While on my first Clomid cycle since the pre-Ovarian Wedge Resection Days (December 2007, to be exact), I was supposed to get an ultrasound to check the follicle/s around Day 12. Day 12 was Friday. So, on Thursday, I decided to take a sneak peek myself, just to be sure the Dr didn't miss anything the next day. And there I was greeted by a crummy, thin lining (even for Day 11), and a Ginormous follicle, about 2.5cm. My follicles are not known for growing that large that quickly, and I know this was the Clomid :( Also, my endometrial lining has never been that thin, it is usually just perfect. I was so bummed, but I knew that I could still rupture normally.
The next day, CD 12, I had the Dr do the ultrasound, and first thing we saw was the thin, ugly lining. Then, the larger-than-life "follicle" on the left ovary, with no other follicles anywhere around. Not that I blame them, what with Big Mama taking over the whole damned show. The "follicle" was measuring about 3.0cm, and the reason I put follicle in quotations is because I really NEVER see a follicle get that big and still rupture normally. By the time they get to be 3.0cm, they are usually classified as a LUF (luteinized unruptured follicle.) But here's the thing: The cyst was completely void of internal echoes, there was no internal hemorrhage or septations or striations - (all signs that the follicle is luteinized and unruptured). But mine was still pretty simple in appearance. AND my lining was still proliferative, and my cervix still had a bit of mucus. So, the Dr said if I wanted, I could take a trigger shot of hCG. I really had a hard time going back and forth about this one... once I got dressed, I went into the Dr's office and went over some options.
While I was still making up my mind about "To Trigger or Not To Trigger," I asked the Dr what he thought about the thin endometrium and how to avoid it in the future. He admitted that it may have been the Clomid that contributed to it, but that in future cycles (if I want - he made it very clear that he didn't want to make me feel pressured to do or try anything) we may want to consider going back to Femara. He said we could try a higher dose early in the cycle to aim for 2 to 3 follicles each treatment cycle, and he said that of course there is always the risk of multiple gestations with that... he didn't even finish the sentence when I cut him off to say, "Oh, that is JUUUUUUUST fine by me." :)
He gave me a study published about the use of Viagra, Vit E, and L-Arginine for the bloodflow to the endometrium in women who have had thin endometriums, and said this was also something we could consider for upcoming cycles. (For now, I am doing the Vit E, but the Viagra and L-Arginine are only taken up through ovulation.)
Finally, he asked me about DHEA and when I said that I was taking a small daily dose because my last labs showed very high stress levels, he asked about my overall stress. Uhhhhh... yeah. I have it. He shared with me a story of one of the NaPro patients who was extremely wound up, her NaPro Dr gave her Valium, and she conceived in that cycle. Haha, gives a whole new meaning to the old "Relax, and it will just happen!" addage ;) I told him that DH would probably appreciate if I had something like that around the fertile window, when I routinely put a ton of pressure on myself and on him. So, he prescribed a small dose of Ativan. The funniest part is the instructions on the label:
Yes. The instructions say: "Take one tablet prior to intercourse." I can ONLY imagine what the pharmacists must be thinking of me. And of my husband.
By the end of the appointment, I was still on the fence about this cycle - whether or not to take that trigger. What are the chances that a 3.0cm follicle would still rupture?? Plus, as JellyBelly sat in the office adjacent to the Dr's - I explained briefly to the Dr that my hesitation in taking the trigger was because a long time ago, I made a "pact" with St Gianna, and asked her to allow all of my friends to become mothers first... and that JellyBelly was the last remaining friend. She can't try again until December. So why should I bother? The Dr said it was a very selfless request I made in my prayer, but that ultimately, God decides how to answer the prayers and when.
So... I got the trigger.
I'm still not too hopeful for this cycle, because the Big Mama Follicle just didn't look normal, to say the least, and my lining is still pretty crummy. But at least I may still have a "chance" for pregnancy. I will check again Sunday evening to see if it ruptured or not. St Gerard will have to pull out a real big miracle for this one.
Speaking of St Gerard, JellyBelly and I went to the Mass for Women Praying to Conceive on Wednesday evening. It was PACKED. It was all at once beautiful and so sad. The priest read a testimony of a couple who had suffered several miscarriages and through persevering prayer to St Gerard, they were finally able to (with the help of their Dr and "more aggressive treatments") sustain a pregnancy. These types of testimony stories are always wonderful to hear, but for a barren woman who has never once had life inside of her, it is hard for me to translate directly into hope for myself. At first I thought I was being overly sensitive, but JellyBelly agreed with me. What did give me hope was the priest's thoughts after reading us that testimony. He reminded us that we should never give up on our prayers, and that if our prayers don't seem to be answered in the time we want or in the way we want, it's because God is working on something better than we asked for. It reminded me that just because I've prayed 48 Novenas to St Gerard, I shouldn't throw those prayers by the wayside. I need to keep on praying. I need to keep talking to my friends the Saints and to God. I need to let them know I am still here, ready to do God's will, but still in need of support as I suffer.
Poor JellyBelly also had some suboptimal results this week during her ultrasound series, so please pray for her. I am still SO hopeful for her surgery, though.
Someone remind me why I wanted to try Clomid, again?? Blech. Never again.
TCIE on Viagra and Ativan next month should be... very interesting... Lucky Mr. TCIE.