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Thursday, May 6, 2010

New Treatments!

When it rains, look for the rainbow? I don’t know why, but for years now it has either rained or snowed every single time I have had an appointment regarding PCOS and today was no exception. There was only one time that it was sunny and that was the day that both of my doctors agreed to give me clearance to begin Clomid. Ironic, isn’t it? (Yes, I now have Alanis Morissette in my head!)

Now… things are changing gears a bit… ok, a lot. In the past, if you recall, I did Provera for a week, followed by Clomid for a week, had some ultrasounds, and was supposed to have an injection of Human Chorionic Gonadotropin (hCG) had that whole process been successful (which it was not – twice). Now, some steps will remain the same but others are completely different, somewhat scary, and others are just not what I was expecting!

Step 1: Since I still do not have a regular cycle, I need to continue taking Provera to begin AF.

Step 2: Once AF and CD1 arrive, I need to schedule an ultrasound right away. If the ultrasound shows a cyst remaining that is 15mm in diameter or more, I cannot continue with this cycle and treatment will be postponed. However, if there is no cyst I can continue on to the next step.

Step 3: Self-injections… FUN! I will be using the Gonal-F Pen which is a Follicle-Stimulating Hormone (FSH). The pen is preloaded with medication and ready to use. Dosing adjusts with a turn of the dial, making it precise for every injection. You can find an image or the pen here and there are also videos around the internet on how to use it properly if you are really interested. I will be starting on 37.5 IU and the pen holds 8 doses (300 IU). I will be taking 5 doses initially; once daily. Oh yeah, and this pen costs 300-350$! Actually, the pharmacy won’t even order it for me until I pay!

Step 4: On CD9 (or after the injections are done) I have to go back for another ultrasound. This is when they will assess the growth of follicles, see how many I have, and adjust my medication if necessary. I will keep going back for ultrasounds until I have at least one follicle that measures 18mm or more. And yes, this could be a daily trip to the hospital since we do not yet know how I respond! Once I have one (or more) follicles that are the proper size I will receive the injection of Human Chorionic Gonadotropin (hCG) which should make me ovulate in 48 hours or so. At this time, DH also has to “get to work”. He will need to produce a “sample” to be tested in the lab to make sure things are still ok on his end. This test will cost us another 400$ but for once, his name will be on the bill!

Step 5: We return to the hospital 48 hours or so after receiving the hCG injection. At this point, DH will have to produce another “sample” only this time… I will be having Intrauterine Insemination (IUI), otherwise known as Artificial Insemination. I had no idea when I went in this morning that I would be getting ready for this! A plastic catheter will be used to inject DH’s “sample” directly inside my uterus, bypassing the cervix and bringing the sperm closer to the fallopian tubes (where fertilization occurs). This increases the chance of pregnancy but we should also BD to increase our chances… and maybe add some romance to the otherwise un-romantic procedure.

Step 6: I have to have a blood test 16 days later to see if I am pregnant. If positive, I will have to have another ultrasound 2 weeks later to see if the pregnancy is viable.

Yes, there are a number of things that can go very right and/or very wrong in this whole process but it’s the next logical step to take. I am still trying to wrap my head around everything, figure out how to plan for the unexpected, organize schedules, etc… but it will come to me at some point, no need to hurry just yet!