It's September!

It's National Ovarian Cancer Awareness Month!

Ovarian cancer is the fifth most common cancer among women, and it causes more deaths than any other type of female reproductive cancer.

1 in 77 women will be diagnosed with ovarian cancer during their lifetime.

Symptoms:
-Bloating
-Abdominal pain
-Feeling full quickly
-Urinary Symptoms
-Irregular Cycles

Risk Factors:
-Genetics
-Increasing Age
-Reproductive History
-Infertility

44.6% is the 5 year survival rate

It's Simple: Have Faith!

If I could for a change just cross some terrain to bring you all up to speed on where I am now and speak just a tad on how I got here. As I mentioned in the last post I am now pregnant! 38 weeks pregnant and one day to be exact. As many of you know I started this blog as an Ovarian Cancer survivor as a means to bring awareness to women's health issues and to tell my story. My story has certainly been interesting and much like a roller coaster. At the time of my original post I did not know whether I would ever conceive, it was only a dream.

Last September when the doctors confirmed I was pregnant it was so surreal. They scheduled me for an ultrasound when I was just 5 weeks pregnant. I was able to see my little nugget at that time. That was officially my last appointment meeting with my fertility specialist. They sent me with tons of sendoff gifts and paperwork to prepare for the life I was carrying. They recommended I follow up with my OBGYN to schedule an appointment. Since this was all new to me I really didn't know what to expect. I had read other blogs where the fertility specialist continued seeing you but mine explained that she did not as if anything happened to the fetus they wouldn't be able to do anything and it was really left up to your OB.

The following Monday I called my OB to let her office know I was pregnant and to find out what my next steps were. That same day I received a call back from my OB herself who was so happy for me. She stated she had been praying and was so glad to get the news. She scheduled me for an 8 week appointment and that began the beginning on my monthly appointments.

Things seemed to be going really good. I was having a very good pregnancy; no morning sickness, minimal heartburn the only real changes were that I was sleepy ALL of the time and seemingly gaining alot of weight. When I reached my mid-pregnancy appointment I was due for another ultrasound which looked closely at the baby's heart, brain and other vital organs/limbs.

The tech mentioned she couldn't get very good pictures of the heart and that something was causing a glare on the screen. After speaking with my doctor about it they recommended I see a heart specialist at the hospital who would be able to get better images.

My appointment for the hospital was scheduled for the following week and ofcourse I received results back the same day stating that my baby's heart was enlarged. Could you imagine getting results like that after all of the health issues I've been through?! I felt I had overcome some major ordeals myself and here it was the devil was trying to attack my baby's health. I remember telling the devil that he was a liar, manipulator and simply afraid of my future and the future of this unborn child I was carrying. I then began to pray this long prayer to God asking for a healthy baby and that this news simply wasn't true. after about a 10 minute prayer the Lord responded with two words, "Have Faith." I had mixed emotions with this answer. Here I was praying this long prayer and that was the only response I got?! We all know having faith is much easier said than done.

Each time the devil tried to remind me of the news I kept telling myself to have faith. When I was diagnosed I had faith, when it came to conceiving this miracle baby I had faith so what was different about this time. I simply needed to rely on faith and that's what I did.

My OB encouraged me to make a follow-up appointment and also scheduled me an appointment with the local Children's Hospital fetal imaging for an EKG. When I went to the follow-up appointment I was met with a medical team of 4 in a small room to look at additional images of my baby's heart. The initial tech said the heart looked fine in her opinion, the head doctor chimed in and said the same. They went on to say they were sorry they had caused all of the confusion but simply wanted to take all precautions. They even stated there was no need to have an EKG and suggested I cancelled that appointment. His heart was normal and it was apparent that the scarring I had from both surgeries resulting from Ovarian Cancer was causing a glare on the screen giving the illusion that the heart was larger. Meanwhile, God's two chosen word to me remained in my mind. He said it was all simple: "Have Faith." Anything you stand in need of my friends, "Have Faith!"

I'm Pregnant!!!

In June, I had a follow-up with my Fertility Specialist and the head nurse to discuss additional options as it seemed perhaps Clomid was not the drug for me or whether we should consider a higher dose. After speaking with them both it was determined I likely needed to switch drugs because it wasn’t that my body wasn’t responded to the drug because the fortunate thing was it responded really well it just seemed as though with it I couldn’t fall pregnant. They discussed that it didn’t appear I needed any other radical change either like intrauterine insemination or (IUI) or even IVF since I was responding so well to prescription drugs. They did mention they would switch me over to Letrozole or as some may be more familiar with its other name Femara. 

If Letrozole didn’t prove to be a success after a couple rounds we would then consider IUI. My doctor explained Letrozole may be a good option for me as its most common use is to treat cancer, breast cancer specifically in women who has reached menopause . It is used to help prevent the cancer from returning and decreases the amount of estrogen the body makes and help slow and reverse the growth of this cancer. It has been found to be effective for fertility treatment in women with ovulating problems or for those with unexplained infertility. This drug is known to suppress estrogen levels in young women which result in producing  an increase in FSH or follicle stimulating hormone. In women who have ovulating problem like PCOS the FSH can help  develop more mature follicles in the ovary and ovulation of an egg.

I previously mentioned that taking Clomid is typically always the doctors first recommended option for women seeking to get pregnant as long as there are no other problems they are aware of but when this option fails Letrozole is usually the next best option. It has been found that women who do not respond to Clomid will have better luck with this medication. In my case, although I did respond with Clomid meaning I ovulated I never became pregnant and it was my doctors hope that Letrozole would be the key.

In July, we proceeded with Letrozole using all of the same steps with Clomid in the previous cycles and once again my body responded well to this prescription. Unfortunately I did not become pregnant. I wondered if I’d have the same luck of the draw with this new medication as I had with Clomid but I still hung on to hope….

August came and we tried again following all of the same steps using Letrozole and I made it to the day 27 appointment to test whether I was pregnant. A few hours later I received a call from the clinic and I’ll never forget the call that changed my life forever. I was pregnant!!!.....

There is No Need to Worry...It's All in His Hands!

Though April was unsuccessful I was hopeful that May would be better. I followed all of the steps from last time and unlike last month my cycle had beaten me to the punch. There was no need for a pregnancy blood test. By this point it is now June and after taking Clomid and following all of the instructions I went to my day 13 appointment and was hit with more bad news. Unfortunately my doctor did not want me to proceed with this cycle because it was determined I did not ovulate all of my follicles from the last month. I had a 21mm follicle left over from my May cycle and my doctor believed that cycles involving leftover follicles usually were not successful and did not want me to waste my time nor money. I felt defeated at this point. I had 3 unsuccessful Clomid attempts, 2 using Ovidrel which was also a fail and now one I couldn't proceed with.

It started to seem as though I'd never be able to conceive my own child and I certainly wasn't interested in adopting at this point either. After prayer, shedding some tears I did the only thing I knew would help and that was spending time with the Lord. He directed me to some Bible plans via the Bible app regarding infertility. Some of the plans that helped me if you are interested are: " A Seed of Hope During Infertility and Thriving Through and After Infertility and Loss." What not only blessed me in these plans was not simply the scriptures but the devotions. In some cases the devotions gave accounts from other women, some from therapist, perhaps doctors and even couples.

One devotion even helped me get over a fear, which was adoption. After hearing many accounts from children that were adopted I simply was not open to it. These children felt that the parents who lovingly adopted them was not enough and I just never waned to experience that kind of heartbreak. Well, let me tell you about this devotion...Not only did it come with a story but a video. In both you relive the account of a couple who grew up with one another because their families were close however she was much younger. Once they grew up they went away for college and then both moved back home. This is ofcourse when they began to date. One night on a date ofcourse like most they talked about their likes, dislikes, if they wanted to be married and how many kids they wanted etc. He goes on to say how he wanted a daughter and she agreed she did also. He even went as far as saying he had already picked a name. Now women, this would shock you too right?! How many men do you know that want a daughter and says he already has a name picked?! She was certainly caught off-guard but interestingly enough she had a name picked as well. They both sort of blurt out the name which was Chloe. Long story short he knew then this was his wife.

He gave an account about how when he was just a young boy God would give him visions of pushing a little girl on a swing and running through an open field. He said that is when God had given him the name Chloe and even showed him the little girls face so he knew exactly how she would look. Fast forward, this couple gets married and they decide they don't want to have kids right away and went on a missions trip for the first year of their marriage. Once they came home they decided they was ready and if I can recall correctly 3 years had gone by with no baby. She learned she had unexplained infertility. She began thinking about adoption but was met with his certain NO. Like me, he had no interest. He went on to say he didn't like the idea and knew God was going to give him Chloe naturally.

After much consideration they did move forward with an adoption agency although he still was on the fence about it and ofcourse they waited and waited. One night the wife was up late and checked her emailed and the subject of one read, "It's a girl." They had finally been selected by a birth mother for adoption of a little girl. They ofcourse like most began prepping their home for the babies arrival. Though they initially thought they would name the baby Chloe they began having second thoughts. They started picking other names in hopes that God would still one day bless them with Chloe by natural birth. They received a call from the adoption agency advising them that the birth mother wanted to meet them in person. They traveled to her home and once she opened the door he immediately knew the baby she was carrying was Chloe. This woman had a grown up face of the child God once showed him in the field. Once they got in the house and began speaking with her for hours she said, "I sort of picked out a name for the baby, I've been calling her Chloe." With this news they began to cry and the birth mother assumed it was because they didn't like it but they explained everything that brought them to this point and how in that moment it was confirmed this was their child, their Chloe.

 Though this story was long I wanted to share it because it blessed me in many ways but more importantly God used their story to help me get over my own fear of adoption and certainly realized no matter what lied ahead He had already orchestrated it. The ultimate lesson I learned was that we simply do not know what tomorrow holds but we must remain faithful in the one who holds it and we need not be afraid and certainly there is no need to worry because He has it already figured out.

With that encouragement I decided to try fertility treatment again in July....

The Cycle Continues...

Once the Ultrasound Techs have noticed you have atleast one mature follicle which I mentioned previously is atleast 18mm they will have you "trigger." A trigger shot is another name for Human Chorionic Gonadotropin (HCG) which is a pregnancy hormone that encourages the production of progesterone. It ultimately triggers your ovaries to release eggs and ultimately narrows down the best time for conception. Trigger shots are usually given to women who have irregular cycles and those that do not ovulate which ultimately is the factor in why it was hard to conceive in the first place.  It is often given to women like myself who is trying to conceive naturally, via IUI or even IVF. This shot can be administered by your doctor or at home. Typically once you have triggered your eggs are released within 36-46 hours. As you may have guessed prior to triggering you should have already begun having intercourse atleast every other day, the day of the trigger and every other day after then. 

From this time you wait until day 21 of your cycle when you will have an appointment to check your progesterone levels. This test will determine if you actually ovulated or not. I've have heard and read that as long as your levels from the test are atleast 15 ng/ml you have ovulated however my fertility specialist says a minimum of 10 ng/ml when medically assisted. If your numbers are lower than that it typically means the cycle was anovulatory, meaning you did not ovulate. I fortunately did ovulate and up to this point all seemed well with the medically assisted cycles. 

The last step was determining if the cycle was fruitful and you actually conceived. 7 days after the day 21 Progesterone test confirmed you ovulated you are to return for a pregnancy test and that is if your next cycle hadn't beaten you to the punch. I returned for the test and learned later that day unfortunately I was not pregnant and if I wanted to try again the next month to call them once again on cycle day one so they could call in my next prescription for Clomid and schedule my day 13 follicle check.

Hot Flashes?

Clomid comes in different milligrams and my fertility specialist thought it was best that I start on the lowest dose which is 50mg. I have read that the higher the dose the more likely you will have side effects. I am no stranger to the side effects of this drug which include hot flashes, mood swings, abdominal discomfort, ovarian cyst and some nausea. Did I say hot flashes? This is the one that plagued me the most. As you all know I am a young woman so I have never experienced a hot flash before nor did I understand how women who have them feel but now I am very sympathetic towards these women. I often felt that I was sitting in front of a heater and the heat was blowing directly in my face at full blast. Unfortunately it is nothing you can do either to turn down the heat if you will until it subsides.

So month one of the drug which was in April 2016 I took the pills as prescribed and had to be monitored. So again, I took the pills days 5-9 of my cycle and upon calling to alert my fertility office that my cycle had come that month they scheduled my day 13 appointment. The cycle day 13 appointment is to monitor your egg growth via a transvaginal ultrasound. The ultrasound techs are checking to see how many follicles (the sacs that hold your eggs) you have and tracking their measurements. Some people have mature follicles then at 18mm however if you are like me you may not. If you do not have mature follicles the doctors will likely have you come back the next day and any days after in the event they are not fully matured. This particular cycle I had 4 follicles that were very close in size though they were not mature so I had to return the next day and the day after. Once they were finally mature I ultimately had 4 follicles that potentially could be fertilized which could result in multiples. This is yet another side effect of Clomid. You, I will repeat do run the risk of multiples. We will talk more on the next blog of the next steps and the outcome.