Our (In)Fertility Journey: Round Two, Part Two.

Feeling a little nervous about the way the last post ended....nothing compared to how nervous I was about this meeting! It was mid-cycle in July. This round of treatments had been canceled pending this meeting.

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. 

Our (In)Fertility Journey: Round Two, Part One.

Here we go again...

*Reader beware: These posts will include talk of periods, ovulation, semen, etc...if you're uncomfortable, don't continue. I want to help spread the word about fertility treatments and help to inform others either going through it, thinking about, or anyone who can relate - especially people with CF.

Tim and I always knew we wanted to have more than one child...as many of you know, Tim always jokes that "only children are weird". When Anna was about 9-10 months old, my cycle finally came back. When she turned one, we decided to start trying on our own again, but soon realized we'd have to go the fertility round again when my cycles never regulated. 

In November 2015, I went to see our amazing fertility doctor to discuss the steps we'd need to take to try for another baby. I thought we'd have to go through more testing, blood work, etc. since it had been two years since I had gotten pregnant. Much to my surprise, he was pretty much ready to start me on meds right then and there! Tim and I weren't sure when we wanted to start fertility treatments exactly (he wanted to time things, I wanted to start asap), so I told the doctor we weren't ready just yet, but that I just wanted to know the direction we'd head when we were ready. He was understood and explained that we'd pick up right where we left off. We'd use the same oral hormone and ovulation injection, and go with an IUI which is what we did to get pregnant with Anna. All he wanted me to do was get the A-OK from the high risk OB team who took care of me during my first pregnancy. 

Tim and I decided that we'd try on our own for a little bit longer and pursue fertility in the spring/summer. I made my appointment with the high risk OB in March and she was so excited to see me back. She was very pleased with my health and was so excited to have me as a patient again. The only thing she needed me to do was have an echo on my heart to rule out pulmonary hypertension (which could be there because of my CF). She felt that with my health as good as it was, I'd be fine, but it was more of a formality. I had my echo done over spring break, in April, and the OB said it was "the most normal echo report I have seen in a while". She sent the results to the fertility clinic and said she'd see me "soon for an OB visit". If only it were that easy...

We decided to start fertility up in May since it was the end of the school year and I'd be able to have my appointments over the summer...plus, if it worked out, we'd be set for a spring baby -- aka: maternity leave at the end of the school year + longer time with baby over the summer. Again, if only it were that easy...

We went in at the start of my cycle in May. For those of you who don't know, I only have one Fallopian tube. That means when I ovulate on the side without the tube, the chances of me getting pregnant are extremely slim, even with IUI. So, the follicle has to be on the correct side, which is the left side, for me to have a good chance of getting pregnant with an IUI. In May, I started taking the oral drug, Fermara, to help stimulate my follicles to grow. Of course this month, my body decided to produce its biggest follicle on the wrong side. Lovely. So we were told to still do the trigger shot and have timed intercourse. This, to me, is a waste of time and money. There's a reason we're at a fertility clinic, but whatever. It's basically their way of us at least trying something. Needless to say, it didn't work.

In June, we did the same thing, used Fermara. This time I produced a very large follicle on the WRONG side again! The doctor told us it wouldn't hurt to try an IUI this time around. We knew the chances weren't great, but figured why not? So we went in for the IUI the morning we scheduled to leave for vacation. Two weeks later....no good. I wasn't surprised, but still disappointed. I felt like maybe we had a bit more of a chance. 

In July, we did the Fermara again. And I ovulated on the wrong side AGAIN! So if you're keeping track, that's three months in a row that I ovulated on the same side. It's a myth that you ovulate on opposite sides every month! After my ultrasound, when I saw the follicle on the wrong side, I wanted to cry. I was getting so frustrated. This was the last month we'd go through treatments before school started and it was a bust, again! Then the clinic called me and wanted to schedule a meeting with the doctor to discuss other options. This freaked me out a bit. I knew the only option left was IVF and I wasn't ready to throw in the towel on IUIs yet. We hadn't even had the right circumstances yet. I was quite nervous to meet with the fertility doctor, but I knew it had to be something important for him to arrange a meeting mid-cycle.

Our (In)Fertility Journey - Part Four, Conclusion

Read "Part One" here.
Read "Part Two" here.
Read "Part Three" here.

Every part of the July cycle was exactly the same, except instead of doing timed intercourse, when I was ovulating Tim would go in and provide a sample. Then they would wash his sample, pulling out the strongest 5 million sperm from around 20-30 million to give us the best chances. I would go in and have his sample inserted, past my cervix and directly into my uterus with a catheter. The procedure itself took less than a minute and felt very similar to a pap smear with a bit more discomfort. I told the doctor to make sure to "aim left" since that's where my mature follicle was, he said he'd try! ;) Then they had my lie on the table for about 15-20 minutes, and then I was free to go about my normal activities. Two weeks after the procedure, I would take a pregnancy test to see if it worked.

My IUI happened to fall on the morning of the first day of Country Thunder (four day long country concert in Wisconsin), so as soon as the procedure was over, I spent four hours driving north to see the first night of performers. (Unfortunately, I took too long to get there & traffic was horrible, so I decided to skip the concerts and head back to my friend's cottage to relax). Thankfully, I was preoccupied all weekend, and of course very relaxed, which was nice because it kept my mind off of the fact that I could be growing a baby inside me!

Thirteen grueling days later (yes, I tested a day early - I couldn't wait!), I took a pregnancy test. Shortly after I took it, there was no second line (negative), so I threw it in the bathroom garbage can. A couple hours later, I went to use the bathroom and decided to pull the test out of the garbage and look at it again...just in case. To my surprise, there was a faint second line! I couldn't believe it! I thought for sure it was just an evaporation line because it had been a couple hours, but just to make sure I took another test. This time I followed the directions on the test and waited the entire five minutes before allowing myself back in the bathroom to look at it again. Longest five minutes ever! When I went back in....there were two pink lines!!!! I was absolutely shocked!! I called the fertility clinic to see if I could come in for blood work within the next day or two, and they told me that I could come in right then! So of course I hopped in the truck and drove there as fast as I legally could! :) A couple hours later, they called me back and told me that for a viable pregnancy, my hcg level should be above 20 and mine was 25. They said that we should be "cautiously optimistic" and come back in two days for a repeat blood test. So, in the meantime, I was trying to decide how to tell Tim. I didn't want to tell him over the phone because I wanted to see his reaction. I went to Target to buy him a new hamper (since his broke during the move - oh yeah, we had just moved into our first house a couple weeks prior) and I bought a St. Louis Cardinals onsie. I kept the onsie in the bag and put it in the hamper. When Tim got home and saw it, he was completely shocked! He said, "I didn't think about how I'd react when it actually did happen." Needless to say, we were extremely excited!

Two days later, the day of my bestie's rehearsal dinner, I went back to the fertility clinic first thing in the morning to get repeat blood work. They told me they'd call me in the afternoon with the results and then we'd go from there. When I got the call from the fertility clinic only an hour or two later, I knew something was up. The head nurse was on the other line and told me that my hcg level actually went down to a 19, which means that this was not a viable pregnancy (it should have at least doubled). They suspected that the egg probably fertilized, but never implanted. She explained that its extremely common and that if I wasn't being monitored so closely, I probably would have never known. This being a Friday, they wanted to see me back on Monday to make sure that my levels continued to drop and get back to normal. She suggested taking the month of August off from any treatment to let my body/hormones regulate, and then we'd try again in September. I was crushed. I had no idea what to say. I couldn't believe it. For the past two days I was on the biggest high of my life and it all came crashing down in that moment. When I got off the phone, I cried. I tried to compose myself enough to call Tim. I wasn't going to see him the rest of the weekend because I was going up for my friend's wedding and Tim had to work all weekend. I couldn't keep my composure on the phone with him for very long, and it was so hard doing it over the phone. I decided to pack up my things for the weekend quickly, stop by his work on the way up north and see him. I couldn't go all weekend without seeing him. I brought lunch and we sat in an empty apartment where he was working for the day, just wondering why it happened this way. *Looking back, I understand it's very common for women to miscarry (especially this early on), but at this time, I just couldn't wrap my mind around it.* Something we had been working so hard for years on, and wanting so bad, was just at our finger tips and ripped away from us. While I was with Tim, my CF doctor called me (I texted her to call me) and I told her the news. She was extremely understanding and was an amazing person to talk to about this. She reassured me that in the month of August, she would do everything she could to get me on Kalydeco because she really felt it would help me get healthier and might even help me get pregnant - this, at least, gave me a little something to look forward to. After Tim's lunch break, I headed up north, put on my happy face and watched my best friend get married! It was a great distraction, but it was still pretty difficult. Over the weekend, my period started, only about a day later than it would have typically, so the nurse was right - if I hadn't done any tests or blood work, I would have never known I was pregnant.

Looking back, it was actually pretty nice having the month of August off of any fertility treatments because the beginning of a school year is very busy and stressful. At the end of August, I started taking Kalydeco! When my cycle started at the end of August/beginning of September, I started another round of the same treatment. I was determined to do another IUI. We knew the procedure would work, we just had to try again! This month my mature follicle was on my right side - the side with no tube - so the chances of me getting pregnant were extremely slim, but I pushed for another IUI anyway. Not a huge surprise when it didn't work two weeks later, but I was still bummed. Tim and I agreed to not go through another IUI until my mature follicle was back on the left where we needed it to be. In October, my follicle was on the right side again, so we didn't do anything that cycle. Again, it was kind of nice to have a break and not stress about it, but it was still another month gone by that I wasn't pregnant. In November, my follicle was finally back on the left side!! I was so excited to finally go through another IUI with better chances this time.

My IUI was on Thursday, November 21st, first thing in the morning. It was the day of my first graders' Thanksgiving Feast put on by our partner church, so I decided to take a 1/2 day in the morning for the procedure and then go back to work for the afternoon. The IUI went well, same procedure as last time. While I was having the IUI done, the head nurse was asking why Tim and I didn't just go for IVF. I explained our situation and how, really, this was our second "good" IUI and that I didn't want to go for IVF until I knew these IUIs weren't going to work. I told her that I thought the IUI was just what I needed, but she said she was going to sign us up for a IVF consultation meeting in March/April to do a summer IVF in case these didn't work. I just brushed it off and didn't think about it too much after.

Twelve days later, on Tuesday, December 3rd, I took a pregnancy test. Tim was annoyed that I did it two days early because of what happened last time only a day early, but I just couldn't wait any longer! My boobs were killing me, so it had me thinking...

This leads me to this post!

The test was positive!!!! I took another test Wednesday morning, Wednesday evening, and then again Thursday morning before getting blood work later that morning. My hcg level was 189....much, much stronger than the first time. The following Monday, my hcg level rose just as it was supposed to, to a nice strong 1,015! Two weeks later, Tim and I went to our first ultrasound at six weeks, three days, and saw our little peanut (blob) for the first time - it was so unreal!

It took me a long time to accept the fact that I was pregnant. I kept telling people I was pregnant, and I saw it on the ultrasound, saw it on the million pregnancy tests I took, but it took a long time for it to sink in! It really took the physical changes to my body and then finding out it was a girl for me to start bonding with her and accepting that this is reality. Even today, at 20 weeks - halfway through my pregnancy - I still find it hard to believe. Sometimes I wonder if I'm going to wake up from this crazy dream only to find out it's not really true. But I try to push that aside and embrace what is happening! This little miracle child is growing perfectly inside me and will be our daughter in only four more months!

There is absolutely no way I would have made it through this process without my amazing husband, Tim. He has been an amazing support and trooper, going through his share of testing, too, to make this happen. There were times over the last three years where I just wanted to throw in the towel and give up (ask him about the time I trapped him in the bathroom and cried...). There were plenty of times where I thought this was never going to happen for us. But he was always there, with a level head, to keep me pushing through. I couldn't have asked for a better person to be at my side through all of this. I know he is going to be an AMAZING dad to this little girl. He already loves her so much. It's absolutely amazing to see how involved he already is and I can't wait to see him interacting with her once she's here. :-)

I know this sounds so cliche, but I hope this helps people who are going through similar experiences to never give up!! Also, don't be ashamed or embarrassed by what you're going through! Thankfully, along the way, I felt more comfortable sharing bits of our experiences with some family and close friends. This really helped me realize it was nothing to be ashamed of, but I also didn't publicly document it as we went along because it was very emotionally tolling for us. PLEASE, please, please ask me any questions if you or someone you know is going through a similar experience and I will gladly share more of our experiences with you.

And if you have some friends or family who you think should start having kids, maybe this will help you be a little bit more sensitive to why they don't yet...
When people would ask when we were going to have kids while we were going through all of this, I would just brush it off as "hopefully soon" or "eventually", when all I wanted to shout at them sometimes was "I CAN'T!" or "We've only been trying for ____ months/years!" You have absolutely no idea what people are going through in their personal lives. Please try to be sensitive to others, especially during such an emotional process.

The reason I titled this series "(in)fertility" is because I feel like the word infertility has such a negative connotation to it, but that's often what it's referred to. I prefer to use the word fertility because I feel like it gives me hope. No one wants to hear that they're "infertile". But going through 'fertility treatments' at least gives me the outlook that we're a work in progress. Clearly our journey was not short or easy, but it was absolutely, positively, 100% worth it. Here I am, halfway through my pregnancy already, but I will never forget what we had to go through to get to this point. This little girl has been so deeply wanted and loved well before she was even created. 

Thank you so much for reading. I hope you've learned something from me sharing our story. :)

Our (In)Fertility Journey - Part Three

Read Part One here.
Read Part Two here.

After the appointment, I felt defeated. Removing my Fallopian tubes was such a permanent decision, but it was our only option if we wanted to have children. A few weeks after the appointment, I had a CF clinic appointment and brought all of this up to my CF doctor. Surprisingly, she was not on board. She did not want me to go through surgery because she wanted me to get a second opinion. She thought the surgery was too drastic of a measure and that we could do IVF without having to remove my tubes. She was seeing the CF side of things and my fertility doctor was seeing the "getting me pregnant" side of things.
I was stuck between a rock and a hard place. I deeply respect my CF doctor and everything she has to say, and I've never gone against her advice before, but I just knew I had to go through with the surgery. It was very hard for me for a couple weeks, deciding if I was going to go through with it, but I finally called my CF doctor and told her it was something I had to do. She supported me and apologized for sounding so against it, and she understood why I wanted to go through with it.

On a Thursday in late February, Tim and I headed out to the hospital to have my tubes removed. Here's what I wrote about the surgery the day after:
"Overall, things went well. We arrived at the hospital at 12:30pm expecting the surgery to start around 2:30. Well of course it didn't go according to plan – I was taken in the operating room around 3:45 and the surgery began around 4:30. All I remember is going into the operating room, switching myself onto the operating bed and the anesthesiologist telling me not to be nervous and that I'll be in good hands. Next thing I remember is waking up in the recovery room around 7-7:15pm with a mask on my face giving me some albuterol. They let me go as soon as I was able to get up and walk to the bathroom. I had to prove that I could urinate (to make sure nothing got messed up down there) and then they let me get dressed and leave. We didn't get home until almost 11pm because the roads were terrible due to the snow and ice storm we got while we were at the hospital.

My fertility doctor was the one who performed the surgery and talked to my husband, Tim, after the surgery was over. He told Tim that I only had one tube removed! Apparently both of my tubes were surrounded by a significant amount of scar tissue (I'm assuming from my meconium surgery at birth). They removed the scar tissue on my right side and my right tube because it was so dilated and bad. They removed the scar tissue from my left side and around the tube and realized that my left tube is perfectly fine – no mucus or fluid in it! Yay! Due to the amount of scar tissue, I had to have 4 incisions, but they're pretty small.

The doctor also told my husband that we aren't going to go straight to IVF. My husband said he wants to put me on "drugs" and let us try to get pregnant naturally! I was VERY surprised and excited to hear this!!! Going into the surgery, I thought when I came out there was no chance of us getting pregnant naturally anymore! I don't know if this means Clomid or IUI, but our post-op appointment is next week, Thursday morning, so we'll be able to discuss everything then – I'm really looking forward to that.
Finally, my lungs are doing pretty well. I haven't tried my Vest yet, but I did do an albuterol treatment this morning to help open and loosen things up. I am able to cough and spit, but it's a little painful, mostly for the incision right at my belly button. I've also only been taking ibuprofen for the pain. They wrote me a prescription for Zofran (or something), but I haven't had it filled yet – I don't think it's necessary. 
Long story short, no IVF right away! I still have one Fallopian tube! And now I'm recovering at home and I'm not as uncomfortable as I thought I would be. Overall, I'd say it was a successful surgery!"

The next week, I had a follow-up appointment with the fertility doctor to check my incisions and discuss the next steps. It worked out perfectly that right after the surgery, I got my period, so I was at the beginning of a brand new cycle to start treatment. We decided to try six months of Fermara (which is just like Clomid, but since I didn't respond to it before, he wanted to try something different) with timed intercourse. Then if it didn't work within six months, we'd go to Fermara with IUI.

Of course I was super hopeful that the first round would work and was heartbroken when it didn't, but the doctor and nurse both told us it'll take a few rounds to get everything right. Since I was only doing each round with one working Fallopian tube on my left side, if my mature follicle was on the right that month, there was a very, very slim chance it would work at all because there was no way the follicle could get to the right spot without a tube to transport it. So each month I would take Fermara on days 5-9 of my cycle, then I'd go in for internal ultrasounds around day 12 and every few days after to make sure my follicles were growing and to see which side they were on. Once my follicle(s) were large/mature enough, I would give myself a shot of Ovadril to make myself ovulate. Then we'd do what we had to do and wait two weeks to see if it worked. We did this for four months, March - June, with no success. It was very emotionally tolling for me because each month I'd get my hopes up and each month I kept getting negative tests. There was even a month where I produced three mature follicles and nothing happened - that was frustrating! So after many discussions with Tim, we decided to try our July cycle with Fermara, Ovadril and an IUI.