So to catch you up, by the end of June 2016, I had been diagnosed with PCOS and we had already tried 2 cycles of Clomid, 2 cycles of Femara, and one IUI using Femara and Menopur; all of which ended with zero pregnancies. I was feeling pretty defeated but was trying my hardest to stay positive that one of these cycles would work and we would finally become parents.
In early July 2016 we started our Supercycle IUI. This cycle would have me taking 2 needles a day, one of Menopur which I was already familiar with, and adding in Puregon which was an easier injectable to give myself. So away we went with the needles and the ultrasounds. I hoped that this combo of injectables would give my ovaries the push they needed.
By week 2 of stimulating, I should have had some significant growth however there was next to nothing. It seemed like there were a bunch of follicles starting but nothing that wanted to grow past about 7mm. Remember, the goal was to get 1-4 follicles around 18mm.
By week 3, there was some growth but still not enough to do the IUI. My largest follicle I believe was around 11mm at that time. Dr. P considered cancelling the IUI but decided I would do a couple more days of medication and we would see where that next ultrasound had us. Well a couple of days passed and there was some growth! I had a couple of follicles in the 10-14mm range and also had numerous smaller follicles around 5-7mm. Dr. P decided we would continue with the treatment in the hopes that we could get some of the larger follicles to continue to grow and we hoped the smaller ones would stay where they were. If they also grew, we would have to cancel the cycle or risk the chance that I became the next Octomom.
At this point it was the last week of July and I had been stimming for well over 20 days. It was going to be a long week; I was busy with it being our local Stampede, my busiest work week of the year, plus we were planning to take off on that Friday night to Kelowna with some close friends for our annual G and B adventure weekend. By that Monday, I had started feeling some pressure in my lower abdomen but it wasn’t too uncomfortable and I had another ultrasound the next day so I didn’t think too much of it.
Turns out, after weeks of my follicles doing next to nothing, in a matter of a few days my ovaries must have finally given into the meds because I had completely over stimulated and had well over 20 follicles all large enough to ovulate. The pressure I had been feeling was these follicles growing and stretching my ovaries. Normally, an ovary is the size of an almond. However, with the overstimulation, my ovaries had grown to the size of oranges.
Needless to say, we had to cancel our treatment. I was fairly disappointed; we just had an IUI with only one egg that didn’t work, and now I was forced to cancel a cycle and give up on these follicles I had grown. Thankfully I had such a busy week that I didn’t really have a chance to let myself fall too far into despair. I quickly accepted this was not our cycle and was ready to find out what would be next.
To ensure I did not ovulate naturally and run the risk of becoming pregnant with more multiples than I could fathom, Dr. P had me inject Orgalutran for a couple of days, combined with no intercourse for 7 days. Orgalutran is used to prevent premature ovulation in women undergoing ovarian stimulation. These few needles would keep me from ovulating all these eggs and the follicles would be reabsorbed.
Our trip to Kelowna could not have come any sooner. We needed a getaway to recharge our batteries and get our minds off the stress of the past few months. The G’s are some of our favorite people and we love to travel with them. We had an absolute blast while we were there; visiting many wineries, eating good food and of course meeting Kangaroos! I definitely could have stayed longer and spent more time enjoying the beautiful city and our rental house. Alas, after 5 days we headed back to reality.
Reality for me was more appointments with Dr. P. The meds up to this point clearly were not working the way they should so in early August we made the decision to schedule me in for Ovarian Drilling. Ovarian Drilling is basically what it sounds like. It is a laproscopic procedure in where a tiny needle is used to puncture the ovaries 4 to 10 times each. With PCOS, the ovaries can have a thick outer layer. The goal of the drilling is to break some holes in this layer and in turn lower the levels of testosterone my body was producing so that either I would start ovulating or at least the meds may work the way they should.
Dr P. also decided to start me on Metformin, an oral drug that can be prescribed to women with PCOS as a way to help regulate their insulin. Basically, elevated insulin causes elevated testosterone, which is a big issue with PCOS. So the Metformin’s job would be to decrease blood sugar, which lowers insulin, which lowers the testosterone.
My ovarian drilling surgery was scheduled for mid September so I had 6 weeks to try to enjoy the rest of my summer and get used to the Metformin. Well that wasn’t going to happen. The Metformin made me sick daily; headaches, nausea and stomach aches became expected. I lasted less than two weeks before I had to quit. Thankfully there was an alternative, a med called Glumetza which is essentially an extended release version of Metformin. Although it gives me stomach aches now and then, I was able to stomach taking the Glumetza and am still on it to this day. The best part, it seemed to help me lose some of the weight the PCOS had made me put on. Before my surgery in September I was able to lose about 15 pounds just thanks to the meds!
Before I knew it, surgery day was here. Unfortunately due to the weight I still carried I was not able to have the ovarian drilling done laparoscopically the way it’s traditionally done. I was however able to have it transvaginally which if you know anything about egg retrieval for IVF, is essentially the same procedure, expect for the whole puncturing holes part. Turns out doing it this way is not very common and I became the first person in Medicine Hat to have this surgery. I thought that was kind of cool but it also made me very nervous. Thankfully I was completely under for the surgery and in less than an hour and a half I was finished in recovery and was back up in my hospital room. Since it was a simple day surgery I was able to go home and sleep in my own bed that night.
I don’t remember much from that first day other than I was pretty sore and slept a lot. For the next few days that’s about all I did. I continued to be fairly sore and spent most of my time napping and trying to relax. I watched a lot of tv and spent far too much time googling success rates after ovarian drilling. By the middle of the next week I was able to head back to work and resume some of my normal activities. I needed a few weeks to fully heal from the surgery but by the end of October I was heading back in to see Dr. P and begin what would be our final IUI…. More on that in the final part, part 4.