I got some bad news in this past week. I’d gone in for a follicle check on day 14 of this cycle where I’d used 2.5 mg Femara on days 3-7 and dexamethasone on days 3-12. The doctor looked over my ovaries, and no dice. The largest follicle present was 1.2 cm, definitely not large enough to trigger, and immature. There’s no doubt about the diagnosis at this point, several physicians have now seen my ovaries on ultrasound, and every one of them has remarked, politely and gently, but remarked nonetheless on the fact that these are definitely polycystic. Coupled with the stubborn lack of ovulation, there’s just no denying the fact any longer.
At any rate, when I first got my diagnosis, I sort of felt I was in an “infertility lite” situation. I was pretty certain Clomid or Femara would get me ovulating. While it was a set-back and worrisome, we’d get the drugs and they would work. I could continue to work with my local doctors. I wouldn’t have to see an RE and do injections and more invasive treatments. Then my doctor called, and the whole lovely myth shattered into millions of pieces.
The Femara hadn’t worked at 2.5 mg. They were still somewhat concerned about my endometrium, which while much better than on Clomid, was still thinner than they would have liked. Trying Clomid again at a higher dose was not an option, due to the really nasty way it had thinned out my endometrium on the first cycle and not produced ovulation to boot. I could try the Femara again at 5 mg, but they weren’t really very hopeful it would work for me for a variety of reasons. Injectables were probably what I was going to need, and at that point, a reproductive endocrinologist was the only one who could do the appropriate monitoring.
I just listened in shock. I heard myself making a plan that we’d go ahead and try the 5 mg dose of Femara next month, just in case, since it won’t harm me to do so. It’s more for my psychological benefit than probably treating the PCOS and infertility. I’m not holding my breath that it will work, but I really want to exhaust the possibility before moving onto far more expensive and invasive options. It’s not a matter of age where every cycle needs to count and taking a month to try out a rabbit trail might really be harmful to my chances of conceiving.
Frankly, I’m just not quite there right now. For me, injectables are a huge step for a number of reasons. Those drugs really increase the chances of a multiple birth, it means a lot more money, and it means driving an hour to see the RE for monitoring quite often. I know that it’s likely coming, and I know there are a lot of other women on these drugs who have had so much success. That gives me hope. I’m still struggling a bit with the whole thing, though. That’s why, for me, giving myself that extra month on Femara is necessary. It truly eliminates the chance that maybe it would have worked at the higher dose, and gives me an extra month to do the mental/psychological work that I need to do before moving on.
The biggest thing has been the psychological blow. Like I said earlier, I’d been living in “infertility lite” world. Perhaps (or even probably) it was a complex denial mechanism that allowed me to cope with the situation, but it was working pretty well. All of a sudden, I’ve undeniably moved into a new category where I am infertile. Period. I think it’s the fact that I have to see a specialist now and that means confronting the fact that I am an infertile woman. It’s the fact that this whole journey may take much longer and be much harder and more expensive than I’d ever imagined.
I spent three days crying on and off. Then I forced myself to call the RE’s office and schedule an appointment in a couple of months. That will give me the time to think about all of this, save up cash, do my Femara cycle, and if (but more probably when) that fails, then I’ll be able to have the HSG done through my doctor here before the RE appointment. It’s good to have a plan, but it doesn’t change the overwhelming sense of sadness that I feel now.