2009 Goal #1

One of my friends over at Conception-Obsession challenged all of us ladies to create nine goals for 2009. After much thought and many drafts, I'm ready to announce them to the world. I realize this is potential pride suicide. If I don't meet my goals this year, I've got a lot of people to answer to. But, I figure I haven't made resolutions in a few years, so I'll pack 'em in for 2009. And besides, I could use the encouragement.

2009 Goal #1:
Get back and stay on the Dysglycemia Diet. When I was first diagnosed with PCOS in 2003, I was flooded with all sorts of emotions: anger, sadness, relief, hopelessness...the list goes on. I tried a few things to get pregnant like the magical Metformin my weirdo RE promised would knock me up. Apparently, Kev and I didn't even have to hold hands and a baby would miraculously begin growing in my womb. Sort of like the Immaculate Conception, I suppose, though raising Baby Jesus seems like a daunting task. Talk about a tough act to follow. Anyway, I also tried Chinese herbs and acupuncture as well as Mayan abdominal massage. I loved these treatments because they were so relaxing and I was encouraged to do things that I would normally consider pamper items such as meditating, relaxing, taking baths (ok, a vaginal steam bath is not quite the same as a relaxing bubble bath, but I take what I can get).

After a couple of years of these treatments (paid out of pocket, I might add) and no baby, I decided to make an appointment to visit my regular doctor. She practices holistic medicine and is a good friend of the family. She recommended that I try the Dysglycemia Diet to regulate my blood sugar. Because I have Polycystic Ovarian Syndrome, my body doesn't process sugars and starches the way a normal person's body does. In a normal person, sugars and starches are turned to energy. In my broken body, sugars and starches are turned to fat instead. This starts a vicious cycle of decreased energy, weight gain, depression, and yes, infertility (on top of some other yucky, more scientific things). Some experts think that the Dysglycemia Diet is perfect for people with PCOS. I followed this diet for about a year and lost weight, felt great, and got pregnant (even though I lost the baby) a few months after quitting the diet - might just be a coincidence, but I'm desperate here. I'm ready to try it again.

One thing I really loved about this diet is that it is vegetarian friendly. For every meatatarian dish, there is an equally delicious and nutritious vegetarian substitution. The document includes meal plans and recipes, reproducible checklists to keep track of what you've eaten each day, and daily menus for 1300, 1600, and 2000 calorie daily allowances. The first few pages also explain how the diet works and what the absolute no-no's are while on the diet, as well as tips for us veggies. It's really comprehensive. It's really a lifestyle change. It's really something I've needed to do for a long time.

If anyone out there is interested in taking a stab at this with me, I'd love to have a diet buddy. The link above takes you to the exact document I used a few years ago and will use again starting January 5. Why January 5 and not January 1 you ask? Because I plan on being thoroughly hungover on January 1 and I will want some pizza and soda. Maybe even some sweets of some kind. Yeah, I'm all over the sweets. Of course, I'll need a day or two to clean out my cupboards and fridge and shop for items on my new menu and plan out meals. Then, it's bubbye to indulgences and hello to a healthier, happier, thinner, more energetic Gina.

ONE MORE TRY AT IUI

I finished the 21 days of the Pill on Tuesday and am currently on cycle day 2. I had an ultrasound this morning that showed that the three large cysts that were holding us back had withered away and my sleepy little ovaries are still polycystic. This is good news. I will start stimming (stimulating my ovaries with injectable drugs) tomorrow in order to attempt another IUI. So for roughly the next two weeks, I will be getting shots in the stomach and ass, getting bloodwork taken a few times a week, and having ultrasounds a few times a week. Oh, and I'll also have an HSG. The bloodwork monitors my estrogen levels, while the ultrasounds monitor the growth of follicles on my ovaries and the thickness of my endometrial lining. The HSG is a procedure where the doc forces liquid dye through my fallopian tubes (it's terribly painful for some, but I seem to handle it okay). Keep in mind that although I am currently covered under THREE insurance policies, all of these expenses come right out of our pocket. No one covers infertility treatments. Insurance companies act like I've elected to have these disorders - that infertility is something that I've chosen. Bastards.

Anyway, I thought I'd include a picture and explanation of what a month in the life of Gina & Kevin on infertility meds is like. In the above picture, I have laid out all medicines that I will pump through my body over the course of about 28 days. They are aligned from left to right in the order in which I will take them. Follow along...

Pre IUI cycle:

Metformin 2000 mg daily (This is to regulate insulin which my body does not do on its own thanks to PCOS. Without it, all sugar and carbohydrates turn to fat instead of energy like in a normal body. I've been on this for two + years.)

PreNatal vitamin daily (This is obviously to prepare my body for baby. I've been on this for five years.)

Birth Control Pill (I take this between medicated cycles in order to let my body - especially my ovaries - rest from the hyperstimulation. It pretty much gets me ready to go into overdrive.)

During 28 day IUI cycle:

Follistim (FSH) - Injected subcutaneously in my stomach CD 3-7 (This makes my ovaries produce a whole bunch of follicles and tells them to GROW!)

Puregon (HMG) - Injected intramuscularly in my ass CD 8-19 or 20 (This makes my ovaries pick a few - between 1 & 4 - dominant follicles and only make them grow. These follicles will *hopefully* each release the egg inside it after the next step.)

Pregnyl (HCG) - Also injected into one of my bum cheeks once my follicles and endometrial lining reach an acceptable size (This tricks my body into ovulating. The mature follicles each release their egg to make their way through the fallopian tubes, hopefully to meet Kev's little swimmers.)

Prometrium - Taken until I get a period, or if I am pregnant, until my Dr. tells me to quit (This makes my endometrium a nice and hospitable place for the fertilized eggy to attach and grow.)

Crinone (Unfortunately, I haven't ever gotten this far in any of the IUI cycles. It is a progesterone gel that is inserted vaginally that ensures the endometrium stays nice and cozy for the little growing babe. Maybe this time I'll get to use it.)

So there you have it, folks. A month in the life of an infertile trying IUI. We are ready to roll. Wish us luck!

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.