Saturday, May 8, 2010

Breastfeeding, PCOS, and fertility

I am a proud La Leche League member, and (eventually) future LLLI leader. Apparently it is common to not start cycling again until more than a year post-birth if you're still breastfeeding, especially if the baby is not sleeping through the night. (My son isn't, unfortunately, even at approaching 10 months...) I had issues with getting my period anyway before getting pregnant, thanks to my PCOS. We are still breastfeeding, and cautiously introducing solids. (There are a lot of allergies in the family, so we need to watch for possible reactions, especially when introducing foods that commonly cause allergies. I also agree that breastmilk is the best basis for nutrition through the end of the first year, and that solids are more for acclimation and learning than actual nutrition before a year. I would rather give our son a variety of foods in smaller quantities instead of lots of the same few foods. So, we're not rushing the solids.) So yeah, I'm not cycling yet, and odds are at this rate, it'll be at least another 2-4 months before we even have any chance of getting pregnant. Plus, I had a reaction that could be termed an allergy to Clomid (one of the easiest and cheapest fertility drugs to try), so I can never take it again. So if I have to do fertility treatments, we would almost certainly have to go straight to injectables, and maybe even straight to injectables plus IVF.

So, where does all that leave me, as far as any chance of getting pregnant without significant interventions? Who knows... it's frustrating. I just keep hoping that somehow I have a "suitable ovulation" (sometimes with PCOS you can ovulate, but have the egg not form correctly, so it's very unlikely to fertilize), we actually do the deed at the right time, the pregnancy "sticks", etc. Given my challenges, the odds seem long. But then again, I know women with half a reproductive tract, or were told they were in premature ovarian failure years before, or who did fertility treatments that didn't work, etc. who managed to get pregnant on their own and carry a baby to term. So I keep hoping that somehow it'll work out for us without treatments, but who knows. And at our ages, we can't wait forever before going back to the doctors.

Breastfeeding is known to reduce fertility, especially in the first 6-12 months. But I value breastfeeding for the first year or more, and don't want to rip off my son by forcing weaning on him, when given my fertility challenges it may not significantly increase my odds of getting pregnant.

That said, we're working on getting our son to sleep better at night, without doing cry it out methods. We're trying to get him to be better at settling himself when he wakes up at night by putting him down when he's half asleep instead of fully asleep. Since he's teething, it also means having to make sure we address his discomforts more aggressively so we have better odds of him staying asleep. The next step - whenever that comes - is to start limiting his nighttime feeds, and eventually eliminating them. My loose plan is to try to help him to sleep better (and as a consequence, feed him less often at night, hopefully only 1-2 times most nights), and by around a year, hopefully eliminate night wake-ups entirely. But we'll see what actually happens. Once he sleeps through the night (around the same time as his solids intake will be increasing), my husband and I can try to sleep better ourselves, and have more time for activities that could lead to another baby. :)

Gratitude & desire

I am so endlessly grateful to have my son. Even as he can be frustrating at times these days - being too distracted to nurse consistently, thinking chewing on power cords is fun, pulling everyone's hair (mine, the cats', etc.) - he is just so amazing. As I've said recently, watching him become an active agent in his own little life to an ever-increasing degree is simply amazing.

But - it's *because* our son is so amazing that we want to have another baby. We have a nickname related to what we called our son while I was pregnant already picked out for the hoped-for new baby. We thought of that one even before our son was born. Growing him inside me, feeling him squirming, and then being able to give birth to him (as much as that was a challenging process), and then breastfeeding him, has just been incredible.

As I pack up some of the baby items that we don't need for our son anymore (small receiving blankets, outgrown clothes, etc.), it's definitely more than a little sad. I hope to need these items again for a second baby. I even hope to have the dilemma of figuring out what to do with the most boy-type things, should we have a girl for a second child. And our son is increasingly a toddler, not a little baby anymore. The idea of never having some of those little-baby moments again makes me quite sad and makes it harder for me to let go of the moments when he is still a small, vulnerable little one.

Having lost my first husband to cancer, I really want my son to have a sibling. My husband and I won't live forever. While my own sister and brother are married (or almost married) and likely hoping for kids, who knows what will happen. Hopefully if my son has a sibling he has a good relationship with, they can support each other in life. If he has cousins he's close to, that would be amazing. At least last I knew, my brother-in-law from my first marriage was close with one of his cousins. That is great, since he lost his only sibling (my late husband), and he already had some issues in some ways. But I am hoping my son will have a sibling eventually... and my husband and I can have more of those little-baby moments.

Reviving my blog!

April 27, 2010
I’ve been saying for a while that I was going to get back to blogging. Here we go! After going through fertility treatments, I am a mom, and an educator by both training and interest. We live outside New York City, in a condo. I am married to my second husband - I was widowed by cancer in my late 20’s. Even after getting remarried, it took a while (and assisted technologies) to get pregnant due to my Polycystic Ovarian Syndrome (PCOS). Since Mommy-hood took a while to come to me, I am continually grateful to finally be a mom. However, I’ve found that both for a little additional money, and for my sanity (and resume), I would like to find work that is hopefully interesting and leaves me with a few bucks after independent-contracting taxes are taken out and we pay the babysitter. Since we live in an expensive part of the country, and I’m finding that something that actually meets those criteria is quite difficult - more difficult than I’d expected. But I keep trying, and I’m sure I will be writing about it!

Who is the little guy? I have a fabulous 9-month-old son who thinks he’s already a toddler - crawling, pulling up, cruising, generally getting into everything. He is NOT a consistent sleeper, so that has been a challenge, particularly over the last few months as he’s gotten more active. We are breastfeeding, and plan on continuing until 12 months and possibly beyond. I’m a strong advocate of breastfeeding, and am actually just starting the process to become a La Leche League leader. At least that will be good for my resume!

Since I am not 25 anymore (and my husband isn’t even 35 anymore), we’ll be trying to get pregnant again soon... although it will almost certainly be a challenge with my PCOS issues. We’re open to adopting, but after being able to be pregnant and breastfeeding my son, I’m really hoping we can get pregnant on our own. (Plus, the older we get the harder it will be for us to qualify for adopting, especially in the current climate surrounding international adoptions...)

I hope my blog will be interesting enough for people to read - at least now I’ve gotten started!

Wednesday, July 16, 2008


Geez, if I'm this anxious just before a stupid ultrasound when I'm not even on Clomid yet, how am I going to deal with my nerves before bigger things?!

I am 99% sure that there won't be a dominant follicle (though last Friday's bloodwork seemed to say it could maybe kinda almost happen, hence they're having me come in again). I just want to work out a plan for where to go from here.

I had a bit of a "discussion" with my boss late this afternoon. (She has been getting stricter and stricter about hours for summer Friday afternoon flex time as a way to deal with her own stress, I think. As far as I can tell, all or most of the other departments in the company aren't nearly this strict. I get the brunt of it because of my job, but she's been doing it to the rest of the department too.) Anyway, long story short, I tried to impress upon her that I had other obligations and appointments over which I only had some control outside of work, and thus I couldn't necessarily work the extra hours in the way my boss wanted me to, that I needed some flexibility on that. She knows I'm dealing with PCOS - I briefly gave her an idea a few weeks ago. But I made it clear that I was not at all comfortable discussing such details with my boss, so it's been VERY awkward, that I've tried to just get the extra hours in earlier in the week the last couple of weeks before the ultrasounds so I wouldn't have to discuss it at all with her. We'll see how much the situation improves, but supposedly she's going to try to meet me halfway - let me work the extra hours in whatever way I feel is reasonable, as long as I give her an idea of how I'm going to do it at the beginning of the week. So we'll see... if she really is a bit more flexible, that will buy me some more time in the job. But it also depends on how many appointments the doctors want me to do, and how soon.

I think my boss dealt with infertility - she adopted an older child about 10 years ago. Weirdly, in a discussion tonight, I floated the idea that she may see pushing me toward putting in more hours etc. as a way to "help", subconsicously, in case it doesn't work out for me to have a bio child of my own. As in, make sure you get a solid career for yourself, in case this pregnancy thing just doesn't happen and you need something to keep yourself busy and distracted. Just a theory...

Now, if only PMLG (Post Maternity Leave Girl) would kindly move her baby pictures *inside* her office door that I have to walk by nearly constantly, that would also help make the work stuff a bit more bearable.

Also, I've paradoxically found that a pregnant co-worker who usually works remotely has been really supportive since I told her last week that we were TTC, I hadn't ovulated since January, and that with our boss becoming ever more weirdly obsessed with our hours, I was losing my mind. Seeing pregnant women is usually hard, but I know this co-worker miscarried before her current pregnancy (it's her first), and she was really kind when I told her about what I was dealing with. I really appreciated that. She looked at me knowingly when she was in the office a couple of days ago, asking me with more depth how I was REALLY doing. I said that I was getting through - at least the Weight Watchers thing was going well (almost halfway to my WW goal weight!), at least that was one thing that was going well! The only other co-worker I've told that we're TTC and having trouble was super supportive also. She started cooing sympathetically when I told her (whispering on my cube phone). She's a mom herself (a teen and 9-year-old), and it was so obvious in the "there, there" sounds she was making! I just thought I'd burst if I didn't tell a couple of people at work.

Well... bedtime, since I have to be up very early to get to this appointment, and because my boss was only out for the late afternoon and will be back tomorrow morning. I hope either there is a big, bold, obviously lead follicle - or nada, like last week, so I can just ask when I could schedule the HSG (after Provera and AF, of course).

Good night.

Tuesday, July 15, 2008

What would your t-shirt/bumper sticker say?

You know those t-shirts that seek to inform, instruct, or just generally badger people into seeing your point of view? In this age where you can lay out your t-shirt online and order it, you can get any old t-shirt saying you want. Better not order one while drunk or in the middle of a crying fit!

Hmmmm... among the things my tshirt might say:

"One cat shy of A Cat Lady"

"Widowhood is permanent. Getting remarried doesn't make it 'all better'."

"'Relax' is NOT a cure for PCOS!"

"I'm having trouble getting knocked up, and you tell me to relax? RELAX?! Come closer and I'll relax YOU!"

My infertility has given my mom "grandma envy"

Okay, so maybe I don't have a future in the t-shirt design industry, but you get the point. :)

What would your t-shirt or bumper sticker say?

Sunday, July 13, 2008

Ultrasounds; next steps

I got a call from one of my RE's practice partners last Wednesday (my usual RE is out of town). He suggested I come in this past Friday to get an ultrasound to see where things stand for me. They were able to fit me in at 8am, which is great since I have to be at work a little ways away from the doctor's office. I went in (was late because I messed up getting there, another story, I was nervous etc.), got the bloodwork and ultrasound. It was fortunately a female doctor who did the wanding (I hadn't had one done in 4 years), which made it slightly less awkward.

She basically told me I had "stereotypically cystic PCOS ovaries with no dominant follicle" and that "there is no question you would benefit from medication, no question at all." Again, not anything that surprises me, but it's still not fun to hear. But, later that afternoon, she called me back and said my estradiol was a bit elevated, so there was some chance I could develop a dominant follicle sometime in the following week - neither she nor I expected that. (Although I wonder if she looked at the full blood profile closely enough - what if my estradiol is just elevated this cycle? My temps seem lower than in the previous cycle? Don't know for sure if there is a connection.)

So, I'm going in for another ultrasound on Thursday to see if by some chance I've developed a dominant follicle. I'm not holding my breath, but I guess we'll see.

My tentative plan is to ask them about Provera to start an AF very soon; do the HSG before we go away for a week (command performance with in-laws); then do the birth control pill for that month to calm down the cysts; then the Clomid. We'll see what the doctors say when I ask them what they think of my tentative plan! I want to maximize the chances that the Clomid will work (or at least not quickly cause large non-functional cyst issues that would lead to some time on the pill anyway), so this seems to make sense to me. Make sure my tube are open with the HSG, and calm down the "millions of little cysts" currently on my ovaries.

And in the meantime, I've decided (pretty much) what I'm going to do work-wise. My DH and I have drafted a letter to my boss, giving her far more detail about what I've been dealing with than I'd wanted to share... but I feel like I have no choice but to share more than I'm comfortable with to lay all my cards out, so to speak. I basically said that I didn't expect to be at the point of having to choose fertility treatments only 6 months after starting the job (I'd hoped to ovulate at least 2-3 times by now, but instead I last O'ed back in January); that emotionally this is especially difficult for me because of the loss of my late husband and the loss of having a family with my LH, and now I'm having "fertility challenges" with my new husband; that I have no choice but to have some of these appointments at times that will eat into standard work time, and with what she's said about how I would be allowed to make up some time, it would be extremely difficult to make up enough time if I start having a lot of appointments. And that the choices are either for us to work out SOMETHING in the way of time flexibility for me to have my appointments (unlikely for a variety of reasons); for her to help me find a job that is part time with benefits there and with some flexibility in the hours so I won't have to worry about that when I have appointments; or... I would have to quit (and find a part-time job somewhere else). I am not thrilled with the last option. The best choice would be the part-time gig somewhere at the company. But I don't know if it'll happen.

Nonetheless, I have decided I will make it work as long as I can (probably until shortly before I start Clomid, whenever it winds up being), and then give her the letter and see what happens. Although I am NOT looking forward to having to actually give it to her and have the inevitable super-awkward conversation, I've made some peace with knowing that this is the deal, and I have gone as far as I can with this.

Another week is starting... we'll see how this one is.

Friday, July 11, 2008


I keep struggling with the idea of meaning of life. (I seldom do anything small-scale, do I?!) I lost my LH - a great guy who was overall an wonderful husband and would have been a great father - before he was even 30. I struggled so hard with the grief (both for LH himself and for our hoped-for family) - the worst of it took up almost 2 years of my life, and then it only gradually ebbed after that (it's now been over 3 1/2 years, 4 years this fall).

In the grief, it was hard to hear about widows with kids saying how they didn't think they would be able to continue or find any meaning in drawing the next breath if it weren't for their kids. I knew that was their reality and that was great for them, but conversely - what is the PURPOSE of a 20-something widow without kids? What reason WAS there to go on, without kids to take care of, or some all-consuming consmic mission to carry me onward?

But I believed that somehow, some way, there would be some form of okay life in my future. I fell in love again and took the chance to get married again. I guess I just figured, somewhere subconsciously, that because of all I'd been through but despite the likely PCOS, I would at least ovulate occasionally and thus not be trying to decide on fertility treatments only 7 months after going off the pill. That I could at least go 9-12 months believing we had SOME chance to have a baby without serious intervention, before having to take the next step if nothing worked during that time. I know life doesn't work that way, as far as getting a "free pass" or some amount of a break if you've already been through a lot... but I guess somewhere deep down I believed that somehow, I would, anyway!

So now that I'm having to accept that ovulation (much less a positive pregnancy test) is not happening on its own and we'll need help, I guess my house of cards is coming down emotionally, and I'm really having a very hard time. It was already hard for me to be the medical patient when I had two sinus surgeries over the last couple of years - far too many memories of what I went through as the caregiver, both with my LH and before that with my mother. Starting into the fertility realm will probably be even harder on me emotionally.

DH and I have talked about not letting the meaning of either of our lives (but especially mine) be wrapped up in having kids. But given that I haven't found a job situation I'm okay with for more than a few months running and have sufficient interest in, and if it takes us a long time to get our BFP, and/or we have to go through the adoption process (which can take years), what is my PURPOSE in the meantime? Is it now to make my DH happy, only? (No, according to him, we've had this discussion.) Is that any better of a reason for my existence than being almost solely focused on being a good mother for kids to carry on some piece of me into the future?

The truth is, having kids is more central to my sense of meaning (not to the exclusion of everything else, but it's a HUGE facor) than my DH would like... he is a guy, he had started accepting that he might never have kids because we didn't meet until he was in his mid-30s, and because he hasn't been through what I've been through. I think having been widowed, and knowing that I am one of the few people who could be said to be carrying on my LH's legacy, has only highlighted the temporary and ephemeral quality of human life and human legacy.

I desperately want something, or several somethings, to survive my existence on this planet. Whether that's just a couple of well-raised bio kids and the memories of DH, family and friends, or maybe finding some way to contribute to the help and comfort of people beyond my own circle of friends and hopefully eventually adopt (and raise that child well) along with the DH/family/friends' memories, I just have to feel like there is some REASON to my being here on Earth.

And I feel like I carry my LH's meaning with me too, doubling the urgency. I feel like some part of him lives in me spiritually, so in a sense my having kids is also a small way of carrying my LH's spirit forward as well. I can't fail all three of us - LH, me, and DH - in such a fundamental way without it tearing me apart.

I hate being old before my time, as I am in some ways.