It took some time, but I eventually came to terms with my infertility, and became more hopeful as we got closer to starting our first medicated cycle. If we could just get my follicles to grow and release some mature eggs, then we'd be back on track. I was to call the doctor on CD1, to let her know we were ready to start our next cycle. The doctor had suggested starting with clomid first, but I opted to try femara instead. It isn't FDA approved for the treatment of IF, but it is commonly used by many doctors for that purpose. We chose to try femara because it is generally known to have fewer side effects than clomid. I was scared of the "clomid crazies" I had heard about - apparently clomid can cause some pretty intense mood swings - and I figured I could do without those! Clomid can also cause cysts, dry out your CM, and thin your uterine lining, and since I already had a thin lining to begin with, I didn't think we needed to make matters worse.
As an aside - many ob/gyn's will prescribe clomid to women who are having trouble TTC but will not monitor them via u/s during the process. They will hand out a prescription for 3 months of clomid and say, "If you're not PG in 3 months, come back and see me." This is very very dangerous and I would caution anyone who is in this situation to consider seeing another doctor (like an RE - reproductive endocrinologist). If you fail to get PG during a cycle, you won't know if it's because of bad luck or if it's because (1) the clomid dose was too low and it did not stimulate any of your follies (2) you had a cyst and the clomid only stimulated the cyst, not the follies or (3) clomid thinned your lining to the point where implantation was next to impossible. Without this crucial information, the doctor cannot increase your clomid dose for the next month or put you on estrogen to counteract the thin lining if needed. If you have a cyst (either naturally or caused by clomid) and stimulate it with clomid, it could rupture and be quite painful. So please please please do not take clomid (or any other follicle stimulating drug) without proper monitoring. Ok, *stepping off soap box now*
In all our months TTC, I always hoped that AF would be late and stop visiting. During each and every 2ww, I'd will for her to not show up. Like clockwork, she'd always show up 14 DPO. Of course the one time I really wanted her to show up so we could "get the show on the road," she refused to show up. During this particular cycle, I had a 20 day LP for a total of 41 days in my cycle. I don't know why she always has to be so cruel. I knew that scientifically speaking, there was no possible way for me to be pregnant - we saw with our own eyes on the ultrasound that my follicle had not matured like it was supposed to. Yet here I was, with the longest LP ever, wondering if I might miraculously be pregnant. Was it possible that despite NO growth in 4 days, my follicle suddenly had a "growth spurt" after we stopped the monitoring appointments? I knew it was stupid to get my hopes up, but somehow I did. Only to be let down, of course. I took a HPT at 17 DPO only to see a BFN.
It seems that this is always the general rule when you're dealing with IF. When you're TTC and you want AF to stay away, she always shows up. Then when you actually want her to pay you a visit, she takes her sweet time making an appearance. I had looked at the calendar and planned everything out. If I got AF on "X" date, then I'd be able to start the meds CD3-7 and then go in on CD12 for a follie scan and hopefully trigger shortly thereafter. We were working with a very tight schedule and I needed AF to show up on certain dates. You see, DH had a series of interviews he had to fly to, and there obviously wasn't going to be any baby making when he was out of town. So if the stars didn't align just right, we'd have to skip this cycle and wait until the next one. And that was the last thing I wanted to do.
By the time AF finally showed up after a 41 day cycle, I was relieved we could finally get started with my first medicated cycle. Looking at the calendar, however, I could tell that it could get very tricky. Depending on how I responded to the meds, it looked like I might end up O'ing while DH was out of town. I talked to my doctor about this and we decided to just push forward and see what happens. If nothing else, we could see how I respond to the meds.
Due to some scheduling conflicts, I ended up going in for my first follie scan on CD 11 instead of of CD12. That morning I was so excited and nervous at the same time. DH was slated to go out of town from CD15-17, so I was really hoping my follies were already mature and we could trigger O and BD before he left for his trip (the trigger usually induces O 36 hours later). Ideally, the meds should stimulate the develop of 2-3 follies, but in my case I only had one. It only takes one, though, right? That's what I kept trying to remind myself. My follie was measuring at 15mm, not quite mature yet, and my lining was 8mm. I was disappointed that I hadn't responded better to the meds, but I was at least glad to see that my lining was already 1mm thicker on CD11 than it had been on CD20 the last cycle. At least it was looking like implantation would be more favorable this time.
So then I was scheduled to come back for another follie check on CD14. I had my fingers crossed that my follie had continued to develop over the last few days. I was even hoping that I had already spontaneously O'd since we had BD'd the day before just in case. The u/s showed that my follie had grown from 15mm to 18mm in 3 days. This is about average, as follies tend to grow 1-2mm/day. At 18mm, the odds of that follie containing a mature egg were high, and the doctor said she would have given me the trigger shot to induce O if it weren't for the fact that DH was going out of town. So instead we were given instructions to BD that day and then as soon as he got back from his trip, hoping that I would either O that day (CD14), or that my body would wait until CD17 when DH returned. The good news was that my lining was nice and thick. It had gone from 8mm to a whopping 12.5mm, perfect for implantation!
So, I found myself with mixed emotions going in the 2ww. I was thrilled that my lining responded very well to the meds, but a little disappointed that my body only produced one follie this time. Add to that the fact that we had less than ideal timing due to DH having to go out of town for interviews. We probably ended up with one or two BD sessions within my fertile window, so the odds of conceiving during this cycle were just "ok." We were only beginning the 2ww and I had already started to think about the next cycle and how the timing might or might not work out around our previously planned vacation. I was hoping that we'd get PG this cycle (could we be so lucky as to get PG on our first medicated cycle?!) but deep down I just didn't have a good feeling about it, so I tried to mentally prepare myself for the "failure" and plan for the next cycle. And so the dreaded 2ww began...
You're leaving us there? I'm on pins and needles...
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