As I mentioned in my previous post, following my short stint with fertility meds, I became a bit jaded by the Western approach to "help" my situation. Since I'll be blogging about all the crunchy holistic stuff I'm doing now, I figured it was worth giving a little more background on what exactly happened to make me say buh-bye to meds and travel the path I'm currently on.
After seeking help from my OB and receiving the drugs Provera and CloMAD to help me ovulate for two cycles, I didn't become pregnant and my OB informed me that my history of not having a period or ovulating for almost 3 years was "complicated". She thought I should see a specialist and referred me to an RE, who's modus operandi, is to use ovulation medicine as well, although a different type. Her drug of choice is called Femara. You may have heard of it. It's actually FDA approved for breast cancer, but RE's are now using this ovulation inducing medicine to treat infertility...off label of course, because it's not FDA approved for this reason.
However, RE's will not treat you until they run a whole host of invasive diagnostic tests on you. All of these tests are very hard to pronounce; Try saying hysterosalpingogram ten times fast! They also involve sticking foreign objects up your lady parts and then asking you to pay large sums of money before you leave their office. I kind of felt like they should be paying ME by the time I left!
In the amount of time it took to undergo the plethora of unpleasant tests, and between going off of Clomid and before starting Femara with my new dr., I did unexpectedly become pregnant. Honestly, to this day, I feel like the Clomid had something to do with me getting pregnant, because it just has a very long half life and stays in your system a while.....which can be good for conceiving for some, but isn't good in other respects, many of which can cause more harm in your body than good. I won't get into the nitty gritty of my miscarriage in this post, but that's what happened, and soon after I tried my best to move on and stay the course.
So, after the failed attempts with Clomid, the tests coming back clear with nothing obstructive showing up, one short pregnancy, and a miscarriage later, my RE finally wanted to start me on Femara to help me ovulate, with less side effects than Clomid. This seemed logical since I STILL wasn't ovulating on my own. I agreed, eager to work with this amazing specialist who was going to know exactly what to do!
She gave me the prescription. I took it on the days she told me to, and I went in later that month for ultrasound monitoring, which revealed I had some rather large follicles (this is where the eggs grow and get bigger before they are released). BUT, there was a problem. She said my uterine lining was looking very thin for being this far along in my cycle. The uterine lining is important because it basically acts like a bed of soil for any fertilized eggs to take root. If the uterine lining measures too thin, a couple things can happen: a fertilized egg won't have anywhere to implant and will just dissolve away OR a fertilized egg can implant, but won't take hold very well, and will eventually lose it's ground....this can lead to early miscarriage. Oh no! I thought. I don't want to miscarry again. Now what?
Not to worry said the RE. We have another drug, called Estrace, which is a synthetic form of estrogen. It's taken vaginally, and the pills are bright
green, so if you see bright green spots in your underwear, that's
completely normal. WTH? Yes, this is for real! When taken it will thicken that uterine lining right up to where it needs to be to provide a nice cushy bed of soil for that egg. Hmmm, more drugs? Not liking this trend, but if it's the only way, ok I guess.
But wait, there's more! (insert best infommercial voice here) The only problem with Estrace, is that when taken, it will prevent that ripe and ready egg from bursting out of it's follicle, even if the egg is nice and mature and ready to emerge. Say what? Yes, that is why we then have to give you another drug called Ovidrel. This is what they refer to as a "trigger". It's a drug made with the hormone hCG and comes in the form of a shot that you administer to yourself. You'll have to buy it at a specialty pharmacy and save it at home for when it's time. Come back in 48 hours to do another ultrasound, and we'll see if your follicles and lining are ready. If they are, you'll then give yourself the trigger shot, and that will guarantee that you ovulate 36 hours from the time of the shot. You will time intercourse around the shot, so you have the best possible chances.
Despite the red flags and lunk alarms going off in my head, I reluctantly agreed to follow the protocol. She was the expert after all, and I had no idea why my body wasn't working like a normal person's should. I ran out, bought the magic green pills and spent another $100 on the shot. 48 hours later I went back to the RE, with my trusty little cooler and my Ovidrel shot on ice in case it was time. I did NOT want to have to stick that thing in my stomach on my own.
Well it looks like you won't have to after all, says the RE. It looks like your body responded really well to the Estrace. Your lining grew 4 mm in only 48 hours! But, it turns out that your follies have gotten smaller...meaning I either ovulated on my own (unlikely) or my eggs shrank back into my ovaries faster than an African in the 2012 London Games. Yep, it was the latter.
So, after 3 drugs Rx'ed, numerous ultrasounds, and $2000+ later, it was clear that ALL THAT WORK WAS FOR NOTHING. The cycle was a complete wash, and it was the last straw after an already tough few months prior. It seemed like a lot of unnecessary money and putting meds with known side effects into my body, and for what??
One thing I've learned through this process, is that reproductive endocrinology is NOT an exact science. It's much like a game of darts. Many times RE's use a one size fits all approach, without even considering your particular circumstances. That is just the way that field works. They each have their favorite set of drugs and protocols, but every patient reacts differently to each of those drugs. They have no way of knowing how each person will react until they try it. Most of the time, these drugs are used to treat the symptoms of infertility and not the underlying cause. So, even though ovulation meds might trick a woman's body into ovulating, it will never correct a hormonal deficiency causing the problem, or teach that body to ovulate on it's own. If anything, it can cause more dependency on the fertility meds in order to maintain normal function.
I left the office that day, resolved to do whatever I could to research what was going on with me. I sought out a 3rd opinion from an ACN (Applied Clinical Nutritionist) who specializes in fertility and also a 4th opinion from a TCM (Traditional Chinese Medicine) practitioner, a.k.a. acupuncturist. I read the book The Infertility Cure and it was like a lightbulb finally went on for me! I highly recommend this book to anyone dealing with hormonal imbalances or infertility. Everything I read and heard form these other sources made so much more sense!
I started following the advice of the ACN, TCM practitioner, and The Infertility Cure. I began taking a regimen of organic whole foods based supplements and herbs, and made changes to my diet. Sure enough, the first month of following the all natural protocol, I began ovulating on my own....this month makes 7 months straight. I began seeing many other signs of improvement as well, and I have no doubt that all of the natural things I'm doing are working. I've still being checking in with my RE from time to time for monitoring, but have been meds free the past 7 months. At my last appointment, my RE actually told me, "I rarely ever say this, but just keep doing whatever you're doing, because it's working. You have picture perfect ovaries. This is what we love to see as RE's."
Accepting compliments on behalf of my uterus and ovaries is something rather new to me, but I will take it! Besides, I was never good at the game of darts anyways. I am hopeful going natural will be all I need to conceive, and then I can really say I TOLD YOU SO Western medicine. I realize that there are a lot of women out there who have undergone much more than me, and I am thankful to be 34 and still have at least a little time to give going natural a chance. We're giving it until the end of 2012. If it doesn't happen by then, at least I will know I truly gave my body the best chance possible to do this on it's own.