2001 PCOS Journal
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2001 PCOS Journal

1/8/01 - BF had his appointment with the urologist... he did a full physical examination and reviewed the results of his first semen analysis and said that he honestly didn't think that he had any problems... and that being he has fathered two children there is nothing to say that he hasn't always been this way. So he ordered another semen analysis to be done to compare to the first just to be on the safe side... but said he honestly thought that he would have no problem fathering a child... it would just be a matter of getting someone to treat me and get me regular... he said its hard enough to get someone pregnant 12 times a year... but when you narrow it down to 2 or 3 times and then there is no guarantee that she is even ovulating those times, it makes it nearly impossible.

BF is suppose to call back on January 16th to get the results from the 2nd semen analysis and then fax the results to Dr. Butler where she will look at them and then providing that they are the same or better than the first time... Then they will talk to me about starting me on medication for PCOS... yeah right... I am sure something will change that yet!!!!

1/16/01 - BF got his results back from the urologist and his numbers were almost double from the first time around... his urologist was very pleased with the results of the semen test and said again that he didn't see any problems with him fathering a child... that the problem would be getting a doctor to treat me. He faxed the results down to Dr. Butler for her to review.

1/17/01 - Dr. Butler called me today to tell me that she reviewed the results from the semen analysis that the urologist did and even though they were better than the first time... "They aren't perfect like they need to be in an infertility case" what the hell does that mean??? She said that even though she felt that more needs to be done with BF to get his numbers better, that the urologist seems to think they are fine and that I need to be the main focus. I said well yeah I tend to agree with him on that one. So she stated that she could continue working with me with her associate Dr. Kulbida or that we could go to an RE. I said that at this point I would prefer going to an RE and she agreed with me that I need someone that will be a little more aggressive and maybe I will have a chance.

1/19/01 - I emailed Dr. Horvath one of the two RE's in my area... and I told him my whole story from start to finish about my AF or should I say the lack of... to the treatments I have had with Provera and Clomid and doing the donor insemination. He responded back on 1/22/01 stating that I need to make an appointment with him and he will review things with me and see what my options will be.

1/23/01 - I called Dr. Horvath's office to make an appointment but its not that easy... they take down your name and address and then they send you an information packet that you need to fill out and send back to them. Once they get it, they will review it and call you to schedule an appointment. I do already not like that part of it... and being that I called them 2 days ago I should have gotten the packet today in the mail...but I haven't yet. This is just soooo frustrating.

** I decided for grins to try the other RE in the Albany area to see if I could get an appointment with him any sooner than April 26th. I was informed there was an appointment available on March 13th so I decided to take it!! We'll see what happens....

3/13/01 - I had my appointment with Dr. Henriques today at 9:45 a.m.... naturally things can't be easy and we had a lovely ice storm to deal with driving out there. We got there and had to wait about 20 minutes before they called me in... Joel and I went in and talked with Gina, who is the registered nurse at Dr. Henriques office. We talked to her for just over an hour about my medical history and what has been done for me... then I had to leave a urine sample and then go in the examination room. Dr. Henriques came in and did a quick exam and then said meet him back in his office! We went into his office and he was reading my chart... he told Joel that he wasn't all that thrilled with his semen count... but he didn't say he was doing anything about it... so I don't know if its going to be a problem or not!!

Then he informed me that he was going to start me on Provera 10 mg. to get my period going again being that I haven't had one since December of 2000.

On Cycle Day 3 before 10 a.m. I have to go to the LabCorp and have the following blood tests done:

Cortisol AM

Dehydroepiandrosterone Sulfate

Estradiol

FSH and LH

Prolactin

Rubella Antibodies, IgC

Testosterone, serum

Progesterone

Androstenedione

Then on days 5 thru 9 I will be taking Serophene - 50 mg - 2 tablets. Then Cycle Day 10, I have the following blood tests done:

FSH, Serum

Progesterone

Then on day 12, I am to call Gina.

3/17/01 - I was scheduled between 7 a.m. to 8 a.m. to be at LabCorp to go in for a 3 hour glucose/insulin response test. This is one test that I had asked my previous gyn if it was something I should have done a couple of years ago, when they had a 2 hour glucose/insulin test done on me and it came back "borderline". I had read that one there is no such thing as being a "borderline diabetic" and two if you do have "borderline" like results after a 2 hour test that you should have a 3 hour test done and that will give you a definite answer as to what is happening! So that is a test that Dr. Henriques requested be done... to determine if I am "insulin resistant" and can be put on Glucophage or not.

We arrived at LabCorp at 7:55 a.m.  They didn't call me in right away so finally I went up to the window and said I am suppose to be here for a 3 hour insulin test... she said well they are suppose to be done at 7 a.m. you are late! I told her that I was told I could arrive between 7 or 8 a.m. but no later... and I have been here... so she told me to go in and leave a urine sample... then I had to go and have blood drawn.... then I was given the "lovely" orange drink. She said its 8:25 a.m. now... it has to be done by 8:30 a.m.... oh yuck!! So I drank that and gave the empty bottle back to them and had to go in for blood to be drawn @ 9, 9:30, 10:30 and 11:30 a.m. The first hour I felt like I was going to throw up... I just felt horrible... the second hour I wasn't all that bad... semi normal (well as "normal" as I can be I guess) and then right after she took the blood work at 10:30... I went back out in the waiting room... I was sitting there and the longer I sat there the worse I was feeling. I started feeling very sick.... I was getting light headed, dizzy, nauseous, cold sweat and clammy... I didn't think I was going to make it. Finally she called me in at 11:30 and she noticed I wasn't doing good at all, and when she went to take the blood she noticed I was "clammy feeling" and said that it will be good for the blood test... she drew the last vial of blood and told me to immediately go and get something to eat and drink to bring my levels back to normal. So now we'll see what the results say... I have an appointment on March 21st for a pap... hopefully they will have the results by then and will know if they can treat me with the Glucophage or not.

I also took my first Provera pill 10 mg. tonight... I held off on starting them until tonight being that I am scheduled for a "pap" this coming Wednesday... I didn't want to have to postpone that appointment until after my period was finished. So I am hoping by not starting the pill till tonight that I will still be fine for my appointment.

3/21/01 – I had an appointment today with Gina for an annual pap.  I was in and out in a couple of minutes.  I asked if they had received my results from my 3 hour glucose test.  She checked and it said that it was still pending…  so I have to sit and wait to see if I will be put on Glucophage or not.  I also took my last of the Provera pill 10 mg. tonight… now we’ll see when AF decides to make a visit. 

3/27/01 – AF made her arrival this morning when I got up.  I got a phone call from Gina on March 26th to let me know that she got my results back from my 3 hour insulin test… the first hour my insulin level was 243, my second hour it was 182 and all she told me about my third hour was that it dropped a lot… I kinda figured that from my reactions.  She called in the prescription of Glucophage and wants me to start out only taking one 500 mg. a day and then she will have me tested again in a couple of weeks and see if I need to have my dosage increased or not!!   She told me that she didn’t want me to start on the Glucophage until AF arrived… so I took my first one tonight with dinner. So far it seems that I am fortunate enough that I make visits of the “little girl’s room” from the Glucophage!!  Oh joy!! 

3/29/01 – Arrived at LabCorp for my Cycle Day 3 blood tests at 7 a.m. this morning… of which consisted of:

Cortisol AM

Dehydroepiandrosterone Sulfate – DHEAS – another male hormone that is found in all women.  It is secreted by the adrenal gland.  Women with PCOS often have elevated DHEAS levels.  DHEAS levels that appear within the higher limits of the “normal” range are common among PCOS women. 

Estradiol – Estrogen is the female hormone that is secreted mainly by the ovaries and in small quantities by the adrenal glands.  The most active estrogen in the body is called Estradiol.  A sufficient amount of estrogen is needed to work with progesterone to promote menstruation.  Most women with PCOS are surprised to find that their estrogen levels falls within the normal range.  This may be due to the fact that the high levels of androgens found in women with PCOS can sometimes be converted to estrogen.

FSH and LH – Follicle Stimulating Hormone and Luteinizing Hormone – FSH and LH are secreted by the pituitary gland in the brain.  These hormones encourage ovulation.  The beginning of the menstrual cycle, LH and FSH levels are usually about equal.  Roughly 24 hours before ovulation occurs, the amount of LH increases significantly.  This surge in LH is what causes the egg to be released from the ovary.  Once the egg is released the LH level goes back down to its original pre-surge level.    Many women with PCOS already have an elevated LH level, so the amounts are not equal in the beginning.  Although some women with PCOS still have LH and FSH levels that appear “normal range”, their LH level is often 2 or 3 times or more than that of the FSH level. 

Prolactin – hormone that stimulates and sustains milk production in nursing mothers.  Prolactin levels are usually normal in women with PCOS.  However, some women have a slightly elevated level of prolactin, or hyperprolactinemia, which tells the body to produce milk.  It is important to check for high prolactin levels in order to rule out other problems, such as a pituitary tumor, that might be causing symptoms similar to those caused by PCOS. 

Rubella Antibodies, IgC

Testosterone, serum – all women have some amount of the male hormone testosterone in their bodies.  Women with PCOS often have an increased level of both total testosterone and free testosterone.  Some women with PCOS have total testosterone levels that are still within the “normal range”, although often on the high end of “normal”.  However, even a slight increase in testosterone can suppress normal menstruation and ovulation and lead to other PCOS related symptoms.

Progesterone – is produced by the corpus luteum after ovulation occurs.  It helps to prepare the uterine lining for pregnancy.  Testing levels of this hormone is especially important.  Sometimes women with PCOS can show signs that ovulation is occurring; however, when the progesterone test is done, it shows that ovulation did not occur.  If this happens, your body is producing a follicle and preparing you to ovulate, but for some reason the egg is not being released from the ovary.  In addition, low progesterone levels may tell your doctor that your body is not producing enough progesterone on its own to sustain a pregnancy even if the egg is being released.  All this info can help adjust any fertility medications for the next cycle to encourage the release of the egg and help sustain a pregnancy.

Androstenedione – ANDRO – another male hormone that is produced by the ovaries and adrenal glands.  It is more potent that DHEAS, but significantly less potent than testosterone.  Sometimes high levels can affect estrogen and testosterone levels, which in turn can contribute to PCOS-related symptoms.

They informed me that it would be 2 to 3 days before my RE will get the results from the blood work done this morning… which I really question going to a lab that doesn’t do the labwork there and has to send it all out… I mean what if the results don’t get back in time and I miss a chance of getting pregnant cause I don’t know the results of the blood tests.  I want to talk to the RE about this situation and see what they say!!

4/5/01 – Arrived at LabCorp 7 a.m. for Day 10 blood work which only consisted of FSH (Follicle Stimulating Hormone), Serum and Progesterone.    I finished the last of my Serophene (Clomid) last night… for the most part I wasn’t all that bad this time around and I was very impressed!!  I was a bit more emotionally in that I could cry at the drop of a hat… but a lot of personal issues were going on at the same time including my father being in the hospital and all… so honestly it seems to have gone well!  I am suppose to call my RE on Day 12 of my cycle… but being that is on Saturday and they won’t be open, I don’t know if I should hold off until Monday to call or just try calling tomorrow… worst they could say is that I have to call back Monday I guess!! 

4/6/01 – I called my RE today and she told me to go to LabCorp in the morning and have my insulin level tested to see if they will have to increase the dosage of Glucophage that I am currently taking or not.  Thankfully it will only be blood work and not the three hour test. 

4/17/01 – Well I finally got a phone call from the RE’s office… she told me that my Day 3 FSH level was 5.2 and that my Day 10 FSH level was 5.3 and that they were both good.  Then she said that the insulin level test came out good… but that she is going to increase me up to three 500 mg a day of Glucophage and then wants me to go back in a week to have my insulin level taken again and see how I am doing on it!  She made an appointment with me to come in on April 27th for a PEP test and to check my ovaries. 

4/27/01 – We went to LabCorp at get tested yet again for FBS (Fasting Blood Sugar) and Insulin to see how I am reacting to 3 pills a day of Glucophage.  From there we went to the RE’s office.  Let me just step back a minute and update you on what else has happened in between all this fun… on cd 18 & 19 my fertility monitor said that I was at “Peak” so we did BMS and kept our fingers crossed that all would work!  The following 2 weeks after I had every symptom of pregnancy… we thought for sure that I was pregnant… of course that bubble was popped pretty quick.  Monday I had one spot of blood, same on Tuesday, Wednesday I had a little more but all three days it only happened once each day and then I seemed fine… but it was like I was spotting.  Then when I came home from work Thursday, April 26th AF decided to make her presence known!  Needless to say, I was majorily bummed out… I even had been taking my BBT’s the last two weeks cause I thought I was pregnant and watching what that revealed… I went between 98.4 to 98.8 every day of those two weeks… now this morning I was back to 97.9.  Anyhow we got in to see Gina and she did the PEP test… which basically is a blood test checking my progesterone level… of course we won’t have those results back until at least Wednesday… so I don’t know how that turned out!  Then she did an internal and checked my ovaries… they were fine!  She wrote me a prescription for Serophene to take from days 3 – 7… so I start that tomorrow… oh joy… let the mood swings and hot flashes begin… ugh!!!  She made an appointment for us on May 9th to come in for a post coital test… even though it’s a painless, quick and easy test… its not something I am looking forward to… it will be embarrassing… we have to be there within 2 to 3 hours of BMS… oh joy!! 

5/9/01 – We had our appointment this morning at the RE’s office for a Post Coital Test and an ultrasound.  Today is day 14 of this cycle.  The PCT wasn’t as bad as I was thinking it would be.  When we first got there, both of us had to do a urine test… to test to make sure neither of us have any infections.  Then I went into the room and it was basically like a pap… but she didn’t really take a swab that I thought it was like a long suction thingy that when she did it… it felt like a puff of air each time.  It was quick and painless and if it helps with getting pregnant then it was worth every minute of it. 

Post Coital Test is a test of receptiveness of the cervical mucus to sperm and sperm motility, both of which are needed for the test to be positive; it is essential that the test be done to coincide with ovulation, tested with a Urinary LH Kit or measurements of Serum Estradiol (high), Serum LH (preferably high), and Serum Progesterone (still low), because the job description of the cervical mucus at other times is to be impenetrable to sperm, that is, the PCT will be negative for normal reasons.   One of the reasons for a PCT (Post Coital Test) is to get a better idea of sperm function by looking at sperm in the mucus of the cervix after sexual intercourse.  A PCT must be done during ovulation because you will get a negative result meaning that no sperm or motile sperm are present; versus a positive test shows more than five normally motile sperm per microscopic field of examination.

After that was finished they had me go to another room for a Transvaginal Ultrasound – which is just an ultrasound image of the pelvic organs for diagnosing abnormalities of (particularly) the Uterus and the Ovaries and for monitoring the development of ovarian follicles with ovulation induction and assisted conception programs.   That didn’t give me the best results… my follicles weren’t really all that big… so they were concerned about that… that biggest was only 17 mm but being that last month I didn’t ovulate until day 18 they said I could still be fine.  I also had one at 15 mm and a couple of 13mm’s.  They scheduled an appointment for me to come in again for another transvaginal ultrasound on May 14th… she said then she can check and see if I have ovulated or not… she said if I didn’t by that date then I won’t be ovulating this month.  So hopefully I will… keeping my fingers crossed!!  This month feels so much different than last month though… so that is making me nervous… this month really seems to be dragging… and I have been very depressed and moody this last week or so.  They told me that my Progesterone level on day 1 for the PEP test was excellent… and my endometrial lining was 9 mm which she said was great for preparation for pregnancy.  So now we sit and wait to see if I ovulate and with any luck get pregnant this month. 

5/14/01 – Today is CD 19… and I was spotting this morning and still am this afternoon.  Well as I expected this was a waste of time today going for another transvaginal ultrasound… I had to wait forever to get in there which bothered me even more… when they finally called me in Crystal did my ultrasound today… who I wasn’t all that crazy about… but that is besides the point.  She did the ultrasound and said my endometrial lining was 13mm which was good… then she went to check the follicles and there were NONE!!!!  The ones that I had were now gone and I had nothing… so I won’t be ovulating this month… which I kinda am not surprised about cause I never seemed any different at all this month… but I was still very upset and disappointed.  So after the ultrasound we went in to talk to Gina, who annoyed me today… but I think the mood that I am in most everyone is going to annoy me!!  Gina informed me that they screwed up my urine test that I did before the post coital test and instead of testing me for T-mycoplasma…which is a sexually transmitted microorganism implicated in infertility and miscarriage.… but they tested me for a UTI (Urinary Tract Infection) and I have one to my surprise!  So they gave me a prescription of Macrobid to take 1 tablet twice a day for seven days… I have to go and pick up tonight.  Then I asked her if I had to come back in on day 1 of the next cycle for a PEP test and she said no.  She increased my dosage of Serophene to 3 pills a day from days 3 to 7 for next month or for the next time I get my period if I get it on my own again this time around.  She also informed me that my Rubella (German Measles virus) number is less than 5 meaning that I have a high chance of getting it if I came in contact with someone with the virus.  She said my options would be to wait until AF arrived and get an immunity shot and then take a rest for 3 months before trying to get pregnant again… or… hold off and try and get pregnant and just don’t come in contact with any kids thru my pregnancy and get the shot after I had a baby… which I am going with that option… being that I am only trying this year and that’s it for getting pregnant… if it doesn’t happen this year, then I give up.  I just don’t want to be older than 35 and having a baby… even though I would still want one… I will have to accept it and move on. 

5/18/01 – Okay nothing has really happened other than me being super depressed and very negative the last couple of days… I don’t know what that is all about… normally I am pretty good about all this… but lately everything is annoying or bothering me more than it should!  I think its just a combination of things that have been going… basically now I am just sitting here waiting for AF to arrive… which if it were to make an appearance it should be Memorial Day Weekend… if it doesn’t come by June 7th… I have to call Gina and tell her so that she can give me Provera to bring it on.  Then I guess its bothering me about this UTI… I mean the last couple of days I have been having a discharge like a yeast infection… but that is all that is happening… which I told her that I get that like a week up to two weeks before I get my period almost every month… I don’t know what that is about… I just want this month to be over and start a new cycle and hope for better results… I am getting way too frustrated way too early with this and that’s not good.

 

          

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