timing is everything
Once the decision was made to proceed with fertility treatments, everything was a bit of a whirlwind. I started Progestin to induce my cycle and on day two, I returned to the doctor’s office to have my baseline ultrasound, check for any cysts, bloodwork and recieve my first prescription of medications.
This is what that process broke down to after that first cycle day (CD) one appointment:
CD 3-7: Take 2.5mg of Letrozole twice daily.
CD 9: Go back for an ultrasound for a follicle check. The doctor needed to see how my follicles were responding as well as how my uterine lining was. At this check my follicles were not yet very mature so the doctor put me on three more days of Letrozole and upped my dosage to three times a day.
CD 12: Another follicle check. Still my follicles were not mature enough so the doctor put me on two more days of Letrozole.
At this point, I was slowly starting to feel some of the side effects of Letrozole like bloating, headaches, and ridiculous hot flashes! But everything was manageable.
Another thing of note when taking fertility medications is that they typically cause multiple follicles to develop, which increases the chance of releasing more than one egg during ovulation — and therefore raises the chance of twins or multiples.
Because of my unicornuate uterus (UU), the doctor had already warned me that they would only proceed with the cycle if I had three or less mature follicles on each side. Because I was already high-risk, if I were to become pregnant with multiples, they would pursue selective reduction, aka abortion, because it’s too risky to allow me to carry multiples. Even so, we kept going with more medication and a higher dose.
CD 14: Finally my follicles were the size they wanted! The good news was that I only had one mature follicle on each side. The even better news was that the larger follicle was on my left side which is the side that has a fallopian tube. At this point my uterine lining was still a bit thin so the doctor prescribed Estradiol for two days to help get the lining thicker which is important for implantation. (TMI ahead, but this blog is all about honesty!) I was prescribed a vaginal Estradiol which are blue tablets and therefore make your discharge look like you just got frisky with a Smurf, but at least it created some levity at the time.
CD 15: The evening of CD 15 I was able to do my trigger injection of Ovidrel. Ovidrel mimics the body’s natural LH surge and tells your ovaries: “Release that mature egg!” And then ovulation typically happens 36–40 hours after the shot. Basically it takes the guess work out of when your body will actually ovulate since it will happen during that window. The night of my trigger shot we had to be at a church for mass because my ex-husband was a confirmation sponsor for a family member. Halfway through when I knew it was time, I excused myself and locked myself into a bathroom stall to give myself my first injection. I was alone, shaking because I didn’t know what the hell I was doing, all while hearing a congregation pray and sing with no clue to what was happening just on the other side of the wall. It was weird. Really fucking weird.
After the trigger shot we had to have timed (cringe) intercourse 12 hours after the injection and again 36 hours from the time of injection. Talk about taking the romance out of the process. When you’re literally setting an alarm to get busy it can be a bit odd. But still it was all worth it for the hope of having a baby of our own.
After said timing, we entered the dreaded two week wait (TWW). The ~14 days between ovulation or your trigger shot and when you can reliably take a pregnancy test. If you test too early, you might get a false positive from the trigger shot or a false negative because implantation hasn’t happened yet.
You suddenly become hyper-aware of your boobs, dreams, discharge, and bathroom trips. When Googling things like “twinges 7dpo (days post ovulation)” and “is nausea at 9dpo real or in my head?” becomes your part-time job. During this window you also never know if things going on in your body are actual pregnancy symptoms or just hormones. It’s an absolute rollercoaster.
The TWW finally came to an end, but then aunt flow reared her ugly head. I had a feeling something was up the day before when I had a headache and some spotting. I often get a headache right before my period starts, but a headache and spotting are also early pregnancy signs so it can be hard to know for sure. I woke up early that Saturday morning – too anxious to sleep in. As I was taking my pregnancy test my period started in full swing. Here I am literally sitting in the bathroom peeing on a pregnancy test and bawling. Naturally the test showed a BFN – big fat negative.
It was definitely tough and emotional during the moment, but then we decided right away to press on and started our second medicated and timed intercourse cycle heading to the doctor’s office that next morning. For the second round, the doctor upped my dosage right off the bat so I took 7.5mg of Letrozole. Unfortunately, when I went in for my follicle check I was told that my mature follicle was on my right side, which is my tubeless side. Because there is only a small chance for conception to occur when you ovulate from a tubeless side, the doctor decided to cancel the cycle. That meant no more medication or trigger injection for that month. I would have to wait until my next cycle occured. I felt deflated and started to figure out other ways I could keep myself distracted for the next month.
One thing I started pouring myself into even more was my job. I’ve always been incredibly career driven, but now more than ever I felt like I needed to do something I could control. And it paid off – during that month off I was promoted at my job – and it was something good I could focus on for the time being. No one at work knew what was going on in my personal life. Something, as a woman, I very much felt I needed to keep to myself. If I would have told anyone, would the VP over my office have treated me differently? Would he have approved my promotion? It’s all speculation, but I wasn’t going to take that risk.
It’s terrible as women and individuals generally that we feel we have to hide things like this for fear of the consequences or potential obstacles they could produce. Sadly, while I do think more and more people are willing and open to share what they’re going through, we as a society are also continually told to keep our mouth shut. I too admit that I rarely share anything in my personal life with my coworkers even now, which is so at odds with who I am as an individual. I’m not saying I necessarily want to change that, but it’s strange sometimes to reflect on how ingrained that mentatility is in me, which is likely even more of a reason for wanting to write this blog. So if you’ve made it this far, thanks for being here as I spill my guts
Honestly,
Theresa