What I did differently

I know there was a lot of luck involved in us getting pregnant in April. There was also a lot of prayer (I truly believe my Grandma had something to do with it! When we told her we were pregnant she said, "There's only one baby in there? With how hard I've been praying I was expecting at least two!").

In addition to luck and prayers, I made some pretty big changes to my diet and daily habits in the 3-4 months prior to Ponyo. I made the changes because I wanted to feel like I was doing something to increase our chances of success even though my husband and I had both resigned ourselves to the fact that nothing would be possible until after my laparoscopy. I am by no means a medical expert, and I don't claim to be, but here are the changes I made based on what a friend dealing with infertility told me, lots of research online, and reading these books:

The Infertility Cure: The Ancient Chinese Wellness Program for Getting Pregnant and Having Healthy Babies by Randine Lewis  

Recipes for the Endometriosis Diet by Carolyn Levett 

Endometriosis: A Key to Healing and Fertility Through Nutrition by Dian Shepperson Mills & Michael Vernon

The 9-Day Liver Detox Diet by Patrick Holford and Fiona McDonald Joyce

First, what my friend told me: She and her husband were seeing a specialist who was trained in NFP. Their doctor told them that over 30% of couples struggling with infertility conceive after 3 months of taking this combination of vitamins:

Vitamin C (1000 mg)
Calcium made with D3 (500mg)
D3 (2000 I.U.)
Magnesium (250 mg)
Stress B-Complex
Zinc (30 mg)
(My friend also took Flaxseed oil, which I skipped due to the warning about blood clotting and surgery risks)

I did some research and found that endometriosis and low progesterone can be linked to deficiencies in some of these vitamins (especially Magnesium). PCOS is also affected by these vitamins! I picked up the vitamins and the nice pharmacist at the grocery store even gave me a pill case to use so I wouldn't have to open 6 bottles every night when I took my many pills with dinner. I also gave my husband the same Vitamin C and D3 that I was taking as well as a normal multivitamin. Maybe it was a coincidence, but both my friend and I are now pregnant (due about 3 weeks apart) after both of us trying for about 2 years, which seems too weird.

I did some simple liver detox. In The Infertility Cure, I read that endometriosis can be caused by "stagnation of the liver." Sounds awesome, right? So I decided to read The 9-Day Liver Detox Diet. The detox book listed 5 habits to break:
1. Wheat
2. Milk
3. Caffeine
4. Alcohol
5. Bad fats

Interestingly, ALL FIVE of these things are to be avoided by women dealing with endometriosis (as mentioned in Recipes for the Endometriosis Diet and Endometriosis: A Key to Healing and Fertility Through Nutrition). So, I got super serious about going gluten free. No more cookies. No more sandwiches, or Triscuits (my fave snack!), or pita bread, or traditional pasta. I cut back on dairy. No more Kefir, limited cheese, limited yogurt, limited ice cream. I stopped drinking coffee, tea and alcohol. Once you cut out all of that, you pretty much cut out all bad fats, too, so that was taken care of!

I started drinking lemon water every morning. I started eating at least one serving of broccoli, spinach, or kale every day (these green veggies are good for you and also are known to help your body get rid of excess estrogens). 

To help rid my body of even more excess estrogen (excess estrogen is what causes endometriosis) I started using natural body products. I gave up scented soaps and used Kirk's Castile which is a coconut and vegetable glycerin soap. I started making my own deodorant out of coconut oil, baking soda, and arrowroot powder (I do still use normal deodorant for working out or very hot days even though the coconut deodorant works really well). I am still using my normal make-up and shampoo/conditioner although I am thinking of moving to healthier brands after I use everything I already have.

Because this post is getting so long, I'll do another where I'll write about the results I noticed after the changes.

The Plan

We had our surgery consult this afternoon. The doctor (we'll call her Dr. D) started out by saying that we know a lot more now than we did last time we met with her. She said there is some good news:

• my prolactin levels are normal
• my FSH level was very good
• The Bee's SA came back with good results

All of these are things we have working for us.

Some news that we now know that is not so good:

• my progesterone level was borderline low
• we don't know from last cycle if I am ovulating (ever or irregularly)
• my DHEAS level, which is a precursor to testosterone, was a little elevated, which can be a sign of PCOS
• I have cysts on both of my ovaries
• I have endometriosis on both of my ovaries (most likely, but they cannot diagnose for sure without a laparoscopy)

The next step, as we have known, is a laparoscopy to diagnose and treat endometriosis. She suggested that within the 6-9 month window of opportunity after the laparoscopy that I take Clomid to stimulate ovulation, since "a titch" of PCOS could be at play here, too. She kept saying that there is inconclusive evidence pointing towards PCOS:

• The slightly elevated DHEAS levels, but so slightly elevated that if there weren't infertility issues, they wouldn't even pay attention to it
• The cysts on my ovaries, but they are not typical of PCOS - mine are larger and fewer. These "chocolate cysts" which are common in endometriosis, could be kind of obscuring the true appearance of my ovaries, though
• The irregular ovulation or anovulation, since nobody could tell what was going on last cycle

Whether or not I have PCOS, the Clomid would help us take full advantage of my fertility while the endometriosis is more under control.

Dr. D said that waiting until June or July would be just fine. I am young and there is no time pressure yet. She seemed to think it might be good for me and The Bee to take a few months off from the whole fertility circus anyway, to give my body some time to recover from stress.

She talked about the mind body connection and, more than once, mentioned that both endometriosis and PCOS are treatable and usually have pretty good success rates as far as treatment and pregnancy go. She said that I need to think positively and suggested that we try to relax and maybe even go on a vacation before having the laparoscopy done. To her credit, she did preface the "relax and go on a vacay" with "I know you have probably been told this and it is hard to do, but taking care of yourself, both physically and mentally/emotionally is very important in all of this. I truly believe that positive thoughts are important." I, the ultimate pessimist as of late, know that nothing is a given. There is a chance that we'll follow through with this and be the most positive, enthusiastic people in the universe and still won't have a baby. But there is also a chance that we will.

So, the plan is to call the surgery scheduler when I get my period in June. Somewhere between day 5 and 11 of that cycle I will have the laparoscopy where they will go in through three 5mm incisions (one through my belly button - yuck!) and remove the cysts from my ovaries, the endometriosis from my ovaries (and any other endo they see) and they will assess my fallopian tubes. After that, we'll have to decide if we want to chance it and see if I can ovulate on my own and get pregnant or if we want to start Clomid the following cycle, which would be July.

In the meantime, I am going to try to take care of myself. I am not going to use OPK's or chart BBT (you have no idea how much I have LOVED not charting the horrible and hideous BBT!!). I will still keep track of my cycle using NFP but will try not to obsess. Dr. D said, "You never know...if you are ovulating irregularly, something could happen between now and June." I appreciated her encouragement and kindness, but I have a hard time believing anything will make the next 5 cycles more successful than the last 17 have been.

So, here we go, waiting for June or a miracle!

Infertility clinic: blood work results

I got the results from last week's blood work.

My FSH, LH, prolactin, and free and total testosterone were all normal.

My DHEAS level, which is a precursor to testosterone, was a little elevated, which could be a sign of PCOS. I broke my internet moratorium (shhh...don't tell!) and saw that, yes, it is indeed linked to PCOS (and other fun things) but it is also elevated in people who are stressed because it is related to cortisol somehow. Hello! Who in the world can ttc for over a year and NOT be stressed? Okay, I will NOT look up any more info. The internet moratorium is reinstated. I did last a whole week, which is pretty amazing. I need to remind myself that I am in good hands and no matter what they find, we'll be able to deal with it and make decisions based on the results. Knowledge is power, right?

My doctor wants me to stick to our original plan: follicle ultrasound tomorrow, use the OPKs at home and then go in to get my progesterone checked after ovulation. The Bee also needs to get in for his SA and then we can go from there!

Infertility clinic visit #1

The appointment went really well today. I picked The Bee up at his work and we drove to the clinic together. Side note: It was the first time I have been to The Bee's office and, holy cow!, it is a BEAUTIFUL building with fanciness everywhere! It has tons of plants and fancy staircases and it is especially lovely right now because it was all decorated for Christmas!

Okay, back to the appointment...

We arrived at the clinic (which is only an 8 minute drive from The Bee's office, NICE!) and I had to sign some paper work saying that I understand that I am responsible for any payments for services that insurance won't cover. Then they took my picture (I tried to look good for the appointment but made the mistake of wearing my naturally curly hair down on a windy, December day - oops!) for my file (to prevent identity fraud, apparently). Then they weighed me (unfortunately I am down another pound, but more on that later) and took my blood pressure.

When I got to the exam room, I held my composure while the assistant took down a few more bits of information. She seemed a little uncomfortable asking The Bee if he had fathered any children and if he has had a semen analysis done (answer to both = no). Then she left and said the doctor would be in shortly.

The doctor came in about 5 minutes later and went over some of the records sent from my general physician and the specialist at my doctor's office. She asked us for our story so far and of course I started to cry! The Bee held my hand the whole time, though, which helped my cry substantially LESS than I have at all of the other appointments that I went to by myself. She was very nonjudgmental and also very kind. She seemed glad that I know a lot about my cycle (who wouldn't after 5 years of charting CM and 4.5 months of charting bbt?!) and hormones and what they do but at one point she did say that she was recommending an "Internet Moratorium." Haha! The Bee laughed pretty hard at that because all along he has been telling me not to look up all of the things that could possibly be wrong with me (it's not like I've told him I am insulin resistant, have a gluten allergy, have a "cold uterus" and hostile cervical mucus, low progesterone, a pituitary tumor...oh, NO...I have NEVER used the internet and test results to diagnose myself and in turn make myself completely cuckoo and practically impossible to live with! Not me!).

Her opinion, given the results from my previous blood tests and ultrasound, is that it may not be PCOS. She isn't ruling it out at this point, but said more testing needs to be done. She said I didn't have very many cysts and that they are larger than most PCOS patients have. At least 2 of them were like 2cm - which freaks me out a little because it sounds BIG (and not good) but she didn't seem concerned when I asked about it. She asked what cycle date the blood labs (cd 21 in November) and the u/s (cd 13 in December) were done and kind of seemed like, "Hmm...those are not the best days to do those tests..."

Then she asked what cycle date I am today. It is cd 2 (boo for AF over the holidays!) and she said it would be the perfect day to do the first blood work! So today they drew blood to test (from what I can remember) FSH, LH, prolactin (to see if that high level was a fluke in November or if my level is consistently high), estrogen, and androgens (which, of course, includes testosterone). That should help figure out if it is PCOS or something else, or something else and PCOS...here I go making myself crazy again! I also have an u/s scheduled for next Saturday morning (New Year's Eve!) to check my follicles. And I have to start using my ovulation predictor kit (thank you, Amanda, for the info about OPKs!) so that they can do another u/s 5 or 6 days after I get a + on it. Even though I don't know any new news, I feel like we are making progress! She also gave The Bee a referral for his SA. I will be glad (and possibly sad, mad, shocked...) to finally start to figure out what is going on with us!

She asked if we had any questions and I asked if my vegetarian diet could be part of the problem. She said it could be contributing if I am not getting enough protein and fats, but probably isn't the main issue. I told her about how I have cut out almost all gluten from my diet since August (due to constant stomachaches) but she seemed to think that less gluten = generally healthy.  And then I told her how now am worried about eating too much sugar (because of my self diagnosed insulin resistance after my sort-of diagnoses of PCOS) and too much dairy (after I read about all of the yucky hormones in, like, EVERY dairy product I eat). Through tears I asked, "How can I eat anything if I have to be a gluten-free, diabetic vegan?!"  She told me not to limit myself too much and that low BMI can cause problems while ttc. She actually recommended that I eat full fat, organic dairy from now on since my BMI is currently borderline low (not on purpose, I truly think it is stress!) and that I not worry about sugar at this point (but of course try to avoid refined sugar and processed food, which I think The Bee and I do a pretty good job of already). The sugar thing really makes me feel better because I love fruit and eat a lot of it (especially clementines and pineapple, which are pretty sugary). And the dairy thing made me feel better because I eat a lot of yogurt (with frozen blueberries in it) for protein and I LOVE cheese! I communicated that I have been trying everything I can think of to make better choices and to "fix" whatever I am doing wrong. She looked at me with the most gentle eyes and said, "You aren't doing anything wrong. You can't blame yourself for this, even though it is easy to go down that road. We will figure this out!"

She also told me to take care of myself (specifically make time for my YOGA and she recommended getting massages every once in a while). Oh! And the BEST part of the appointment today? The doctor actually TOLD me to STOP taking my bbt! She said that if you don't sleep consistently(which I don't) it is not very useful and it causes many women in my situation undue stress. So, hooray! No more bbt charting! Although now I have to start the OPKs...

Hope everyone has a Merry Christmas:)

NOT a good day

I got the call from my doctor. My uterus looks "very normal" but both of my ovaries have cysts. Two on the right and three on the left. This could (obviously) mean PCOS. My next step is to see a gynecologist at the fertility clinic. My doctor mentioned Clomid and Metformin as possible "minimal interventions."

The Bee still hasn't been seen in regards to this whole mess, although it sounds like it is probably me. I don't know a ton about Clomid or Metformin but medications in general scare me a little. My doctor said that people on Clomid are closely monitored so if we end up taking that route we'll probably have to wait until summer (I think I'd be able to handle everything better when I'm off of work and making appointments would be a lot easier then, too). I'll be giving the fertility clinic a call tomorrow and hopefully setting something up.