Monday, January 7, 2008

A freaking minefield

I have a freaking minefield in my ovaries.

This cycle has been f*'d up to say the least. And now it continues. So far I don't like my experience with medicated cycles.

Here's a brief recap: After RPL testing showed no problems except for my Advanced Maternal Age, my new RE put me on Clomid to produce more follicles and maybe even a better quality egg. The first cycle I responded beautifully, 4 potential eggs. Due to hostile CM from the Clomid, we had to switch from timed intercourse to IUI. The sperm count post wash was only 4 million. We attributed this to having sex only 24 hours before and the high fever my husband had a few days prior. Because of the sudden switch, the IUI was 48 hours post trigger which was really awful timing. No surprise, first medicated cycle BFN.

The second cycle during my baseline ultrasound, I had a small 11 mm cyst on my left ovary. My nurse okayed my to start Clomid. At my ultrasound on CD 11, I had a 35 mm cyst on old leftie. The rest of the medicated cycle was canceled, no trigger and no IUI because of the risk of ovary torsion. We were given the okay to try on our own. And so we did. I dutifully POAS trying to detect my LH surge. I saw lots of lines but the digital OPK never read positive. My chart was very inconclusive since the Clomid jacked my temps up.

Fast forward to yesterday. I started bleeding. It was light at first but got heavier to the point that I considered calling it CD 1. This was only 23 days from my last period. I'm normally a 28 day girl. But considering that this was a possible annovulatory cycle, I really wasn't expecting my period any time soon. My ovaries started getting even more painful and I went to bed early.

When I awoke this morning, I knew that my period had definitely started. We are going out of town tonight so I really needed to get into my clinic today for the baseline ultrasound. I might have stretched it a little by saying yesterday's flow was CD 1 but I hated to miss a full day's work to make it to an ultrasound later in the week. I felt pretty crappy and figured I still had a cyst or two. I knew Clomid was out this cycle. Instead of going on BCP, I planned on TTC a couple of cycles unmedicated to allow us a chance at getting pregnant and time for the cysts to go down.

I was prepared for a cyst or two and no Clomid this cycle. That was pretty much a given. Well, that one freaking cyst from CD 11 has grown and invited friends to move into the neighborhood.

I was not prepared for a freaking minefield and very serious warnings about the danger to my fertility.

Simply put, I have 9 cysts ranging from 21 mm to 46 mm. My ovaries are extremely heavy and there is a serious risk of ovarian torsion where the blood supply could get cut off to the ovaries. The ovary would then die without emergency surgery.

Left Ovary:
46 mm
37 mm
34 mm
33 mm
32 mm

Right Ovary:

38 mm
25 mm
21 mm
21 mm

My nurse thinks that since my period started early, I ovulated early. Maybe around CD 10 or 11. She said it would be very unusual for me to not ovulate on 100 mg of Clomid since I ovulate on my own.

My chart doesn't really show ovulation but I could almost see that it's possible based on how my temps all were pretty steady. All the annovulatory charts I've seen, are pretty rocky up and down.

My lining is thick so a beta was ordered. Might as well throw a chemical pregnancy into the mix. (heavy sarcasm) I'll get the results after 3 pm. If it's positive, it really can't be a good thing because of the amount of bleeding.

I'm not allowed to lift anything heavy. No jumping around or exercising. No sex.
She said any of those things could cause the ovaries to twist on the thin ligaments that hold them floating in my pelvis. So despite my intention of going unmedicated, I really didn't have much of a choice about going on Aygestin. The cysts need to stop growing ASAP. I have a follow up ultrasound in two weeks.

God help me. I just want a baby. Not a fleet of cysts trying to take over my pelvis.

Aygestin (Norethindrone Acetate)
Aygestin is a form of progestin, a synthetic substance that chemically resembles progesterone, that may be prescribed in ovulation induction therapies to inhibit ovulation and quiet the ovaries in advance of egg stimulation using injectable hormones. This "down time" helps the ovaries respond better to treatment. In much the same way that oral contraceptives prevent pregnancy by inhibiting normal ovulation, Aygestin is used in IVF and related procedures to turn off the body's natural ovulatory cycle. Side effects of Aygestin may include: abdominal pain or cramps; diarrhea; fatigue; unusual tiredness; weakness; hot flashes; decreased sex drive; nausea; trouble sleeping; depression, irritability, or other mood changes; swelling in the face, ankles, or feet; weight gain.

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