The Plan

I haven’t written here in ages or talked about any of this stuff either, so bear with me. I had to go back and read my last post to see where I had even left off. We basically spent most of 2014 with little to no western medicine fertility interventions. I wanted to see what the acupuncture/dirt tea etc. could do and honestly I just needed a break from that other stuff. All told, since starting the acupuncture I had four cycles that I assume were probably ovulatory, although I don’t have actual confirmation of that. One of those cycles was also, I strongly suspect, a chemical pregnancy. Which is neither here nor there, though it was the closest I’ve come to any success on this so far!

I started acupuncture and the TCM stuff at the end of March. It’s now December. Owing to my long cycles and an unfortunate hiccup at the end, I guess that’s the best we can expect from acupuncture alone, so far. In September I missed three acupuncture sessions in a row (I go weekly) because my acupuncturist was on vacation and apparently that threw a wrench into everything because I stopped having cycles. September went by – nothing. October went by – ditto. I realized just how I’d come to depend on the somewhat reliability of feeling like my body was “working” and then when it didn’t I was miserable and cranky. Finally, by late October my acupuncturist suggested I might want to take Prometrium to induce a period and start things over again. (I joked that my body apparently needed a hard reset).

She was right, and I realized that after I did it. I felt more at ease, and at least had peace of mind. The few months prior hadn’t been easy ones and I was coming to terms with the fact that I would need to go back to the fertility clinic. My acupuncturist (K) agreed. At this point I have tried medication (Clomid/awful Letrozole) and I have tried acupuncture/herbals but I have not tried the two together and we feel they could work well in tandem. I think I was always pretty adamant that I hadn’t turned my back on science or anything, but that if alternate methods had something to offer me, I would take them. We made an appointment to see our RE again, which is a precious thing – he books about 5-6 weeks in advance.

Yesterday was that appointment. I went armed with the knowledge that I had been/could have cycles on my own and that whatever acupuncture and dirt tea does, it isn’t nothing. I wasn’t sure how the reception was going to be or whether our RE would scoff at any of it, etc.

First of all, I think the waiting room there is my least favourite place in the entire world. Not just because it’s a clinical waiting room, it’s just not a happy place. Unfortunately our RE was running late (15 min late, they told us when we arrived) which turned out actually to be an hour late. So we weren’t thrilled by the time we got to see him, but like I told V, I already waited 6 weeks, what’s one more hour? He’s a doctor and a specialist, it happens. As it turns out he apologized straight away, said he’d had some emergencies that came up that day and it snowballed on him. That’s a good enough apology for me, and I think everyone relaxed at that point.

So then he said basically, long time no see, and asked me to tell him what had been going on with me in the interim since he’d seen me last. I got the impression that he did not know about the side-effects I’d had from Letrozole, because when I described them and explained why I’d refused to take a higher dosage, he was basically “Yikes, yeah, no.” This feeds my suspicion that the nurse who told me “the doctor” wants you to take a higher dosage either made that call herself or didn’t bother telling him about the side-effects. Because it wasn’t in my file. But anyway, he won’t make me take it again, so that’s good.

He asked me more about the acupuncture – whether I’d made any other lifestyle changes during that time, diet, exercise, etc. and I know I had intended to but honestly I didn’t that much. Maybe some more walking with the dog, but not enough to explain such a radical shift in the way my body was working or not working. If anything we ate worse this summer than we had been. The only change really is that because I’ve been taking seeds per my acupuncturist’s suggestion, I tend to have more fruit/veg at breakfast in my smoothie. I take pumpkin/flax seed from days 1-14 and then sesame/sunflower from 15-28. I think he was skeptical about that one but figured it couldn’t hurt.

We told him that we are ready to/want to move forward with IUI at this point, so we talked a bit about the protocol for that. I told him that I had recently (Sunday) had a positive result on an OPK for the first time, but also that it had been positive on Monday, and Tuesday. He said that’s not really normal, although it could be possible depending on the timing, but said he wouldn’t use OPKs for me for the IUI anyway and would prefer to do ultrasounds, probably three per cycle because of the irregularity of my cycles. That’ll be a bit of a hassle (getting around isn’t always easy and transit is a pain to get there but I’ll manage).

We talked about a natural/no drugs IUI cycle versus using Clomid. We also talked about my cycles, even the ones I’d had, and he said that the thing is when a cycle is that long (e.g. 40 days) even if you’ve ovulated you may not get pregnant because of egg quality at that point. So he said he would prefer if we used a medication to help things along, but he was really receptive to the suggestion that we try Clomid at a lower dosage than before (100 mg instead of 150 mg). He agreed that it was worth a try, saying that it makes sense that we treat things differently now because “You are different,” and “Maybe your body is self-correcting.” We all agreed that’d be great if it was. He got really excited when I said it was currently CD20 and that I think I just ovulated. “That’s perfect!” he exclaimed. “Go for a blood test! On Monday!” So we’re going to do that, to see whether I ovulated this cycle just on my own.

So that’s what we’ve decided on for the IUI. It may not be the next cycle IF this cycle is “normal,” because then it’d be happening at Christmas/New Year and who needs that hassle, really? Plus I think the office closes for parts of it and our RE agreed it would be best to wait until January. So if need be, I’ll take Prometrium then if things haven’t “progressed” on their own, to get things started for the IUI.

As for the IUI itself, I have a lot of documentation that lays out exactly how they do it, they schedule your ultrasounds based on your cycle length etc. There’s a nonrefundable $125 fee or something at the start of the cycle, and if it has to be cancelled because you didn’t ovulate, you’re out that much. Which is not too bad I guess, and still worth the lower dosage experiment to me. I’m going to continue with acupuncture and my herbals throughout. Basically he agreed to everything we’d already more or less planned, and I’m happy he’s willing to try a lower dose of the Clomid. Unfortunately apparently there’s an issue with Clomid’s supplier right now and it’s not obtainable, so he said their pharmacy has made a compound and we can only get it there. Which sucks because their pharmacy is closed at 3:15 in the afternoon? I mean. Come on, now, try and work with us. Anyway, we’ll get it all figured out. We will do three IUI cycles before we meet with him again to discuss. For the time being I am going to just go for the blood test and not worry about this stuff until January and just have a nice holiday!