Friday, February 4, 2011

My Journey Continued: Injectables!

The next step after my surgery was to try an injectable fertility medication.  This is either FSH or a combination of FSH and LH, the hormones the pituitary makes to tell the ovaries to mature eggs for ovulation.  It's stronger than Clomid and can get more eggs ovulating then Clomid.  More eggs means more chance of getting pregnant, but more chance of ending up with more than one baby.  Most women who end up with triplets, quadruplets, etc used these medications.  The injections are once a day from about the third day of the cycle until the eggs are ready.  That usually takes 8-10 days.  Because of the risk of a multiple pregnancy, you need blood tests and ultrasounds of the ovaries every 1 -3 days while you are taking the medication.  It's a big step from Clomid, but I figured that I could handle it.  I wanted a baby, and I was willing to do whatever it took!

My doctor ordered the medication, and I picked it up from the pharmacy.  It was close to a $1,000 of medication in little glass vials.  Yikes!  I decided to seatbelt it in to the passenger seat of the car, so it didn't accidentally go flying!  I got it home safely and opened it up.  There, among the neatly-ordered vials, I hoped, was my baby.  Now, I had a decision to make.  Was I going to the the injections myself or teach my husband how to do them?  I had the training to do them, but I found the idea of sticking a needle into myself surprisingly daunting!  My husband was an insurance underwriter with no medical training whatsoever--also daunting!  In the end, I did a combination.  There were nights where I just couldn't bring myself to jab the needle into my body.  On those nights, my husband stepped in.  Other nights, it seemed like a piece of cake.  I still have no idea why some nights were so hard, but I am glad that my husband was willing to help.

I felt great on the injectables!  No more hot flashes.  I had all this energy and a strong desire to organize everything in sight.  This is the same nesting instinct that pregnant moms get, and it's not uncommon on injectable medications.  I knew the eggs must be about ready, for instance, when I found myself cleaning out closets at three in the morning!  I'm sure my husband thought I had gone nuts!  I could definitely feel my ovaries, though.  It felt like I was walking around with two large grapefruits in my pelvis.  I didn't care, though, those were my potential babies in there!

After a few days, however, I started to notice that something was wrong.  I was getting fevers, aches and chills that would start an hour after I took the shot and wear off a few hours before the next shot.  I went to my textbooks.  I discovered that this was a rare febrile reaction to the medication.  In those days, most of the injectable medication were made from the urine of women who had gone through menopause.  The ovaries stop working after menopause, but the pituitary still sends out lots of FSH and LH in a desperate attempt to get them working again.  This FSH and LH is eventually excreted into the urine.  Unfortunately, there are a lot of other things in the urine and some of those ended up in the medication.  I was reacting to one of those extra things, and my body was trying to attack it.  It was a Sunday when I figured this out, and I didn't want to bother my doctor.  I took one last shot and suffered through the fevers.  I called a different medication into the pharmacy on Monday morning.  This one was "highly purified" and so had less contaminents.  I let my doctor know what I had done and why, and he took the opportunity to teach me about the purifying process.  It reminded me that I was both a patient and a fellow studying infertility.

These days, most injectable medication is made by genetically engineering FSH (so it doesn't come from a human or from urine) or is highly purified. Febrile reactions are pretty much a thing of the past, thank goodness!

I did the IUI again and waited.  Right on cue, my period started.  Despite lots of nice looking follicles (sacs with eggs) and a great estrogen level, it hadn't worked!  The second cycle was harder.  I wasn't having the fevers, but I was having more trouble giving myself the shots.  I was starting to get discouraged.  I had been at this fertility treatment stuff for 8 months and trying to have a baby for over 2 years with nothing to show for it.  It felt like my life was on hold.  I didn't want to buy any new clothes, because I was going to need maternity clothes soon.  I didn't want to plan a vacation, because I didn't know whether I would be pregnant or not.  My parents were living in Colorado, and I turned down a chance to go out and ski, because you can't ski when you are pregnant.  All that optimism now felt ridiculous.   I couldn't get away from infertility either.  I spent all day treating it only to come home at night and treat my own.  I was drowning!  I decided to redouble my efforts to stay positive and keep going.  What else was there to do?  So on I moved to the third cycle.  Unfortunately, the third cycle did not work either.  Now I was facing the most expensive and invasive option: IVF.

No comments:

Post a Comment