I asked Tim to take off work for this so he could be there to support me and hear our new plan of action. We discussed the first issue of how I had been ovulating on the wrong side for the past three months. Unfortunately, there is absolutely nothing a fertility clinic can do to have my body ovulate on a specific side - that was just up to my body.
Another major issue that was brought to my attention was my uterine lining, or lack there of. Apparently in June and July, my uterine lining was "too thin" to sustain a pregnancy. So why they had me try an IUI in June I'm not really sure, but I didn't think of that until after we left. The oral drug, Fermara, I had been taking was supposed to help stimulate follicle growth as well as my lining, but it wasn't doing it's job and/or my body wasn't responding properly. This just blew my mind because it's exactly what we used to get pregnant with Anna, so why wouldn't it be working now? Mentally and emotionally, I wasn't ready for IVF yet. It was nearing the beginning of the school year which is one of the most stressful times of the year. I didn't want to use up all of my sick days for IVF appointments, and emotionally, I just wasn't ready to give up in IUI yet. It had worked before, why not now?! Thankfully, there was one more option left before IVF.
After explaining to the doctor that I wasn't ready to start IVF yet, he said that there was one more thing we could try before IVF. We'd pursue IUI, but instead of taking Fermara, I'd do an injectable hormone. They'd put me on a low dose so I didn't over-stimulate, I'd still do the Ovidrel trigger shot and we'd still do an IUI as in cycles previous. I'd have to do a daily injection and have a couple more ultrasounds (plus blood work each time) to monitor my ovaries. The biggest concern was over-stimulation and a multiple pregnancy. Because of my CF, my fertility doctor (and high risk OB, but not as much) really wants to avoid a multiple pregnancy. I agreed to do the injectable hormones because I really wanted to keep trying for an IUI. We made a plan - we'd try the IUI with injectables and if I wasn't pregnant in October, then we'd take November off to prepare for IVF in December over Christmas break. This would allow us three more rounds (August, September and October) to try an IUI, and put my IVF over Christmas break which should help reduce the number of days I'd have to take off work for appointments.
I was very thankful that the doctor was so understanding and that he listened to our wants and needs. I also appreciate that he is looking out for our best interest. He feels like we'd be very successful with IVF because we wouldn't have to worry about which side I'm ovulating on and because he thinks I'd respond to the medications well, but I just wasn't ready yet. Leaving that appointment, I felt very good. I loved the feeling of having a plan and I was glad that we still had a few IUI cycles left to try. I was very hopefully that the injectable medication would be exactly what we needed.
Fast forward a couple weeks to the beginning of August when my cycle started again. I had to get in for my baseline ultrasound between days 1-3 of my cycle because I had to start the injectables earlier in my cycle than the oral meds. *In the last two weeks, the fertility clinic had contacted my insurance to get me approved for the injectable medication. Of course when they called to order it when my cycle started, that couldn't be an easy task either. My cycle started on a Wednesday and they wanted me to begin the injections that Friday night. I was on the phone with several different people Wednesday and Thursday trying to get this medication over-nighted to me by Friday and they were all giving me the run around. Then I found out that the medication that was prescribed wasn't covered by my insurance and it would cost thousands of dollars out of pocket -- that wasn't an option. So then I had to call the fertility clinic back to see if I could take the "generic" kind. Thankfully the nurse was amazing and got it all straightened out for me and my meds arrive on Friday afternoon.
So, the injections weren't too bad. It was only one a day and the needle wasn't big. They were also preloaded in a cartridge which was really nice. I went into the fertility clinic a few days after starting. My follicles were responding well, but it looked like my biggest one(s) were going to be on the WRONG side AGAIN! I went back a few days later to double check and I had two huge follicles on the wrong side and one just under the wanted measurement on the correct side. I was almost in tears during the ultrasound. I was SO frustrated!!! They wanted me to do an IUI anyway (again). My lining responded perfectly to the medication and the doctor said there's always a chance that one of the follicles to move to the other side where my fallopian tube was (they've seen it happen, just not often). So, I actually triggered that night and we went in for the IUI on a Sunday, the day before I went back to school. Perfect timing.
The whole week after the IUI I felt weird. I was having random cramping throughout the week and just felt a little off. The whole next week I felt absolutely nothing. Even though the start of the year was keeping me very busy, it was always on the back of my mind. We were running out of time. If this one didn't work, the next one would probably make me use a sick day or two for appointments - which is a sick day or two less saved up for maternity leave. On day twelve of my two week wait, I had some brown discharge which had me thinking in both extremes. Either it was implantation bleeding or the start of my period. Of course, I took a pregnancy test and it was negative. I convinced myself to chill out because it was still early. I didn't have any discharge on day thirteen and did not take a test. Day fourteen came and I couldn't bring myself to take a test. I didn't want to be disappointed yet again. The whole day, off and on, I was having brown spotting. It was driving me crazy because my period wouldn't just start already, so I kept going back and forth getting my hopes up that it was implantation bleeding. Finally, around dinner time, my period came on full-fledged, so I didn't have to think about it anymore. I can't say I was surprised, because again, we didn't have the right circumstances, but I really had my hopes up that first week after feeling so weird.
So, I called the fertility clinic the next day (Monday) to start my second round of injectables. The night before, I was thinking to myself "we have two more months; two more shots to get this right before IVF". I was able to get an appointment for my baseline scan right after work. I headed over to the fertility clinic and during the scan, there looked to be a huge follicle on my correct side. For a split second I thought to myself, "Finally! Let's do this! Let's trigger for an IUI!" But I quickly realized that I just started my period, so there was no way I could already have a mature follicle - that's when I knew something was wrong. The girl who was doing my scan was obviously new because it took her forever and I could tell she didn't want to say much. When I asked her if it was a follicle already, she reluctantly said no, that it was a cyst. I knew it couldn't be a good sign. When she was finished, she told me to wait there until a nurse came to talk with me about next steps.
The nurse was really nice, but you could tell she felt bad. She told me that the cyst isn't uncommon after all of the meds I had been on recently. She said that if we went ahead with this cycle and the injectables, that all of the hormones would go straight to the cyst which would just make it bigger. I had to start on birth control (what?!) to help get rid of the cyst. Apparently that helps get rid of them. I'd take a low dose birth control for three weeks, go back for a "cyst check", and if it was gone, I'd stop the birth control and wait for my cycle to begin again. While holding back the tears (emotional much?), I asked if we'd still have time to do one more cycle? I wasn't sure if we had to be pregnant by October, or if we could still try in October to be pregnant in November. She said that since my cycle will likely start towards the end of September, we'd still have time to try one more time before taking November off to prepare for IVF. And in that short time, "two more months" quickly turned into "one more month".
So here we are, I've been on the birth control for just over a week now. I haven't had any side effects from it, but I'm so ready to be done. It is a little nice to not be stressed this month with fertility appointments, it's frustrating that we only have one more shot at IUI. Realistically, we could post-pone our IVF, but it takes months to get on the list (we were put on the list in July for December) because it fills up so fast. I can't put this off any longer. I'm at a point right now where I feel like IVF is just the way we have to go, and I really have a strong feeling that it's going to work for us because so many of the factors are controlled. Tim's struggling to accept IVF as our route. He feels like it's our last chance and doesn't want to give up on IUI when we haven't even had the correct circumstances. I completely understand where he's coming from, and I'm really bummed that IUI most likely isn't going to work for us this time, but emotionally and mentally, I don't know how many more rounds of it I can go through. He wants to keep trying month after month until my left ovary decides to get itself in gear, but we're already going on month five and I'm getting so drained. I don't think he completely understands how emotionally exhausting it is for me every month - he's better at controlling his emotions and not getting his hopes up than I am. But it's also not his body. I feel like my body is failing, and if there's another option that could potentially work better, than I think that's the route we have to take. I feel like people who don't go through fertility don't have a clue what couples go through. They don't realize how taxing it is on a relationship. I am so lucky that Tim has been so supportive throughout this entire process, and even talks about having a third child (which means he's willing to go through all of this again) one day. We'll see what the future brings, and we have to take this journey one step at a time. It's only something that him and I can decide together which is why we don't share much while we're going through it.