Our 4 months old…time flies

Everything going well…and already thinking of a second baby

We have been blessed by a beautiful (I am probably a bit biased!) baby girl in April. She is an absolute delight, and is filling our days with joy.

I do not spend a day without thinking that it was thanks to Duofertility…and my monitor is “staring at me” every time I open the bathroom drawer…the question is only “when” rather than “if”. In our situation, I think that it would be wise not to wait for too long before we start trying again, as who knows,… this may be our last month for all I know (my cycles may suddenly stop with the onset of menopause).

I had promised not to be one of those bloggers who cannot help themselves talking about their baby despite the fact that it was originally a blog about infertility struggles. As this was really upseting me when I was looking for answers…. as you cannot help feeling happy for the person who has managed to have a child, but at the same time ….”why not me???”.
I of course want to bring some hope to women out there who have been told by their doctors that there is no chance that they will get pregnant naturally… well I proved them wrong, and you probably can too! Thanks Duo fertility!

I will get back to the blog when I am starting to try again – so hopefully not in too long. I have already noticed that clearblue has a new monitor in Boots – I wonder if it is any better?? I will probably have to try it out!

Right, my period has started last weekend again – an Easter surprised. I didn’t expect it so soon. I am of course disappointed, but that it apparently “normal”. So I am attempting to stay calm and not to worry too much. It is “only” my 4th cycle, and I have a particularly poor ovarian reserve.

worried

I had a comment on the blog from someone at OvaCue who mentioned that I should use their website to chart my data as the monitor itself may not be able to deal with unusual cycles. My cycles are quite regular so I am not too sure why this was unusual! But anyway, I will input the data at the weekend and I see if I come up with anything more useful than my 2 ovulations dates as predicted by the machine.

My cat played with my duofertility sensor and lost it last month, so I cannot be sure if I have ovulated or not – my temperature went up on a day ( which could be ovulation) but then when I found the sensor back (behind the sofa – when I always leave it on my bedside table!) and put it on it was quite low. I contacted the DuoFertility team and they say that with the limited information they couldn’t tell me if ovulation took place or not. I only have 3 data point in my luteal phase as I ran out of sticky adhesives to attach my sensor, and I forgot to ask them. My fertility expert at duo advised me to see my doctor to get a progesterone test (blood test) and that I should be able to then confirm ovulation for sure. I call the surgery on the 27th and they didn’t have the possibility of getting a blood test done unless I saw a doctor first, and the first appointment that they could give me was on the 5th of April ( today – that is not my luteal phase anymore). No need to say that I didn’t do the test, but the duo team is working with a laboratory and could get me a kit to take my blood at home (it looks like a little system like diabetic people use to check sugar level) and then I send the sample to the lab by post. This was only £20 or so, and I find this a lot more convenient than working with my NHS doctor! I have got it now, so I will be able to do the test if I am in any doubt in future cycles – hopefully not.

I am all set to do better this month with data collection – got a new sensor and plenty of adhesives. I am wondering if I should use the OvaCue again for a cycle to see if it works better with the online software. It would be a good test to do so! So I will probably do it.

Another month of delay

My periods have arrived yesterday, i was hoping to take my pregnancy test today, but i had brown spotting yesterday. My tummy is not sore, but my periods are definitely there.
What a pity, I was hoping that the progesterone would be fixing my problem. I guess it may need time to work. No magic solution for getting pregnant.
I have been quite low as my husband is travelling for work and I was on my own faced with another negative result. I called duofertility to get some support and I was able to speak to an advisor. I didn’t catch her name but she was so helpful. We discussed my options and I feel much more in control. She recommended that I should speak to an IVF specialist to discuss my treatment plan. The fact that I have a poor ovarian reserve mean that IVF clinics will not be very happy to accept me as a patient as I might get their success rate down, but she recommended a couple of clinics who have a good reputation and who are likely to be happy to help us. I feed quite cynical about the private clinics as I think that all they want is my money, but I now feel that she they may not all be like that.
I want to try 2 more months before I see an IVF specialist. To give ourselves the best possible chance of getting pregnant. I need to discuss this with my husband of course, but I feel that this is a good compromise between trying naturally and leaving it too late for IVF to work. This is not about starting IVF, but it is about getting advice from someone who works in a clinic to get another point of view.
I also wanted to know if I would be given clomid, and she said that it was unlikely as it is not in the guidelines for women with low ovarian reserve. Some doctors use their own treatment plan, so it is possible, but apparently unlikely.
The duofertility advisor told me that about half of couples in our situation should be pregnant after 6 cycles, so this is making me feel more normal. But doesn’t stop me being impatient!
I do not think that I will be using the clearblue fertility monitor this cycle as it keep telling me that I have high fertility for most of my cycle, which I do not find helpful at all.

Antral follicle count – another measure of ovarian reserve

So I happened to visit my doctor too late for starting clomid, but it was the perfect timing to count my antral follicles. Ho yes, it is very exciting!

It was definitely not the most comfortable of exams. She used an internal ultrasonic machine. And we could see my ovaries on the screen with a few black spots. Those are the antral follicles. So one of the test to measure ovarian reserve (as well as FSH and AMH which I have done already) is the AFC = antral follicle count.

Each of those follicle has an egg inside it, so counting them allows the doctor to count how many eggs are getting ready.

Anyway, she found 5 follicles, which confirms that my ovarian reserve is low. She reassured me by saying that because we had not been trying for very long it may still happen naturally.

Looking at my charts, she agreed that my luteal phase looked weak. And she prescribed progesterone supplements – vaginal tablets containing 100mg of progesterone. I have to take them for 2 weeks after ovulation.

Apparently it is very important to be sure that I ovulated, as the progesterone may prevent my ovaries from releasing the egg! So I can only start after duofertility confirmed ovulation.

Preparing to see my gynecologist

As I am home (Berlin) for a few days, I am going to take advantage to see my doctor.
I am not too sure if I should be discussing the fact that I have been using 3 fertility monitors _ she may think that I am mad.

Ovacue:

I have been trying to get to the Ovacue software, but it doesn’t seem to work. Maybe it is because I am in Europe and it can only work from the USA? I will therefore have to plot it on an Excel document. I cannot make sense of it, but maybe she will be able to.
I want to ask my doctor if it is possible to ovulate twice in a cycle. The duofertility team told me that it was very unlikely more than 24h apart. I will see what my doctor says.
I did receive an email from the Ovacue support team, but it wasn’t very helpful.

Duofertility:
I have printed my charts to show her what data I have as well as couple of emails I have got from the experts. If my doctor was in England or the USA, I could have provided her with a login details to access it from her practice. This could have been so helpful so I could ask her questions when I have doubts or worry. The duofertility team is good, but I have known my gynaecologist well since I was 12, so I really value her view. It is not the same.
I definitely want her opinion on the possibility of the implantation. And if she thinks that I conceived when that happened. As from what I understand it happened at the time when duofertility told me that I was fertile, but the other monitors didn’t.

Clearblue fertility monitor
I got an email from one of the doctors from clearblue, and he was indicating that the monitor may not work for me as I have a fertility condition. Well I didn’t see anywhere on their site that I shouldn’t have bought it because I have a low ovarian reserve. This seems to me like an escuse for it not to work.
The monitor has not asked me to test yet this cycle, however I have set it up a day too late as my periods started during the day and I wanted to make sure that the testing time would be first thing in the morning to avoid the drama of the first cycle. Anyway I didn’t figure out how to set the monitor to day 2 of my cycle. Hopefully it will not cause issues.
I have made records of the results in my diary, so I can show my doctor that. I am confused as to why I have had no peak so far. Could it be that I do not ovulate? But if that was the case I wouldn’t have got pregnant last cycle? And duofertility couldn’t confirm ovulation?

I hope that my gynaecologist will have answers to some of my questions and be able to help me with my luteal phase. I am worried to lose the pregnancy again if it happens.

Anyway, today is Valentine’s day, so we went out for a nice dinner, but I should not be spending the evening in front of my blog ! I will not get pregnant like that! 😉

Not pregnant this month….

Despite my temperature being quite high, I have taken a pregnancy test this morning and it was negativenot even the slightest line indicating a possible pregnancy.

My temperature seems to have taken quite a few days to get up to the maximum level. It was getting a little higher – although quite variable for the 4-5 days after ovulation, and then it got higher and more stable for the last 5 days (note that I have not yet started by periods) and that apparently has 2 possible explanations:

  •  Either I got pregnant and the second step was linked with the hormone increasing when the baby sticks to my womb – but that is unlikely given that I had a negative test.
  • Either I have a problem with my progesterone level  – which may well be the case give that I have experienced a few days of spotting before my period start. Maybe my ovaries are not only poor in eggs, but also in their stock of progesterone to start using after ovulation.

What happens during a cycle

Talking to the duofertility team, it appears that there are different ways of looking at this, and their recommendation was to speak to my doctor to see what option is best for me. I could wait for another couple of cycles to see if this just random, if I didn’t want to wait I could take clomid (which is usually helping ovulation, however it also seem to help progesterone levels), or I could take progesterone supplements (however apparently the UK doctors don’t usually give this medication but as I travel to Germany once a month for my job, I could see a doc there instead). They also explained that my stressful job could affect my chances of pregnancy as stress can cause low progesterone.

I found some interesting reading here:

“If progesterone levels drop too soon (usually within a few days of ovulation), then the body will automatically think that it is time to flush out the uterus and start all over again. Very short cycles (usually less than 24 days) is usually a sign of this type of luteal phase defect.”

My cycles are indeed quite short – the last one was 22 days (currently I am on 25 days)

Reading the information on how clomid and progesterone can help – there is a lot of mixed messages out there.

Anyway, it looks like I now have to wait until the end of the cycle… hopefully it will not be too long!

I think that I will see my doctor back home the week after next as I never feel welcome at my GP here in England – he never has time for me and doesn’t want to talk about fertility with me. So I will not be able to start clomid this month given that I would have to take it in the first week of my new cycle.

Let’s see what happens!

Lola

So on Friday – Ovacue came up with a “purple box”??!!

I think that this means that ovacue does not know when I ovulated. I cannot see how the readings can mean anything – it is so variable!

The manual states that :

“A decline in the vaginal readings following ovulation can indicate the presence of a fertility issue that warrants

further investigation. The OvaCue® is the only fertility monitor that can detect this unexpected shift in vaginal hormones post ovulation, providing you with valuable information about your cycle.

[ ]There are a number of possible explanations[ ] :These include the occurrence of unexpected hormonal fluctuations or the occurrence of secondary fertility (multiple follicular stimulation). For more information about the purple box and secondary fertility, please contact Customer Service or visit www.ovacue.com.”

I contacted them a few days ago ( on Friday) – and I am still waiting for an answer!

I am very suspicious that I can ovulate twice in a cycle – surely if I have low ovarian reserve I do not have spare eggs popping out part way through my luteal phase!

If I get an answer from them, I will share this information.