Earlier this year, I was diagnosed with polycystic ovarian syndrome (PCOS). This did not come as much of a surprise since my husband and I have been trying to conceive our first child for almost a year with no luck. I've blogged about our infertility here and there, but have held off on the specifics until we knew more about our situation.
Now, about two months into treatments, I have a better idea of the road that lies ahead. This seems like the best place to share updates, since a mix of family, friends, and readers have reached out to ask for updates.
First, I'll briefly summarize PCOS and how it affects my body. Contrary to the name, this syndrome isn't defined by having ovarian cysts, although they are a common symptom. It's actually a hormonal endocrine disorder. Hormone and insulin levels are irregular and out of control, causing all manner of problems.
While this condition (obviously) influences fertility, there are several issues it causes for my overall health, whether or not I'm trying to conceive. Problems I've struggled with during adolescence and adulthood like rapid weight gain, difficulty losing weight, general sluggishness, anxiety, depression, etc., all turn out to be symptoms of PCOS. Untreated, it can eventually lead to diabetes, heart disease, and other high impact conditions, so while I hate having it, I'm very glad we caught it while I'm relatively young so we can tackle it head on.
When I met with my gynecologist back in August and discussed the difficulties we'd had in the TTC department, he made a tentative PCOS diagnosis. He prescribed a seven day round of Provera, a hormone which jumpstarts a new menstrual cycle, and had me come in for some blood work. My A1C (glycated hemoglobin) levels were on the high side of normal, indicating PCOS-related insulin resistance, so he started me on metformin. This is a drug often used to treat Type 2 Diabetes in addition to women with PCOS. After this, we waited for six weeks (forever) for our follow-up appointment.
In that six weeks, I managed to lose 14 pounds after a year of struggling to get the scale to go down even an ounce (THANK YOU, METFORMIN). The low-carb diet and regular exercise probably also played a part, but the metformin really did do the bulk of the work by helping me fight the insulin resistance. I also lowered my heart rate and blood pressure. My menstrual cycles have begun to shorten, although they're still too long and irregular for us to conceive without assistance.
At the follow-up appointment, my doctor was pleased with my progress and suggested we move forward, if my husband and I were ready. We've been wanting a baby for so long, we both practically jumped up and said "Yes, please!" Here's what the next few months (or less, hopefully) will look like for me:
- End long cycles with a seven day round of Provera (medroxyprogesterone) if a home pregnancy test shows "negative."
- Starting on cycle day 3, take a five day round of letrozole, an estrogen suppressant that encourages the release of my body's natural store of FSH (follicle-stimulating hormone). This is not a drug that will greatly increase my chance of multiples. Our chance of twins is 8%, compared to 3% chance we'd have without assistance, and our chance of triplets or more is negligible.
- On cycle day 13 or 14, visit my doctor's office for an internal sonogram, where he will check my follicles (eggs). If my ovaries are releasing mature follicles that look healthy and robust, he will then give me an injection of HCG (human chorionic gonadotropin) to trigger ovulation.
- On cycle day 21 or 22, go in for blood work to check progesterone levels.
And lather, rinse, repeat.
While this process is a bit overwhelming, and not at all what I expected--this wasn't exactly part of The Plan--I'm excited to get this show on the road. This journey has been an emotional roller coaster and I'm more than ready to leave it behind, but it has made me realize how much of a miracle life really is.