CD20 Ultrasound and Progesterone Bloodwork

A few weeks ago, George and I went in to our clinic for our education class. When the nurse gave me my protocol, she mentioned birth control pills. I know they don't typically prescribe bcp, so I asked about it. She said Dr. T was thinking I don't have a true natural ovulation and therefore do not truly shed my lining with each period. In order to get a good start to the IVF cycle, he wanted me on 14 days of bcp to stimulate a good AF.

Instead of just sitting back and letting them tell me things I didn't feel were true, I actually spoke up (which is a big deal for me in a situation like this.) I told the nurse that I thought I was actually ovulating on my own. I asked her if it would make a difference one way or the other and she said she needed to ask Dr. T. When the verdict came back, she said that yes, it would make a difference. If I'm ovulating on my own, the bcp would be a bad idea as it would mess with my natural cycle. So, in compromise, we decided to do a u/s and progesterone check near the time I thought I was ovulating to see if it looked like I was going to ovulate on my own.

Today is CD20. I got a near-positive OPK yesterday and the day before along with some twinges on my left side. I also have EWCM (egg-white cervical mucus), so I was pretty sure I knew what we were going to see today, but I still had my doubts. I kept thinking, what if I haven't even been ovulating the past six months like I thought I was?

I still have to wait for the results of the progesterone test, but there was no doubt what was going on with my ovaries! My right side was quiet, but on my left side, I had a big 22mm follicle. Definitely looks like I'm ovulating on my own! This is such good news for me, because a year ago when they did this, there was absolutely no activity. That's why I went on Clomid in the first place. Now, because of the lifestyle changes I've made with diet and exercise, along with the metformin and vitamins, I'm actually ovulating on my own. I looked at that big follie and thought, "Wow, I did that! I made that happen." It was pretty exciting to see.

Unfortunately, ovulation has not equated to pregnancy. I'm not sure of the reasons behind that. Maybe the outer shell of the egg is too hard, which often happens with PCOS, and the sperm just can't get in there. If that's the issue, the embryologist will bypass that step with ICSI (where they actually inject the sperm into the egg with a tiny needle). I pray it's not an implantation issue or a problem with the overall quality of my eggs. We'll know more once the embryologist gets hold of them next month.

Anyway, I'm going to have to wait until this afternoon to know officially, but I am pretty sure this means no birth control pills for me, which makes me a happy girl. I should be on track for AF to arrive around October 7th, which means my baseline u/s, blood draw and stims will all be starting CD2, October 8th! That's only 15 days away! I'll update later with official word, but it looks like a natural cycle for me this cycle, and I honestly couldn't be happier. It just goes to show that with PCOS, sometimes changing diet and adding exercise really can make a difference. All this hard work has not been in vain.

*UPDATE* - Seems I spoke a little too soon. Carla called me around 2:30 to say that my progesterone levels were nearly 0. Basically, what that means is that even though I have a mature egg that is ready to pop out, my hormones are not giving it the go-ahead. When that happens, the egg ages and deteriorates and in the end, if it does come out, it's not good anymore and my lining doesn't totally shed with AF. BCP would be bad because since I already have a big follie, the bcp wouldn't get rid of it and it would still be there in 2 weeks and I wouldn't be able to start stims, so it's definitely good I went in to have this all checked.


Still, this explains why I'm not getting pregnant naturally. In order to solve the issue, I went back in this afternoon and got an HCG trigger shot. Basically, that forces the egg to ovulate. I don't want to get my hopes up and think that maybe we could end up pregnant on our own, but it is a possibility. They want me to come in for a blood test in about 12 days to make sure I'm not pregnant before I order my meds for IVF! I should still be right on track for AF to arrive on October 7th and stims to begin on the 8th, but man, wouldn't that be amazing if I got pregnant? I know, I know, stop dreaming, right? Haha.