Stormy With A Chance of Twins

I went for my follicle check (ultrasound) on Day 10, which was on Saturday.  I had to go down to South SLC for it since they are open on Saturdays.  Charles luckily had the day off, so he met me after my night shift, we ate breakfast at Village Inn and then drove down to the clinic.  We had a lovely morning with lots of laughing and joking, probably because we were both very sleep deprived!

When we got into the exam room, I pointed out the magic wand and Charles' eyes got huge.  He started laughing and asked, "THAT has to go up there?"  Not the whole thing, but yes!  I had told him I would need to get halfway undressed and that I felt gross after a night shift.  But it didn't occur to him that the ultrasound wouldn't be on my stomach like on TV! 

Dr. Mustache-and-Eyebrows came in (not my regular doctor) and we got right down to business.  He said there were 2 mature follicles!  Yay!  But then he said the risk for twins was increased with 2 follicles that could possibly both hold an egg inside of them, and he said we'd talk more outside.  I got dressed and we went out into the hallway where he pulled up my recent labs and we talked about the "super ovulation" I'd had last cycle.  I likely had 2 follicles then, too, but we didn't have an ultrasound that time.  He said we have options, and he had the nurse take us into the consult room to talk.

The first option we were given was to get the HCG trigger shot which would make the follicles release their egg(s) in 36-40 hours.  That sounded really good since I had 3 nights off work and we could pinpoint exactly when this whole thing could go down!  But then she said she didn't know if it would be wise to even try getting pregnant this cycle with my kidney issues.  The kidney's workload is increased with even just one baby, let alone two.  At that point, Dr. Mustache-and-Eyebrows poked his head in, and he said he had been thinking more about it and he would strongly recommend we not get pregnant this cycle.  I asked if he thought we should try a lower dose of Femara (which is also the lowest possibly dose and most conservative treatment possible) next time, and he thought that would be a good idea.  So, we made the decision to call it a month, and we left the clinic very down-hearted.  All that pain and bleeding for nothing.  And I still had ovulation cramps and another Femara period to look forward to.  :(

We got home, and I totally broke down.  It always eventually comes down to "Why do I have lupus? It makes my life so hard!  It's not fair!"  Charles comforted me for the millionth time, agreed with me that it wasn't fair, and eventually I fell asleep for the day.  When I woke up, we had some retail and ice cream therapy.

But then I had a thought!  Dr. S said there may be some months when Femara would cause me to release 2 eggs (but no more than that).  He hadn't said if we'd need to abandon those cycles or not!  I couldn't wait to call the clinic on Sunday morning!  The time finally came, and I didn't realize there was no one there, even for phone calls on Sundays. :(   So, I took matters into my own hands.  I tried to look up studies done regarding the incidence of twins on Femara with 2 mature follicles and timed intercourse.  I searched all the trying to conceive forums on a ton of different websites.  I talked to 2 girls in my ward and a high school friend who had had trouble conceiving and had been on Clomid and Femara, as well as one friend from work who had undergone IVF.  The general consensus was that multiple follicles (2) did mean a possibly higher chance of twins, but it also meant a higher chance of conceiving just one baby as well.  I could take that information how I wanted to.

In church, I tried to listen for answers.  The Sunday school lesson was on Job.  After reviewing all of Job's trials, we ended with reading Job 42:10.  "And the Lord turned the captivity of Job, when he prayed... The Lord gave Job twice as much as he had before."  No!  I don't want twice the blessings!    

Many prayers were said that day, and I could see both sides of it.  Trust God that He wouldn't give me more than my body could handle.  Or don't be stupid and risky and just listen to your doctor!  Maybe I didn't get pregnant last cycle because Heavenly Father knew I hadn't had an ultrasound and didn't know I was at an increased risk for twins then, too.  I ended up e-mailing Bishop Ritchie because he is the one I go to when I'm in turmoil!  I asked him if he thought a blessing to not have twins would be something reasonable to ask for.  He said a blessing would be a great idea and that I should always remember Heavenly Father wants to bless me with whatever I need help with.  I just need to ask and then have faith!  But then he said he was worried about me.  Haha!  Oh great!  My wise and knowledgeable father-figure has doubts, after he told me to go for it.

So, Charles gave me a blessing to not have twins, and I took a pink dye OPK test (my clearblue easy was still negative).  Of course, it was blatantly positive!  It was now or never.  We went ahead with things Sunday night, and I didn't feel panicky before, during or after, so that's good I guess.  Now I just have to have faith and trust in His plan for me.  I called Dr. S's nurse today as soon as they opened.  She talked to Dr. S and he highly recommended I cancel this cycle as well, but he couldn't tell me what to do.  The nurse said to go with my gut.  Gut, impressions from the Holy Ghost... same thing.  I don't feel bad that we tried once.  But I think that Dr. Mustache-and-Eyebrows randomly coming into the consult room to specifically warn me meant something, too.  I had my ovulation temperature dip this morning, so we had good timing.  The two week wait likely starts tomorrow.  So we will see...

        

     

Round Two

Taking my temperature last cycle was very helpful!  But it also crushed my dreams two days prematurely.  I saw a beautiful drop in my temperature of 97.19 on Day 11 which indicates ovulation, then it kept climbing daily, to a max of 99.05.  It bounced around in the 98.8-98.9 range for about 15 days, then dropped suddenly to 98.46 on Day 27.  I wanted to cry.  Besides a negative pink dye pregnancy test, my true confirmation of not being pregnant started two days later.

Femara has definitely done weird things to my body.  I was extremely emotional on Day 2.  I'm not sure if this is from meds, or if it was just really hard to accept that I wasn't pregnant after we tried something different (meds) for the first time.  I was at work on Day 2, and I started having really bad cramps.  This felt different than my non-medicated cycles.  It felt kind of like gas pains, sharp stabbing then disappearing and happening again on the other side of my lower abdominal cavity.  I also felt a heaviness like things were growing inside of me.  I turned to Dr. Google (stupid, stupid, stupid!), and found that I could have residual ovarian cysts that didn't dissolve from last cycle.  There is an increased risk for this when on fertility meds.  I have had an ovarian cyst rupture when I was 19, and that was definitely not fun and cost me a trip to the ER.  I made plans to call my doctor on the way home from work, but then I started to feel a little better.  They had already told me they don't normally do ultrasounds at the beginning of each cycle unless I'm doing injections, so obviously they think the risk of cysts is low with just oral medication. 

I got home, then basically had a murder scene in the bathroom.  It hasn't been that bad since I was diagnosed with lupus and became anemic from bleeding so much.  Also, this was Day 3, not Day 1!  What the heck?!  Cue more emotions.  Thank goodness I had a full day of sleeping planned, which is pretty much what happened, along with binge-watching Pretty Little Liars on Netflix.  Even though I didn't feel like it at all, we went out on a double date that night which was the best thing that could've happened.  I love my hubby and our friends who we finally confided in.

I started taking Femara again the night of Day 3.  I thought maybe I could sleep during the awful headaches it causes.  Day 4 was yesterday, and it did not work.  I woke up with my head throbbing, especially anytime I did anything to increase my intracranial pressure (pressure inside of my head) like coughing, sneezing, stretching, yawning, etc.  I couldn't turn my head in church and basically looked like a zombie.  Today is Day 5, and with no headache yet today, I feel hopeful again!  I will have an ultrasound on Day 10 since I ovulated so early last month which was not expected.  So here's to another month of strong and painful ovulation, early morning temperature taking, OPKs, timed intercourse, and hoping the stars align.
     

1st Month with Femara

  1st Month and hopefully only month on Femara!  It wasn't that bad actually.  Not nearly as bad as Clomid horror stories of women wanting to kill their husbands (see ecard below). 

Femara gave me occasional hot flashes, minor nausea and a headache of maybe 6/10.  No emotional mood swings that I could tell.  So all in all, not too bad! 

I went to the Layton office for the first time on cycle day 2, and it was really nice there.  A very friendly receptionist, a water/stone/soothing display in the waiting room, free water bottles, and just a general feeling of zen.  It was very nice.  I was taken back to the room and also shown the bathroom where there were free products to use.  Dr. S came in to the room and we talked for a little bit about what labs I would need today and how my appointment went with Dr. A with Maternal-Fetal Medicine.  I think he was still considering if it was ethical or not to get me pregnant!  haha.  He then did the ultrasound (mandatory before a medicated cycle to make sure there aren't too many follicles that could release multiple eggs).  He said I had 7 follicles on each side, and he had hoped for 6.  Yay for exceeding expectations!  Then he wished me luck, left the room and I got dressed again.

After the ultrasound, I got my blood drawn to test my ovarian reserve again.  He wanted to make sure my first AMH level was accurate, since it had been low for someone my age.  Then I went into a consultation room and met with the nurse.  She gave me an outline of what I should be doing on each day of this cycle on Femara.  I went home feeling very optimistic!

I took Femara 5mg days 3-7.  I started taking my basal body temperature at 5:30 AM every morning I was home, or 3 PM on days when I had worked all night beforehand.  The key is to get 3-4 solid hours of sleep.  I definitely noticed a drop in my temperature on day 10.  I also started using the ClearBlue Easy Digital Ovulation Prediction Kit (OPK) on day 10, but it was negative that day.  I used one of my Wondfo pink dye OPK strips that I had been using prior to seeing Dr. S, and it was almost positive.  I thought that was interesting.  Dye is definitely more sensitive than digital! 

Another negative on the CBE OPK on day 11.  Then, on day 11 at night at work, I started cramping and bleeding for about 6 hours.  Usually when I ovulate I get a feeling of heaviness and have some spotting.  This was hardcore ovulation going on!  I called Dr. S's office when I got off work in the morning and they said to call back if the bleeding starts again.  Days 12-15 I had negative CBE OPKs still!  It didn't make sense.  I called Dr. S's office on day 15, and my progesterone level (which tells if you've ovulated or not) was 28.  Normal ovulation is around 5-10.  Medicated ovulation is 10-15.  So yeah, I definitely ovulated!  It was weird that the CBE OPK didn't pick up on it.  So now we wait and pray and fast and cross our fingers and wish upon a star!