My body has always been a bit of a struggle bus when it comes to health since my teen years. I have never been the epitome of a healthy person. Something has always been breaking or stopped functioning properly since I was a kid, but it just kind of became who I am. I’ve never dwelled on it, or let it get in the way of me doing things that I want. But now that we were ready to make a baby, it was a hard realization that it was going to take a bit of work to get it functioning properly in order to be able to conceive and nourish a healthy baby.
When I was 14, I was diagnosed with PCOS, Polycystic ovarian syndrome. PCOS currently effects around 1 in 10 women, and is one of the leading problems of female infertility. The biggest indicators for me when I was first diagnosed was excessive weight gain, irregular periods, and insulin resistance. I gained an excessive amount of weight exceptionally quickly and couldn’t figure out why. As a teenager, you already deal with body issues, but this lead me to an unhealthy hatred of the way I looked. No matter how healthy I ate, or lack there of, or how often I worked out, I could not lose the weight. I was finally sent to an OBGYN who ran the tests and finally gave me the answers that I was desperately seeking. I had bloodwork done to check all of my hormone levels, and an ultrasound which showed that my ovaries were covered with small cysts. The first thing that she did was put me on birth control, to regulate my period, and metformin to help regulate the insulin resistance. I was 14, 240 pounds and a type 2 diabetic, and all I needed to do was lose the weight to manage the diabetes, but with PCOS this is insanely difficult to do.
I hated Metformin. Absolutely HATED it. It is an extraordinarily harsh medication on your digestive tract, but it does help regulate your insulin. So for me, I sucked up the side effects and took the medication. I carried that weight with me for a long time, and it was a constant reminder that my body was not working. After time, the metformin stopped working for me, regardless of the dosage, and I chose to stop taking all of the medication. After YEARS, I lost most of the weight and got to more of a healthy weight zone. My insulin started to balance out, but my body never began to ovulate on its own,
It was always my best superpower that I was lucky if I had two periods a year, but I never thought long term that this was going to affect me. When they told me at 14 that I might have a hard time getting pregnant, I didn’t think twice about it, but at 27, it hits a little differently. At our first appointment, we started talking about the medication regimen that I needed to start again in order to begin to track ovulation and follicle health. We chose to start our fertility journey doing IUIs, Intrauterine insemination, and we would plan for IVF if necessary.
April 2019: I started 5 mg of Provera each day, which helps medically induce ovulation, with the hope of my body beginning to regulate itself. Provera, is a 10 day pill, and by the end of the 10th day, you should start your period. After the first two months, I still wasn’t ovulating, so my doctor recommended metformin once again, which has been shown to help PCOS patients conceive, but due to my history with the medication, we chose against it. We decided to try and give my body some time with the Provera to see if it would balance out and begin to ovulate. By the third month, July, I finally had a positive ovulation test!
July 2019: Once we figured out I was ovulating, it came time to start Letrozole! We chose to use one table of Letrozole rather than Clomid, because it tends to work better for patients with PCOS. I took 2.5mg of letrozole from day 3-7 of my cycle. We did an ultrasound on day 13 of my cycle, which is the day when the average woman ovulates, to check and see the quality and quantity of my follicles. We were crazy optimistic that there was going to be a plethora of follicles, but instead, there was only one small follicle, 14 mm, which was super disappointing. In order for our office to complete the IUI, my follicles needed to be a minimum of 18 mm big. The bigger the follicle, the better the chances of fertilization! We went back the next day to see if it the follicle had grown, but instead, the follicle ruptured, meaning ovulation had already occurred. You want to catch the follicles pre-rupture (meaning pre-ovulation), because you want to be able to time fertilization perfectly. Since there wasn’t much action happening in my ovaries, she recommended Myo/Chiro inositol, which is a herbal supplement to help balance hormonal and ovarian health. I took 8 capsules per day, which was double the dose on the bottle, but I trusted my doctor explicitly! We realized July wasn’t going to be our month, so on to the next.
August 2019: Time for round 2! I took Provera, and then started Letrozole once again! This time, we upped the dose of the letrozole slightly, to 5 mg per day. We scheduled our day 13 ultrasound, hoping for a better outcome, but this time we discovered that my body actually ovulated somewhere between day 9-11. There was two ruptured follicles this time, but two was better than one! They were still measuring on the smaller side, 13 mm and 16mm, but at least there was more progress. I had been on the Myo/Chiro inositol for four weeks not, and it seemed to be helping!
September 2019: Round 3! I completed the Provera and Letrozole, and the wait was on! We decided to go in for multiple ultrasounds this month to try and find the exact day that my body ovulated. I went in on day 9, 10, and 11 of this cycle, and we decided that day 11 was my sweet spot! This month, we had two bigger, healthier follicles, 18mm and 21mm, so we decided to give it a shot, literally! It was time for the trigger shot and our first IUI!
On the next post…the process of our first IUI!