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We left off yesterday with Dr. Craig noting he wanted to try a different medication protocol with us. This cycle #2, he wanted to use both oral and injections. He explained I was going to take 5 mg of Femera orally for 5 days, during CD 3-7.
Meanwhile, I was going to have a total of give 75 IU injections of Follistim on CD’s 3, 4, 6, 8, and 10. He hoped this would help grow my follicles nice and big.
I left the office hopeful, too. Something in my heart, mind and spirit felt “right.” In hindsight, I believe this was my intuition whispering softly and gently to me. Yet, I also remained cautious, as I didn’t want to get my hopes up too much, yet I had a strong belief that this would be my miracle from God…that this cycle would work!
Dr. Craig also explained that during my last blood test, I had slightly lower-than normal blood sugar readings. He prescribed Metformin, which is a medication given to those with Type 1 or 2 diabetes to stabilize their insulin and blood sugar. He prescribed a dose of 500mg twice a day (for a total of 1000mg). He explained that with women with PCOS, often they have unbalanced blood sugar levels and explained the Metformin would help me.
On Monday January 16th, I started the Femera and Follistim protocol, as it was my CD 3 (the 1st day of my period happened on Saturday 1/14). Mike gave me the injections on the proper days. We followed the little calendar the fertility clinic gave me which clearly listed which days I was to take each medication. I posted on the wall of our kitchen where I’d created a little nook where we kept all our medications.
Hopeful: My Follicles Were Big!
On CD 10, Monday January 23rd, I went in for my ultrasound. I was elated when I saw the big dark spots on the monitor! I asked the nurse, “Are those my follicles? They look big!” She noted that there were two follicles, both at 16mm, in each ovary! That meant I had a total of 4 follicles at 16mm! She explained that likely Dr. Craig would want to schedule the IUI for that week, Wednesday, Thursday or Friday.
I nodded my agreement, but mentioned my concern about how I had ovulated, on my own, during Cycle #1, and I was worried I might do the same. She told me we could check my LH levels to see if I was “surging” or not. A little lesson, during a woman’s cycle, right before she’s going to ovulate, her LH hormones will surge/increase dramatically. That spurns the follicles to release the follicles/eggs into the fallopian tubes. This also creates a BBT temperature spike which helps us know when she’s ovulated.
When the nurse called me a couple hours after my appointment, she noted my LH levels were still low. Therefore, she said I still had a little more time. A few more days would enable my follicles to grow a bit bigger. She noted Dr. Craig wanted me to take the Pregnyl 10,000 IU “trigger” shot on Wednesday January 25th night at 10:00 PM to induce ovulation.
Since the largest follicles on Monday were 16mm, and since they typically can grow 1-2mm per day, that would hopefully mean they would be 18-22 mm when I ovulated.
The nurse noted my IUI procedure would take place on Friday. When I asked her why it was 2 days after my trigger shot, she explained why. For most women, it takes 36 hours after the trigger shot for ovulation to occur when the follicles to burst/are released into the fallopian tubes. Therefore, my IUI would take place Friday January 27th at 10:00 AM. She explained that Mike would need to give a sperm sample that morning.
Mike had to work 8am-5pm that day, so I received a “kit” which contained a small sample cup, used for urine tests. She noted that he couldn’t give the sample any sooner than 30-60 minutes before I then had to drive it to the clinic by 8 AM and return back home. Once I dropped off the sperm sample at the clinic, they would “wash it” and prepare it for my IUI. Then, at 10:00 AM, I’d return to the clinic for the IUI.
*Next: The IUI…
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Do you have any questions about FSH and LH and their role in ovulation? Did you know much about PCOS and how Metformin can help with blood sugar issues? How about follicle size? Did you know that typically doctors want follicles to be 18mm or larger to be viable for IUI and IVF’s?