After Birth: Birth Control and PCOS

I’m back for a bit to update you on the recent information I’ve gathered regarding my lovely PCOS and my future birth control plans.

I have my six week checkup on Thursday (has everything healed?  Are my goodies permanently deformed??), but before I go in I decided to gather some information from my RE.  (I absolutely adore this doctor and wish I could pay him to be my doctor for everything).  I asked his opinion on what I should do for future birth control, both for my PCOS and for the future (if we choose to do an FET).  I want my body to be both healthy for now, and healthy for a possible second child.  Since I am on the cusp of menopause (already peri-menopausal) I wanted to also verify that menopause would not deter a future FET.  Turns out it won’t!  It won’t even hurt the chances of success!  Science is on the ball, guys.

So, the birth control options are an IUD, progestrin only pills (refered to as a “mini pill” by the RE), a combined pill with progesterone and estrogen (he is not 100% sure they will still do this for a breastfeeding mother, but they used to ten years ago when he did his residency), and good ol’ condoms.

Condoms are out.  Those are so not fun to deal with.

The mini pill is most likely the way my OB/GYN will have me go.  I already know a girl who was put on this from the same practice.  She said they recommended this as the only option for a breastfeeding mother.  I may not have an option.

The combined pill is what I want the most.  I am worried about remembering to take a pill at the moment, since I am quite tired most days, but it is best for me because of the estrogen.  The estrogen will help keep my not-so-fun PCOS symptoms under control.  I’m just not sure they will let me take a pill containing estrogen while breastfeeding.  We shall see!

IUD is an option, of course, but it worries me that I do not know one person who has successfully had an IUD placed and kept it longer than a couple months.  Constant pain seems to be the biggest complaint, and who wants to live with that?  Only upside?  My RE believes that it will prevent any future periods.  This is good for convenience sake, but I was quite worried about the risk factor for endometrial cancer.  For those of you with PCOS, we have a very high risk of endometrial cancer due to our lining not shedding enough.  The lining stays in and basically rots.  Awesome.  But rest assured, if you go with the IUD, the hormone that is released by the IUD keeps the endometrium from forming, which prevents the risk of the cancer.  Hoorah!

So, these are my options.  I will update and let you all know which I’m going with.  IUD, combined pill, or mini pill??

One More Scan…??

Looks like I should only have one more scan, which will be tomorrow (Tuesday).  I am glad to hear this because every time I go in for a scan it’s $300.  I only had to go in today to make sure I didn’t need to order any more drugs.  From the looks of things, the doctor says I should be good to go with what I have.  He says if I need another round of meds on Tuesday night, then I can just use follistim at a higher dose, since I will be out of Menopur. Cool!  I already spent $4,200 on meds, so I’m glad to not have to spend anymore.  Oh, and I spent $33 (love this price!) on the other drugs… Hydrocodone (for the egg retrieval), Aspirin, Azithromycin (antibiotic), Ondansetron (?? No clue… Guess I’ll have to look back at my papers) and Methylprednisolone (Steroid).  I remember that the antibiotic is to help keep infections away after the retrieval and the steroid is to lower my immune system a little so the implant is more liking to take.  Yikes, what a stash!

So here are the results… Looks like we will have about 6-7 mature follicles by the time the retrieval is done (looking like it will be Thursday).  I really did expect more, but that’s probably because I’m still in my PCOS brain, instead of my DOR brain.  It’s hard to switch over when I’ve been so used to producing follicles like it’s nothing.  Well, the doctor is still happy with the size and he seems to be happy with the amount, but I know he wanted me to have 12.  Hopefully he will at least get 5-6 out during the retrieval.  I’m hoping for at least three to be implantable, but I will be overjoyed if we have at least one.  I cannot believe how stressful this whole process is.  There are just no guarantees, so the longer you go through, the MORE anxious you get.  I thought once I saw maturing follicles, I’d be a little more relaxed.  Wrong!

Next scan is tomorrow morning at 7:30am.  My estrogen level is at 1,253, which is amazing.  So glad that’s going up!  My lining is at 6.6, so it still has a little ways to go, but my estrogen is quite high, so I think it will get there.

Tonight: (Last injections?) 300IU Follistim, 300IU Menopur and one Ganirelix.  (I started the Ganirelix last night and it still burns and makes a nice, red, irritated patch on my skin).

Also, my husband came with me again today.  When I dropped my pants he giggled, got a big smile on his face and starting clapping.  What would I do without him? 🙂

Pumping Up The Meds

Had my first monitoring visit this morning at 9:00.  I’ve got three measuring around a 6 on righty and 3-4 measuring around 6 on lefty.  Righty also has a tiny one.  So I have about eight total, which is about half of what they want me to have.  Grow follicles, GROW!!  They are upping my dosage to 300IU of Follistim with 3 vials of Menopur (Follistim went up, Menopur is staying the same) and I’ll go back in on Saturday.  Since my period finally stopped yesterday, my estrogen should start going up to help with my lining (currently at 4.4) and follicle growth.  I’m hoping for really good results on Saturday with the combo of a higher dose and estrogen doing it’s job.  I will be able to tell when my estrogen goes up because I will begin to get weepy.  Doctor Who made me cry last night, so that might be good sign. 😉

Other than a tiny bit of weepiness creeping up on me, I’m getting an achy back, achy ovaries, bloating (of course) and as soon as I take my injection I get totally exhausted.  I was falling asleep within ten minutes of doing the injection.  Instant sleep! Sweet!

The cravings for food are still there too.  Right now i’m drinking a decaf frappachino and eating cheez-it’s.  Not even sure how those two things work together, but they are so so yummy!

Okay, that’s all I’ve got for now.  Just waiting on my phone call for my estrogen level, which I know is going to be lowish, and my updated dosage information.  Hopefully it’s a straight forward phone call with no problems….

**Update**  Just got the call — Estrogen is only at 119.  They are confident that the higher dose and a few days will help get things moving at a better pace.  They think I may have to be on the meds longer than they thought.  Guess I’ll have to break the credit card back out….