I had my follow up appointment yesterday afternoon. There hasn’t been any change since my initial consultation. Absolutely no sign of ovulation in the past three months. I’ve relied on progesterone pills to trigger a period each time. So. We move on to the next step: Clomid.
For the uninitiated, Clomid is a drug that induces ovulation in women who don’t ovulate on their own (or occasionally prescribed to trigger a super-ovulation in women who do ovulate). I take it five days, near the beginning of my cycle, then watch for ovulation using test strips for the next several days. If no ovulation occurs, it’s back to progesterone to trigger a period and try again. Rinse and repeat.
Yesterday, as my doctor was laying out this next step in the process, he offered to go ahead and refer me to an infertility specialist. He said the specialist would likely prescribe Clomid as a first step as well, but being there (rather than with my GYN) would give me a jump start on the process should we need to take further steps after the Clomid. He told me, in all honesty, chances of conceiving on Clomid aren’t great. Of the women who take it, only 70% will actually ovulate. The chances of conception are slim because (a) the chances of conception in any given cycle of even a perfectly healthy couple are low (around 25% I believe) and (b) doctors typically limit you to about four to six cycles of Clomid back-to-back which isn’t always enough to overcome the odds from (a). So, basically he thinks it’s likely that I’ll be referred to a specialist eventually and I could go ahead and start that process now if I wanted.
I took a moment to think this through and I turned down his offer. Going to a fertility specialist seems so extreme. I’m 27 (although I’ll be turning 28 in a few days) – I’m young. Why should I go to extreme lengths so quickly? As I told my mom last night, I don’t want to come at it with a cannon if a pea shooter will do. Plus, once I go to a specialist, both Luffy and I go. Right now, the problem is clearly with me. True, Luffy could have some issue that we don’t know about, but right now, it’s completely my problem. I’m not ovulating. Period. There’s no need to involve him yet.
At this point, my doctor asked me how I was feeling about the process. I brought up my research about thyroid disorders and he quickly assured me that we could test for that (which we did). I told him that I too was frustrated because I don’t meet many of the criteria/signs for a thyroid problem, or for PCOS, or any of the primary causes of anovulation for that matter. I’m not overweight. I’m active and young. I eat well. I’m not pre-diabetic. I don’t have acne or problems managing my weight. My metabolism and appetite appear appropriate. All these little things that I’m so proud of or thankful for just mean that we’re less certain of what’s causing my anovulation. So we’re testing my thyroid and prolactin levels. It’s unlikely to yield anything, but at least we’ll be able to definitively scratch something off the list (unlike PCOS which just looms overhead).
Yesterday was the first time he used the term PCOS in relation to me. He said that it’s unusual for a woman to present with PCOS without being overweight, diabetic, or having cysts on her ovaries. However, it’s certainly possible and he couldn’t rule it out. Unfortunately, there’s no test for PCOS – no needle prick or x-ray or scan to decisively diagnose PCOS.
My birthday is coming up this week. I’ve been thinking about my birthday last year, when we had just started trying. I was probably on cycle day 38 or 39 at that point. I remember feeling so frustrated with my body, upset that I wasn’t pregnant, and wondering when my period would show up. I ranted to a friend that we were “still” trying and that I obviously wasn’t pregnant yet (I was drinking whiskey at the time – a clear sign that we hadn’t conceived). I mean, it had been a whole month already – why wasn’t I pregnant?! (please note the very sarcastic tone) Of course hindsight is 20-20 and all that. I realize now that the road to a baby isn’t something you can plan out with precision and that, even when you’re doing everything right, sometimes your body just has other plans. More importantly, I think – I hope – I’ve developed more patience. For myself. For things I can’t control. I can help, but ultimately, we’ll get pregnant when/if we get pregnant. Rushing won’t help. Impatience won’t help. Fury and outrage and frustration won’t help. I’ve stopped looking towards future events and saying to myself “maybe I’ll be pregnant by then” or “if I’m pregnant, I won’t want to do x.” It just puts a bookmark in my head, on the event, so that when it comes around, I can’t help but remember that I thought I could be pregnant by now. I’ve started talking to my mom more, rather than trying to keep the whole thing a surprise.
I’ve also started to react to other women’s pregnancies better. We found out over the weekend that a college friend’s wife is pregnant with their first child. She’s ten weeks along. We’ll end up seeing them when she’s six months pregnant. When Luffy told me, I immediately felt that sharp pain of anguish – you know the one that hits you right in the stomach and clenches up your muscles so that you feel like you can’t breath. I immediately told myself to shut that down; I don’t want to feel jealousy or hatred towards her. I have no idea what they went through to conceive that baby. After a few moments though, I realized that it’s ok to be sad – as cheesy as that sounds (we watched Inside Out last night – can you tell??). It’s all right to be upset and to process that feeling. I left Luffy in the living room and took a few moments for myself in our bedroom. To collect myself, as they say. I was sad and upset that this process hasn’t been going well. I shed a few tears. Then I dried my eyes and joined Luffy again. A few hours later, when he asked me, I could honestly say that I was ok and that I was very happy for them and looking forward to seeing them.
Breath. Remember this. It’s just Luffy and me, no matter what happens.