PCOS to Pregnancy

I've had several emails and requests to discuss my personal road to here.. many questions regarding the twins, do they run in your family, did you do InVitro, how long did it take for you to get pregnant, etc.. 

So- after seeking permission from my sweet husband to share his experience as well- because the pieces don't fit well together without him, I've decided to share:)  This post is long, and I apologize in advance for it.. but I feel it is necessary to cover all the bases.

The Beginning

My (our) story starts about 10 years ago.. I started having issues with regularity.

(Ok- stop right there.. this is going to have some pretty deep info about myself and Jordan's reproductive abilities..nothing to gross you out per say, but I would stop reading if you're fearing TMI..)

Back to my irregularity.  Off and on I couldn't get a regular monthly cycle going, and it was at that time my Ob/Gyn at the time decided to put me on birth control.  I was 17 years old. 

Irregularity continued over the next 5 years, through 4 doctors, multiple trials with hormones, birth control, and uncomfortable exploratory exams- nothing.  Even on the highest dosage of birth control/hormones my body could handle, I was still not getting into a regular monthly cycle (I would start my period about a week into active pills.. sometimes really light and other times had me headed to the hospital for excessive bleeding or cramps that put me to my knees and would force Jordan to carry my into the ER in his arms curled in the fetal position.  Makes me want to cry thinking about those times..)  Finally the last doctor I saw took me off everything and decided to let my body do it's thing.  3 years went by and I can count the number of times I had a period on my two hands. 

A Diagnosis- Finally.

Jordan and I finally, after 5 years of marriage, decided it was about that time to have kids.  We wanted them, and wanted to take the next steps in doing so.  This led to another doctor search.  Randomly one day in November of 2009 I opened up my insurance book and picked a name.  Dr. Walsh. I liked the name well enough.  It sounded.. pretty.  So, I called and made an appointment, with the new doctor (yet again.) and got into see her in the New Year, January 19th.  After 20 minutes with this woman I realized the fact that I 'liked her name' was no accident (duh..God's hand is in everything.  It is humorous to think that I actually had something to do with it all).  She scheduled me for a sono that following week and I was diagnosed: Polycystic Ovarian Syndrome (PCOS). After 8 years, and finally FINALLY some answers.  My misdiagnosis for so long was simply because I didn't 'fit the bill' for a classic PCOS'er.  I was not overweight, did not have facial hair due to overproduction of testosterone, I surely don't think I look like a male.. but what I do have?  Irregularity and acneic skin (which I only thought I could attribute to my mother..) as well as ovaries that look like two clusters of grapes at any given time of the month. 

So where does that leave us for babies..?  It was shortly after my diagnosis when we decided to seriously start taking steps on the route to pregnancy.  Per recommendations of my ob/gyn, and the fact I've been off birth control for about 4 years at this point and no baby, we had Jordan screened for infertility as well.

A Bump in the Road

The results came to conclude that Jordan had fertility issues of his own. (The hits just keep on coming..) Jordan has what is called varicoceles or varicose veins on his man parts.  His results showed that while he has an absurd amount of spermy guys, but they are with decreased morphology or, for lack of a better way to describe it- lazy sperm due to the addition warmth of the blood flow in the varicoceles down there.  There were millions of them, but once they got to my egg (if I even had any that month) they had no strength to break through.  Surgery to repair this birth defect was scheduled and Jordan began his (rather painful) recovery.  The three month follow up after his surgery was rather disappointing.  His numbers hadn't budged from before surgery. We knew of the risk that this surgery wouldn't work, but surely there was something we could do to improve his number in the least bit, right?  I decided to pull out my dietitian brain and do some research. 

After a brief evidence-based analysis on male infertility I decided on several things to include in my sweet husband's nutrition prescription. 

1.) Cut the caffeine.  I didn't realize what a crazy role this plays with fertility- for both male and female. 

2.) Increase your fruit & vegetable intake.  No problem there.  I keep him loaded.

3.) Flaxseed.  The Omega-3's are beneficial for male fertility.

4.) Supplements.  Jordan began to take the following supplements: Vitamin C, Zinc, Vitamin E, Vitamin B-12, Men's Multivitamin, Acetyl-L-Carnitine, and L-Carnitine (I think that’s all of them..) 

At his 6 month post-op appointment Jordan's numbers went through the roof.  The urologist had never seen such numbers of improvement before.  So much so, that he decided to see Jordan back for a 9-month appointment before releasing him to make sure.  Finally the 9 month post-op appointment came, and Jordan was still with improved numbers, and finally he was released as fertile:)  

Reproductive Endocrinology

So back to me.  With my lack of ability to produce viable eggs, we were advised my by Ob/Gyn to seek assistance from a fertility specialist for further care.  She recommended IVF Plano with Reproductive Endocrinologist Dr. James Douglas and his amazing team of nurses.  Our first appointment with Dr. Douglas consisted of a basic interview/counseling session as well as the drawing of our plan of care through this process- due to the history of infertility in the both of us, Dr. D decided our first step: IUI ( Intrauterine Insemination).  We left the appointment feeling ready and confident, and about half a mile down the road reality set in.  What if this didn't work.  What happens when we have to repeat this process multiple times.  Were we financially ready to make the commitment?  We had done some previous research on PCOS and treatments and have had several friends try different things before skipping right to the serious treatments of IUI and In-Vitro.  Jordan and I both felt we were skipping a step here somewhere. 

Finally, after a couple weeks of praying and talking about what we thought was the right way to go about this, we decided to try simple hormone therapy (Clomid) to start.  We figured going this route for a couple months would help us to feel more confident in our decision to go with IUI after the hormone therapy didn't work rather than skipping it all together.  I had a friend give me some advice, and through my tears it clicked.  After starting IUI it isn't like you can take a step backward to hormone therapy and expect it to work.  Start from scratch, and see where it takes you. 

And that we did. 

 

And Then There Were Nine

After taking the prescribed Clomid as directed I was at Dr. Douglas' office multiple times over the next couple weeks- sonogram after sonogram- monitoring for egg production.  It seemed that my body loved Clomid beyond everyone's expectations.  I was on the lowest dosage of Clomid (50 mg) you can give (My Ob/Gyn actually laughed out loud when she discovered my dosage and how my body reacted to it.) and my body produced 9 eggs- yes NINE eggs.  The sonographer confirmed with me that I did have two larger eggs, and promised that the other 7 would stop growing and eventually fail to be viable for ovulation.  I was scheduled to return in 3 days for yet another sonogram to check measurements.  On that day I did in fact have two eggs ready to go, and the other seven, well, they did not stop growing, and were rather large at this point.  My doctor made it clear that I needed to ovulate today or I may have a problem on my hands.. Yowza.  After testing for my LH surge, and I was without (classic PCOS), the office decided to give me an injection (Ovidrel) to force ovulation.  I was advised to go home and make sure I have sex  the following day (Tuesday) and again on the day after (Wednesday) in hopes for it to work.  No problem, right?

Not So Romantic After All

Jordan and I decided this wasn't going to become some robotic action just to try and get pregnant- it was all stressful enough in the first place.  Well- no one plans for the weather.  That day happened to be a day of crazy storms and multiple tornado touch downs and disaster here in Fort Worth/Arlington.  Jordan was called into work for emergency assistance, and on his way to grab his bag from the house he called me at work to inform me of all this.  We were running off generators and hiding in doorways away from windows here at the hospital- so when he called I said "Okay, love you and be careful." and we hung up. 

Immediately it clicked in my brain and I called him back- "You aren't going anywhere before you see me- wait right there, I'm coming home."  My boss looked like she had seen a ghost when I walked into her office and told her I was leaving.  Thankfully she is aawweesommme and totally knew and understood what was going on.  I had to be open and up front since I was in and out of the office several times during the week due to doctor appointments and follow-ups. 

I got home safely and it was just wham-bam-thank-you-ma'am.  And he left.  So romantic.

Follow Up- Again.

At the end of that week I went back to the doctor for another sono, and this time I was looking at empty follicles where the eggs once were and had since ovulated (so incredible.) It was confirmed that I ovulated 2 eggs- one from my right ovary and one from my left.  I left there with instruction to take a pregnancy test in two weeks (Wednesday) and then call if it is positive.  So- you mean to tell  me I have to wait two weeks before I found out if all this worked?  Good grief.

 

The Time Has Come

Finally the time came to take that test- I/we had been waiting for two long weeks!  I say long- it actually flew by and I couldn't believe it was already time.  I kept counting my days to make sure I wasn't off somewhere.  That morning I woke at 3am having to pee so bad.  I laid there realizing quickly that I wasn't going back to sleep unless I got up to pee, and I wasn't going pee unless I pee'd on that stick.  So- 3am was in the morning, the early morning of the day they told me to take the test.  What the heck.  

May Take Up to 3 Minutes For Results to Appear

3 minutes?  Try 30 seconds.  That test was positive in no time flat.  I couldn't believe it.  I got back in bed and felt Jordan moving around a bit.  'Jordan.. I'm pregnant.'  It worked.. I feel like it is too good to be true at this point.  That was.. easy.  But- reality is, it wasn't actually easy as I recollect back through our journey here to write this LONG post (sorry).  

In the days following my positive pregnancy test I took multiple blood tests to check HCG, progesterone, etc.. all came back healthy. Very healthy.  My HCG level was well into the 700's in just two weeks of pregnancy.  That flew up some red flags for me.. even though all the nurses could say was 'You have a very strong pregnancy.'    On the morning of my second HCG test a couple days later, the nurse informed me that it would be okay if my numbers didn't quadruple as they would normally since mine were so high to begin with.  Oh, but they did,  more than quadruple might I add.  HCG was in the 3,000 range.  Even with all this, I had thoughts of multiples, but since multiples are pretty uncommon with simple hormone therapy, I didn't think twice (no pun intended).  

Finally came the time to see this sweet baby on the monitor!  I couldn't contain myself!  I was 6 weeks 2 days along when the sonographer said "Well.. how do you guys feel about twins?" 

Tears.  All I had was tears.  I couldn't stop crying- joyful crying, let me be clear on that..

So here we are- with our sweet baby twins.  A rather long time coming, and we are blessed with not one baby, but God chose me to carry and be a mother to TWO babies.  What an honor that he would bless me in this way. So, no IUI, no In-Vitro.. just a little help from hormone therapy and a good doctors.  I have been so blessed with GREAT doctors.

Road to Fertility ROUND 2 HERE