Tuesday, August 28, 2012

Story of my Life: Curse of the Thin Lining

Today is CD13, the day my OB/GYN offered to do an ultrasound to see how I responded to Femara. For anyone who doesn't know, they can usually tell how you respond to an ovulation medicine by doing an ultrasound to count & measure follicles growing in each ovary. It needs to be done prior to ovulation, because the follicles shrink back down after ovulation.

Seeing a follicle around 20 mm+- in size would generally be considered a "good response". Many women produce this size of a follicle or larger on their own without meds, but some don't and still others (like me) just take much longer to grow a mature follicle. Today was supposed to be the day I could assess if the Femara helped me grow a mature follicle sooner in my cycle...which was the goal.

Only one problem; I think I might have misjudged just how soon Femara might make me ovulate. I did not use OPK tests over the weekend as I did not see any other signs of fertility and figured surely I would be good to go if I started using OPK's on CD12. I woke up yesterday (CD12) and got a blazing +OPK on two different brands of OPK tests. Getting a +OPK is always good news of course, but I had no idea how early it would come this cycle! I have never gotten a +OPK this early EVER! I tested again in the afternoon and the OPK's were completely negative. Further complicating my ability to pinpoint the exact O date, is that my Basal Body Temperature has not yet risen as of this morning, which would also signal that ovulation has in fact occurred.

So, I'm guessing one of two things happened:

1) My LH surge actually started on Sunday (meaning I could have ovulated yesterday or last night but it still didn't show in my rising temperature as of this morning)
2) My LH surge was super short this time and already gone by the afternoon, which also could have happened (meaning I could have ovulated today or will tonight)

It's pretty damn important to know when I'm actually going to ovulate (it's usually within 36 hrs. of the initial LH surge) so this threw me for a loop. Luckily, we'd already been babydancing all weekend, but I was really hoping to get in for the ultrasound before I ovulated to see my real response to the Femara....seems I may have missed the boat on that. I tried getting an emergency apt. yesterday but they couldn't fit me in.

I did go in today for the ultrasound, but left feeling less than enthusiastic about the experience. For one, my uterine lining only measured 5 mm. Story of my friggin life! Ugh! That is not good at all. No cushy lining for an egg to implant means very low chances of a pregnancy happening or high chances of a miscarriage. No bueno.  This thin lining issue is my never ending problem.

The largest follicle she saw only measured 13.7 mm. So either that was the leftover corpus luteum from an egg that had already ovulated and had shrunk back down, or she just didn't know what the heck she was doing and wasn't seeing another follicle hiding somewhere. Who the heck knows! Honestly, at that point in the apt. I wasn't betting on my OB/GYN's ability to even see all of the follicles present. She said that her machine is not "high tech" like my RE's and that she can't even tell much difference of an ovarian cyst from a true follicle with an egg in it. Huh? Then she proceeded to tell me that:

A) I am the second most complicated case she has ever seen.
B) In a nutshell, my issues are too complex for her to help me with.

Well it's not what I wanted to hear today, but maybe I did need to hear it AGAIN. I have been trying so hard to make this happen naturally and with the least amount of medical intervention possible, but I feel like the whole universe is sending me the message that I need the extra help of an RE again. It's hard for me to come to terms with this, because I wanted to believe that if I did all the right things to help my body naturally, that God would reward me and show me just how amazing He and my body both could be, even against all odds. I wanted to be one of those amazing success stories of someone who used acupuncture and holistic medicine and prayer, keeping the faith long enough to become pregnant "in God's perfect timing." I just don't know if that's possible anymore, no matter how much I'd love for it to happen that way.

My husband has been gently telling me for months that we might need more help. He is so supportive in anything I want to try to help things naturally, but I have not wanted to believe that getting "more help" was the only way for us. I wanted to prove to him and to myself that I wasn't damaged beyond repair. It is one of the most desperate feelings in the world to feel like you can't even do the one thing women have the God given gift to do; To have children. I have been fighting having to admit that it's just not working, with everything that I've got. Taking a small new step with this cycle, agreeing to do Femara, I held out hope that maybe we could be one of those couples who just needed a little Femara to do the trick and that's all it would take.

I realize this cycle is not over, and that there is always a chance. However, today's ultrasound, albeit not a very reliable one, makes me less than confident that anything would actually stick this cycle, especially given the lining issue. And so the waiting game continues. I'll take a progesterone test in 7 days to confirm ovulation and show my progesterone response and then wait one more week to see if I am pregnant. You never know, miracles do happen! That's what it's going to take at this point, but only time will tell.


  1. You never know! I was SO sure that we weren't going to get a BFP when we did. That was a week after my dr gave me a 3-5% chance of concieving on our own.

    Yeah it sounds like you need to go back to the RE. Although from what I hear about your RE isn't my favorite. Is there another one you could go to? Too bad you dont have an OB that specializes in infertility. I guess I just got lucky on that one!

    Oh and I also noticed I ovulated super early with femara (well letrozole) too. I'm a natural late ovulator so I wasn't used to it. The bright side is the cycles go by so fast because they are so much shorter!

    Good luck! Its such a difficult situation to be in.

    1. I agree, it was great to get a +OPK so early, but now here I am still doubting whether or not I even ovulated. STILL no temp rise today and no other signs of ovulation were ever present, which is driving me nuts, because I just want some sort of confirmation I ovulated ya know? I had gotten so in tune with my body going natural and now my body is doing something different on these meds, and it's hard to know what's really going on without extra eyes to help.

      I am going into my RE today for another ultrasound, because that is how "off" I felt it was yesterday. I need to get the ball rolling with the RE again anyways and let her know where I'm at in all this. I hate not knowing what's going on with my body and I at least trust her to do an ultrasound correctly.I may switch to a new RE soon though...strongly considering it. We'll see what she has to say today.

  2. Ugh, how frustrating. I only had a freaking 12mm follicle on cd 14. I'm supposed to go back tomorrow, which is only 3 days later, to see if it's mature and I'm ready to trigger. The late ovulation thing is so frustrating. I don't understand why my body takes so long to produce just ONE good follicle. Anyway, I feel your pain. But yeah, that's a weird result. What did the RE say?

    1. Well, I did end up seeing my RE yesterday (CD14). I am still waiting on results to a progesterone test (to tell whether I for sure ovulated) and AMH test (to test my ovarian reserve). I never had AMH done, so she just threw it in to make sure I have no issues with it.

      She saw 4 follicles, all ranging in size from 11-12 mm and my lining was 5.5 mm. From the ultrasound alone, there is no way to tell that I for sure ovulated, especially since she didn't do the ultrasound herself the day before on CD13. Measurements can vary according to the person doing them, especially if one of the dr.'s is less experienced. So just because the follicles seemed slightly smaller than the day before there's no definitive answer yet.

      Just waiting on blood results here, and then I'll blog more about the actual RE appointment. I will say it went REALLY well and I left feeling good about moving forward with treatments if I don't get pregnant this cycle.