May 2005

Isn't our baby the most precious thing you've ever seen? I think Baby Martin has my eyes! What do you think? J/K! Looking back over the last year, boy things seem like they've been easy. If you asked me while we were going through the treatments I would have told you how long it took! There is hope for our future children. Now that we have figured out how to get me pregnant things will be a piece of cake for the future!

Once we got the ball rolling with my Infertility Doctor things went so fast. This pregnancy thing isn't so bad. We feel so blessed to be pregnant and healthy. God is good and faithful!

"Ask and it will be given to you; seek and you will find; knock and the door will be opened to you." Matthew 7:7

One positive and exciting thing about going through the infertility treatments is that you get more ultrasounds than others. How lucky are we to be able to see our baby and have so many pictures of her in the womb.

April 2005

You are not supposed to test before your two week window is up if you take and HCG shot. This is because it is the very hormone that a pregnancy test picks up to test for pregnancy. I'm not known for my patience so I tested Sunday April 3rd, 2005. One day before I was supposed to take my test.

Results:
POSITIVE!!!

I cried. Phillp cried. We hugged and danced around the bathroom and then went to church. We were a bit nervous because I tested a day earlier than I was supposed to.

I called the Dr.'s office first thing Monday morning and told them that I had gotten a positive pregnancy result from a home test and they told me to come in right away so they could do a blood test to confirm the pregnancy. So I did just that and they called me back several hours later to confirm that in fact I WAS PREGNANT!!!

April 21 I had my first ultrasound at 6 weeks pregnant and we were able to hear the baby's heart beat! It was strong and healthy. Absolutely incredible and once you hear that you really know that life starts at conception and that it's a real live baby! We felt so blessed to be experiencing this. I was released to my OB/GYN and hopefully they would not see me hear again!

March 2005

We went back to Dr. Lucas in March and we went back to the Pregesterone to start my period, continue taking the Prednisone and we were going to start doing fertility shots. I thought this was so exciting! Every month it was getting closer and closer to getting pregnant and this just had to be the month. Month 3!

Day 3 of your period you are to go into the office and have an internal ultrasound and bloodwork. They do an ultrasound to take a picture of your ovaries and to make sure you do not have any cysts before you start the treatment.

Monday morning at 7am I was at the Dr.'s office waiting to have my ultrasound and bloodwork done. I had to be their first thing in the morning because I had to be at work by 8am and didn't want anyone there to know what I was going through. This was my first ultrasound and as soon as they saw my ovaries it confirmed that I was in fact a perfect PCOS patient. My ovaries looked like big chocolate chip cookies. All of the chocolate chips were little cysts on my ovaries waiting to be stimulated.

Seeing the results of my ultrasound and bloodwork Dr. Lucas started me on the Low and Slow schedule. Low dosage of medicine given slowly so we do not stimulate 40 follicles from both my left and right ovaries increasing the chances of multiple births and increasing the chances of overstimulating my ovaries which in turn could cancel this cycle of treatments.

Each cycle has a management fee of $250. This cost covers what the insurance does not pay of the ultrasounds and bloodwork and the Dr.'s reviewing my results and ultrasounds every two to three days.

Results from each day I went for my ultrasound and bloodwork:

Cycle Day 3
Monday 3-7-05
Left ovary- no follicles seen
Right ovary-
1- 0.4
2- 0.35
8 total follicles counted on right
Endometrium- 0.3
75iu's of Gonal F for 3 nights

I started my shots that night. I took 75iu's of Gonal F Pen for the next three nights. You take the medicine every night as instructed between 7-9pm. It was fairly easy to prepare the Pen to take the shot. You clean the end of the Pen with a cotton swab and then twist the needle onto the end. Then you "dial" up the dosage. After cleaning your skin with the cotton swab then you are to insert the needle and inject the medicine. We had planned on Phillip giving me the shot because I was so scared it would hurt. I prepared the Pen for him and handed it over. He wrapped his fingers around the pen and started laughing and joking around saying, "I am Dr. Martin here to give you your shot." This followed silly gestures which weren't very funny to me. I told him "thanks but no thanks. I can do this myself." I then sat on my bed for about 10 minutes trying to get up enough courage to inflict myself with pain. Once I did it it really wasn't that bad. I just had to do this for two more weeks. I can handle it.

Cycle Day 6
Thursday 3-10-07
Returned to the office at 7am for ultrasound and bloodwork.
Left ovary-
1. 0.5
2. 0.45
3. 0.45
4. 0.3
10 total follicles on the left side.

Right ovary-
1. 0.5
2. 0.3
10 total follicles on the right side.

Estrogen level- 60
Endometrium- 0.5
75iu's of Gonal F for 2 more nights

Cycle Day 8
Saturday 3-12-05
Return to office at 7am for ultrasound and bloodwork.
Left ovary-
1. 0.5
2. 0.6
16 total follicles on left side.

Right ovary-
1. 0.56
2. 0.59
20 total follicles on right side.

Estrogen- 84
Endometrium- .84
100iu's of Gonal F for 3 more nights.

Cycle Day 11
Tuesday 3-15-05
Return to office at 7am for ultrasound and bloodwork.
Left ovary-
1. 0.55
2. 0.35
20 total follicles on left side.

Right ovary-
1. 1.0
2. 0.6
10 total follicles on right side.

Estrogen- 93
Endometrium- .75
150iu's of Gonal F for 2 more nights.

Cycle Day 13
Thursday 3-17-05
Return to office at 7am for ultrasound and bloodwork.
Left ovary-
1. 0.55
2. 0.45
20 total follicles on left side.

Right ovary-
1. 1.45
2. 0.45
20 total follicles on right side.

Estrogen- 133
Endometrium- .8

150iu's of Gonal F for 2 more nights.

Cycle Day 15
Saturday 3-19-05
Return to office at 7am for ultrasound and bloodwork.
Left ovary-
1. 0.7
2.
20 total follicles on left side.

Right ovary-
1. 1.45
2. 1.25
3. 0.95
4. 0.85
20+ total follicles on right side.

Estrogen- 478
Endometrium- 1.0

112iu's of Gonal F for 2 more nights.

Cycle Day 17
Saturday 3-21-05
Return to office at 7am for ultrasound and bloodwork.
Left ovary-
1. 0.9
2. 0.95
3. 0.7
4. 0.6
20 total follicles on left side.

Right ovary-
1. 1.7
2. 0.95
3. 0.8
4. 0.75
20 total follicles on right side.

Estrogen- 514
Endometrium- .95

HCG shot!

The HCG shot is the last shot given in the cycle. This is to trigger ovulation. Now starts the two week waiting period to take a pregnancy test.

February 2005

Back at Dr. Lucas's office we got great news! My hormones leveled out and the Prednisone had done it's job. Our next step was to continue taking the Prednisone and add Clomid to the mix. If I hadn't started then we would check for pregnancy.

No pregnancy.

January 2005

We met with Dr. Lucas to receive the results of my bloodwork. I don't have the exact results with me today but I did have high levels of testosterone in my system.

WebMd explains it further for us:

Polycystic ovary syndrome (PCOS) is a common hormonal condition in which women produce a surplus of androgens. This causes irregular ovulation, or even a lack of ovulation.

Androgens are sometimes called "male hormones." Men have very high levels of androgens, which are responsible for male body changes like hair growth and muscle mass. In women, androgens are necessary to make estrogen. Women with PCOS have androgen levels in the "high normal" range (for women). The additional androgen in these women can cause excessive hair growth and acne.

Excess androgen production also leads to irregular or absent ovulation, which the women experience as irregular or absent menstrual periods. Because of the problems with ovulation, women with PCOS may have difficulty becoming pregnant.

Many women with PCOS are resistant to the action of the hormone insulin. This means that it takes larger than normal amounts of insulin to maintain normal blood sugar levels. These women are at increased risk for diabetes and heart disease. High insulin levels caused by insulin resistance can lead to excessive androgen production.

Well this explains a lot. Dr. Lucas started me on a course of steroids, Prednisone was my drug of choice, that would level out my hormones. He would see me back next month to see how my levels were and then we would go from there.

November 2004

Once again we started on my regular regimen of Prometrium to start and then 150mg of Clomid a night for 5 nights to stimulate ovulation in the middle of the cycle. Mood swings are swinging and I'm packing on the pounds.

Result:
No pregnancy

This time Dr. Fowlkes recommend that I go to the world reknowned UAB Kirklin Clinic to see the Reproductive Endocrinologist Richard Blackwell. I called and made my appoint for a week later.

This whole time Phillip and I felt that the Lord was in control. We put our faith in God and knew that if we trusted in him, followed His will for us that everything would work out.

October 2004

I started out on my regimen of Prometrium to make me start. Once I started I then took 100mg of Clomid to get me to ovulate in the middle of the cycle. Day 28 if I haven't started check for pregnancy.

No pregnancy.

August/September 2004

I went to my OB/GYN, Dr. Fowlkes and he said that he was going to help me out. Starting September 2004 I started out on a regimen of taking Prometrium (Progesterone) once a night for 5 days to make me start. Then the first five nights of my cycle I would take 50mg of Clomid the month of September. Clomid is to used to make your body ovulate. Taking this medicine increases your risk of multiple births, mood swings and weight gain. 28 days later if I didn't start I was to check for pregnancy and then call Dr. Fowlkes.

Results:
No pregnancy.

My journey...

As a young girl coming into puberty I wasn't thrilled when I had my first menstral cycle. I thought I was one of the "lucky" ones because not every month did I have a period. At the tender age of 18 my pediatrician recommended that I start having my yearly checkups. Yes, I was still seeing my pediatrician. Dr. Soho and I were fairly close. I even babysat her 6 boys for her! She said she could do my first exam and as we talked I told her about my irregularity. Sometimes I could go 3, 4, even 6 months without having a period. She told me that this is fairly common and that we could fix this easily. We discussed the option of putting me on birth control at such a young age but she said that as a woman we need to have a monthly menstral cycle so that we can shed the lining of our cervix which would decrease the long term risk of cervical cancer. The treatment would last only 6 months and after I stopped the birth control I should return to having a normal monthly cycle. If it was only that easy. The medicine stopped and I never got a normal period. I was now frightened that if I didn't have a cycle that I was increasing the chance for cervical cancer down the road so I continued taking the birth control. Every once in a while I would stop taking the pill just to see if I ever started having regular cycles but never did. Deep down I had this fear that one day I would have trouble conceiving since I wasn't ovulating every month.

Seven years later when Phillip and I decided that we wanted to start thinking about having a baby. This was May 2004. I stopped taking the pill and to see what would happen. This was goign to plan out very well since I had my yearly visit coming up in August. Knowing deep down in my heart that I wasn't ovulating I started to chart my temperature every day before I got out of the bed. This meant that before my feet touched the ground or I sat up in the bed I would have to pull out my thermometer. I then would take out my charts and place a dot on the specific day and what my temperature was creating three months of charts. I even ordered a lipstick ovulation test. This required me to run straight to the bathroom after taking my temperature and spitting on a lens in a lipstick looking tube and then checking to see if my spit turned into funny shaped meaning that I was ovulating. My spit never turned into funny shapes.

December 2004

What an adventure our first fertility appointment ended up being. We had an early appointment with Dr. Blackwell and found out that in 20 years he's only called in sick twice and today happened to be that second time! The nurse asked if we would like to see Dr. Lucas instead. We said sure and sat in the exam room for the next several hours waiting to see him. As each hour passed we kept saying to ourselves, "well we've stuck it out this long we might as well wait it out for him." He was in the middle of doing a surgery so we sat and waited some more.

Knock knock! He's arrived! Dr. Lucas took one look at me and my chart and said that I was a poster child for PCOS (PolyCystic Ovarian Syndrome.) Huh?

WebMd says this about PCOS:

Polycystic ovary syndrome (say “pah-lee-SIS-tik OH-vuh-ree SIN-drohm”) is a problem in which a woman’s hormones are out of balance. It can cause upsetting changes in the way you look and problems with your periods. If it is not treated, over time it can lead to serious health problems, such as diabetes and heart disease.

Polycystic ovary syndrome (or PCOS) affects up to 1 in 10 women, and often the symptoms begin in the teen years. Treatment can help control the symptoms and prevent long-term problems.

How is it treated?
Regular exercise, a healthy diet, and weight control are key treatments for PCOS. Medicines to balance hormones may also be used. Getting treatment can reduce unpleasant symptoms. But more important, it can help prevent possible long-term health problems.

The first step in managing PCOS is to get regular exercise and eat a heart-healthy diet. This can help lower blood pressure and cholesterol and reduce the risk of diabetes and heart disease. It can also help you lose weight if you need to.

Try to get 30 minutes of physical activity most days of the week. Walking is a great exercise that most people can do.

Eat a heart-healthy diet. In general, this diet has lots of vegetables, fruits, nuts, beans, and whole grains. It also limits foods that are high in saturated fat, such as meats, cheeses, and fried foods. If you have blood sugar problems, try to eat about the same amount of carbohydrate at each meal. A registered dietitian can help you make a meal plan.

Most women with PCOS can benefit from losing weight. Even losing 10 lb may help get your hormones in balance and regulate your menstrual cycle. PCOS can make it hard to lose weight, so work with your doctor to make a plan that can help you succeed.

A doctor may also prescribe medicines, such as:

Birth control pills. They can help your periods be regular and can reduce symptoms such as excess facial hair and acne. An androgen-lowering medicine, spironolactone, may be used with birth control pills to help reduce symptoms even more. These medicines are not used if you are trying to get pregnant.

A diabetes medicine called metformin. It can help control insulin and blood sugar levels and reduce androgen levels. This lowers your risk for diabetes and heart disease and can help restore regular menstrual cycles and fertility.

Fertility medicines, if you are trying to get pregnant.


It is important to see your doctor for follow-up to make sure treatment is working and adjust it if needed. You may also need regular tests to check for diabetes, high blood pressure, and other possible problems.

It may take a while for treatments to help with symptoms such as facial hair or acne. In the meantime:

Over-the-counter or prescription acne medicines may help with skin problems.

Waxing, tweezing, and shaving are easy ways to get rid of unwanted hair. Electrolysis or laser treatments can permanently remove the hair but are more expensive. Your doctor can also prescribe a skin cream that slows hair growth for as long as you use it regularly.

It can be hard to deal with having PCOS. If you are feeling sad or depressed, it may help to talk to a counselor or to other women who have PCOS. Ask your doctor about local support groups, or look for an online group. It can make a big difference to know that you are not alone.

As far as managing PCOS I have lived in the gym pretty regularly these days.

Our diet... that has some improving to do. I am a fairly new married girl and my list of things I know how to make and the things that I can make that are edible is pretty small.

Losing weight. Ok, here's the kicker for me. Since I was a young girl I was always on the super thin side. So thin my Grandparents would always worry about me not eating enough. My choices in food were not the greatest and that one day it would all catch up to me. When I went away to college I started gaining weight and have continued ever since. Throughout my different sizes I've never been regular.

Taking birth control pills is the only way I will have a period every month. At some point though you get sick of taking pills all the time. But knowing that you will have a period every month by taking the pill gives you a piece of mind and helps you to feel somewhat normal. Not being on the pill and not having a period only reinforces every month that you are not normal. You just don't feel right even though it's really nice not having to worry about "that time of the month" and everything else that comes with it.

Other medicines such as Metformin and fertility medicines will come into the picture further down the road and I will talk about those when we get there.

After explaining what PCOS is and what it means to me he looks at me and says, "we'll have you pregnant in 3 months." Three months! Woo hoo! Holy cow that's not long from now! It's all starting to sink in. Dr. Lucas wants to start by running some blood work to measure all of my hormone levels and then we will meet again.

We left feeling so confident and truely believed that God had placed Dr. Lucas in our lives. We were so excited to see where this journey was going to take us.