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.

Getting Back on Medication

I've been a bad girl long enough. The time has come to get serious about my health. I wrote earlier last week about my terrible Metformin habits, but it hasnt' just been a problem with the Met. It's also with all my other drugs. My vitamins, everything. Tonight, I officially started back on all the medications and vitamins I'm supposed to be taking. If I can be really good and take them every single day, I'll have just over 2 months of getting used to the drugs and getting in shape before we do IVF. Hopefully that's plenty of time to get myself in tip-top health before we start going through the hard stuff.

As much as I feel bad and regret going off my medication for selfish reasons (I felt awful ALL the time), I know that my doctor has my best interest in mind. I know these are medicines I need to be on to give myself the best chance of getting pregnant. So isn't it worth feeling bad and having digestive issues for a few months? Yes, I would say it is. In the grand scheme of things, there are much worse things I could be taking. Metformin is just a temporary sickness as long as I keep my nutrition under control. So as of tonight, I'm back on a plan and determined to stick with it.

Here's what I take on a daily basis:

• Glumetza, 1000 mg (This is the metformin. My doctor prescribed 2000mg, but I have to work up to it since it makes me so sick. I'm going to start on half dose first, then work back up to the 2000 in a couple of weeks. Yikes!)
• Vitamin D3, 1000 IUs
• New Chapter Organics Prenatal Vitamins, 3/day
• Fish Oil, 800mg EPA twice a day (I take Carlton's Finest Fish Oil from Whole Foods. It's a liquid but it tastes like lemon. I used to take pills, but then I always had this fishy taste in my mouth that I HATED. This fish oil is actually quite nice and has no real aftertaste issues. Plus, it's pure.)

It doesn't sound like a lot. Especially not compared to what I'll go through with an IVF cycle. It's definitely manageable, and I know in the long run, it's best for my body. I'm going to get back in the habit of taking them and hopefully with a new plan for diet and nutrition, the metformin won't bother my stomach quite as much.

As a side note, PCOS bites. I sometimes wish I could be like a normal woman who could just take the vitamins and be fine. End of self-pity moment.

Metformin Misstep

Metformin sucks. For those of you who have never heard of this medication, you'll just have to take my word for it. It's a diabetes medication that reduces blood sugar levels. I don't have diabetes, but with the Poly-cystic Ovarian Syndrome, I am insulin resistant. Metformin is prescribed for a lot of women with PCOS to manage blood sugar levels. Researching up on it, I know that it has some amazing benefits for dealing with the symptoms of PCOS. The problem is, as I said earlier, Metformin SUCKS.

I was first prescribed it by my regular general doctor a few years ago. She put me on 250 mg a day and it made me so sick, I was miserable for weeks. Almost 3 months, honestly. Then, she bumped it up to 500 mg a day and the hell started all over again. You can imagine my shock and dread when I went to see the doctor at the fertility clinic and he prescribed 2,000 mg a day of Glumetza, which is another, nongeneric form of Metformin. I almost died. 2,000 mg? You've got to be kidding me!

If you just google "Metformin side-effects", you would probably get pages and pages about what this drug does to your body. It's extremely unpleasant. I'm about to get a little graphic, so if you get disgusted easily, just skip over the next part, haha. Here's what metformin does to me. First of all, it gives me a terrible stomach ache. It puts me in a constant state of feeling nauseated. I have only thrown up a few times, but it's just miserable feeling like I could throw up at any moment. Then, there's the diarrhea. Literally, I have had days where I cannot leave the house because I'm on the toilet all day. It's disgusting and miserable and totally steals my dignity. I get awful headaches, have to drink a ton of water to stay hydrated, and am pretty much miserable all day every day.

Now, even after saying all that, I will admit that it does get better. After a few months, it gets better. At least until I eat a few bites of sugar. Then, it all starts over again. All it takes is a single cookie or even too much ketchup and I'm in the bathroom for hours with awful stomach cramps and misery.

So, after going through months of getting used to it, why would someone ever stop taking it? I have no idea, but that's exactly what I did. Multiple times. It seems like every time I get through the worst of it and start to get used to it, I just stop taking it. It's like a part of me just gets so tired of not being able to eat anything I want and not knowing when I'm going to wake up feeling awful. I just can't take it anymore and I rebel. I stop taking it. I binge on sweets and fried foods. Then, I reach a point where I know I have to start taking it again and the hell starts all over.

A couple months ago, I went home to Georgia. I knew we were going to the beach and I wanted to be able to eat when we went to dinner. I wanted to drink and have fun. So I stopped taking the Metformin and haven't taken it since. I don't know why, but food is a huge part of my happiness. It's so hard for me to live without it. I know that sounds awful and shallow, but it's the honest truth. On the other hand, taking the metformin means a healthier body. It means a better chance of getting pregnant, and more importantly, it greatly reduces the chance of miscarriage in women with PCOS. It's a medicine I HAVE to be on. Plain and simple. I'm just not looking forward to going through the side-effects all over again.

I know this has been a total whiny post today, but I just needed to get this off my chest. I wish there was some other way to get healthy besides taking this drug, but I trust my doctor and he firmly believes I need to be on it. I'm planning to start back tomorrow with 1,000 mg a day for a few weeks until (hopefully), my stomach starts to get used to it again. Then, I'll go back up to the 2,000 mgs and stay on it until I'm 12 weeks pregnant. I can only hope that in the end, it makes a real difference.