Monday, July 23, 2007

CD 1 (with updates at the bottom)

Full on CD1, complete with cramps, irritating people and multiple trips to the bathroom. AF is here and making her "presents" known about every 20 mins. A required trip to the bathroom is much needed to keep from any incidents. (anyone knowledgeable about clotting, baby aspirin, endo.metriosis, implanting disorder?) I haven't been diagnosised with endome.triosis but the more cycles I do not get a BFP, the more I can't help myself to ask more questions. Does Heavy cramping, nasty clotting/expelled weird tissue, MTHFR auto-immune, spontaneous aborter, frequent tampon changes = possible endo? Or is it possible that Clo.mid can make me experience all of the above. It doesn't happen every period, just seems to happen at least every other period - but didn't happen at all from Jan - Jun when I was on a "break" from Dr's and Clo.mid. (neither did Ovulation either though)

OK enough with the gross talk - sorry, thanks for hangin' in. OK So you are aware it's CD1. I made that lovely "got my period, need more cl.omid" call to my Dr's office today. The nurse called me back at 2:30pm, and I asked her AGAIN about doing my blood test on CD3 and CD21. *my gyn was doing those, and this Dr only does the CD21 and I am confused on why not more monitoring also why shouldn't I be doing 7dpo blooddraws and not just CD21 blood draws? My though process - I have PC.OS, I do not have a 28 days cycle (insert hysterical laugh here), and those CD21 tests are assuming that I do have a 28 day cycle and CD21 would be 7dpo - so why the hell am I doing a test based on the assumption of a "normal woman" at a RE office???? I feel like we are missing a piece of the puzzle. I truly understand that the normals out there are only given a 20% of pregnancy each month - and the nurse told me that because I ovulated last month, I only had a 20% chance also - and because I ovulated last month, I am being placed in the "normal" category. I have to admit, I'd liked nothing more to be NORMAL, but I assure you I AM NOT a normal cycling woman. She also informed me that my "clomi.d injectible" (smart nurse huh) would screw up my OPK results. I insisted that cl.omid was not an injectible and that clo.mid was suggested to be used in conjuction with OPK's and should not alter my results in any way, shape or form. I am dealing with Rock Scientists it seems. She also informed me that I was asking complicated questions and she suggested I have a Dr consult since I have so many difficult questions and I want to make exceptions to their procedures. SOOOOOOOOOOO, with that said, I have an appointment tomorrow at 8:45 am. I dunno if this is the right place for me, We will find out tomorrow. I don't know what else to do. I am not new at this, but I have not experienced any other forms of fertility treatments except clomid. I just need to ask a few questions and hopefully have him ease my mind. I am confused on why my gyn monitored me more on clo.mid than him. Why do I feel like some piece of the puzzle is going unnoticed? If I have doubts, why can't the nurse put me at ease, even if it is for 10 minutes?? Why do I feel like I know way more about reproductive medicine than this hussy of a nurse? I am going to run down my list of questions and any thoughts on them would be MUCH appreciated:

  1. Why am I doing CD21 day test and not a 7dpo test specific to my cycle?
  2. Would we be able to tell something more at a 7dpo blood draw that we would not be able to detect at the random cd21 blood draw?
  3. Why did the nurse say that progesterone is rarely prescribed?
  4. Why did your nurse tell me that would alter my opk results?
  5. Do you think U/S for monitoring and measuring my follicles would benefit or increase my chances of getting pregnant while on clomid?
  6. Is it possible to ovulate and release an egg that is not mature enough for fertilization/implanting?
  7. Do you think it is possible to learn something from U/S monitoring my ovaries on c.lomid?

I am tired of the tried and tried and tried method of wait and see. I am ready to partake in the medium sized guns ( IUI"s if that is necessary). I have done the wait and see game for 4+ years and it didn't kill me but it has surely has damaged me. I just want to maximize my cycles as much as possible - PLEASE leave me your thoughts/opinions/history - since I finally ovulated last month, do you think I should stick it out a few more months and suck it up and wait and see then monitor or Do you think we could learn something from a month of monitoring. I will have to pay out of pocket for all the U/S, injectibles and such but I am willing to do this if it means helpful information and knowledge to come for later cycles.

*** Update*** Kudos to my sleep deprived Husband who worked all night and showed up at the dr. office in time for the visit!!! The Dr. agrees that at 150mg a day 5-9 isn’t cutting it. I am barely getting by and he totally agrees that I should be alarmed by my low progesterone levels. He agrees that my # should be in the 20+ range on that much clomi.d., but it isn’t. It was 7. He agrees that I am just spinning my wheels and wasting a lot of time/energy on the fat chance that my body gets its act together and does some kind of fierce extreme improvement in clo.mid …. I could not agree more!!!! So we are moving on to injectibles (brave.lle) with IUI as an option. I called the pharmacy that they recommend. It’s relatively affordable. I have placed a phone call into the Dr’s insurance coordinator because, our crappy insurance will not cover anything other that a diagnosis. I want to be aware of all the costs and see if we can start this month – or have to wait til next or whenever we have the money. We are in the process of moving and have spent a lot of unforeseen funds in the process. So, seems like I am back to square one .. I have another post coming – just need to stomach all of this first.


FattyPants said...

Your progesterone level should be tested at 7dpo or half of your usual lp. Progesterone is prescribed pretty frequently, at least where I go. I believe you can ovulate bad eggs. Since we have so many I'm sure not all are stellar. I've heard clomid can give a false positive opk if you start using them while you are on it. But if you wait until day 10 or so to start it shouldn't.

Its late so I can't think right but I have an entire basketfull of thoughts on the entire clotting pain issue because I've JUST started dealing with it in the last year or so. Hope some of that helped.

Trish said...

I think your questions are spot on.
As for my history vs what you're experiencing, here's what I've got.
I have a feeling I'm going to get wordy, I apologize in advance.

I charted for 6 months before I saw the doctor. I had technically been off of birth control for a year, so I felt warranted in asking for some tests, but really only trying for 6 months.
Anyway, my GYN was wholly convinced I was fine because I was having regular periods (in the 25-28 day range.)
I was using OPKs & charting and did NOT agree.
I had to get pushy to get my way. "Fortunately" I have my fair share of experience with shitty doctors & wasn't going to be talked out of it, so she finally saw the light. She agreed to do a progesterone check basically to prove that I was ovulating and to shut me up.
Well, it was low. Yes, I was ovulating, but like shit. My 7dpo progesterone was 6 or less. (That's 7dpo, btw.. NOT CD21, cause that's complete and utter bullshit and any RE should know that.)
Anyway, that's what got us referred to an RE in the first place.
And yes, we were told that while it was POSSIBLE I could get pregnant the way I was, it was unlikely for a few reasons. #1, the egg was probably so shitty, it didn't live long enough to meet sperm. (We didn't quite know yet that we didn't have enough sperm, either.) Then if it DID meet sperm, it was so cruddy it probably wouldn't fertilize. And if it DID fertilize it probably wasn't strong enough to implant. And if it DID implant, my progesterone was so low that it likely wouldn't support a pregnancy.

Now, my RE did say that sometimes (not often) Clomid can screw with OPKs. We started out using them but I have had such a god-awful time with them that we have since moved on to follicle scans & a trigger shot. That first month of THAT got us pregnant.
If the OPKs were working for you.. I'd say go for it. Some people have no trouble. Me? Not so much. In probably 18 cycles of this, I've had maybe 3 clear positives on some form of OPK. I don't like those odds. Particularly considering our sperm issues, timing is VERY important to us.

Anyway, the only thing I really do agree with the nurse on is that you should see the doctor. Though I think her obvious annoyance at your "complicated" questions is enough to make me throttle her.

MY experience was that the nurse that the GYN's office was a complete and utter moron when it came to infertility. (Had many conversation similar to what you described. Which is actually why I moved back to an RE again.) But the nurse at my RE's office really knows her stuff.
Hell,she's the one that does my IUIs. Not the RE. She's the woman that got us pregnant.

Anyway, I hope you get some better answers, tomorrow.
As for whether or not to use OPKs vs scans.. that's a tough call.
Maybe give it one month, try a CBE digital set and *IF* they work, save yourself the time and trouble of the follicle scan etc.
But if they DON'T, I'd insist on it.

Honestly, though, if you can afford the scan, it'd be nice to make sure things are going as planned and your lining isn't too thin, etc..

Good luck! I'll be watching for an update.

Artblog said...

Wahh, sucks! They don't go much for these supplements, as I call them, here in France. Not without proof you need them. 7dpo test are the norm here too. anything over 20 and your good to go in their opinion.

Amanda said...

I agree with trish. Push until they give! Maybe your RE is different, but from what you said your RE's nurse is a MORON! Complicated my butt! She should at least know that clomid isn't an injectible. Come on! Even I know that and I haven't even tried it, yet.

I say push on the 7dpo instead of 21cd testing. Push for an ultrasound to check everything out. Even if that's not how they're going to monitor everything, I'm all for a good wave's eye view of the insides. (Of course, I admit I'm still amazed (not in a positive way, but in a "wow" way) at the view of a PCOS ovary)

I would probably monitor for two more months since this is the first month you ovulated, but after that, NEXT STEP PLEASE! Of course I may have that 3 month mark in mind becuase that's what my OB/Gyn is doing with me.

Good luck sweetie!
<3 Amanda

SaraS-P said...

Looks like others have covered it, but, yes, your "CD21" labs should really be done 7DPO, so later ovulation = later labs.

As for clotty, heavy periods, I spoke to my RE about this, and he told me it does not necessarily signify a problem, but he did put me on baby aspirin, which did thin my menses (but I still have clots). I know some women have to go on Heparin (a blood thinner).

I agree that your nurse is a moron (is it a requirement for RE and OB/GYN nurses???).

Hope your RE knows what to do and gets you on the right track.

Dreamer4agift said...

Well, I'm glad to hear your meeting with the RE went better than the convo with the dumb nurse. I hope you got all of your questions answered.
I have tried OPK's and have gotten 1 positive...which didn't surprise me since I knew I had issues with O. I'm possibly going to use them again this cycle, but I'm not sure. I have heard Clomid can alter the OPK if used before cd10.
As far as the clotting--I have not had really bad clotting issues until over the last year. I have had 2 really bad ones and the first one I really feel it was a m/c. I've been on Clomid since October and the first one was prior to the use of Clomid. I would think it could be a possible sign of the endo, but not necessarily. Did you mention this to the RE? I would ask him (not his nurse) and see what he thinks for you. All body's react differently to diff. things--as we all know, so what might've been a sign of endo for me might just be a crappy period for you. Good luck and here's to a new cycle for us all.

sharah said...

For what it's worth, my periods on clomid were extremely light -- almost nonexistant. My RE said it didn't really matter, because they were checking my lining thickness to make sure it was enough before I triggered.

And I'm glad your RE took you much more seriously than your nurse. Way to stand up for yourself! Go get'em!

Courtney said...

I'm so glad to hear that the doctor is on board with 'stepping things up' a bit. Those injectable meds might be just what you need to get that elusive +!

Jayleigh said...

My nurse says the CD 21 blood draw is to check progesterone to see if I ovulated.

The hCG shot is to make your body make it's own progesterone. Your own will work infinitely better than having suppositories or shots or whatever else.

The clomid didn't seem to mess with my OPK results. Or maybe I was just way too early.

That's all for now. I'm sleepy. Hope you get the answers you're looking for.