The hunt for my elusive right ovary - Clomiphene Cycle # 4 - June 14

Got my period on my DH's birthday! How romantic xx we went to a movie so got to sit and rest for two hours which was great. I seem to take a while to come on, im getting alot of what they call old blood, then one day of heavy bleeding, then tapers off. Clomiphene started 20.06.14. No side effects again this month, the odd hot flush but really bitchy again haha.

Day 10 bloods arrive, levels look good! Will post results at a later date. Waited for phonecall re ultrasound, tuens out its going to be Saturday if they can fit me in. Didnt hear from them in the morning so went out, helped Mum and my brother take my little nephew shopping for his 3rd birthday, exhausted after chasing him around Farmers off we went to Mcdonalds. After losing him in the playgroubd i grabbed him before he coukd run back in and my cell rang. Holding his jumper with one hand and cell in other i only just managed to answer it. "Hello is this Trudi... Can you come into Womens for a scan asap as i can fit you inbetween acute cases". Heh! Great timing, let Mum with the boy and raced out of the mall and up to hospital. Turns out radiology is closed on a Saturday to the public so i had to ring through to let in. I hung in a dimly lit room on my own for a bit until Jo could scan me.

No dominant follicles on my left ovary this month. Thats strange..? Well it must be my right! The ovaries alternate per month and if you count it back the last time would have been April, our month off.

So the hunt for my right ovary commenced. A previous MRI had seen it, so had a previous Ultrasound. We tried everywhere internally and externally. During the internal i saw a puzzled look on 

Jos face. My TV screen was off that day so couldnt see what was going on. She then mentioned shed found a tubular structure filled with fluid. My right fallopian tube?! Could it be? So she followed it along, still no sign. She stopped there and said she was sure the specialist will want to know about what she'd found. The radiogist called me later that night and said not sure who to tell but no follicles to mention. I said no worries ill follow up Monday. So rang nurse, she suggested another blood test see where levels at incase im running late.  Dashed up to lab at hospital gave blood and went back to work. Cell rang in the morning, they can scan me at 1.30pm today. Levels must be still up?

So, todays scan was with Penny. Turns out its the same Penny my sister had in Fetal Medicine. Shes lovely and funny. I apparently have a nice cervix and my anatomy is great to photograph. I start with my usual "Do my notes say I have UU and one kidney and a missing right ovary? She looked at me and said i thought we were only doing ovulation induction scan? I explained my dud follicles on left so must be right and we just have to find it. She was determined, as was the previous radiologist Rex, but i had faith in her that shed find it.

Neither of us were prepared for what happened next... this will need a whole separate post... 

TTC - Clomiphene Cycle #3 - May 14

Tuesday 20.05.14 (CD3) started my next Clomiphene cycle which the hospital decided to keep at 25mg per day based on the good results I had last cycle. No sense in putting it up unnecessarily as it will put me at a greater risk of hyper-ovulation.

No physical side effects that I could see this month apart from the odd spike in temp but most definitely mood swings! My goodness, did help that there was a little bit of tension in our household trying to find our house-guest alternative accommodation. I was a real bitch! There were many apologies for this as no one wanted to be around me really.

Day 10 bloods came in ok for the follicular part of my cycle, levels look good so was booked in for an ultrasound.

28.05.14 - US @ Christchurch Womens Radiology - this time I had a lovely medical student doing my scan, she said she would be supervised so had no problem with that. I told them both before we began that I had a UU and again this was not mentioned anywhere so was told to always mention that at the beginning, save everyone a lot of time.

This time we got some really great scans. Ive called the hospital to get these saved to disc so I can post a few for you all.


I had 17 follicles this time! wow, 7 more than last month. Only once single dominant follicle again, this time measuring 15mm x 17mm x 12mm. My endometrium thickness was the same as last time at 7mm, and the search began for my right ovary, this turned into a bit of a wild goose chase, they looked everywhere, both having a go, trying to push my bowels out of the way. We gave up in the end, so the radiologist had a look back at my MRI from Sept 13 and thinks that I may have a tiny right ovary deep to the caecum in the right iliac fossa. Long story short right under my bowels where you appendix would normally sit.

Nurse called late that arvo to confirm no hyper-ovulation and told us we were all systems go for BMS commencing Friday 30.06. We decided to go for everyday of my 7 fertile days this month and wait and see at the Day 21 bloods (taken on day 20 as it was a Friday so Nurse and I could chat afterwards).

She phoned that afternoon of Friday 6.06 to say Progesterone looked good for ovulation this month and we will now commence the 2WW. 

Here were my results:

Progesterone - 45 nmol/l
Reference intervals:
Follicular        1 - 4
Mid Cycle

Luteal           15 - 100

Post menopausal  <4

Estradiol - 507 pmol/L
Female Reference intervals:
Follicular        46 - 600
Mid Cycle
Luteal           160 - 770
Post menopausal  <200
Male Reference interval <160

LH - 23.1 IU/L
FSH - 8.1 IU/L
LH reference interval:

0 - 9 years       0 - 2.5 IU/L

>=10 - 15 years   Prepubertal range 0 - 2.5 IU/L. 

Levels rise during puberty towards adult ranges.

Adult male        2 - 9 IU/L

Adult female      Follicular                2 - 8 IU/L

                  Mid Cycle                 10 - 75 IU/L

                  Luteal                    2 - 8 IU/L

                  Post Menopause            >15 IU/L

                  Antenatal                 <1 IU/L

FSH reference interval:

0 - 9 years       0 - 6.5 IU/L

>=10 - 15 years   Prepubertal range 0 - 6.5 IU/L. 

Levels rise during puberty towards adult ranges.

Adult male        2 - 12 IU/L

Adult female      Follicular                3 - 10 IU/L

                  Mid Cycle                 4 - 25 IU/L

                  Luteal                    2 - 8 IU/L

                  Post Menopause            >20 IU/L

                  Antenatal                 <1 IU/L

Its Day 24 of my cycle today and I am feeling very tired and uncomfortable which I normally am prior to my period. We have decided to take a early detection pregnancy test this month before Day 30. I am incredibly nervous and trying not to get my hopes up. Hubby's birthday next Wednesday so hoping for an early birthday present... we will see. Will post results.

Well Saturday came, we decided to do the HPT first thing in the morning. It was a fairly quick BFN but had a very very faint second line at the 10 minute mark, so we waited till Day 30 to see. AF came on Day 32 this cycle. 

After doing some reading on 'timing' I have realised that those on Clomiphene can have their cycles lengthened and also ovulated later than usual on Day 19 or 20. This doesnt help! Our timing was all round O on Day 16 which tested positive on the OPK? im confused now. Just something else to talk to my Nurse about, that and the pain im getting in my right hip. Found info online about Clomiphene increasing your chances of Ovarian cancer so not taking any chances with my 'missing' right ovary.

Anyhoo, May wasnt our month, so lets try for June. Cycle 4. Ill post again soon.

TTC - Clomiphene Cycle #2 - Mar 14

Before we begin, we are getting to the part of my blog that might need some translating so here is a helpful link to some fertility acronyms that might help you out.
http://www.fertilityplus.com/faq/acronyms.html

Wednesday 19.03 (CD1 #2). Time to call my nurses at the hospital. Spoke to Stephanie and she confirmed we were all go for the same dose this cycle (25mg from CD3-CD7) as we would assess the dose and look at putting it up if we had no luck again this month.

Friday (CD3) arrived and I decided to take my dose at 6.30pm when I got home from work. They suggest you take it at the same time every day and take at night to reduce side effects as you can sleep through them. Few hours in and feeling ok. Thats great as last cycle I had the hot and cold sweats by this point.

CD4 - CD7 went ok this time, I had a few things to note like nausea, moodiness (my god I have a patient DH) and this time had very dry eyes and sinus resulting in some blood in my nose. Strange as it sounds I found a lot of similar experiences online.

I made it! that was nowhere near as bad as last month. Maybe I have some good luck finally coming?

Friday 28.03 (CD10), time for my blood test. This is to test the Estradiol and FSH levels to confirm if an ultrasound is ready to book as these levels indicate the possibility of growing follicles. I have to get these bloods done before 9am in the morning to ensure the results are back with the nurses in the afternoon. 1.00pm got a call on my cell and it was Stephanie to see if I could come in at 2.30pm for my ultrasound. Great! meds worked! Work was fine, I just said I was going and rocked up to the hospital in time, lucky my work is so close.

My sonographer was lovely. We had a chat about why I was there, she would be scanning my endometrium lining and ovaries to confirm follicle size. She asked if id had one before and I let her know my journey thus far which is great as they had not noted my unicornuate uterus or renal agenesis, that would have made for an interesting scan! haha. She took a few 'good shots' of my kidneys and think she even got a good 3D of my uterus. It seems mine is of a decent size for a 'half', lucky me.

So...here are the results of the scan. Endometrium is 7mm, that is kind of the baseline as far as linings go, but its a pass! they think it should be cushy enough for an egg. 
Follicles... 10! good job Left Ovary! Only one of these seems to be mature @ 16mm which is actually good news for me as reduces the chance of multiples. Good size for follicles is actually 17-18mm and over but as they grow 2mm every 24hrs we should be looking good for O which should be Tue/Wed (CD14/15). Right Ovary could not be spotted on this occasion due to a large amount of gas in my bowels (stupid IBS) so we have no idea where it is or what its doing at this stage but its not connected to anything so shouldn't be an issue. Feeling a wee bit anxious about this as my cycle is currently a reviewed cycle so Im not that closely monitored which means if we did end up in a multiples situation it may not be picked up till later, we will deal with that when time comes I suppose. 

Time for some BMS! (Baby making sex). Nurse has suggested we go for every second day at least to ensure enough of the boys hang around for O and DPO. DH not complaining at all haha but will need to work around our current house guest situation.

Next blood test is Tuesday 8.04 (CD21). This should confirm O and I hope to have nothing but good news for you all, what ever will be will be.

Well test results looked good for O, so my nurse said, for those that need them, I have included the reference intervals below:

Progesterone - 57 nmol/l
Reference intervals:
Follicular        1 - 4
Mid Cycle

Luteal           15 - 100

Post menopausal  <4

Estradiol - 635 pmol/L
Female Reference intervals:
Follicular        46 - 600
Mid Cycle
Luteal           160 - 770
Post menopausal  <200
Male Reference interval <160

LH - 18.2 IU/L
FSH - 7.1 IU/L
LH reference interval:

0 - 9 years       0 - 2.5 IU/L

>=10 - 15 years   Prepubertal range 0 - 2.5 IU/L. 

Levels rise during puberty towards adult ranges.

Adult male        2 - 9 IU/L

Adult female      Follicular                2 - 8 IU/L

                  Mid Cycle                 10 - 75 IU/L

                  Luteal                    2 - 8 IU/L

                  Post Menopause            >15 IU/L

                  Antenatal                 <1 IU/L

FSH reference interval:

0 - 9 years       0 - 6.5 IU/L

>=10 - 15 years   Prepubertal range 0 - 6.5 IU/L. 

Levels rise during puberty towards adult ranges.

Adult male        2 - 12 IU/L

Adult female      Follicular                3 - 10 IU/L

                  Mid Cycle                 4 - 25 IU/L

                  Luteal                    2 - 8 IU/L

                  Post Menopause            >20 IU/L

                  Antenatal                 <1 IU/L

So we waited... and waited... from Day 21 - Day 30. It really is the worst part, esp for the ridiculously impatient... I think I did quite well not to cave and HPT. It's also really hard as most pre-pregnancy symptoms are the same as PMS so you really can't sit around worrying about it all day.

So, Day 30 arrived and so did AF. It was pretty normal with one day of heavy bleeding then 2 days of very light flow. Safe to say it was definitely AF and not implantation bleeding.

We decided to take April 14 off as DH's father was very ill and our house guest also still living with us (not a stress free situation). Was the right choice as one week later my father-in-law passed away :-( May has to be the month! we are conceiving for him as we hoped he would be here to meet his grandchild. I know he will be here in spirit tho xx

May 14 will be our next cycle, waiting to hear if they will be putting me up to 50mg, after speaking with my GP she has advised to be cautious of this due to multiples and my lack of housing for them, also to find out my Fertility scoring so we know were we will be at for IVF waiting lists etc, just incase Clomiphene doesn't work we can plan for the next stage.

Fingers and toes crossed.

TTC - Clomiphene Cycle #1 - Feb 14

Wednesday 12/02 (CD1 #1). I decided it was time to call the hospital to start my first Clomiphene cycle...why wait? Still not up to 56 kgs (BMI baseline of 20) but decided to call the hospital anyway. My nurse at GYN Outpatients was really helpful, normally it would be a case of needing to lose weight, so she said "lets just do it" and see what happens. So she faxed a script through to my chemist for me to pick up and start on Friday (CD3).

Later on that day I found out my husbands grandmother passed away. Tickets were booked for Sunday morning Christchurch to Auckland so we could meet Fraser's sister from Sydney there and drive to up to Whangarei to be with the family.  

After talking to my mother that night she asked if it was a good idea to be starting this cycle with all of this going on? I said, of course! we will be fine, sooner we start the better.

Thursday (CD2) I called the chemist to confirm the script was ready to be collected and they queried why I had half a tablet for Day 3 to Day 5, I said I suppose that's right? I later on found out later in the month that this was not right, on reflection I should have checked with the hospital.

Friday came, Valentines Day (CD3). As I take Thyroid meds in the morning I opted to start my Clomiphene in the evening, so after I got home from work I took my first half a tablet, so 25mg. Later on that night I definitely started to feel hot and cold, wondering if I had picked up a bug. After doing some packing I decided to go off to bed.

Next morning I got out of bed in a rush as things to get done before we left for Auckland but after getting up I found that I could hardly walk fron lethargy, nausea and dizziness. Great... side effects from meds? bug? wasn't sure, all I knew is I got worse throughout the day and was anxious as I had a 7am flight the next morning (Im a terrible flyer anyway).

I made it to Auckland in once piece, just! after a very nauseating drive to Whangarei I spent the next two nights hardly sleeping due to intense stomach cramps, hot flashes and headaches so bad I could hardly move my eyes or head. I managed to make it through the funeral and family get together.

When it came time to leave Whangarei the following Wednesday I was stoked to be going home, and off the meds, still blaming them for these "side effects" which later I found to be common for alot of women but not that common.

CD10 arrived Friday 21/02. Time for my blood-test. Went in before work as need to get them done before 9am so results will be across to hospital that afternoon. Testing for FSH, Estradoil, etc. Results came in, weren't good, so off next day for another blood-test in the hopes we were too early, and nope, levels dropped again. No ultrasound for me this month, the whole cycle was a bust. Nurse said she was concerned my dose wasn't right and she would check with GYN, lets get it sorted and try again next month. I counted out my 30 day cycle and realised that cycle would be just before my 34th birthday.

Time goes by, sooo slowly.

Im normally a patient person but this past year has gone sooo slow. I knew I was in for a long wait tho, they keep telling me good things take time. 

My weight gain has been painfully slow. Jan 2013 to Jan 2014 i think ive gained just under 6 kgs. Im nearly at my optimal weight to start my meds, will be sitting just inside the optimal range so the next 28-30 days will be lots of eating and sitting round to make sure i keep that weight on.

Starting to freak me out a little that by next Christmas we could have a new family member to celebrate with, not getting my hopes up to high tho as my Thyroid is going to make TTC very difficult.

Ill update again when i find out more about the Ovulation Induction. Bring on February!

Finally see the specialist

18.10.13  - Todays the day!

Arrived to my appointment at the Assisted Fertility Clinic to find DH in waiting room, he was early, I late, after getting my car stuck under a railway barrier arm (dont ask haha). We didnt have to wait long and a nurse led us round to a consulting room to wait. We were in there quite some time before Dr Tawfeek and my next med student arrived.

Was not a long appointment, he was on call so answered his phone a few times. He confirmed my unicornuate uterus, one fallopian tube, one possibly two ovaries and my missing kidney. He even drew me a diagram which I thought was sweet, however informed him of the excessive Googling i had done on myself haha.

Regarding my test results, he confirmed its highly unlikely I am ovulating, unsure if its the thyroid, weight, or the UU. Tube looks fine so if egg is present should be making it there. Sooo after talking about my diet, thyroid, plans etc it was decided that we would try the ovulation drug Clomid however  until i can get my BMI up to 20-22 (currently 19) and thyroid TSH level down (was 4.8) needs to be below 2.5, then I would not be able to start.

8.11.13 - Since appointment I have had a great result for my thyroid, its down to 1.4 so will remain on the 100 mg daily Mon-Fri and 50 mg daily Sat/Sun. Seen the dietician and have a diet plan to get that weight on, its tough as the Levothyroxine speeds up my metabolism so I have to pay attention to input/output.

Hope by Xmas ill have a few kgs on me so I can see the nurse at Chch Womens and get cracking.

Its going to be many months of drugs, blood tests and internal/external ultrasounds until we know if its working or not. Lets not waste any time.

My new nephew is due to be born this coming week, so im thinking all that time up at Chch Womens Neonatal ward will have me clucking all over the show.

Update again soon.

MRI again confirms it

17.09.13 - last MRI, I hope!

I arrived way early for my 8:15am appt, which is better than being late. The lady at reception said they may take me early and as luck would have it they did. I had a lovely young man that sat down with me and DH for a chat. He confirmed no IV dye or IV to stop my bowels from moving so they got me in early so we had a bit more time up our sleeve for some extra pics. Best thing about spending 30 mins in this machine was no gown...I got to stay mostly dressed so I was nice and warm, im ridiculously cold most of the time. Upon disembarking the lovely young men that photgraphed my insides confirm they got some great shots of my uterus. Nice work guys lol. 

So, I gave it a week then called my GP for the results...Yup! Its definitely a unicornuate uterus! But a decent size one? Lol. No rudimentary horn that they can see, so still no surgery on the table. Still big question mark on the right ovary, seems to be a now you see it now you dont situation. So all good news so far.... Fingers crossed it stays that way

Right now that those tests were done I called the outpatients at hospital to make sure they were aware and no, was still on wait status, that was promptly changed and lovely helpful lady went on hunt for my HSG results. She also put me on the cancellation list as with only 2 more monthly clinics to go this year It wasnt looking hopeful to see specialist until after Xmas.

Not even one week later my cell phone rang. 3 cancellations! Yipee! All booked in with GYN 10.30am Friday 11th October. This is it. Everything is about to get very real!

Update to come next week...with some answers...Eee im excited and scared at the same time.