 of your cycle and takes about 30 minutes to perform and does not usually require a general anaesthetic. Some hospitals suggest you take a painkiller before having the procedure.

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.

NOW THE FUN STARTS!

Yes, I have decided that I am sick.

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:

1. 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.
   
2. 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.
   
3. Luteinizing Hormone (LH): <>
4. Prolactin: <>
5. Progesterone (P4): <>
6. 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.
   
7. 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.
8. 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.
   
9. 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.
   
10. Free Testosterone: .7-3.6 pg/ml
    
11. Dehydroepi-androsterone Sulfate (DHEAS): 335-430 ug/dl.
    
12. Androstenedione: .7-3.1 ng/ml
    
13. Sex Hormone Binding Globulin (SHBG): 18 — 114 nmol/l, Increased androgen production often leads to lower SHBG
    
14. 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!!!!