Cycle 2 of shut-down, also a fail!

Well, not going to try the "third times a charm" theory.  I used the progesterone cream days 7-26 and still ovulated on day 37 and had a 15 day luteal phase (longer than usual - unless TCOYF and I are both off on O date?).  I don't think that I will go for another shut-down cycle, seems to not be doing what it's supposed to do and just delaying ovulation rather than suppressing it which is making for longer cycles than before even!  So.... not really sure what's next.  Menses started today, will think more about it tomorrow.

Progesterone shut-down cycle #1

Today is day 26 of my cycle. I used 96mg of progesterone cream (32 in AM and 64 in PM) each day from day 7 - today.  Tomorrow I will not use it and hopefully within a couple days will get a period (withdrawal bleed).  I have had quite a few side effects / symptoms this cycle, most notable being:

1)  Moodiness - tense and "on edge" much of the time.  Teary and weepy other times.
2)  BBT higher - fairly steady around 97.7, some fluctuations at a couple points during the cycle but no ovulation which is one goal.
3)  Acne - my skin has been the worst it's been in a LONG time, my face has had several places break out, not all over but the ones that were there were big and red and sore.  :-(
4)  Sleep disturbances - night sweats and restlessness, lots of dreams which is very rare for me.
5)  I had some abdominal cramping off and on, days 22-24 I was sore and tender like around ovulation but it didn't happen.
6)  Sore breasts on a few days but not all cycle.

I think that's it.  I'll update when my cycle starts over and let you know how that goes, any changes, etc...  It's been interesting.  I hope that next cycle is better, it did get better toward the end of this one and I am attributing much of this to the temporary rise in estrogen and activation of receptors that is expected at the beginning.  I plan to do 3 total cycles and I'll keep you posted!

The beginning...

New cycle began yesterday. I had another 16-day luteal phase with the help of hcg, which is great, whole cycle was 39 days long. We have decided to do a 3-month "break" during which I will use progesterone cream on days 7-26 of 3 cycles. It will help dissolve any cysts, reduce estrogen dominance and just give my body a break. This amount of progesterone will suppress ovulation (thus the break from ttc), when I stop the progesterone on cd26 it will induce a "period" (actually withdrawal bleed) and create a better pattern of shorter cycles. We will begin ttc again in December. I will also be working on exercising more and returning to better eating habits during this time. I hope to lose about 20# before December. This will also give us a financial break from the meds and appts. We may try to do a couple more diagnostic tests toward the end of the break to make sure things are clear and a "go" for December. Hopefully all will line up that month and we can have a fall 2012 baby!

Radiology report

NaPro Dr kindly forwarded me the radiology report so I could read for myself all the details (fitting, since they ARE my ovaries - why we don't get them automatically is beyond my understanding!).

Here we go - FINDINGS:
"Examination shows endometrium to be normal for age with the uterus measuring 8.5 x 3.1 x 4.9 cm. Calcification is suggested adjacent to the cervix which could be seen secondary to prior inflmmation or delivery. The right ovary measures to 3.7 and the left to 3.4 cm in size. Multiple cysts are seen bilaterally within the ovaries with the largest on the right measuring 2.3 cm and the largest on the left measuring 1.9 cm. No free fluid is identified. Small nabothian cyst is noted which may reflect earlier inflammatory or post surgical change."

My NaPro doc said that the larger cysts are consistent with physiologic follicles (follicles preparing to release an egg). He also said that he can't tell from this report whether my ovaries are consistent with PCOS or not. The cyst and calcification on my cervix was not mentioned to me by either doctor, but is a bit alarming to me.

So... now what? I don't know. My NaPro Dr. has moved to MO and requested that I find local care. :-( The family doc here offered me a referral to the ob/gyn in their practice and I may take them up on that for further testing and treatment. Planning to sit down with my hubby tonight for some R&R and discussion.

May & June cycles

We gave in and have tried some new meds the last 2 cycles. I have taken Femara (letrazole) days 3-7 and hcg injections days 3,5,7 and 9 dpo. These are to stimulate a stronger ovulation and to jump start the corpus luteum into producing progesterone. The cycles have definitely improved, but I am not yet pregnant. They have both been 35 days long and ovulation occurred around day 20 which makes my lp go from 12 days to 15 days - very nice! I am encouraged by these things and thankful that my follicular (estrogen dominant) phase and luteal (progesterone dominant) phase are waaaay more balanced - this is so much healthier for me over all. My bbt chart the 1st cycle on the meds was beautiful and I was very hopeful. The 2nd cycle (ended yesterday) was not as good, temps went up a bit, went up some more but then by 10dpo they were dropping and stayed just barely above coverline the rest of my lp. I also had a tiny bit of spotting on 10dpo and a headache the day before menses (with migraine "aura" the night before the headache), all of this indicates low progesterone to me. So... keeping on keeping on. Sent an e-mail to my Dr and FP tonight to see what's next and if any changes are in store for the next cycle.

Soooo looooooong....

This cycle has been incredibly long and ridiculous. I am on CD 64, 12dpo - I assume af will arrive today. Had a migraine yesterday, low back pain and a bit of cramping, still some of the same today though the headache is much better. Hubby and I both gained almost 10# while we were on vacation, so hitting the diet pretty hard again - eating only meat, veggies and fruits (no beans, grains, sugars, nuts or dairy). We are gearing up for a serious try on the next cycle. I have some new prescriptions, started back to serious diet-watching, and am planning to be very focused this next cycle. I'll keep you posted!

Discouraged

Well, here I am at cd43 and no sign of ovulation or af yet. It is very discouraging to say the least. I am feeling okay, have had a few days of being moody/angry - my joints are pretty achey - I am tired. I actually am wondering about my thyroid, I had a temp of 95.8 this morning - eek! I have been having cold hands and feet again too. Bummed 'cause it was doing so much better, wonder if I am sensitive enough that the leak in Japan is bothering me? I stopped all supplements this month except the Metformin, wasn't really a conscious decision - just got so busy. Just had a phone consult with my Creighton Practitioner and sent off an e-mail to my NaPro Dr. I am hoping that my 8 months of charting and almost 6 months on Metformin will earn me something... labs at least? I am getting tired of being patient, especially when I'm not seeing improvement. So, that's where I am currently. I'll keep ya posted!

Finally... ovulation, whew!

Crazy cycle finally balanced out and I ovulated last week. I am glad that's finally done with and I can relax and look forward to the next cycle. I feel good and temps seem to be nice and high, so hopefully progesterone and my body's response to it is improving. Time will tell. Here's to 12 days of rest...

Calling fertility journal testers!

I had a couple ladies comment a few posts back about wanting to be a tester for my fertility journal. I have used it for a full cycle now and have a few adjustments to make and then was going to have some printed. If you are still interested, please send me your address so I can mail one to you. There are 100 pages, enough for 3 "normal-length" cycles (ha for us PCOSers!). I will send a questionnaire to you every 30 days for 3 months, so I can find out how you like it and what suggestions you may have. Thanks for being willing - and if you are reading this for the first time - I could use 1-2 more testers, so comment below and INCLUDE your e-mail addy so that I can contact you.

34 days!

That's how long this past cycle was (starting tonight). An improvement over 42 days for sure! I am encouraged by that and plan to up my soy isoflavones to 200mg and add royal jelly supplement this cycle to improve egg quality. Thankful for a fresh start! :-)

Plans (occupying my mind)

Hanging in here!  I am trying very hard not to look for signs, but it's hard!  8dpo and nothing exciting to report, my lp is 12-13 days normally.  We'll see.  I try to use this time to consider the cycle and what worked and what changes, if any, to make for next cycle should it come (that way I have something to look fwd to if af shows).  I am thinking that I will take the soy isoflavones again at 150mg days 5-9 and I also will commit to getting maca in me.  I really, really dislike the taste of maca and just cannot get it down in smoothies or by just guzzling it in a bit of water (that was about disastrous).  I am planning to capsule it and commit to taking 4 capsules a day which should equal 2 tsp.  Starting Monday, I also plan to exercise for 30 min daily whether af comes or not, and work more on eating well - low carb whole foods.  I did get a menu made for this week and did grocery shopping based on it yesterday so that shouldn't be too hard!

Oh, one thing to make note of is that I have had the sciatica pain on my right side and that strange itchy nerve pain in my right hip for the past 4 days.  It seems to be subsiding today.  Very annoying, painful and frustrating!

Some improvements this cycle

Well, my chart looks even better and ovulation came a few days sooner and definitely stronger than last month... now we are in the two week wait which can be so hard, but I try to look at it as a break from all the tests and observations that I have to be so careful about in the follicular phase, I still temp and track cm but no OPKs, no microscopes, and it's just waiting.  :-)  I am encouraged by this cycle so far.

A couple changes I've made

I don't think I've mentioned these other changes in our attempt to improve my health and balance my hormones.  First, about a month ago we started making a point to sleep in complete darkness.  Turning off all electronics and any thing that puts out even the smallest amount of light in our room at night.  It has been very nice.  Here is an article about how a woman's fertility cycle can correspond with the lunar cycle.  Interesting!

Also as of about 2 weeks ago, Tom and I have stopped drinking our daily cup (or 2) of coffee.  We have replaced it with tea or hot cocoa (I'll have to share that recipe).  We will still drink a cup socially, but didn't think our habit was healthy.

This week I purchased an ovulite which makes it easier to check for ferning daily.  It also is portable - I about went crazy when we traveled for a week at my peak time recently and I didn't have my microscope with me for observations.

Book notes

Finished reading The NaPro Technology Revolution:  Unleashing the Power in a Woman's Cycle. Yes, all 400 pages of it!  It was good, enlightening, sobering, encouraging and overwhelming all at the same time.

Here are a few notes that I took:

In PCOD women, 61% of their ovulations (often 6 or fewer per year) are defective in some way.  That alone drastically reduces chances of conception!  That means if I ovulate 6 times this year, only 2-3 of them will be viable chances... a woman of normal fertility would have 12-13 chances in a year.

Androgen levels can be treated medically, but the gonadotropin levels respond only to surgery.

Benefits after surgery (ovarian wedge resection) include:

1. decrease in testosterone, free testosterone, androstenedione, & DHEAs. 
2. LH comes down significantly while FSH remains the same - correcting the ratio
3. over 90% return to regular cycles.

Long-term medical impact from PCOD (besides the obesity, abnormal hair growth, skin problems):

1. 7x increased risk of heart attack and heart disease due to lower HDL, higher triglycerides, higher homocysteine levels.
2. by age of 40, 40% of PCOD women have Type II diabetes
3. increased risk of endometrial cancer due to elevated insulin levels and unopposed estrogen (because of long follicular phases without ovulation to produce progesterone).
4. 3x increased risk of postmenopausal breast cancer
5. increased risk of hysterectomy because of dysfunctional uterine bleeding
6. ovarian cancer risk increased
7. women with PCOD are more likely to have chronic fatigue syndrome

He states that all too often we are asking "Is ovulation occurring?" when we should be asking "Are there defects in ovulation?"
Quote:  "In actuality, when one studies ovulation closely by daily ultrasound and hormonal parameters, one realizes that there are a number of different "ovulatory events" that mimic ovulation but are either completely annovulatory or represent a significant defect in the ovulation mechanism.  An example of an ovulatory defect that is anovulatory is the luteinized unruptured follicle syndrome.  An example of an ovulatory defect in which the ovulation process is significantly defective is the immature follicle.  While ultrasound is commonly used in the ART programs to monitor ovulation inducing medications, it is rarely used for studying spontaneous ovulation patterns and their defects.  The latter is extremely important if one is to design treatment strategies that meet the specific demand of the underlying problem."

It goes into descriptions of several different types of ovulatory dysfunction and the follicular and luteal phase deficiencies associated with them, along with symptoms.  Intriguing and mind boggling!

Not this month...

Still a very encouraging cycle.  Temp finally dipped below coverline this morning and I can feel af on her way.  I tested with a First Response on Sat morning (12dpo) and it was negative.  I had been hopeful as I could see a true ovulation.  I do still think that ovulation was "weak" and the corpus luteum was definitely not producing sufficient progesterone as the temps were barely above coverline.  I hope to see more improvements on the next cycle.

We are thinking and praying about the next steps and will update here as we decide.  Thanks for your prayers and support!

Ovulation!

I am so excited!  By all signs, it appears that I have actually ovulated and my charts looks so beautiful to me. :-)  Check out the TCOYF chart in the sidebar link --->.  I am in the lovely 2ww, actually half way through it now, so we shall see... I may start testing the middle of next week because if I get a + I want to get a progesterone test ASAP.  Pray for us!

Fertility Journal completed and printed!

I am pretty excited about how this turned out.  I will start using it next cycle, want to keep using my current notebook so this cycle is all together.  It will be a lot less work for me on a daily basis a time-saver, gotta love that!

It has 50 double-sided pages that are a form (one form per page per day).  There are blanks for you to fill in all your TTC / health info... BBT, CM, fern, OPK, BD, meds, vitamins, as well as water, weight, exercise, foods eaten, blood sugar readings, symptoms, etc...

I am planning to use it for at least one cycle and contemplating getting a few volunteers to be "testers" and give feedback.  In the meantime, looking into the basics of how to offer them for sale at a reasonable price. Any advice?  Leave a comment if you are interested...

Brief update

I just had a lovely chat with my Creighton practitioner.  I just love her.  It is so encouraging to hear that you're on the right track.  She is going to look into some things for me and I am also going to contact my Dr at the end of this cycle with all the info I have gathered (my bathroom looks like a lab -seriously!) and see about some more aggressive / long-term treatment.  Waiting is so hard and it seems we've been on this track forever - even though it's really only been since August since we've been actively pursuing this!  I am still encouraged with my temps, have only had one dip in the 19 days of this cycle - much more stable so far which is encouraging.  Still waiting for my peak this cycle but feeling much more positive thus far.  Tom has been doing my CrMS charting for me each night - somehow that helps my sanity lots!  :-)  That's it for now...

Looking a bit encouraging

I am encouraged with this cycle so far (granted - only on day 9, but still)... my temps in the AM have been much more steady, haven't seen any peaks or dips showing hormone fluctuations.  I am hoping this continues, we will see.

I am upping my doseage of Metformin to 1500mg this evening which is where Dr. Yeung wanted me and we've gradually increased over 3 weeks now.  I am not noticing any side effects other than a bit of gassiness on the days that I have upped the dose.  Hoping that continues.  I need to get out more blood glucose test strips to check my fasting #s and see what kind of difference it has made.

We have decided to wait another couple months to see if the Met gives me a good strong ovulation before any further testing, etc... I am so anxious and excited, it's hard to be patient, but this is best.  :-)

A new month, a new cycle...

Feeling a bit encouraged this morning.  I had a rough week last week, feeling very moody and overwhelmed and confused.  :(  However, last night that cycle ended - AND it was right when I predicted that it would come.  My peak day and probable ovulation was on day 30 which gives me a 12 day luteal phase.  I say probable because while cm and ferning support this, it wasn't a very strong shift in temps - you can see a gradual shift but the variance wasn't great and it's not a good indication.  Dr. Yeung thinks that I am ovulating but not very strongly or adequately.  The corpus luteum is not producing enough progesterone to support a pregnancy (build a lining).  The corpus luteum could be underdeveloped due to insufficient FSH or my ovaries not responding to the FSH... need to look into that more.  We will be doing progesterone blood levels on peak day +7, +9 and +11 of this coming cycle to confirm this.  I am taking the antibiotic during menses right now in hopes that it will clear up any other reason for the continuous cm and make identifying peak more clear.  Please pray for my ability to easily identify peak day this month!