I don't think I am very good at updating my blog! It has been almost a week since both of my appointments and I haven't updated at all, so sorry.
Last Monday my appointment with Dr. Kopher went well. We talked about the last cycle and what went well and what didn't. He was very happy with the amount of medication we used and the amount of follicles that grew. He felt this last cycle was more controlled then the last cycles with Follistim. However, the one downfall was getting cellulitis on my abdomen from the injections. I asked him why he felt things weren't working. He said there could be multiple reasons, one being luck, two being maybe the follicles weren't "good" follicles and three this was only the third time I have ovulated EVER in my life. His suggestion was to keep trying what we have been doing. We have gone through 4 cycles, 3 being successful ovulation. He gives women 6 successful ovulation cycles with injections before he is convinced it won't work.
I explained to him that we would like to take a break from the injections and what would be his suggestions in the mean time. He brought up taking Metformin. I told him I had an appointment with Dr. Malo the following day. He suggested I go to the appointment, see what Dr. Malo has to say and go from there. I left the appointment feeling well. He took the time to answer all of my questions and explore every opportunity.
So the following day, Tuesday, I went to my appointment with Dr. Malo. My wonderful husband did come with me for support, as much as he didn't want to. We met with a nurse practitioner the first half of the appointment, going through all of my past cycles and history as well as Eli's history. She was very surprised at Eli's sperm analysis and the fact that he smokes a pack a day. She said she sees more times then none that smoking greatly affects men's sperm analysis. I think god knows that he isn't willing to stop smoking, so he is giving us a break in this area! We then met with Dr. Malo. He went right into all of options and what he thought would be worth trying. He also went over the things that Dr. Kopher has done and said he would have done the same and thinks Dr. Kopher is handling my care well.
Here are the options he gave us:
1. Try another cycle with injections. He as well isn't convinced injectables don't work in a woman until they have had successful ovulation for 6 cycles. He did say he would try another medication that is like Repronex but doesn't give the injection site side effects.
2. Have surgery known as "ovarian drilling". He said that in countries like Europe, reproductive medicine doctors do ovarian drilling before even trying injections. He said it wasn't an "experimental" surgery, patients just opt not to go down that road. The one downfall of the surgery is it may cause scar tissue that would prevent follicles to pass through the tube to the uterus. He said it works for about 60% of PCOS patients that do it. Effects show right away.
3. Take Metformin for the next 3-6 weeks and try to lose weight.
4. Be very aggressive and go right to Invitro Fertilization. This he felt would result in a successful pregnancy for us.
He left the decision up to us and explained we need to choose what to do based on how aggressive we wanted to be with things at this point.
We went into this appointment knowing we would take a break, so option number 3 was what fit us the best at this time. He did an ultrasound that day too check my uterine lining and to "make sure" PCOS was what I had. He said that my ovaries are "text book" Polysitic Ovaries. He also had blood drawn to check my liver function before taking Metformin. This post is getting long, so I will add some info on how Metformin works with PCOS in a different post. I left Dr. Malo's office feeling well, I think maybe when we decide to "try" again we will go back to Dr. Malo.
Things have been going well on the medication. however I am experiencing many side effects. Stomach upset, lots of diarrhea after eating, not feeling hungry and feeling tired. Despite the side effects I have lost some weight so things are going well and the side effects might be worth it in the end! If I don't get a period by the first of September I have to take some medication to induce one. Dr. Malo stressed the importance of getting a period while taking Metformin.
Until next post...whenever that will be :)
Love, Kristen & Eli