The Great Follistim Shortage

I was finally able to start a cycle with my doctor's office!

After waiting for a cyst on my ovary to collapse and travel plans to pass, I was finally able to move forward with treatment.

This time around, my doctor had me go straight into injections with Follistim. I was really lucky to have a friend who had some Follistim leftover from another cycle that was not yet expired. However, when I tried to order more, I learned that there was a national Follistim shortage.

How the heck does that happen!?

Considering that Follistim is lab-derived, you'd think that it would be fairly straightforward to keep in stock. Right? Well, apparently not. 

When I used up my supply from my friend, and needed more the same night, I let the nurse know that I didn't have any. She sent out the prescription for GonalF, which was it's own adventure in fertility drugs. However, since I didn't have any on hand and needed to inject myself with a dose that night, I was lucky enough to get some Follistim from my doctor's office that had been donated back by another patient. 

I drove through rush hour traffic all the way across the city and back, and in the midst of it all, one of my tires was losing pressure and I was super paranoid driving back across town in the event that it might blow out or get flat. Talk about stressful...

It boggles my mind how a pharmaceutical company isn't able to accurately forecast med quantities. You'd think that a shortage would be unheard of...or if there was a shortage that the pharma rep would let the doctor's office know.

And let's now get started on the complete and utter racket that the pharmaceutical companies and insurance companies are. They are no doubt in cahoots with each other for profit. I feel like insurance companies should be a non-profit organization based on principle alone - in order to provide the best care for their customers, instead of gouging them, quoting ridiculous pricing for medications.

I'm not sure how it's possible, but the medication that I ended up ordering through a cash pharmacy was quote to me at almost THREE times the cash price, and that was supposedly the "co-pay". In my experience, co-pays shouldn't cost more than the CASH price of a drug. Maybe I'm wrong, but something just seems terribly fishy there. 

As of this writing, Follistim is still in a state of national shortage, and hopefully should be back to normal stock by July. 

Our Infertility Journey

Going through infertility is probably one of the hardest things I've had to deal with in my adult life. It's kind of weird because it's not a life-threatening condition, per se, but it is a disease. One that people often suffer in silence with. 

However, infertility has also proved to be a great blessing. How? If it wasn't for being on this journey through the waters of infertility, I would have never met the amazing community of ladies who are going through the same thing. We all belong to a club that we wish we weren't a part of, and each wait for the day when our membership is revoked. We can't wait to be kicked out of the club.

I don't think I've shared our own infertility journey, and if anything, it needs a little updating. 

We got married in July 2009 and because we dated long distance for three years, we wanted to spend the first couple of years of marriage as a couple. We knew we wanted children, but we wanted to savor the time just the two of us. 

In 2012, during my annual well woman exam at my OBGYN's office, I was officially diagnosed with PCOS - polycystic ovarian syndrome. I had the symptoms: trouble losing weight, craving carbs, unwanted facial hair, thinning hair, irregular periods... All "manageable" symptoms through nutrition and exercise, but annoying nonetheless. Since we were not yet trying to start a family, I continued on the pill to regulate my cycles.

In 2013, we were ready to start trying for a family. I came off the pill and knew that it could take a couple of months for my hormones to regulate. We made it to the end of 2013 with no success.

In 2014, after about a year of trying, we saw my OBGYN to try some medicated, timed intercourse cycles. We did Femara/Letrozole and also tried Clomid. I seemed to respond decently to the medication, but no pregnancies. 

In June 2014, my OBGYN referred me to a reproductive endocrinologist - the office whose Letrozole and Clomid protocols she was following. I made the appointment and went to my first RE consultation.

I went to the consultation by myself and walked away overwhelmed and unimpressed. The doctor I met with didn't take any time to get any of my history (which I thought was important) and quickly launched into a standard protocol of Clomid and trigger shot.

At the time I wasn't as familiar with medicated cycle protocols as I am now, and I felt like the doctor was not listening to me. My OBGYN had suggested that I had a uterine lining issue (it was thinner than ideal), and told me to tell the RE. Well, he didn't even listen to that. I felt like I was wasting my time if he was just suggesting the same thing I had already done at my OBGYN's office.

I was annoyed. I didn't like that he didn't get to know me at all. I felt like a number and he was just giving me the standard plan of care. I felt like if I was going to have to pay out of pocket for this anyway, I needed to like my healthcare provider.

Needless to say, I did not return to his office ever again. 

At the end of 2014, I did return to my OBGYN's office for two more medicated cycle attempts. When our final attempt had no progress, we decided to take a break from medicated cycles. Around the same time, I also started seeing the nutrition testing specialist through my chiropractor. We started supplementing what I was deficient in to help rebalance my hormones.

I continued to see the nutrition testing specialist through the beginning of 2015. I was a lot of vitamins and supplements, and I felt like if I could help my issues in a natural way, that would be great. 

After about a six month break, I started to look into a new reproductive endocrinologist. There were a few top offices in our area that I found.

I had a couple important criteria I wanted in a doctor:

• female doctor
• experience with PCOS
• compassionate, empathetic, kind

While I know that male doctors are probably just as qualified as female doctors, I believe that female doctors understand these issues on a level that a man cannot. I feel way more comfortable with a female doctor and it helps when she can empathize (NOT sympathize) with me.

In July 2015, I made an appointment with an RE at a new practice. Based on her online profile, she seemed to fit most of my criteria. The personality component would be determined at our consultation.

Well, long story short, I LOVE our RE! She fits all the criteria and really appreciated that she spent about an hour with us going over our family histories, our personal medical histories, and personally did my first baseline ultrasound. I was impressed. She was kind and carefully reviewed our case to give us her honest suggested plan of care.

In August 2015, while waiting for my cycle to start before we could move forward with the plan of care with our RE, I was on cycle day 40...and I took a pregnancy test. It was positive! I had never seen a positive test before! Coincidentally, the RE's office called that same day to have me come in for routine bloodwork. I told them that I had a positive home pregnancy test and they said they'd do a beta Hcg test as well.

Later that day, it was confirmed that I was indeed pregnant, with an hCG level of over 9,000! (If you're new to beta numbers, that's super high! I didn't really know at the time how high that was). The following week, we went in for our first ultrasound and we got to see the gestational sacs...there were two! But only one looked to be growing. However...based on the date of my last period, it looked like the size was a little bit behind, so they had me come in the following week to check again.

The following week, there was no progress in growth. The doctor seemed to be cautiously optimistic about it, and had me come in the following week. She said that if there were no changes or heartbeat the next week, then we'd have to discuss options.

Well, in September 2015, I miscarried. Our baby stopped growing at about 5 weeks. We never got an accurate reading/measurement and never saw a heartbeat. I opted to take the medication to help move the miscarriage along after waiting two weeks to miscarry naturally. You can read about that here.

After the miscarriage, I had to wait for my cycle to return. My first period post-miscarriage was insanely heavy. Like...crazy heavy. The second cycle was a little bit more normal.

In November 2015 after my cycle started, I had my original testing done (that didn't happen because we took a detour with a positive pregnancy test), and that included an HSG and hysteroscopy. My doctor found a polyp during the hysteroscopy and my tubes were clear following the HSG. I experienced minimal pain with both, but I have a higher tolerance for pain.

In December 2015, I had a hysteroscopic polypectomy to remove the polyp. It was pretty easy. I was nervous about the anesthesia, but it turned out to be an amazing nap. I went home that morning and had another great nap. I felt pretty good the next day.

At the end of December, we tried a Letrozole cycle with trigger, except during my Day 12 soon, I had already ovulated.

We did a Letrozole + Ovidrel trigger at the end of January 2016.

In February 2016, we did Letrozole + Follistim + Ovidrel trigger + IUI.

In March 2016, when I went in for my baseline, they found a cyst lingering on my ovary, after having a super light period.

About two and a half weeks later when I thought my cycle started again, they saw the same cyst, but it was smaller. So I had to wait until it cleared.

My normal cycle started at the end of April 2016, however, because I was going to be out of town and unable to come in for monitoring, we have to wait until the next cycle.

I feel like waiting is the story of my life lately!

So here we are...waiting....waiting...waiting.

I'm a professional at waiting!

The Wait Continues

I'm always skeptical when the doctor or nurse tells you that you can test on a certain date. I guess I'm skeptical because I don't fully trust the result. Or, I'm afraid of the result that I don't want. Thus, I wait.

I've become a professional at waiting.

Maybe I should add it to my resume.

We were told that I could take a home pregnancy test on Friday, March 4th. Because my cycle was expected to start on Monday, March 7th, I decided to wait until at least then.

I was so hopeful in this cycle. Things just felt right about it. We made it in a nick of time with my husband going out of town and it seemed like the stars were aligning to make it happen.

I was also really hopeful because that Wednesday was my husband's birthday. I had this dream of being able to present him with an amazing birthday gift...a positive pregnancy test.

Since my cycle did not start that Monday, I decided to go ahead and take the last home pregnancy test that I had stashed away in the drawer. I have always been reluctant to take them without waiting for at least some time past the time my cycle should start as to not "waste" them. I know, other women probably think I'm crazy, but I'm also really pragmatic and frugal when it comes to this kind of thing. And yes, I know I can purchase crazy cheap ones on Amazon...

Much to my disappointment, the HPT was negative. I was hoping for even a faint line. No such luck this month.

The really annoying part was that my period didn't start until that Wednesday and it was really light and kind of odd for my normal cycles.

I called my RE's office to ask about next steps.

I went in that Friday for a baseline ultrasound and if everything looked good we would start straight away on injectables and use the last of my Follistim from the previous cycle.

Unfortunately, to add insult to injury, the sonographer found a cyst on my right ovary. Great. Something else to get in the way of progress. I was given options to take a birth control pill to help move the cyst along or to just wait until my next cycle starts. The nurse also told me that the cyst could be causing the funky period.

Well isn't that nice?

On top of it all, I wouldn't be able to start the injectable Follistim meds...which means that the rest of the vial that I have...that cost beaucoup bucks is going to go to waste. Which hurts my head and my heart from a purely practical standpoint.

And just as the cherry on top to this entire situation, I woke up that Thursday not feeling great, and by Thursday evening, I was running a fever of 102.8 - the highest I've ever seen in my adult life. I had chills, body aches, a slight cough, and a fever. I had the flu. And man oh man, this string of the flu was a doozy. I spent the better part of a week in bed, about 4 days feeling pretty crummy, and finally on day 7, I'm starting to feel normal, but still have a nagging cough.

So yeah, my last two weeks have not been great.

I wish I had more positive news to report, but sadly, I do not.

Just more waiting.

The Cost of Infertility

Sometimes, I wonder if pharmaceutical companies are in cahoots.

Actually, I assume they totally are.

After talking to my RE about next steps, I was prescribed Follistim in a low dose as well as Ovidrel. I remember the first time I paid for Ovidrel and it wasn't covered by our insurance. It was about $175 cash price. 

I thought that was expensive.

Then I was introduced to Follistim.

I received a phone call from the specialty cash pharmacy on my way to my doctor's appointment. I asked about my options and when I would need to ship the meds by. Well, since I would need the medication on Monday, and I was talking to them on Friday, they would have to ship on Friday for Saturday delivery since you have to keep the stuff refrigerated.

Then I asked the amount. 

I kindly asked if I could call them back after I had been to my doctor's appointment.

After going to the doctor, they instructed me to also give my insurance provider's pharmacy a call. For us, it's Caremark/CVS. Now, I must say that they are great and also not so great. They are great if the medication is something generic and general. 

I'm thrilled to say that the Metformin 90-day supply (that I take for PCOS) is $0.36! Yeah, ridiculously cheap. Even the Letrozole, because it's an off-label use is just $0.22. Like, I felt bad swiping a card to pay that little amount. 

Now fertility meds on the other hand, not so great. Like flipping expensive...like I imagine how depressing it would be to be going through infertility and then have the barrier of how expensive it is keep you from moving forward. And through Caremark, with some unknown amount of coverage was still more than twice the cost from the cash pharmacy!

I ended up ordering Ovidrel from our insurance pharmacy (since cost was the same as the cash pharmacy) and Follistim through the cash pharmacy.

Out of curiosity, I checked another online pharmacy that carries Follistim...that was another $100 more than Caremark!

My heart goes out to all the people who are going through infertility and doing IVF and have a PLETHORA more medications compared to what I had to order. I can't even imagine paying for all of that out of pocket.

It's pretty ridiculous. Why is it SO expensive to get help to have a baby? And yet it's so simple to terminate a pregnancy? I don't want to get into a political debate about it all, but it just feels like women who need assistance conceiving are penalized over something they can't control. And that premium? 

Cahoots. 

Starting Again

I never expected that we'd have to wait so long to get started trying again after the miscarriage. Now, having experienced one, I know so much more and have so much more empathy for all the women who have had one or multiple miscarriages.

Any miscarriage is heartbreaking.

I think it's because you have that glimmer of hope. If you had a positive pregnancy test, there's a special kind of exhilaration you experience when you've been trying for years for this one thing to finally happen.

And then it's all taken away.

In addition to the emotional toll that it takes, there's also a physical toll.

I experienced our miscarriage in September 2015.

My RE then told me to wait until my next two regular cycles.

My first cycle post-miscarriage was the heaviest, longest period I've ever experienced. It felt like a mini-miscarriage minus the cramps.

My second cycle post-miscarriage was still on the heavier than normal side (for me), but a lot more normal than that first cycle post-miscarriage.

So that brought us to November, at which point, my RE had us come in for the remainder of the testing that we never had done when we first met with her because I had a positive pregnancy test...all kinds of crazy.

I had a hysterosalpingogram (HSG) and a hysteroscopy.

The hysterosalpingogram is where they set you up underneath an x-ray machine, inject dye to see if your fallopian tubes are clear. For me, the experience was mostly painless - there was some pressure from injecting the dye, but my doctor talked me through it as she completed the procedure. I felt some cramping, but nothing major, and nothing in comparison to the miscarriage. I have heard from other women, however, who have said that when they had the HSG done, it was a very painful experience. I think it really depends on you, your doctor, and your pain threshold.

As far as the hysteroscopy, you're lying down on a exam table, and the doctor will insert a scope with a small/tiny camera to check out your insides. It takes all of about 2-3 minutes and it's similar pressure and I'd say less painful than the HSG. My doctor did find evidence of a polyp on the back wall of my uterus as well as the site of where implantation had occurred. They call it "products of conception."

Because of the polyp, my RE recommended to have it removed as she suspected that it could have contributed to the cause of the miscarriage. We'll never fully know, but for me, it makes me feel a little better knowing there was some kind of "reason" for it happening.

In December, at the start of my next cycle, I had the surgery. It was a hysteroscopic polypectomy, which is a fancy way of saying that the polyp was removed with a hysteroscope. Thankfully that meant that no incisions were made on me. I was put under general anesthesia for the first time ever, and while I was a little apprehensive about it, it was the best sleep that I can remember.

For me, the surgery was easy. I had surgery on Friday, napped most of Friday afternoon, and felt pretty back to normal by Saturday afternoon. I had to take a week off of exercise/activity until my post-op appointment, but otherwise, everything was back to normal.

So that brings us back to now. At my post-op appointment, my RE told me that the surgery was a success and that she removed the polyp and "products of conception". She asked me what we wanted to do and if we were ready to try again. I said that we were ready. I went in for a baseline ultrasound right before Christmas and started Letrozole. I had a Day 11 ultrasound and it looked like I had already ovulated. They drew blood for a progesterone test, and later that day confirmed that ovulation had occurred. At that point we just had to wait to see what the two week wait might present.

Two days before I expected my period, and on the day that the RE's nurse had told me I could take a HPT, my cycle started.

Sometimes I just want to tell my body to stop being so rude.

So I called my RE's office to let them know that my cycle started again, and I went back in for a baseline ultrasound this past Monday on Day 4. I started Letrozole on Day 4, and I'll go in for a follow up ultrasound on Day 8 - a few days earlier than typical with the hope that we don't miss the ovulation window...because the plan is to trigger ovulation with Ovidrel.

It was weird that I ovulated so early last cycle, but after asking in my support groups, it sounds like other ladies who also took Letrozole experienced some early ovulation as well.

So we'll see what happens this cycle.

Where are we now

After the miscarriage happened, I had to take a step back and just allow myself to feel all the feelings. Once the physical part of the process had passed, a lot of my grief and frustration felt like it passed as well. I think I was most sad, and felt the most feelings, between finding out and going through the miscarriage.

It was kind of weird. I guess grieving is such a personal process, that there is no "right" way of doing it.

But I'll be honest, I felt a little guilty that I wasn't more sad. Is that weird? Once it had all passed, it was therapeutic (albeit the worst physical thing I've gone through so far in life). I felt guilty that I "got over it" so quickly. Perhaps it was because it was only at 5 weeks. We didn't know the gender or pick a name....

I had to wait until my next cycle started before doing anything else. I also had to go into my doctor's office for a blood draw to check my hCG levels. I did that bi-weekly until I got down to zero. However, the last blood draw I had, the level was still only at 1.3... the hCG just lingered in my system. It went from like 1400, to 300, to 4, to 1.3....

Also, what I wish I could have known before the start of my first cycle post-miscarriage, is that your period can be SUPER HEAVY. Like SUPER HEAVY. I know this probably doesn't happen to everyone, but just know that it's a possibility. Honestly, it was kind of like the flow I experienced in my miscarriage, but drawn out over 7 days. And clots. LOTS of clots. (Sorry for the TMI) But I would have wanted to know.

My doctor's office told me to wait until my next cycle before coming in again.

All the waiting. So much waiting. But I guess that's just what is required in this journey. Waiting.

When being right is the worst thing ever

I've been trying to process how to even write this.

Attempting to collect my feelings and thoughts and emotions into a coherent paragraph.

Tuesday, we had our follow up sonogram after last Thursday's sonogram. Last week, we were told that there had been no progress since the previous week. Basically, the sonogram was looking about the same, where there should have been growth.

On the bright side there were only five days between our appointments instead of the full seven. It felt like several long days of being in limbo. Not knowing the outcome. Not knowing what lay ahead. Only knowing that it could either be really good, or really bad.

We went in for our appointment and our RE did the ultrasound herself. And in just a few minutes, our futures were permanently altered. Decided. Changed. And not in the result that we were so fervently praying for.

I'm going to have a miscarriage.

Those words just feel ominous and haunting.

We opted to let things progress naturally, and then next week if nothing has happened, we'll talk about medication or a procedure.

I guess I feel like I was slightly prepared for this prognosis because of last week's appointment. But I don't think that you're ever fully prepared to know that the life that was once inside you is no longer.  There's a much more crass way I could put that, but I won't.

It's so crazy how you can go from pure, amazing, overwhelming joy, to utter, complete devastation...in a matter of weeks, a matter of minutes, a matter of seconds. The little world I had cautiously constructed, from baby blogs and registry lists, pregnancy apps and countdown calendars...shattered, obliterated, all came crashing down.

Perhaps the hardest part for me has not been accepting the facts. The hardest part has been the idea of having to tell family of what happened. We didn't tell a lot of people that we were expecting. We only told our immediate family. But still, having to tell them that our exciting news turned to tragedy just breaks my heart into a million pieces.

Maybe it's the disappointment? Maybe I feel like I'm disappointing them? I'm mad and sad and disappointed in myself. I feel like I should blame myself. I know that I shouldn't. I know the facts. I know that about 20-25% of pregnancies end in miscarriages - with most of them happening before the parents realize that they were even pregnant.

The thing that I didn't expect throughout all of this was the immediate bond I felt with the little life that was developing inside of me. Previous to my own personal experience, I didn't really understand why or how a miscarriage under 12 weeks was a big deal. I know how insensitive that sounds. But I didn't get it.

Now I get it. It was like the moment that we saw that pregnancy test, that we heard our beta numbers, that we were "for real" pregnant....that I was forever bonded with the little nugget. That little life was real.

I have such an appreciation for what a miracle life is.

So many people take it for granted. Dumb teenagers get knocked up "by accident". Irresponsible one-night stands result in two pink lines. Unplanned pregnancies. Surprise babies.

I feel like when you are in the trenches of infertility, you learn to appreciate that making a baby is a freakin' miracle. It's not an accident. It takes work. Sometimes it takes tests, medications, procedures, and lots of prayers.

Honestly, I was so excited about our positive pregnancy test. But part of me felt slightly guilty that we got pregnant naturally when so many others have such a hard time. My fears got me too. I was afraid of having a miscarriage, of something going wrong, of it all not being real.

But now it's just too real.

And since I haven't physically miscarried yet, I just feel like I'm in between again. Not pregnant, but not empty...if that makes sense. I understand better why some women opt for medication and/or the procedure right away.

I have no idea how long this grief is going to last. I have no idea when we will get pregnant again. But I have faith that there is a plan for us, that we're ultimately not in control, and we just have to trust that it'll happen in the right time. That's the last thing that I want to hear, but I know that it's the thing that I need to hear.

Have you ever been through this?

The thing you worry about...

Last week, we went in for our first ultrasound. Based on my LMP, the reproductive endocrinologist and ultrasound tech had estimated me to be at about 7 weeks. However, when they did the ultrasound, the fetus was measuring more at 6 weeks. This didn't surprise me because that was the estimate I was going off of based on my irregular cycles. I know that I don't ovulate right at 14 days, it could have been anywhere between day 16-20 really. The RE asked us to come back in a week to do another scan to see how it progresses.

It felt like the longest week of my life, but I tried my best to stay calm, occupied, and free of worry. I didn't want to worry about something that was just in my head. But when it's your first pregnancy you just don't know what to feel or to expect.

I have been having the classic pregnancy symptoms for about two and a half weeks. Sore breasts, frequent urination, some fatigue, and a little morning sickness - mostly just feeling queasy. Even though I wasn't feeling awesome, I figured that having symptoms was a good sign.

We nicknamed the baby "The Nugget" and my husband would talk to my belly and tell the Nugget to keep growing. It's the cutest thing.

I prayed a lot. I did my best to concentrate on other things. I worked out. I indulged a little. I did some work. I tried to reduce any stress I was feeling. But a week is a long time.

In the back of my mind, I couldn't help but think about if something was wrong. What if the baby hadn't progressed in growth? What if I had a miscarriage?

I haven't had any spotting. I haven't had any cramps. I've been feeling pretty good, aside from some of the general symptoms. So I figured that I should just tell my worries to be quiet and wait for the appointment.

Well, our appointment was yesterday. We do the usual drill, another vaginal ultrasound. The tech does the initial scan, and while I'm not trained in reading ultrasounds, I can kind of tell that there's something not quite right. From what I can see on the screen, there doesn't appear to be much if any growth of the fetus since last week.

And I have to say that the ultrasound tech is quite nice and has good bedside manner, but when she says, "I'm just going to have the doctor come in and take a second look," and "It doesn't look like there was any growth, unfortunately," I couldn't help but see my worst fears come to light.

I mean, obviously, if there was no progress, that can't be a great thing. I was desperately hoping to see progress, to see the heartbeat flicker, to have proof that the baby growing inside me is doing well and getting bigger.

As we waited for the doctor to come in, I could only lay there and think worst case scenario. My husband grabbed my hand and we just looked at each other, not saying a word.

The doctor came in, did a second ultrasound scan, and while she could see the yolk sac/fetal pole, she said that it didn't look like the pregnancy was progress like she had hoped it would. She wanted to talk to us in her office after I got dressed.

She compared the ultrasound from this week to last weeks, and the look on her face basically said it. While she didn't rule it a pregnancy loss yet, she wants us to come in on Tuesday for a final scan to see what happens. She said that by that point we should be able to see a heartbeat, and if we can't....then we will discuss "options".

It just feels so grim.

Knowing, but also not knowing, that there's potentially a non-viable fetus inside of me.

It's the unknown that's the hardest. I feel like I have no control...and I while I know that I don't have control because all this is in God's court, still, I wish I could understand what and why this is happening. I feel like it's been an arduous journey to even get here to this point, only to have the rug pulled out from under us in a hot second.

We're in a place of wait and see.

It's crazy to me how we could go from such pure joy to devastation in a matter of seconds. While I don't know if I will have a miscarriage or not at this point, my gut tells me that we probably will. The optimistic side of my brain is grasping to the tiny shred of hope that the baby may progress at least a little bit by Tuesday.

However, I will say, that I am so thankful and grateful that we were even able to get pregnant naturally...or as the office calls it "spontaneously". Seeing that positive pregnancy test was pure joy. I was shocked and couldn't believe my eyes. I know that for many, many couples out there, this isn't even a possibility. So I am really thankful that we know that getting pregnant is a possibility for us. I'm trying to find the silver lining in between sobbing for the unknown.

Have you ever been through something like this?

Positive

The craziest thing happened today.

We got a positive pregnancy test.

I've never had a positive pregnancy test before. I also didn't believe it when I saw the plus sign on the Clear Blue Easy test.

In fact, while I was waiting the three minutes for the test to work, and two minutes and forty seconds had passed by and there was still nothing showing up...I almost gave up. When my timer went off, however, I looked at the test and there it was.

A strong plus sign.

WHAT?

I was in shock. I didn't believe it. We've never had a positive test before. Granted, I've only ever tested twice before this...but the first is definitely amazing.

Being myself, I googled the possibilities of false positives. I read that false negatives are more common than false positives.

I took the test and brought it out to the living room where my husband was working out. I said, "So I decided to take this test and..." and I showed him the stick. He didn't believe it either. He said, "Wait...what? It's positive?"

He stopped what he was doing and gave me a big hug as we both cried happy tears.

We were lucky that it also happened to be one of the days that he worked from home. Just as I was trying to figure out what to do next after having a positive pregnancy test, I made a call to my OBGYN to schedule an appointment. About thirty minutes later, our RE's office calls because they want to run some more tests since the records they pulled from my OBGYN were out of date.

That's when I told them that I just took a pregnancy test and it was positive.

A spontaneous pregnancy.

I still can't believe it.

The RE's office told me that if I could come in before noon for a blood draw (including the tests they wanted to run) they could give me results after lunchtime. So we quickly made that appointment and got there by 10:30.

We got to the doctor's office and after a few minutes they called my name to take me back to have my blood drawn. Throughout the day I was nervous, simply because I've never had a positive pregnancy test before. They told me that following my results they might ask me to come in for a follow up beta hCG test to make sure my levels were doubling properly.

Waiting until after lunchtime felt like slow painful torture. I just wanted to know the results!

At 3:45, with their office closing at 4:30, I stopped being patient and called the office. I finally got a hold of our nurse and she told me that I was definitely and "very" pregnant with a beta hCG of 9,000 and that I did not need to come in for a follow up. They were, however, going to prescribe me the drug Prometrium to maintain and increase my progesterone levels, since it was at 18.

Oh my goodness, I couldn't even believe it. Confirmed by a blood test. We are pregnant! (I am, haha).

We told our parents and siblings over Skype and FaceTime since we couldn't just keep the news to ourselves.

We'll go back to our RE's office for our first ultrasound next week. How am I even going to keep it together to wait these next seven days?!

Cycle Day 40: The Wait Continues

Oh the wait.

I suppose that if I had a normal cycle, I would have already taken a test.

But I don't. When you have PCOS, you have an irregular cycle. I've had irregular cycles most of my life (thought I didn't know it until I was in college)...although I have been having fairly regular 31-32 day cycles.

This time, however, here we are again at cycle day 40. When you have an irregular cycle, you're supposed to wait at least until you have the longest cycle you've had. For me, that's around 42-45 days.

I don't want to negotiate with God. Like, "Okay God, if this happens then this..." or something similar. I know that he has perfect timing in everything that happens, so even if I don't understand, He does.

Cycle Day 42 is on Wednesday. I think that will be the day that I test, should nothing happen between now and then.

I had 41 day cycles in January and March, so while this could be that (we'll see tomorrow), I'm also cautiously optimistic. I know that if this is our time, that it will truly have been a miracle. Seriously.

One of the things that is shaping my positive outlook is the fact that I ovulated this month - the blood test I had a week and a half ago showed that. I've also had sore boobs and frequent urination.

You better believe that I've been Googling "early pregnancy symptoms" and "when to take a pregnancy test."

And you may be wondering why I haven't gotten it over with and just taken one already.

Because my pragmatic side and my idealistic side don't jive.

It's kind of ridiculous.

I'm also naturally frugal, so I don't want to "waste" a test, which some may consider silly. However, considering that the very first pregnancy test I ever took (about a year ago), I totally botched (I did it wrong)...I don't want to make an expensive mistake again. Ha!

I know that I could order those cheap tests off of Amazon, but I haven't done that yet.

So I'm just practicing patience and trust in God's plan for all of this and on Wednesday, I'll take a test...

What would you do?

Our New RE // Cycle Day 37

Last week we had our appointment with a new reproductive endocrinologist.

It was a great experience! I'm so happy that we have found her and feel so reassured after meeting with her. Like a mentioned in my previous post, it was important to me to find a female reproductive endocrinologist. It's not that I don't trust men, it's just that I don't think male doctors who work in the lady part department will ever FULLY grasp what it's like. Sure they can try to empathize and if their wife has ever gone through infertility they can kind of get it....but it's just not quite the same as a female doctor who has had experience with infertility herself.

The experience was excellent from the get-go. I called the make the appointment and the receptionist was super friendly and got me set up in a jiffy. The day before my appointment someone called to confirm and had a bright and cheerful voice on the phone. (I point this out because the medical assistant at my OBGYN's office has the worst phone voice ever...as if it's torture for her to be talking on the phone - she sounds so bored and annoyed.)

That, in and of itself, made me calmer and look forward to the appointment.

My husband came to the appointment with me and though he technically was not required to be there, I was really happy to have him by my side. After the usual wait in a doctor's office and filling out some additional paperwork, I had my vitals taken, and we were led into the doctor's office.

Her office was bright, with comfy chairs and colorful pillows - definitely a woman's office! Dr. T came in and greeted us with a smile on her face. (I point out these details because they make a difference - to me at least!) She took time to take our history and ask relevant questions. I could tell that she was really listening and trying to get a good understanding of our current situation. It felt nice to talk to someone who was really listening and interested. We talked about my PCOS, when I was diagnosed, what I've done to manage it, and she even gave me some more understanding about what was going on.

My husband had just had an SA the week before this RE appointment. Unfortunately, we had not yet received the results...which you know can make anyone nervous. We didn't receive the results until the end of the week and spoiler alert - he's normal!

After taking our histories, the doctor took us in for an ultrasound to check things out. It was the first time that I had a doctor (and not an ultrasound tech) do the vaginal ultrasound. She pointed out everything as she was going and it was the first time that anything had ever been really pointed out to me. Good news, she counted follicles (so it seems like eggs are not currently an issue) and it looked like one of them was nice and big for ovulation. She ordered a blood test to check to see if I had ovulated as well.

Overall, I was just thrilled with how the appointment went. She was very friendly and warm - something that I feel is hard to come by with doctors. When it comes to something like this, infertility, I need someone who is going to be empathetic and sensitive to the experience. I wouldn't do well with someone who was all "JUST THE FACTS". I know some people prefer that, but not me. I like the warm fuzzies. It helps so much with the trust factor.

It was such a contrast from my experience last year. I also had a year of infertility experience and further understanding, but also the doctor herself was a dream in comparison. And let's just say that I had heard no reassuring comments about last year's doctor through the grapevine.

So the plan is to wait until my next cycle, do one more medicated cycle but with Femara, and see what happens before exploring IUI's etc. The doctor says we're "boring" (in a good way) and that because of the PCOS we may just need a little extra nudge in the direction of getting knocked up.

And now we wait.

Oh waiting. It's not for the faint of heart or the patient. Ha.

Well, I got the lab results from my blood test to check for ovulation and I measured at 16. The nurse said that they like anything above an 11 to indicate ovulation, so I hope this is good sign. The great thing is that even if this cycle doesn't result in pregnancy, I feel 110% confident in my new doctor to help us.

Here we are...cycle day 37.

I have to wait until at least CD 42 or 45 before testing...I know I could test...but I'm so pragmatic I don't want to waste them! Haha.

False Alarm

I had promised myself that I wouldn't freak out. That I wouldn't throw a fit. That I wouldn't get depressed.

Well, when I started to spot last Thursday, on Day 32, I was so sad and disappointed.

I had told myself that I wasn't going to let it affect me like it had previously, but it did. Bigger than I expected.

Because this was our first medicated cycle after taking a break for six months, I was really hopeful. I thought also because I had lost another 10-15lbs that it would help things along as well.

Everything was going well, or so I thought.

But then, like old reliable, on Day 32 (why are my cycles 32 days?!), I started to spot and the red tide arrived.

Thursday was hard. I was really upset. I was disappointed. I was discouraged.

Why does it all have to be so hard? Why is it so hard for us and so easy for others? I know I'm not supposed to compare lives and I don't know the backstories for other people, but still.

Some people get sneezed on, then boom. Teenagers barely do anything, and boom.

But I'm done being upset. It's not getting me anywhere.

Instead, I binge-watched Finding Carter all weekend long. I became obsessed with the show. Hey, there's nothing a little binge-watching can't fix, right?

Onto the next cycle.

I actually have my annual OBGYN appointment tomorrow, and unfortunately, we've missed the window to try Clomid for this cycle. So I guess we'll just see how things play out naturally and then move on to see a specialist next.

Day 31: Hello July...still waiting

I, for one, cannot believe that it's already July.

This marks the official halfway point of the year. It's an understatement to say this year has flown by for me.

It's been an interesting year, for sure.

At the end of last year I left my terrible full-time job. Honestly, I could have stayed, but it was a toxic environment and I just couldn't take it for my own sanity. My boss was not cut out to ever be a boss, and that's tough when he is the owner of the company too. Our work ethics just did not align. And maybe I just needed to put my head down, focus, and work.

But sometimes, all that stress, aggravation, discontent is just not worth the paycheck.

I thought I had a miserable job before, but this one definitely takes the crown and glory for worst job ever. It probably would have been better for me if I could relate on a cultural level. But I'm not making excuses for that place anymore.

I'm convinced that we were not able to get pregnant while I was working there because of the stress. Hormonal issues too, but I think the stress played a huge part of it. I almost tried to go on stress leave. Get a note from a doctor to take a couple weeks off. Seriously. Makes me crazy thinking about it.

After leaving that job, I decided to focus 100% of my time on my portrait photography business. I'm a high school senior photographer, specializing in portraits for smart, shy girls. And you know what? I'm haven't replaced my previous income with it yet, although I'm getting closer, but I'm 100% happier than when I was working at what I lovingly refer to as "The Sweat Shop" (not too far from the truth, haha).

So here we are. 6 months into 2015. Starting the 7th month.

Still nothing yet as far as knowing if we put a bun in the over or not. Which is good so far. I'm counting my blessings instead of stressing out over it.

Although, yeah, I'm a little stressed. But I know that's bad, so I'm going to go do some deep breathing.

I'm planning to take a test this weekend. I go to my OBGYN on Tuesday for my annual well woman exam, so hopefully my doc will be able to tell me what to expect....either way.

Day 28: Still Waiting

Yesterday marked Day 28 of this cycle.

It's crazy how aware you become of what day it is when you're keeping track of your cycles.

To most people that probably means nothing.

To a woman who is trying to conceive (TTC) or struggling with infertility it means a whole lot more.

So technically speaking the two week wait is over. I could theoretically take a pregnancy test if I wanted to.

AF did not arrive yesterday, so that's definitely a good sign.

Yet, I don't want to put all my hopeful eggs in one basket, if that metaphor makes sense.

Logically, I know I should at least wait until when my period is due and wait for that to be officially "late". And then I should probably wait another seven days after that.

Such a waiting game.

And I don't want to freak out or stress out about this because I know that's not good either. Maybe I'll go meditate. My favorite part of meditation? Falling asleep in corpse pose...that's what it's called, right yoga aficionados?

Well, we bought a set of pregnancy tests this weekend, but I'm definitely waiting to test because in the words of my pragmatic brain, I don't want to "waste" them. But it's true.

I know that I could purchase cheapie tests on Amazon, but again, I don't want to be wasteful...and let's face it, I also don't want to know the answer yet.

I do.

But I don't.

And I know that it won't be the end of the world if we are not pregnant this cycle. Just another month ahead of waiting and seeking.

On the other hand, I might go out of my mind if it is positive.

I'm trying not to wrap up my emotions in the outcome of the test. Clearly, I'm not doing that great of a job.

I will be fine either way (one more fine than the other, obviously). I trust the plan that is being carved out for us. I trust the big guy upstairs. Although, I'll admit, it's a constant reminder to myself that it's his timing, not my own. His plans, not my own. It's not easy.

I'm also really excited. Cautiously so, of course. And on the same note, I'm also really nervous.

So maybe I should get back to that idea of meditation to clear my fears and worries and focus on the positive.

And of course, the other logical thing is that I could just find out now...theoretically. I could test and just see what happens. But I decided that I would at least wait until AF is projected to arrive, which is Friday, July 3.

Considering that my cycles for the majority of 2014 and early 2015 have been about 31-33 days, I think it makes sense to wait at least until then to see what happens.

This journey is so crazy. I'm sure it's worth it, but gosh, the emotional roller coaster is not for the faint of heart.

The Two Week Wait

For anyone who is trying to get pregnant, you probably know what the two week wait is. It's that two week window from the time you ovulate until you can take a pregnancy test.

Well, we are in the two week wait. I try not to stress out about it, or hang all my dreams in the outcome of that test, but it's hard you know?

This past weekend, we flew out to Atlanta to hang out with my husband's family and we got to see our not so little nephew. He turns 9 months today, and is huge! He's exceeding all the markers (I think!) He's cute and such a sweet baby. He will be walking in no time.

I'm not going to lie, seeing him, getting to hang out with him, and seeing my husband interacting with him, just about made my ovaries burst. I know that my husband will be a great dad and they were so sweet together.

We went to the Georgia Aquarium, which was pretty cool, especially with the walk through shark tank. We also went to the World of Coca Cola, and before you get to walk through the exhibits, they show this short movie. It was about sharing a Coke, but really it was people sharing and doing life together. There was one part where a couple was surprising a set of parents about becoming grandparents.

I almost started crying. Like, I felt it tug on my heartstrings. I want to do that for my parents and my in-laws. I want to see their faces and their reactions when we can finally tell them that we are expecting our own.

It's in times of waiting that you really learn about yourself and your faith. Do I trust God or am I putting my trust in myself? I know for a fact that I won't be able to do this without God. Only He is able to do amazing and miraculous things, and whenever we are blessed with a baby, it will truly be a gift and a miracle from God.

Living in a very NOW society, where people can get what they want nearly instantaneously, it's hard to wait. It's difficult to be patient. When we don't get what we want when we want it, we start to wonder if God is still out there and listening to us or not.

God is there. He is listening. But His plans are not our own.

This has been one of the hardest lessons for me to learn. My plans are good, but His plans are greater.

I have to trust that He has a plan for us and for our lives, and even though we may not understand His plan at this time, he is refining us for the future.

More often than not, that is way harder for me to understand than it is to type.

So here we are. In a season of waiting...within a season of waiting.

I believe that we can be parents, but I won't be wrapping my life's happiness and joy in this month's cycle. I know that's the hard part.

I have this inner battle - of being cautiously optimistic and realistic....but then I have to remind myself that God is able to do abundantly more that I could ever ask or imagine. He is able when I am not. He can do more than I ever could. However, it will all unfold in HIS timing, not my own!

Day 14: Ovidrel Injection

I went to my Ultrasound appointment and my doctor decided to proceed with the Ovidrel injection to be administered on Day 14, which was yesterday. 

Sometimes, this journey just drives me crazy due to the lack of empathy of some people. 

So what had happened was...

My doctor prescribed the Ovidrel to induce ovulation.

I visit my local pharmacy, Walgreens, to see if they can fulfill the prescription.

They tell me that they don't keep it in stock, but if I can find a Walgreens that has it in stock, then they can access my prescription through their system.

I call a couple of different Walgreens and they don't have it in stock. They would have to special order it and it would not be available until at least Monday because it usually takes a business day for it to come in. And it was Friday.

So I called my Doctor's office to tell them of my situation. And man, I'm not sure if I spoke to a nurse or a medical assistant (but I'm leaning towards medical assistant) and wow, she did not listen very well.

To make a long story short, about four phone calls later, they finally got their butts in gear and found somewhere I could pick up the Ovidrel. While I was super annoyed at first, I was thankful that they were able to help me eventually. 

While stabbing yourself in the stomach isn't the most fun activity, it actually wasn't too bad. I had my husband pinch my skin and I injected the syringe. It didn't even hurt. Just a little prick. 

So now we wait. Well, you know, get busy and wait. The injection point doesn't hurt at all, which I'm thankful for. I do also have to use Estradiol suppositories, joy. 

I've decided that instead of lamenting over the infertility we've been going through, I'm going to focus on the possibility. I am able to get pregnant. I release the need to control when I get pregnant and I know that I will be pregnant when the time is right.

Yes, those are positive affirmations. And even if I sound silly, I want to focus on what I want instead of what I don't have. I want to spread gratitude. I want to spread abundance. 

We'll see!

Day 12: Ultrasound Day

After finally going back to my OBGYN after about a 6 month break from fertility medications, taking a course of Clomid and estrogen supplements, today is the day. Today I will have an ultrasound to see if Clomid worked and if it's viable to trigger ovulation.

The biggest things I struggle with is the probability. Even if the Clomid stimulated follicles to mature and the estrogen supplements helped to thicken the uterine lining, that doesn't guarantee anything.

It's definitely a journey of both science and faith.

Which makes it really difficult to see all the people who it "just happens" for. Because really, there are a whole lot of people out there who it doesn't just "happen" for. 

And I know that by comparing myself to other women, I'm only going to drive myself bananas. It's something that I struggle with on the daily and every time I see an announcement, I feel like it's another dig of what I haven't been able to do yet.

I also know that I need to stay faithful. To believe that it is possible. To know that we can become parents someday.

It's truly like fighting an enemy daily to tell him to shut up and go away. 

The doubt. 

The fear.

The negative, fatalistic thinking.

I have to be positive and go in with the best attitude.

In the last six months, I have lost 15lbs (which I'm hoping helps with the PCOS symptoms) and I'm exercising 5 days a week and eating a generally clean diet. It's hard to know what else I could be doing more of or better at, without making crazy drastic changes (what else is there left to do?)

All in all, I'm excited to go back to the doctor's office today to at least see what's next and what lies ahead. I want to be positive even if the outcome isn't what I'm hoping for. That's the hardest part, and yet the key....

Thoughts on the journey

In the last seven days, three women I know have announced their pregnancies. In the last two weeks, at least 4-5 Facebook friends have given birth.

So here's the tough thing. I don't know anything about their stories and how they got pregnant. Was it easy? Was it difficult? Did it require any medication or help?

One friend announced her pregnancy on Facebook, and for whatever emotional reason, it felt like a jab to my stomach. Which, when I think about it, is stupid, because it's not like she's expecting to spite me. It's not all about me.

But when you're going through infertility, not knowing if you'll ever be able to have your own child that you desire so much, every single pregnancy announcement feels like a reminder of what you have been unable to do for yourself.

As an overachiever in life (I was very competitive when it came to academics, at least in high school), and being able to get good grades and ace exams and the sort, it just feels sort of like a cruel joke that this is so difficult.

Then again, I was never good at sports. I was never good at running. And while I suppose that I could have practiced to my hearts content and improved my running, I still would not be an Olympic contender.

It's weird all the thoughts you have.

Will I ever be a mother? How will it happen? When will it happen?

And for now, we really would like to explore becoming parents naturally.

Adoption is awesome and it a whole other conversation for another time. It's definitely a consideration, but it's not at the forefront of the agenda at this time.

Day 5: Clomid

I just finished a course of Clomid for 5 days at 150mg per day. I was slightly worried that I was going to be crazy on that dose, but luckily, I felt totally normal. I know there are other ladies who take Clomid and have crazy side effects. I'm thankful that was not the case.

In addition to the Clomid, I also did Estradiol suppositories for five days. How fun right? (Said no one ever.) I'm thinking the last time I had to do the suppositories, I must have not inserted them correctly (sorry for TMI), and I'm hoping that I did a better job this time.

I'll go in on Friday for an ultrasound to see how the Clomid did it's magic and if my uterine lining is thick enough for implantation.

The annoying thing about Clomid is that it's anti-estrogenic, and actually works against the uterine lining, thus the need for estrogen supplements.

I'm feeling more hopeful this time, but also, I don't want to get my hopes up too high. It's still early in the cycle so it could go either way...if only science were a guarantee. But if it were that simple, there wouldn't be such a desire or yearning for those who have trouble conceiving.

What no one tells you about infertility

Infertility was never a challenge I expected to face.

It's probably the hardest obstacle I've ever come in contact with in my life so far.

I feel like I'm fighting against time and resources. 

I feel like I'm on the craziest emotional roller coaster I could ever board, and I hate crazy roller coasters. 

It's both physically and emotionally draining. 

And, while you're feeling ALL THE FEELS, every other woman around you will be pregnant, just announcing her pregnancy, or have just given birth. IT'S CRAZY.

You will feel like you're the only one.

You will feel like there's something wrong with you because if all these other women can get a bun in their oven, why can't you?

And then there are the couples who made an "oops" baby. "Oops we got pregnant by accident" or "We didn't mean to get pregnant". It can be good or bad, hopefully good for the sake of the child.

My message to those people: There are no "oops" babies. Pregnancy is 100% preventable. Your "oops" is merely your laziness and irresponsibility. But now you have a HUGE responsibility to take care of, and you better do it right...your child deserves that.

You feel like you can't share about your struggles because you don't want to be a Debbie-Downer. 

People ask you if you want to have kids.

People ask you when you're going to have kids.

And how do you honestly answer that question?

Usually the "we're trying" answer suffices.

Sometimes, that opens up a whole other can of worms that presents itself with all kinds of unwarranted and quite frankly, unwanted advice.

"Just relax and it will happen"

"You'll get pregnant at the right time"

"Don't think about it so much"

or

"Why don't you just adopt?"

Okay, so for the record, that last statement is not any more comforting that the previous ones. Actually, that's probably a way more insensitive thing to say because first, perhaps the couple has looked into it, second, maybe they have decided it's not for them right now, and third, if you knew what it took to adopt....it's not just a "JUST" adopt sort of situation.

Adopting a human is way more involved and complicated than adopting a pet. I imagine that it involved a whole new emotional roller coaster track from infertility treatments...similar...parallel.

Infertility can be one of the loneliest roads you'll ever walk. 

It feels like no one truly understands unless they have been through it too.

But perhaps that's the amazing part.

The more I talk to other women about getting pregnant and what it's like, the more I find others who did have a hard time here and there. While it doesn't make up for my own empty womb, it does help to know that I am not alone in this.

Infertility affects 1 in 8 women. 12.5% of the population!

One of the hardest parts of going through infertility is that there is no magic turnkey solution. It works for some and not for others. And as you go through this grueling physical journey, you're faced with an emotional battle you never saw coming. The decisions. The finances. The risks. The outcomes.

Just know that you're not on this journey alone. 

My best advice if you're going through infertility: 

Find someone to talk to; whether that's a friend who is also going through infertility, a counselor, or just someone you're close to that you trust. 

Talk to your spouse or partner.

Find other things to focus on so that you're not dwelling on how you're not pregnant yet. Whether that's a project or new job or new business, or whatever it is, I think it's super helpful to have something else to devote your attention to. 

Pray.

Meditate.

Exercise and eat right. If anything, this is just a good idea for your health and fitness.