Well, it's been six months. So I have a lot to update.

I'll start with the cycle below. I left the blog last as I was going to get an ultrasound. The ultrasound wasn't great - the tech found free fluid and an 11 mm uterine lining.

The nurse freaked out. She said that my fibroid had grown (it was now 5 cm) and was now eating its way into my uterine lining, causing the uterine lining to be larger than it should be. Perhaps the Clomid caused it to grow very quickly in two months. She said I should see a specialist and have the fibroid removed. She said I shouldn't try to conceive until I saw someone because the fibroid was so huge it would cause problems in the case that I DID get pregnant.

I was pretty devasted. The cycle I was so excited about was over, and now I had to wait to get an appointment with a specialist. I made an appointment as soon as I could, which was 2 and a half months away.

At the same time, we were moving into the new house (which is great by the way). So a combination of being busy with the house and being frustrated with fertility proved to be an end to my blog. At least temporarily.

But now I'm back, baby! So here is what happened since then:

During the 2 months where I was waiting for an appointment, I didn't take my prenatal vitamins, I didn't track my ovulation, and we didn't try to conceive. Looking back, it was a huge waste of time. Any time I don't try to get pregnant is a huge waste of time.

Finally, I started seeing a reproductive endocrinologist at the University of Chicago. Unfortunately this means that I have to drive an hour or more to get there. But, he's good, and he accepts my insurance, so that's that.

The first thing he wanted to do was a saline-injected ultrasound to check on my fibroid. Basically, this is a procedure where they inject saline into your uterus and look at it through the ultrasound machine. Because the saline is clearly visible on the ultrasound, they end up with a 3-D vision of my uterus. They can see where the fibroid is, how much it hangs into the uterus (and thus interferes with fertility) and any other problems.

After the procedure, there was good news and bad news.

Firstly, the bad news. He said that the fibroid was actually 8 - 10 cm. This was a huge growth from the previous month. My heart fell into my stomach.

The good news though was that it was all on the outside of my uterus, and didn't go into the uterine cavity at all. That is good for fertility. He said the only potential fertility problems it could cause was that it was so big that it pushed my organs around - namely my left ovary. This is why my left ovary is always hard to see on ultrasounds.

So I talked with the ultrasound technician for a long time after the doctor left. I was so concered about the growth. Were talking about it growing from 3 cm to 10 cm in three months!

If you're not familiar with stuff like this, the problem with stuff growing at a large rate in your body is that it can be malignant. Meaning, cancer. I mean, a fibroid IS a tumor afterall. And if it is growing rapidly, you then have a rapidly-growing tumor. That's never good, and it's often very bad.

But, luckily, the ultrasound technician was able to explain everything to me very clearly and together we figured out the issue. She said that there were multiple fibroids forming a big lump on the outside of my uterus. That one lump could be measured at 8 - 10 cm. Inside the lump there were various fibroids, measuring different sizes. They can easily be measured anywhere from 3 - 5 cm, thus explaining the various sizes I've gotten in previous ultrasounds.

The main measurement to look for is the overall size of my uterus, which includes the fibroid. This number hasn't grown at all in the last year or so, which is terrific news.

We also figured out that the reason for my nurse freaking out before was that I had actually ovulated! Hence the free fluid. The lining that measured 11 mm was actually very healthy for around ovulation time, it had nothing to do with the fibroid at all. That nurse freaked out over nothing. And I wasted 3 months over nothing.

After we found out that that fibroid was OK, Kevin and I decided we would do 3 months of natural cycles. I had lost some weight, my cycles were getting longer, and we thought we'd have a chance.

All negative.

So back to the RE.

The new RE had me take a blood test to start off his treatment. I kept asking him about the FSH to LH ratio - my FSH was a higher than my LH, and they are supposed to be about the same. Everything was still within normal limits, but it was something I was curious about. He said we would go ahead and test it again. I also asked him to include an insulin test, since I've been losing weight and lifting weights and hoped I had lowered my previously-elevated score.

Again, we got good news and bad news. The good news is that my insulin level was lowered, and was now within normal limits (It is supposed to be below 17. Previously it was 18, now it is 11. Yay!)

The bad news is that my FSH was 13.6. They are looking for a number at least under 10, hopefully under 6. Now, for those of you who aren't obsessed with fertility issues, FSH stands for follicle stimulating hormone. This is the hormone that your body creates in order to get the ovaries to produce eggs. A higher score means that your body has trouble telling your ovaries to make eggs, so it needs to pump out more FSH to continue a normal cycle. This is bad. It means that my ovaries are sluggish for some reason. The RE wouldn't call it "premature ovarian failure" but it is sort of a preindicator of it. It also means that if we try to stimulate my ovaries to produce more eggs (say, for an IVF treatment), it will be more difficult because my ovaries are resistant.

This of course sent me into a tailspin. Everything online said that if you have an FSH higher than 10, you should look into donor eggs. I spent a long time looking through possible egg donors, I figured that if I couldn't provide the egg, at least I could get an egg upgrade!

When I met with the doctor he said that my age (31) meant that I still should be able to produce my own eggs. The high FSH number just meant that I might need higher doses of medications.

However, he recommended that I skip the Clomid phase which we were originally going to start with, and move directly to FSH injections. The idea here is that the FSH injections would stimulate my ovaries to produce more, stronger eggs without the negative side effects of Clomid. The downside is that they are much more expensive.

But, we took the dive into expensive, not-covered-by-insurance fertility treatments.

Here is something I posted to my favorite message board, to explain my first injectible cycle. I'll end it there for today, because I think that makes my blog up to date:

Well, I'm doing an FSH injectible cycle with IUI, and I started off with two cysts (one was 12 mm and one was 18 mm on day 3). The doctor said to go ahead and start injectibles and I did (75 units a day).

On day 6, I had one 12 mm follicle and a 5 mm, plus the two cysts, my estradiol was 190. The 18 mm cyst had grown to 30 mm! But the RE said to continue.

Then on day 8, the 30 mm cyst had popped (there was fluid in the cul-de-sac and it was gone). My estradiol dropped to 104 but I still had three 5 mm follicles and one 15 mm follicle.

The RE said it was because the cyst popped that the estradiol went down, and that I should continue.

So, on day 11, they looked again, and my biggest follicle was still 15 mm but the 3 smaller ones were now around 10 mm. But there was still fluid, and I've been charting my BBT and my temp was still up since day 9 or so.

So this time I asked them to take a progesterone test to see if I ovulated. The nurse was kind of resistant, but the RE agreed. He said the chances of someone spontaneously ovulating on this medication is less than 5%. Also, he said that since I was using a fertility monitor, I would have picked up an LH surge if I had ovulated spontaneously.

I also asked if the cyst that popped could be producing the progesterone - he said it is rare, but it could happen, and that would mean that the cycle is busted (since the progesterone produced by the cyst would interfere with the hormonal balance of the cycle).

Well guess what? My progesterone was 8.5. So they now say I ovulated after all! It's very rare, she said, but it looks like it happened. Luckily, we had sex on day 9 and 10, so she thinks we may have caught the egg. I really hope so.

However, I've also been using a Clear Blue fertility monitor, and I haven't gotten a peak on it yet, indicating an LH surge. Personally I don't think I have ovulated yet and it was just the cyst that popped.Anyone have anything like this happen?

Regardless, next cycle I'm going to make sure I don't start out with any cysts. He is also going to include Cetrocide since I like to ovulate on my own. I've had three medicated cycles, two with Clomid and one with injectibles - on two of those cycles I ovulated on day 8 when they said I shouldn't have!.