I decided to do the Lupron therapy. Potentially losing my other ovary scares me too much not to do the therapy now. With the decision made I feel relieved. When this is over, we can start again trying to get pregnant, and then decide what is the best approach. I don’t have to worry about it now. The Lupron therapy will carry me through to my 43rd birthday. Seems like a long ways away, but we still have hope.
I did a one-month shot about 2 ½ weeks ago. Lupron comes in either one-month or 3-month doses. I took the conservative approach because I wanted to see how I would react to Lupron. So far, I am OK. I am still in the initial estrogen surge phase, the body’s first response to Lupron. My skin has been breaking out continually. The endo is getting worse. I can feel it on both sides now. In another week or less, the estrogen level should drop, and the endo symptoms should slowly recede. Plus my skin should clear up. Then, I hope, the progesterone will prevent any major symptoms of menopause. I am actually excited now that I am doing something to get rid of the endo. I am planning on doing a 3-month shot at the next go.
I met with my gynecologist, Christine Hansen, about possibly doing Lupron therapy for my endometriosis. I went in feeling very torn. I have notice over the last couple months that my endo is worse. I feel tight on my right side, in front of the hip. It is also tender at times. During the second half of my menstrual cycle, I cannot sleep on my left side, because on my right side, I feel a heavy weight hanging forward, tugging at and pressing against my organs and tissues on the right side. If I don’t seek treatment for the endo now, I might get worse and eventually loose my left ovary, making it impossible to get pregnant with my own eggs, ever.
Dr. Hansen told me that if I did the Lupron therapy, it could do a lot to restore fertility. I wondered how much the endo was preventing fertility. My tube had been open the two times we did the HSG (hysterosalpingogram). And I was ovulating regularly. At least, I think I am. But the cysts that were hanging around during my IUI cycles were identified as endometrioma (a “circumscribed mass of endometrial tissue occurring outside the uterus…”). These endometrioma could be producing estrogen at higher than normal levels during the beginning of my cycle and really messing up the next phase. Hmmm. Could it even be making my FSH rise too much on Day 3 (the major reason why Conceptions kicked me out of their program)? (See Fertility Journal Entry 9006.)
Lupron therapy would take 6 months of my time– and 6 months of potential fertility. The next 6 months could likely be my most fertile months remaining. Perhaps it would be better to wait another 6 months before starting therapy. The next 6 months would include visiting family over the holidays. The first and only time I got pregnant was at Christmas time when we visited my family in New York. Perhaps being on vacation with family reduced my stress, and/or made my body function more normally in some way. I don’t know. But what if I don’t get pregnant in the next 6 months? What is to prevent me from delaying therapy another 6 months after that?
Lupron therapy also causes a chemical menopause. The doctor gives you progesterone (or sometimes estrogen) to reduce the symptoms of menopause, which include bone loss, hot flashes, and mood swings. It sounds like a hell of a thing to do to one’s body on purpose when it is going to happen naturally anyway.
And then there is the material from the Cooper Clinic. (See Fertility Journal Entry 9006.) They seemed to have a way of helping women over 40 with high FSH, as well as other fertility issues, to have healthy babies. I called them and asked them to send me more recent case studies than were on their web site. I finally received those case studies last week. They look like updates to the prior case studies, with one new article. In looking these over, it finally hit me why they were giving these women the ethinyl estradiol – to bring down their FSH levels. Previously, I had interpreted that as a method to prepare them to ovulate when they were previously annovulatory. And they did not administer a gonadotropin (like Follistim). Hmmmm. I could use that. But I didn’t want to fly to New Jersey twice a month for treatment. Plus, I would have to find a doctor here willing to monitor me in-between visits to Jersey. It is more than I want to contemplate right now. I have enough to deal with meeting work deadlines and taking care of my aging cats, meanwhile spending quality time with my husband and my cats.
My Reproductive Endocrinologist (RE) kicked us out of the fertility program. He called me one afternoon at the office, after a Day 3 ultrasound and blood work. He said he felt that we were making no progress and that our chances were close to zero of getting pregnant, a fact we knew going in. There were more cysts on my ovary, and they were larger than before. (See High). The only way of making sure we were getting rid of them is through surgery, which he didn’t recommend. He didn’t think it was worth the risk. He said that there was no way to tell where the hormones readings are coming from, whether they were from these hang-out cysts, or from newly developing follicles – and it was hard to see what was going on in there. I would think he wouldn’t want to give up because he is a man afterall and this was his program, but apparently he isn’t wired that way. ===:---} Perhaps he has become defeated after years and years of doing this. He has given up. Or perhaps it’s just that they all believe in their protocols, and they are more interested in following them and keeping their numbers by working with couples they know they can help. These seem to be the couples where there is either male factor infertility or blocked fallopian tubes, but no other infertility factors. Why don’t they say that up front? “If you had these problems, we can help you, but with your situation, there is really nothing we can do.” And they would fold their hands and look tight-lipped at you until you left the room. At least this way, you would know before you started climbing the steep stairway of their protocols, step by step, that they had no faith in your ability to become pregnant.
To be fair, my RE always said, from the very beginning, that we had less than 1% chance of getting pregnant with IUI (intrauterine insemination). The only way to increase those chances would be to do IVF (invitro fertilization), which they wouldn’t do for us because my FSH (follicle stimulating hormone) was too high at 23. So, they sorta established that they had faith in our ability to get pregnant, but I always felt they thought it would not work. And now they have totally given up on us.
But I haven’t given up. I let my fingers do the walking through some web pages. I found the Cooper Clinic in New Jersey , which published case studies where women over 40 with high FSH, got pregnant and delivered healthy, full-term babies when the FSH-stimulating hormone (in my case, Follistim) was taken away. And these women were anovulatory, which I am not. And the couples had male factor infertility, which we do not. Ah, ha! These women were also given estrogen to help their ovaries prepare before the Follistim, and then progesterone after ovulation. But my estrogen and progesterone levels are normal. In 8 cycles of IUI attempts, I successfully completed only 2 of them, and without achieving pregnancy. My conclusion is that if Follistim isn’t helping and if I don’t need estrogen and progesterone, then I don’t need no stinkin’ RE or fertility program.
Feels good to say that.