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Dec 22

Fertility Roulette

While we got lucky with Eva, things have not been so smooth with trying for baby number 2. Now that Eva is 14 months old, we are stepping up the fertility game again. I would prefer to try all the things that worked so well with us last time, but it just is not possible to exercise, eat right, take a handful of herbs with every meal and take care of baby, business and everything else. So, we decided to try the medical route.

Surprisingly, I am doing really well on the diabetes prevention drug metformin. This drug is shown to increase fertility in women with PCOS (polycystic ovary syndrome), as well as helping to prevent diabetes, improve insulin resistance, lower miscarriage rates (miscarriage risks are high with PCOS), and possibly reduce gestational diabetes. I’ve taken metformin in the past, but it has many not so pleasant side effects. And, it was not helping me at all on the dose I was at (1500 MG). This time I am on 2000 MG and I am seeing a difference in how I feel as well as my food cravings. Unfortunately, I am also getting the lovely side effect of mild nausea most of the time. UGH!

My OB is working with us on basic infertility treatments since our insurance will cover them – if her methods fail, we will have to go to a cash only basis with one of the fertility clinics (only 2 choices in this little city). Our insurance will reimburse us for some, but when treatments run into the thousands per month – well, if this does not work then we are going to be waiting a good long while before we are able to afford more expensive treatments.

So, we tried 50 MG of clomid (a common fertility drug) two months ago. No dice. So, we tried 100 MG the next month. No help either. So, my doctor said that at my age, I can’t afford to mess around. She prescribed 200 MG of clomid. I was worried about the side effects, since the 50 MG stuff was giving me bad headaches and making me think – very- slowly – and – forget – stuff – a – lot! To my great surprise, I am feeling much better on the big dose than on the little dose. So, we cross our fingers and hope that the massive drugs get my ovaries working again.

If the drugs work, the next step is to schedule a trip to the doctor to give nature a boost with an IUI (intrauterine insemination – yes, it is JUST as much fun as it sounds!). We had James tested just to rule out a problem.  Seems I am not the only one with a fertility issue, and an IUI will give us a better chance of success than just hoping for the best. IUI also bypasses some of the side effects of clomid, making it easier for the key pieces of DNA to meet up.

Fertility treatments are no fun. First, no one can seem to agree on what the odds of success or risky multiples are. I suppose this is because every situation is different. Few studies have been narrowed down to “secondary infertility with PCOS and low sperm morphology (lotsa soldiers, they march well, but far too many are out of uniform).” So, we can only guess. And even if you know the statistics, you can never know how THIS month will go. At least we have one healthy little girl, so we know it CAN happen. That makes it a lot easier. And, if she was our only child together, I’d be ok with that. She is such a joy.

 Studies show that clomid alone is effective about 10 percent of the time for women with PCOS. Clomid and metformin bump the odds up to about 27 percent pregnancy rate. The doctor said that adding the IUI would increase our odds about 4 percent. So, we have about 1 in 3 chance of all of this working within 6 months – but if my body does not respond to the drugs – they have a zero percent chance of working! Then, there is the question every one asks when they hear the words “fertility drugs” – will I have a litter? Most likely not. Clomid is a pretty low level drug. It can and has caused a few cases of high order multiples (HOM – more than 3 babies at once). But, it is far less likely to do so than most other fertility drugs.

The drug pamphlet that came with the clomid says there is an 8 percent chance of multiples. That is 7 percent chance of twins, 0.5% chance of triplets, and a tiny chance of more.  You takes your chances in this game. The goal is one baby. One healthy baby. But, if it is twins or triplets, I’d be ok. The fear with more than 2 is that these babies nearly always come too early and have complications. Not to mention that I had a tough enough time being pregnant with Eva, I am not sure my body could handle twins or more. So, we pray for one healthy baby!

So, I try to ignore the morning sickness from the clomid (metformin makes me mildy nauseated – clomid is making me remember how horrible I felt when I was pregnant). I spend a lot of time wondering. Waiting. Praying. And keeping my fingers crossed.

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