Thursday, November 14, 2013

to infertility and beyond

lets get this started

in 9 months of being together, we regularly do the deed (hehe), that time we are not preventing nor trying, we're just following the flow. we have plans of having a kid/s but as of that moment we rarely talk about it for we are enjoying our honeymoon stage. then he flew to middle east to continue his job. we spent 2 years and 7 years away from each other (long enough to miss each other so much). even if we are thousand miles away from each other we made sure that nothing has changed, instead the love goes deeply and more deeply as the days, months and years goes by. it is indeed difficult for us to accept the fact that we have to endure the pain of not having each other near each other, then finally the long wait is about to end temporarily, the company granted his vacation leave for 2 months. 

december 2012, while we we're chatting via yahoo messenger (like we used to) our conversation goes like this:
(out of nowhere he told me)
him: honey its about time.
me: (confused) whattttt?
him: i think its about time for us to have our little one.
me: i was speechless and suddenly fell in a deep thinking.


that night i cant sleep for my mind is stuck with a big question, after 9 months of being together with no protection everytime we do the deed and the fact that he always released  every drop of it inside me, then why didn't i got pregnant after all?


hmmmm, as the night gets longer, my thinking got deeper too. "i think there is something wrong, i need to find out", 

the diagnosis

january 2013, i spent the whole month thinking and researching over the internet about pregnancy. all of a sudden i became too interested about it which made me decide to finally seek for a help.

february 1, 2013 i sat and talked to my ob-gyne. she first checked my cervix to know if there is something wrong inside. then she ordered me a blood test and urine test.
suggested to drink plenty of water and reduce salt intake due to some crystals found in my urine.
the series of test did not end there, now that there is no problem in my urine and blood test, she ordered for my "hysterosonosalpingogram" (HSSG) this is different from HSG.

"hysterosalpingosonography (HSSG) as a diagnostic tool for uterine cavity defects and tubal patency."

it is important for a woman trying to concieve to know if her fallopian tube is blocked, for it is a passageway of sperm cells to meet the egg cell.

before i go to the clinic for HSSG, my ob-gyne told me to take mefenamic acid 30minutes to 1 hour before the procedure so it can lessen the pain aside from mefenamic acid she also prescribe me an antibiotic (doxin) for couple of days. and its important to wear a pad because the saline will flow out as i stand up after the procedure.

here is my HSSG result:






after all of this test, my biggest question has an answer, i was diagnosed PCOS. so as soon as i got home, the first thing i did was sat in front of my computer and search over the internet the whole thing about this PCOS.

lets talk about it.

polycystic ovarian syndrome (PCOS)


i have the result in my hands now, at first i dont take the result seriously for i dont know what is PCOS (never been heard) but honestly my mind is puzzled, and now the biggest question running in my head is "WHAT IS PCOS?" and the fact that i have pcos does not sync in automatically in my mind, so i ask the ob-gyne sonologist the top question that  i wanted to have an honest answer, "AM I CAPABLE OF CONCIEVING?" she smiled at me and say "dont worry, even if you have pcos you are still capable because you still have your both ovaries, the next time you come here, im sure we will conduct an ultrasound for you are already PREGNANT" (but it doesn't happen). i held her words as i walked out of her clinic.



 What causes PCOS?
 
The cause of PCOS is unknown. But most experts think that several factors, including genetics, could play a role. Women with PCOS are more likely to have a mother or sister with PCOS.

A main underlying problem with PCOS is a hormonal imbalance. In women with PCOS, the ovaries make more androgens than normal. Androgens are male hormones that females also make. High levels of these hormones affect the development and release of eggs during ovulation.

Researchers also think insulin may be linked to PCOS. Insulin is a hormone that controls the change of sugar, starches, and other food into energy for the body to use or store. Many women with PCOS have too much insulin in their bodies because they have problems using it. Excess insulin appears to increase production of androgen. High androgen levels can lead to:



  • Acne
  • Excessive hair growth
  • Weight gain
  • Problems with ovulation

What are the symptoms of PCOS? The symptoms of PCOS can vary from woman to woman. Some of the symptoms of PCOS include:


  • Infertility (not able to get pregnant) because of not ovulating. In fact, PCOS is the most common cause of female infertility.
  • Infrequent, absent, and/or irregular menstrual periods
  • Hirsutism (HER-suh-tiz-um) — increased hair growth on the face, chest, stomach, back, thumbs, or toes
  • Cysts on the ovaries
  • Acne, oily skin, or dandruff
  • Weight gain or obesity, usually with extra weight around the waist
  • Male-pattern baldness or thinning hair
  • Patches of skin on the neck, arms, breasts, or thighs that are thick and dark brown or black
  • Skin tags — excess flaps of skin in the armpits or neck area
  • Pelvic pain
  • Anxiety or depression
  • Sleep apnea — when breathing stops for short periods of time while asleep


Why do women with PCOS have trouble with their menstrual cycle and fertility?

The ovaries, where a woman’s eggs are produced, have tiny fluid-filled sacs called follicles or cysts. As the egg grows, the follicle builds up fluid. When the egg matures, the follicle breaks open, the egg is released, and the egg travels through the fallopian tube to the uterus (womb) for fertilization. This is called ovulation.

In women with PCOS, the ovary doesn't make all of the hormones it needs for an egg to fully mature. The follicles may start to grow and build up fluid but ovulation does not occur. Instead, some follicles may remain as cysts. For these reasons, ovulation does not occur and the hormone progesterone is not made. Without progesterone, a woman's menstrual cycle is irregular or absent. Plus, the ovaries make male hormones, which also prevent ovulation.


the medication


february 5, 2013 second appointmet with my ob-gyne, we sat and talked about her plans to make my pregnancy possible.

she prescribed me metformin 500mg 3x/day, and duphaston for 12 days to force my menstruation.





Metformin (Glucophage) for polycystic ovary syndrome.


Metformin decreases the level of androgens produced by the ovaries and adrenal glands. It also helps the body use insulin and may reduce the risk of diabetes.
Metformin lowers blood sugar levels by:


  • Decreasing the amount of sugar produced by the liver.
  • Increasing the amount of sugar absorbed by muscle cells and decreasing the body's resistance to insulin (insulin resistance).
When blood sugar is lower, less insulin is needed, so the body makes less insulin. And when insulin is lower, the body produces a lower level of androgens.

Why It  Is Used 
Metformin is a diabetes medicine sometimes used for lowering insulin and blood sugar levels in women with polycystic ovary syndrome (PCOS). This helps regulate menstrual cycles, start ovulation, and lower the risk of miscarriage in women with PCOS. Long-term use also lowers diabetes and heart disease risk related to high insulin levels.

dont forget the supplements that are essential when you are trying to concieve.


What is folic acid ?
Folic acid is a vitamin. Folic acid, also called folate or folacin, is found in some vitamin pills.

Why take folic acid before you get pregnant ?
Neural tube defects occur 25 to 29 days after a woman gets pregnant. At that time, many women are not even aware that they are pregnant.
Because these defects form so early, you should begin taking vitamins that contain folic acid before you get pregnant. Begin taking folic acid when you stop using birth control.
Women need more folic acid during pregnancy and breastfeeding than they do normally. So you should continue taking folic acid all the time that you are pregnant.

What is a neural tube defect ?
A neural tube defect happens when something interferes with the way the baby grows before he or she is born. The two most common conditions in which neural tube defects occur are spina bifida and anencephaly. These conditions may be prevented if women take enough folic acid before and while they are pregnant. Spina bifida happens when the spine does not develop normally. Anencephaly happens when the skull and the brain do not develop normally.

Vitamin E (alpha-tocopherol)
 it was given the name "tocopherol" from the Greek words "τόκος" [birth], and "φέρειν", [to bear or carry] meaning in sum "to carry a pregnancy," with the ending "-ol" signifying its status as a chemical alcohol.

Vitamin E for women
It is true that most of Vitamin E’s fertility research has been done on men, but that is not to say that there are no benefits for women as well! Vitamin E can increase cervical mucus in women, which is essential for helping sperm to stay alive for several days at a time. Vitamin E can also help to prevent egg defects and increase overall egg health in women which can lessen the chances of birth defects and miscarriage. Some studies also suggest that Vitamin E can lengthen the luteal phase of the cycle also.

Vitamin E for men
Vitamin E is commonly recommended for men to help them fight fertility issues. Low levels of Vitamin E are usually found in men with fertility problems. So, by using a Vitamin E supplement, men can increase their fertility. Vitamin E can help improve sperm mobility and quality, making it easier for a woman to get pregnant. Vitamin E has also been shown to reduce sperm defects in men, which can lead to less risk of birth defects or miscarriage. The numbers are actually really good, showing that men who take Vitamin E supplements for even just a few months, can see up to a 10% increase in fertility.


March 6, 2013 18days after my last pill of duphaston, aunt flow finally arrived. 
March 8, 2013 as per my ob-gyne's instruction i will take clomid 50mg/day starting on my cycle day 3 for 5 consecutive days.
March 12, 2013 my last pill of clomid (10 days onward is my expected ovulation day)


this is husband's prescription.  this supplement is a MUST.


March 17, 2013, hubby's arrival (finally, after 2 years and 7 months of waiting) yahoooo, its me and hubby's time (baby making time) hehe.

this cycle is not monitor because its summer time and my ob-gyne is out of town with her family.
she just advised me to do the baby dancing every other day.

March 24, 2013, first attempt to test, and it is very disapointing BIG FAT NEGATIVE!

April 4, 2013, second attempt, again its a big fat negative!

April 8, 2013, spotting (it can be implantation bleeding or impending menstruation)
this first cycle of clomid is an epic fail because,

April 9, 2013, aunt flow arrived, i felt discourage by this time, but i am ready to try again.

April 11, 2013, cycle day 3, second round of clomid at 50mg 2x/ day, this time she double my dose.
 but again this cycle is not monitor due to ob's vacation out of town, but she keep in touch, we talked over SMS. she advised me to baby dance every other day and monitor my cervical mucus. i searched over the internet about cervical mucus.

Cervical Mucus Method
The hormones that control your cycle also make the cervix produce mucus. It collects on the cervix and in the vagina. And it changes in quality and quantity just before and during ovulation. With personal instruction, many women can learn to recognize these changes. Instruction is usually given one-to-one. This method is also known as the ovulation method or theBillings method.

The Mucus Pattern

  • During your period, your flow covers the mucus signs.
  • After your period, there are usually a few days without mucus. These are called "dry days." These may be safe days if the cycle is long.
  • When an egg starts to ripen, more mucus is produced. It appears at the opening of the vagina. It is generally yellow or white and cloudy. And it feels sticky or tacky.
  • Usually, you will have the most mucus just before ovulation. It looks clear and feels slippery — like raw egg white. When it can be stretched between the fingers, it is called spinnbarkeit — German for stretchable. These are the "slippery days." It is the peak of your fertility.
  • After about four slippery days, you may suddenly have less mucus. It will become cloudy and tacky again. And then you may have a few more dry days before your period starts. These are also safe days.



April 30,2013(cd 22) soft low open cervix, cervical mucus is watery but not like the raw egg white. sharp left abdomenal pain. OVULATION SUSPECTED.

May 4, 2013(cd26) because of my excitement i did the pregnancy test, and obviously its a BIG FAT NEGATIVE. (this is one of many craziness i made)


May 8, 2013 (cd30) this is one of my saddest day because due to husband's departure (naia terminal 1)
before we went to airport, i tried to test early that morning, but again its a BFN. no more baby dancing for now, and this is my last cycle to concieve for this year. but i did not lose hope, maybe i just tested too early.

May 13, 2013 (cd35) i tested again, i cant resist my pee-on-a-stick addiction, again, BFN!
May 14, 2013 (cd35) BFN!
May 16, 2013 (cd37) very very faint positive line appeared. end to be false positive.

false positive :'(

May 17, 2013 (cd38) brown blood tinged in my cervical mucus.

May 18,2013 (cd39) spotting (implantation bleeding or impending mentruation)
May 19, 2013 (cd40) aunt flow arrived.

as of this writting (november 11, 2013) our tyring to concieve plan is put into hold due to hubby's absence.
we will resume our trying to concieve journey next year 2014.

while i am waiting for husband to come home again, i am treating my pcos, it maybe has no cure but im trying to lessen the cyst, after all of this medication and trying, i realized that being pcos is really a kick in a butt.

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