A 2WW DIGRESSION ON PCOS

I am currently in what is known in infertility circles as the Two Week Wait or 2WW. This is the period of time between ovulation and finding out if you are pregnant or if you need to take the next step on your infertility journey. This cycle, Kevin and I underwent a more aggressive infertility treatment than just the oral meds and monthly shots. We did IUI - intrauterine insemination. It was our second attempt - the first cycle, my ovaries basically over-responded to the injections, causing me to be dangerously close to Ovarian Hyperstimulation Syndrome. A week or two of little to no physical activity and a month of ovarian rest, and we were ready to try again. This month Kevin gave me shots for fourteen days, then made it in a cup. We rushed the sample to the RE's office where it was washed, prepared, and injected directly into my uterus. Thus, we are in the 2WW. We'll find out if the IUI was successful this Wednesday. Keep us in your prayers.

This post isn't about the IUI though; it's about PCOS.

I was diagnosed with Polycystic Ovarian Syndrome in 2003. I underwent a plethora of emotions. First, I was relieved. There was a definitive reason why my cycles were so berserk. On top of that, it explained the weight, the hair, the acne, the depression. Next, I was angry. Why hadn't anyone found this until now? I was 26 for pete's sake! What the hell is wrong with the dozens of doctors I had seen in my post-pubescent life? Finally, I felt sadness. I was sad for Kevin and me. I knew that this meant that we would have a more difficult time conceiving our family than a couple who did not have to struggle with the hurdles of PCOS.

PCOS is a serious condition that is not only difficult to diagnose, but difficult to manage. As I learned more and more about this endocrine disorder, my life began to make more sense. All the things about my body that had bothered me for years were finally explained. It wasn't my fault. I wasn't doing something wrong - there was actually something wrong with my body. Following is a list of symptoms that women with PCOS may experience. Not all women with PCOS share the same symptoms. Of the fifteen below listed symptoms, I suffer from twelve of them.

Symptoms of PCOS:
infrequent menstrual periods, no menstrual periods, and/or irregular bleeding
infertility because of not ovulating
increased hair growth on the face, chest, stomach, back, thumbs, or toes
ovarian cysts
acne, oily skin, or dandruff
weight gain or obesity, usually carrying extra weight around the waist
insulin resistance or type 2 diabetes
high cholesterol
high blood pressure
male-pattern baldness or thinning hair
patches of thickened and dark brown or black skin on the neck, arms, breasts, or thighs
skin tags
pelvic pain
anxiety or depression due to appearance and/or infertility
sleep apnea

PCOS also could have been the reason for my recent miscarriage. The miscarriage rate in women with PCOS is increased 20-50% when compared to women without this disorder. PCOS sufferers are also more likely to develop gestational diabetes during pregnancy. Not only is it harder for us to get pregnant, it's also harder for us to have a healthy pregnancy.

Women with PCOS have greater chances of developing several serious, life-threatening diseases, including type 2 diabetes, cardiovascular disease (CVD), and cancer. There is no cure for PCOS. Symptoms can be managed through a high-protein, low-carb diet and exercise.

It is the PCOS that continues to make our journey to conceive so difficult.

A CONDENSED RECOLLECTION OF THE PAST TWO YEARS

We have been working with an incredible reproductive endocrinologist since August of 2006.  After several office visits and ultrasounds, he put me back on 2000 mg of Metformin, Clomid, and a once-a-month ovulation trigger shot of HCG.   The very first month (October) I was on this protocol, we conceived!  We were ecstatic.  We picked out names, envisioned the nursery, and started looking for an OB/GYN.  A few days before Christmas, we had an ultrasound that showed no heartbeat or fetal growth.  The baby had stopped developing a few days before, and we were devastated.  The D&C was scheduled for a couple of days before New Years.  It was the hardest Christmas season I've ever experienced.  

We continued trying to conceive using the same protocol for the next ten months.  Each month brought us another BFN (big fat negative).  I underwent a surgery in September 2007.  My doctor performed a laparoscopy, hysteroscopy, another D&C, hysterosalpingogram, cystectomy, and he zapped my endometriosis with a CO2 laser.  I was in recovery for about a week, then we picked up with the same protocol.  Month after month I was greeted by AF, which was actually a big step in the right direction in my reproductive health because I had never had regular periods.   Regardless, period equals empty womb.

It seemed like we had been TTC with the same protocol forever.  Finally, this spring we ordered injectible medicines from Great Britain to begin an IUI cycle.  The first month I was on the meds, my ovaries over responded.  My estradiol levels were so high that the lab's equipment couldn't even read the numbers and I had dozens of medium-sized follicles among the few dominant ones.  The cycle was then cancelled.  Damn.  After a month of ovarian rest, we were finally able to try again.  This time, I injected for 18 days and the IUI went off without a hitch.  Now, I'm in the two week wait.  

My blood draw is scheduled for July 2.  Our sixth wedding anniversary is June 29.  If we are pregnant, implantation should occur on the 27th.  Should I test on the 28th?  Theoretically, we could have a double celebration.  On the other hand, it could put a real damper on things.  What to do?   

THE PRELIMINARIES - 2003

Since I was fairly new to the city (and I finally had health care), I searched for a new OB/GYN to discuss my lack of menses.  She diagnosed me with PCOS and recommended that I see a Reproductive Endocrinologist to try and regulate my cycles since birth control-the regulatory stand by- really didn't interest me any longer.  Keep in mind that Kev and I still hadn't come to an agreement about trying to conceive; I was just really concerned for our future fertility, and knew that something needed to be done.  The RE put me on 2000mg of Metformin - a drug that is used to regulate insulin in diabetic patients - and told us that all it would take would be dinner and a movie and I would magically become pregnant.  The only thing that happened was that I became extremely emotional, couldn't tolerate sugar in any form, and had chronic diarrhea.  No periods, no weight loss, and no pregnancy despite our best efforts.  By this time, Kevin was starting to come around.  He agreed that we should keep trying, but that maybe we should use alternative therapies because he hated to see me in pain from the Metformin.  The RE we had been seeing (the one who believes in movie magic) obviously wasn't serious about helping us get pregnant, so we took matters into our own hands. 

 

We ditched the wacky RE and sought out an acupuncturist who was also knowledgeable about Chinese herbs.  Our insurance obviously did not cover this type of care, so about every two weeks we were shelling out around $140 for needles and herbs.  At first, the herbs were terribly hard to swallow.  It was unlike any horrible thing I had ever tasted.  Eventually, I came to love them - almost to crave them.  The 45 minute acupuncture sessions were always wonderful.  I was able to meditate, relax, reflect, dream, and pray while letting those skinny needles stimulate various meridians.  But still no baby.  On to the next step.

 

Through my research on the internet, I learned of another ancient therapy that has been known to help infertile women achieve pregnancy.  Mayan abdominal massage therapy is not widely practiced, not well-known, and interested therapists can only get certified to practice by an intense study program under one woman who resides in the Yucatan Peninsula in Mexico.  This particular massage therapy has been passed down for millennia  and is an external non invasive manipulation that repositions internal organs that have shifted.  I thought it's worth a shot.  After just one session, I did have a period.  It was the first uninitiated period I had had in years.  I thought this was going to work.  We scheduled another appointment for one month later, in the hopes that we could get the same response.  No go.  And no baby either.