Thursday, February 02, 2006

...and the ones that Doctor gives you don't do anything at all

OK, OK, so that is possibly the most predictable Part Two title ever. Also, it doesn't rhyme with the earlier title. Deal with it.

When we left off earlier this week, Ezra and I had decided it was time to try to add a little person to our family. If you've read through my archives (this blog didn't go public until a year after I started tracking our journey), you can probably skip the rest of this post. But if you didn't bother with all those old entries (and why would you want to?) or if you're coming here months or years from now, at a point when February of 2006 seems like ancient history - this post's for you.

Some time before stopping birth control, I had ordered Taking Charge of Your Fertility and read it cover to cover at least twice. I ordered the accompanying software to help me interpret the charts and provide easy records for my doctor to look at, if necessary. I agonized over whether it would destroy my charts if I didn't take my temperature on Shabbat, and decided it wouldn't. I latched onto the idea that some women have "rebound fertility" - strong, on-time ovulation in the first cycle or two after stopping hormonal birth control, the result of ovaries crying out after years of oppression. I practiced temping in the mornings while I was still on birth control, so I could get used to the idea of doing nothing else at the first moment the alarm went off. And then, in January of 2005, I put this all into play and began charting.

I never had clear fertile signs - a cervix on a pogo stick, intermittent patches of "egg white" cervical fluid, maybe a temperature dip here and there - but we had plenty of sex just in case. Seventy-odd days into the first cycle, with no evidence of ovulation or pregnancy, I started Prometrium, which did little more than cause my uterus to hiccup. Then we rolled out the Provera, which did the job, and by the end of April my first cycle was over.
Another anovulatory "cycle" followed by another course of Provera, and in June I had Day 3 testing done: LH - 19.6; FSH - 5.8; E2 - 36; fasting insulin - 6. With an LH:FSH ration of 3.3:1, my doctor concluded that I have PCOS. She offered to start me on Clomid right away, but I demurred and instead opted to attack the problem at its (supposed) source with some metformin (even though technically I am not insulin resistant). I started at 500 mg per day for a week, then upped it to 1000 mg. When, after three months, there was no evidence of ovulation, we decided to up the dose again to 1500 mg per day (1000 mg in the morning and 500 mg in the evening). All this time, I was ending my cycles with Provera somewhere in the 40-60 day range.

Guess what? I'm still not ovulating.

I refused two more offers by my doctor to do Clomid with her. "It's safe," she said. "Lots of women get pregnant on their first or second cycle." And, believe me...it was really tempting. Really, really tempting. But thanks to the wise advice of (and judicious use of scare tactics by) some friends (yes, persephone, I mean you), I resisted the urge and held out for an appointment with an R.E.

And here we are, two weeks away from our first appointment with Dr. Q. I'm afraid the medical history to date isn't as exciting as most others you may have read, but it's mine and that's all that matters. Besides, the road ahead promises to be plenty exciting...

At 4:31 PM, February 02, 2006, Blogger persephone said...

Well, you see what happens when I stop scaring you, I must resort to scaring myself instead. My secret middle name is apparently The Boogeyman.

Boogeywoman? Boogeyperson?

 
At 12:59 PM, February 03, 2006, Blogger Ornery said...

"...ovaries crying out after years of oppression." HA! You really, really crack me up!

In case you're interested, I found this interesting article about alternatives to Clomid, especially for folks with PCOS. It's entitled, "Clomiphene citrate-end of an era? A mini-review," by Roy Homburg in the journal, Human Reproduction. Unless you have access to medical journals, I think you have to pay to get the full article. If you'd like to read the whole thing but can't access it, send me an email (ornerylotus@yahoo.com) and I'll send you a pdf. (That's goes for anyone else who's also interested in reading this article.)

 
At 12:52 PM, February 05, 2006, Blogger Thalia said...

Have you also been tested for thyroid problems? Just wondering...

 
At 9:59 PM, February 05, 2006, Blogger Robber Barren said...

Have you also been tested for thyroid problems? Just wondering...

Thalia - No, I haven't but I'm going to request that Dr. Q run those tests for me as well.

 
At 10:38 PM, March 03, 2006, Anonymous Pipit said...

I also have PCOS without insulin resistance. After a year and a half without ovulating I started taking Estrium (a natural food powder by Metagenics that promotes estrogen activity) and within 2 months I was ovulating. I used 1 tbsp 3 times a day, under my chiropractor's direction. I don't know if it could help you but it might be something to try if you want to avoid drugs like met and clomid, which are worth avoiding in my opinion.

 

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