Tuesday, December 22, 2009

Fertility Game Plan

Photo: www.ovulationsigns.net

The year is almost over. 2010 is just around the corner. For me, it's a huge blank slate. A fresh start, a new beginning, and all that jazz. So, I feel like I need to make a timeline and a game plan for my fertility. Instead of thinking about things month-to-month, I'll just follow the plan and try to look at the big picture. I think I'll go less crazy that way.
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Cycle #1
2 850mg Metformin/day
4 50mg Clomid/day on days 3-7
Did I ovulate? Yes/No
If so, take pregnancy test on day 35: Yes/No
If not, take Medroxyprogesterone on days 28-32 to start next cycle

Cycle #2
2 850mg Metformin/day
4 50mg Clomid/day on days 3-7
Did I ovulate? Yes/No
If so, take pregnancy test on day 35: Yes/No
If not, take Medroxyprogesterone on days 28-32 to start next cycle

Cycle #3
3 850mg (MAX dose) Metformin/day
4 50mg Clomid/day on days 3-7
Did I ovulate? Yes/No
If so, take pregnancy test on day 35: Yes/No
If not, take Medroxyprogesterone on days 28-32 to start next cycle

Cycle #4
3 850mg (MAX dose) Metformin/day
4 50mg Clomid/day on days 3-7
Did I ovulate? Yes/No
If so, take pregnancy test on day 35: Yes/No
If not, take Medroxyprogesterone on days 28-32 to start next cycle

Cycle #5
3 850mg (MAX dose) Metformin/day
5 50mg (MAX dose) Clomid/day on days 3-7
Did I ovulate? Yes/No
If so, take pregnancy test on day 35: Yes/No
If not, take Medroxyprogesterone on days 28-32 to start next cycle

Cycle #6
3 850mg (MAX dose) Metformin/day
5 50mg (MAX dose) Clomid/day on days 3-7
Did I ovulate? Yes/No
If so, take pregnancy test on day 35: Yes/No
If not, take Medroxyprogesterone on days 28-32 to start next cycle

Cycle #7
3 850mg (MAX dose) Metformin/day
HCG injection around day 13
Did I ovulate? Yes/No
If so, take pregnancy test on day 35: Yes/No
If not, take Medroxyprogesterone on days 28-32 to start next cycle

And I'll take it from there...
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I talked with Zay about what he felt comfortable doing - how far he would be willing to go to make little biological babies with me. I'm pretty confident in saying that we want to eliminate in vitro as an option. Too expensive, too risky (both financially and the risk of getting pregnant with high multiples), and too ethically shady (for me - I feel weird about creating a bunch of embryos, freezing them, having a lot of them die, etc.). Artificial insemination (IUI) also makes me feel weird, although it's pretty much the next step if I can't get pregnant on my own with just the fertility meds. I think I just don't like the idea of conception occurring without having to have sex. And Zay is not happy about putting his swimmers in a cup for the semen analysis we're doing next week, so this one time might be all that I can get outta him. I'm a pretty conservative person and I haven't figured out yet where I want to draw my own personal line. I know what Zay's uncomfortable with now. I'll make another plan in 6 months or so, if necessary. And I'll make adjustments along the way if something else comes up (like if Zay has issues too or if I get a cyst and have to take a cycle off).

I saw the fertility specialist this morning. I asked him lots of questions and he helped me figure out my timeline. If I go through all 7 of the cycles on my game plan plus maybe a couple more of the HCG injections and nothing works, that's when he'll refer me to a reproductive endocrinologist. That's where things start getting iffy for me and I can't know how I'll feel about everything until I get to that point. But for now, I'm sticking with the medicine.

P.S. - Dr. Saunders talked me into taking Clomid on days 3-7. He says that 5-9 was the standard maybe 20-30 years ago, but clinical trials showed that women who took it on days 3-7 had a slightly increased chance of successful ovulation. I guess I'll just do what he says! I'll keep it constant at days 3-7. That way I can eliminate that as a factor and focus on other things.





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