He Says…Twins?!…WTF?!

You all are killing me here.  Twins.  TWINS!

Many things DO come better in pairs.  Shoes, gloves, beers…but BABIES?  That just sounds like a crazy idea.  I have been quite aware for some time now that my lovely wife Kate thinks twins would be divine.  I have been pleased to realize, though, that our chances were very slim; neither of us has twins in our family, and most multiples (I think) come from infertility treatments.  Now here we are getting a little “assistance” in that department, increasing our chance of twins.  I realize the chances are still quite slim (thank god) but this is one “side-effect” I am not quite ready for.

Now, I want you all to realize that if we DID have twins, I would certainly love them.  And sure it would make for cute family photos, etc., but I didn’t realize until recently that many women out there actually hoped for twins.  I would like to use this forum to remind my wonderful Kate of all the stories of our friends who have had children in the last few years and all the work it was for them, all the feedings, all the sleepless nights, etc.  Now multiply that by two.  That just sounds like disaster.  I doubt there is enough caffeine in the world to keep us up for all of that.  I have witnessed several parents of twins laugh at Kate when she said she wanted twins.  (See, they understand me.)  And another thing…what if we had twin GIRLS?!?  Talk about a father’s nightmare…teenage twin daughters.  I think I need to think about getting my shotgun license and putting extra deadbolts on the bedroom doors.

Here is the other little problem: I want two kids.  This has not been 100% agreed on between Kate and myself, but my feeling is that if we have twins the first time, well there…we have our two kids.  Now Kate has made it quite clear that having twins, does not in her mind count as “two” kids.  I think it is more her desire to have babies on more than one occasion.

Again, this is obviously out of our control, and I am all for taking the steps we ARE taking to get pregnant, but I am hoping I have some supporters out there rooting for my side, that we get blessed with ONE beautiful, healthy child.

She Says… Clomid: The Good, the Bad & the Ugly

I received so many great comments and emails from my previous post about Clomid. I LOVE to hear stories like, “My friend took Clomid and was pregnant with twins the first month!”. And, although they aren’t quite as exciting (but equally important!), the ones like, “I took Clomid for months and had horrible side effects and still am not pregnant.” If you haven’t already realized, I am a helpless over-researcher. Heck, this blog was mostly a place for me to gather my research for myself and others. Even though I know that there’s no way to predict how I will react to Clomid, it makes me feel better to know that I’ve gathered all of the information. I am a planner, what can I say?

In pure Type A fashion, here’s a list of the top things I’ve learned about Clomid:

• Approximately 80% of women taking Clomid will ovulate within the first three menstrual cycles. (Wahoo! This is great news for me, as it seems that everything works just fine inside my body, except that I’m not ovulating.)
• Research shows that about 40% of women using Clomid are able to conceive within the first three cycles. About 50% of women are able to conceive within six months of use. (Although I wish these numbers were higher, you have to remember that the women taking Clomid in the first place are already struggling with infertility. So if nearly half of “infertile” women get preggo on Clomid, that’s not bad odds!)
• Potential side effects of Clomid include mood swings, dizziness, nausea, and breast tenderness. Some women felt horny and others lost their sex drive, most experienced vaginal dryness (as Clomid dries up your cervical mucus… not a good side effect for trying to make babies!), and bloating. Still others had hot flashes and tendency to cry at the drop of a hat. (We’re in for a wild ride, here, folks! And hopefully it’s all worth it…)
• And last, but certainly not least, the most controversial point about Clomid (at least for Benjamin and I): Taking Clomid increases a woman’s chance of having twins by about 10 percent!

Be still my heart! Seriously, I’m going to let you in on a little secret: I WANT TWINS. I have ALWAYS wanted twins. I am dying for twins. The silver lining of struggling with infertility at all for me has been the prospect of an increased chance of having twins! More to come on this later, though. I know my wonderful husband has some words to say about it…

Any more Clomid stories for me? What do you think about having twins?

She Says… Ugh, Insurance

I have to admit, I do not think much about insurance. I am very fortunate to work for a company that offers good benefits. My payment for health insurance comes out of my paycheck before I receive it, so I barely even think about it. Aetna, a large insurance company, is my insurer, so almost any doctor I want to see is “in network”. Before going to the doctor, I don’t really worry about payment at all — I just wait for the bill to come for my little portion of the total amount, and I pay it.

So when I started going to Boston IVF to see Dr. P, my reproductive endocrinologist, I did just that. I showed them my insurance card and didn’t think about it again. Luckily, the first two bills (initial appointment and bloodwork/ultrasound) were paid mostly by the insurance company with no problems. But then at my last appointment (where I was prescribed Clomid), I was told that I had to enroll in Aetna’s Infertility Program before they would cover the medicine, since it is technically a “fertility treatment”. They consider Clomid a fertility treatment just like an intra-uterine insemination (IUI) or in-vitro fertilization (IVF)! And as I have a limited number of IUI’s covered, they have to enroll me in a special infertility program and make sure I qualify. Usually a couple has to be trying to conceive for a year before they “qualify”, but the lovely nurse on the phone said that since I clearly have ovulation issues, that should “help”. Yes, it certainly should, shouldn’t it?

Here I am on the edge of my seat waiting for my miracle drug to come in the mail, and it can’t even be ordered until Aetna confirms that I really am “infertile” enough to need it! Slightly frustrating. Nevertheless, I think I got everything squared away with Aetna yesterday, so as soon as I’m officially enrolled in the infertility program, my Clomid can be ordered. Chop chop, ladies! I’m ready to get going!

She Says… The Results

Drum roll please… the results are finally in! Ok, ok, the results are kind of anti-climactic, but the result of the results is exciting. Here’s the rundown:

All my labs are normal. Everything looks good. Seems to be what I always hear from doctors… but then why am I not cycling like a normal person? The world may never know. Nevertheless, bloodwork was normal — no high levels of androgens or evidence of insulin resistance or weird hormone levels, ultrasound was normal — no cysts or other physical abnormalities were identified, and the HSG was normal — I “filled and spilled” and the x-ray showed that everything was free and clear. These tests ruled out a ton of fertility issues and health problems (phew!). Oh, and Benjamin’s sperm count was good (double phew!).

Diagnosis: Lean PCOS. Yes, even though I do not have most of the common symptoms. And even though I do not have cysts in my ovaries. Apparently polycystic ovarian syndrome is kind of a misnomer — you don’t need to have cysts at all to have it!  Diagnosis was confirmed by my antral follicle count (the number of viable follicles I had in my ovaries at the time of the ultrasound). I had 14 in my right ovary and 19 in my left. Apparently a normal person has about 10 in each ovary, so my elevated numbers mean that I have a few too many eggies just hangin’ around, chillin’ out in my ovaries. They haven’t gotten the signal to be released yet, which seems to be where the problem lies. The good news is that I have plenty of follicles ready to be deployed once I start ovulating. Those are all potential babies in there, folks! Even though the “syndrome” has a scary name, it’s relatively common and, in my case, isn’t an indication of a more serious fertility problem, provided I respond well to the ovulation meds. It feels good to be able to name the issue and tackle it!

Plan of attack: As I thought (and hoped!) Dr. P prescribed Clomid. Clomid (clomiphene citrate) stimulates ovulation. It’s a pill that I’ll take for 5 days. After those 5 days, I’ll use an ovulation predictor kit (OPK) to figure out if it “worked” and when I ovulate this cycle. If I do ovulate, we bump and grind on the right day(s), and hopefully make a baby! Let’s all cross our fingers that it’s as easy as that, mmmkay? I won’t go into all the backup plans if I don’t ovulate… save those for another post. Hopefully one I won’t have to write.

So, the meds are ordered. Apparently they have to come through a mail order pharmacy, so I have to wait until they get here to start. Boo. But, what’s a few more days, right? You’ll be the first to know when they arrive

Anyone used Clomid before? Did it work? Are there any side effects I should be ready for? I’m so excited!

 

He Says… The Follow-Up

(I’m not going to start with “why I haven’t written in a while” excuses)

Tomorrow we go back to Boston IVF to meet with Dr. P for our follow-up on our tests.  Well, mostly Kate’s tests.  I mean, I assume my tests are normal.  But maybe not.  These past months of babymaking have pretty much indicated that my swimmers have not even had a chance to do their thing, so I just assume that they all work.  But, again, maybe not.  That would suck.

Yesterday I was telling a good friend about our follow up and he knew about “The Cup” and he asked me, would you would rather have no working sperm or have Kate have the fertility issue? I paused.  Not really a great answer for that, BUT, I did think that if my boys CAN’T swim, that that pretty much takes me out of the process of being a father (genetically speaking).  Right?  I mean, assuming Kate has eggs, there are so many things that can be done to insure that we are using them to make a baby.  Right?  So my thoughtful answer was that I’d rather the issues were with her, than me (of course, I hope and assume that there are no issues with either of us).  Does that make me a bad husband?  I would just like to feel genetically connected to my child, and would hate to find out that my only way to participate in that (spermies) didn’t work.  I mean I have taken all the precautions that I learned from episodes of Seinfeld, like wearing boxer shorts.

But we will find all of this out tomorrow.

As a side note, I would like to give my Jon and Kate + 8 update.  My Kate and I were very sad to watch them announce their separation a few months back.  Now the show is back on after a short hiatus, and we waited until 3 episodes were in our DVR before watching again.  And I think that may be the end of it for me.  It is pretty sad watching it now, and I am so fed up with the media frenzy around them that they have just become these kind of trashy tabloid celebrities.  The entire show is such a commercial now (watch for product placements followed by ads for that product) and all they do is get free stuff and go on free trips.  It was a really heartwarming show when it actually seemed like we were watching their real life.  Now there real life is hardly real.  Blah.  I am through with it…I think.

Oh, and a shout-out to all the Healthy Living Summit readers.  Kate really enjoyed meeting you all!

She Says… Good Question

I was catching up with a close friend last night when he mentioned that he and his soon-to-be-fiancee probably won’t have kids. Why not?, I asked him. It wasn’t accusing or judging or snarky, I really just wanted to know how/why they had come to that conclusion. I was intrigued, because I personally can’t imagine the rest of my life without a house full of bouncing babies. And that got me thinking: why do I want to have kids?

Similarly, a few months before Benjamin and I got married, I started a new job. During my first week there, the CFO of the company and I were chatting while making coffee. I told him I was getting married soon, and he said, Why are you getting married? And at first I laughed and made a joke, thinking this was his idea of small-talk. But he wasn’t deterred. He asked again. And at that point I realized it was a very good question. I knew the answer, of course, but I guess I had just never put it into words.

Some people want to have kids to create a tiny little version of themselves — someone who will carry on their personal legacy. For others, kids are a tax exemption or a way to keep their spouse happy/entertained. Some want someone to love, or someone to love them back. To others, kids are a cultural expectation or obligation, something they should do.

And what about me? Why do I want to have kids? I want to create a family. A home. And to me, that means rowdy dinner table conversations and loud car rides and goofy inside jokes. I want to give my kids the opportunity to be loved by a warm and supportive family… one that shares silly traditions and makes each other laugh. I think that Benjamin and I have a lot of love to give, and I’m certain we’ll do a darn good job making a happy, healthy home.

What about you?

She Says… One Week

Man, this babymaking process (or, rather, in my case, the figuring-out-what’s-happening-with-my-body process) takes a long time. I know we’ve only been off birth control for 6 months, but it feels like it has been a constant cycle of one step forward, two steps back.

Alas, here we are. The tests have been done and the requisite weeks have been waited. Next Wednesday we (finally!) get to meet with Dr. P (our reproductive endocrinologist at Boston IVF) to discuss the results and prepare a treatment plan.

At our initial meeting, Dr. P’s working hypothesis was that my lack of ovulation might be caused by “Lean Polycysitc Ovarian Syndrome” (or Lean PCOS). I had read about PCOS before, and was confused by the idea that this could be my diagnosis, as I don’t have most of the symptoms that generally characterize that condition. PCOS is often identified by hair loss or excessive hair growth (I don’t have that), weight gain (nope), too much insulin or insulin resistance (don’t have that), breathing problems while sleeping (nope, not that either), pelvic pain (no), and/or high blood pressure (mine is actually very low). The only symptom I do have is anovulation. Dr. P discussed with me, though, that Lean PCOS is slightly different, and is characterized by having two out of three of the following symptoms:

• anovulation
• a high level of male hormones (androgens)
• polycystic ovaries

This is why he ordered some of the blood tests that he did, as well as the ultrasound (to check for cysts). While I still don’t know what the nurse saw during the ultrasound, I did receive the results from my blood tests, and I do not think I have a high level of androgens (thanks to some Googling to understand what a normal level is). For those who are interested (or want to compare notes!), here are my stats:

Total Testosterone: 39.3 ng/dl (6 – 86 is normal, above 50 is elevated)
Estradiol: 53.4 pg/mL (25 – 75 is normal)
Follicle Stimulating Hormone (FSH): 6.78 mIU/mL (3 – 20 is normal, under 9 is good)
Prolactin: 9.47 ng/mL (<24 is normal)
Thyroid Stimulating Hormone (TSH): 2.04 uIU/mL (.4 – 4 is normal, average is 1.7)

By the numbers, I’m looking good, right? Hopefully Dr. P can find something more meaningful in the test results and can get me ovulating ASAP. We’ll find out next Wednesday…

She Says… You, Me & the HSG

Ok ladies and gents, I will preface this by saying that if you don’t feel like knowing the details of my reproductive system, you should skip this post. Ok? You were warned.

Here’s the play-by-play of how my HSG (hysterosalpingogram) went. I arrived at Boston IVF a bundle of nerves. My obsessive Googling habits had opened my eyes to many, many personal accounts of what the HSG test was like for some other lucky women. Although they varied widely, most reported pain/discomfort during the procedure, and cramps and spotting/leaking for the next few days. Sounds like fun, right?

I went into the exam room and took off my clothes from the waist down, covering myself daintily in a scratchy paper drape. The x-ray machine was positioned over my pelvis as I laid down on my back. The doc (who was not my doctor, actually, but was available when I could come in, and I heard he was the best at HSG’s) told me to bend my knees and put my feet on the table. Thank goodness for no stirrups, eh? He inserted the speculum and, from what I could tell, began to feed a little tube into my cervix. He kept saying, “You’ll feel a little cramping” or “This should feel like pressure”. I felt a little tugging and poking, but nothing painful. I mentally patted myself on the back for being so brave. I can do this, I told myself, as I concentrated on my yoga breathing. Then he says, “I’m going to inject the dye now, so you’ll feel a little burning. Just breathe.”. My stomach muscles tightened and I squeezed my eyes shut in preparation. All of a sudden I felt it. This was not burning. Not cramping. This felt like someone had just lit a blowtorch inside my abdomen and was holding against my stomach muscles. It took my breath away. It was hot and cold at the same time, and felt like it was growing like a ballooon inside me. I thought my whole stomach might burst with this weird, intense pain. The doc kept asking me if I was ok, and I could barely squeak out, “Mmm Hmmm”. The nurse told me to hold her hand and squeeze it. I almost took her fingers off.

And then, as quickly as it had begun, it ended. The doc pulled out the tube, released the speculum, and it was over. No more pain, no more cramping, no more burning. He had me turn over and took another x-ray. He gave me a minute to catch my breath and we went over my reults. NOT MY X-RAY BELOW, JUST AN EXAMPLE!

Voila! He said my tubes looked open. The left one didn’t “spill” as quickly as the right one (they are supposed to “fill and spill”: fill up with dye and spill out into your stomach), which doesn’t mean it was blocked, but the doc prescribed an antibiotic just to ensure I don’t get an infection following the procedure.

I didn’t feel any cramping/discomfort/leakage/spotting following the procedure, except I had the lovely pleasure of wearing a hospital-grade diaper maxi pad that was about 4″ thick during a long car ride up to Maine for a wedding this weekend. Awesome.

So, there you have it. My HSG experience. Although it was pretty painful for me, it only lasted about 7 minutes. I can do anything for 7 minutes… especially if it brings me one step closer to having a baby!