Upcoming decision

I know it's been awhile since I've written.  I've been on track out (I teach at a year round school-I follow the yellow schedule or Track).  I always have these grand plans for track out.  I make these lists of all the things I'm going to do, all the projects I'm going to work on, how I'm going to work out everyday.  Then I get into it and I'm like, "I've worked so hard, I can take a day off".  And that becomes another day and before I know it, it's time for my workdays.  Oh well.  I actually do better on a schedule.  I find myself to be much more disciplined in getting things done.   If I have to go to the gym straight after work, I'm much more likely to go then if I have to leave from home.

Anyways (yes I put an -s at the end of that), today is day 29 of my cycle.  This was the month where we are on an increased dose of Clomid (100mg).  I'm not expecting anything to happen.  I mean, nothing happened before.  Before any of you say it, don't.  You know what I'm talking about.  The whole, "now that you're not expecting it or thinking about it, it might happen!"  That is among the things people who are dealing with infertility do not want to hear (that's a whole other blog post...I need to start making a list.  Maybe David Letterman has already done, "Top 10 Things NOT to Say to an Already Crazy, TTC Lady).

However, we're nearing the end of the cycle.  I expect my period in the next 1-5 days.  Once it does come, I have to go in for the HSG (remember that's the test to see if my tubes are blocked).  Joel has been bugging me about getting the first oil change for our new car (yes, this does have a connection, just go with it).  I didn't want to do it too early over my track out, so I figure I'll just get it done on the same day I do my HSG as I'll have to take a half day anyways.  Might as well get the plumbing in both me and my car taken care of....(and there it is).  I just realized that I never got the results from my "egg reserve" test.  I'll have to ask when I go in.

After that though, we need to really make the decision.  Do we go with only medication, including injectables or do we go to intrauterine insemination (IUI) or IVF.  Joel is definitely leaning towards just medication for a few months.  I am too.  I'm super scared of the needles though.  I can get my blood drawn or get a shot any day of the week.  Those needles don't bother me because I don't have to look.  I do not think I can handle giving it to myself .  Joel may have to come with me to the nurse class where they teach you how to inject it.

In the spirit of information and being a resource, I wanted to share what I have found about the medication that I would be taking (whether we go with just medication or IUI).  All of the information here is how I understand it after research.  It is possible I have misunderstood something or presented it incorrectly.

I spent a couple hours reading all about the exact process that goes on inside my "girly bits" with the eggs and the hormones and needless to say it gets confusing.  I will try to simplify it a little here.

There are two "actions" for lack of a better term that are kind of used here to improve fertility:
1. Ovulation Induction:  This is the process of taking medication to force ovulation.  Ovulation is the rupturing of the ovarian follicle and releasing an egg.  This can be induced with the medication Femara (chemical name Letrozole).  What is interesting is that the main use of Femara is actually for some breast cancer patients.  It is taken to prevent the cancer from coming back.  Femara is the equivalent of the Clomid I have been taking.
2. Ovarian Hyperstimulation:  This is the process of using medication to stimulate the development of many follicles (which would lead to more eggs being released).  There are a few medications used for this, Follistim, Bravelle, or Gonal F.  These medications are follicle stimulating hormones (FSH)

I would be taking a combination of Femara and then one of the other 3.  I would also take a medication called Antagon (Ganirelix) which inhibits the actions of gonadotropin-releasing hormone (this is a hormone that is responsible for releasing FSH and LH from the pituitary).  I would also take a medication called Ovidrel, a hormone called hCG which causes the eggs to finish maturing and be released.

So long story short (TOO LATE):
-F/B/GF to cause more than one egg to develop
-Femara to induce ovulation (all those eggs being released)
-Antagon to...I have no idea.  My guess is to let the medication FSH do the work instead of natural since it inhibits natural FSH from being released.
-Ovidrel to help the eggs finish cooking...I mean maturing.

WHEW.  I feel like I should get an honorary medical degree based on the amount of biological reading I've done.  Now the decision that we need to make is whether we will JUST do the medication with timed intercourse (having sex at the IDEAL moment) or do the medication while also injecting the sperm into my uterus (IUI).  Like I said before, Joel is leaning towards the former.  Mostly to save us the money in our fertility benefits.  We have a set amount of fertility insurance for the lifetime of the plan (which I know is more than many have).  But that means one time use only.  If we drain that money and it doesn't work, we have a much more significant cost to pay for IVF (the next step).

I think I agree with him.  I mean it makes sense to try this new medication regimen for a few months without the more serious intervention (IUI).  Who knows, the additional medication past the Femara/Clomid just might do the trick.  Once we decide, I'll keep you all posted!!