HRT and Cycles

Wow, I can't believe the summer is almost over and it's been April since I last wrote a blog post. Way too long!

Back in March I got my first cycle, after having nothing since being diagnosed, this was a huge hope for us. I had some normal cycles (28 to 30 days) and then in May/June ended up having a menstrual cycle for 21 out of 30 days, yikes! After talking to my doctor he decided to take me off my bioidentical HRT to see what happened with my cycles after not taking the medication. They thought that I was possibly in remission from POF. Music to my ears.

I started HRT back in October, nothing happened until March...5 months. Based on that information they didn't think it was the HRT causing the cycles. The one thing about POF is that you can go in to remission. The doctor was hopeful that is what happened, my ovaries decided to wake back up and work. The only thing they warned me of is that we don't know for how long or if anything will work while it is happening. With this disease there are a lot of questions and a lot of unknowns. At the beginning I struggled with this a lot. I like to know what is going to happen, I am a planner and an organizer. There was a little sliver of hope that something might happen. There have been cases that women who are in remission have a mature egg that drops and pregnancy happens.

After quitting the pills in June, nothing came in July...nothing came in August. Failed pregnancy test and I was back to the doctor. We chatted about what it all meant, again so many unknowns. All I want is an answer. I had my blood work redone to test my hormones. They all came back the worst they have ever been...Blah!

	April 2015	August 2015
Estradiol	35.2 pg/mL	17.5 pg/mL
Progesterone	3.2 ng/mL	.9 ng/mL
FSH	58.4 mIu/mL	127.1 mIu/mL
LH	22.2 mlu/mL	47.5 mIu/mL

Estradiol goal is 50, Progesterone goal is 10, FSH is supposed to be under 10 and LH is supposed to be less than 7 in order to reach pregnancy. Definitely not where I wanted to be. But, it is out of my control. I understand that but it still doesn't make it any easier to swallow.

So, I went back on HRT starting in August.

Show Us Your Life - Infertility

I am linking up to Kelly's Korner blog this morning. She does a "Show Us Your Life" post on Friday's and today is about infertility.

I was diagnosed with Premature Ovarian Failure (POF) in February 2013. I had just turned 29 years old. I have been on my journey now for one year.

POF is the loss of function of the ovaries before age 40. Basically your body goes in to premature menopause. Most people with this diagnosis have hot flashes, night sweats, etc. All the signs of menopause. I have been lucky so far. My only symptoms are my high FSH and amenorrhea.

I was also diagnosed last month with hypothyroidism. This means that I have an underactive thyroid. There is a lot of information out there linking infertility and thyroid issues so I am hoping this will get me one step closer.

Since I started my journey last year I have decided to take a more natural approach. I have been to numerous doctors, 2 fertility clinics and have received the same information from all. That I have a 5% chance of getting pregnant on my own, the same is true if I were to do IVF, only 5% chance with that as well. Since the percentages are so low the only option they give me is donor egg through IVF. My ovaries aren't working but, my uterus would be able to carry a baby.

Back to the natural part. I take herbs/supplements each morning and night. I have been going to acupuncture. I started Mercier Therapy (natural/manipulative therapy on your abdomen). All in an effort to get my body back to what it is supposed to do.

One thing I have learned throughout my journey is that you can never give up hope. It isn't easy, everyday reminders of pregnancy, people my age all having children. Infertility can be a very lonely world. Everyone in my life has been very supportive but unless you have gone through it/are going through it, it is hard to understand.

I have really learned a lot about myself so far. I am a lot stronger than I ever thought I was. My husband is amazing, I knew this before, but until you go through something this hard I guess you don't appreciate it as much.

I am happy about our decision thus far. For now we don't want to do the donor egg/IVF option. We have talked about fostering/adoption. But, aren't in a hurry. We do have some time. One other thing that I have learned is to take time to think about large life decisions. Everything does get better with time. A year ago at this time I was much more emotional/raw. Since then, I don't cry as often and have become stronger when talking about it as well.

My blog is about my journey so far. My hope is that I will be able to help just one person.

Will be praying for everyone going through this journey as well XOXO

Thyroid Testing Results

I had my thyroid appointment last Thursday. I went to Dr. O. I really liked him. He actually sat and spoke with me for 30 minutes which most doctors that I have seen have not done that. He was very easy to talk to and was in agreement with everything that I am doing. He also has treated a patient that has the same thing I do so I really feel like he gets it.

I received my test results this morning. My thyroid is mildly underactive with a mildly elevated TSH. Ideal is 0.7 - 1.0 and this number elevates if your thyroid is underactive. Mine is 2.74 so it is elevated. So I have officially been diagnosed with hypothyroidism. He is suggesting I start a trial of Armour thyroid - I will take one pill a day for 6 - 8 weeks and then get my hormone levels tested again. We spoke last week about the pill as well - it is a more natural pill so I like that aspect of it, it goes along with my path that I am taking. He told me that he likes to start dosages out low and go through a trial period and then increase it if we aren't seeing results. My pill that I will start out on is 30mg.

He also told me that I don't have Hashimoto's thyroiditis. I was so sure that I had it that I wasn't prepared at all for that answer. I was fine initially finding out about it. But, the hard part for me is telling people. The first thing I did was call my husband and I just broke down in tears. Each time that I have to tell him this isn't it just kills me. I just feel like when there is a problem I should be able to fix it. And I can't do that with this.

I asked the lab since they were taking my blood if they could test my FSH and LH while I was there. FSH (follicle stimulating hormone) is the hormone that they tested at the beginning, since it was so high that is how they diagnosed me with POF. The highest it has been is 123, then it has also been 114 and 104 so I guess a positive would be this is the lowest reading I have had - 94. However, in order to get pregnant they say it should be under 10. Other things that I have researched say that it isn't a true reading anyway unless it is on day 3 of your cycle and since I don't have one it is an inaccurate reading. I guess it is all in the way you look at things.

All of this and the fact that it is freezing cold and dreary outside, my husband is out of town on business and I feel like I am coming down with a cold didn't make for a great day. Lots of tears and disappointment. I normally try and be positive but this is real life and I am blogging so that I can look back once I am pregnant and see all that I have been able to overcome. So, I am just putting all the truth out there, even if it isn't pretty.

Below are all of my test results:

Test	Result
TSH	2.74
Free T3	3.5
Free T4	1.28
Reverse T3, Serum	14.1
Thyroid Peroxidase	8
FSH	94.5
LH	34.3

I picked up my pills this evening and am going to start taking them in the morning. 

Second (Or Third) Opinion

We had decided after our appointment at the first fertility clinic that we would get a second (or third if you count the regular doctor) opinion.  We went the same week that I started taking all of my herbs and supplements.

6/13/2013 - Arkansas Fertility

The area that we live in does not have reproductive endocrinologists.  The first place we went was a couple hours away.  Our trip to Little Rock for this appointment was about 3 1/2 hours away.

Dr M welcomed us in to his office.  Right off the bat I had a good feeling about him.  We told him that we really wanted some one to explain to us what the diagnosis was and what our options were instead of being told what we had to do.

He reviewed my previous hormone tests with us:

• Testosterone - a little high
• LH - 42 which is high
• FSH - very high (I already knew this one!)
• Estrogen - 14 - low
• Calcium - little high - one point above normal (this is good)

He told us that I definitely have Premature Ovarian Failure which is now being called Primary Ovarian Insufficiency (POI).

• 4 - 6% of women have spontaneous pregnancy, they have no idea how this happens

He requested that I definitely keep taking DHEA - 75mg daily because it has proven results

One of the things that I am at risk for with this diagnosis is osteoporosis.  Most women go on HRT (hormone replacement therapy) but he suggested I don't have to do this at this time.  I should have my hormones levels drawn yearly.

• Thyroid, diabetes and parathyroid (metabolics profile)
• Should have bone density test completed within a year - request dexascan - if it is decreasing then I need to start HRT right away

If I have a period on my own then I should go get my progesterone tested 3 weeks from the start of my cycle to check for ovulation.

My chances on IVF are 5% which is not large enough for them to consider doing based on my body not having very many eggs.

Egg donor treatments are $20,000 a try and there is about a 70% chance of pregnancy.

After meeting with Dr M and getting all of this information we definitely felt like the natural way that we had chosen was the way to go.  It just feels right and much less invasive.  We decided that day that we would do everything in our power to do this the natural way, and if it doesn't work then we know that we have tried and would be able to move on to foster/adoption or whatever our hearts lead us to do. 

I do have to say after meeting with Dr M I was much more at peace.  The appointment in Tulsa gave me nothing but anxiety.  Dr M had wonderful bed side manner and actually took a complete hour to speak with us.  As I have found out the hard way, most doctors won't give you that kind of time.

I do suppose the saying "time heals all wounds" helped at this appointment too.  The diagnosis wasn't as fresh as it had been the first time.

High FSH = Premature Ovarian Failure

When I had my blood drawn my original FSH came back as 114, the doctor thought maybe it was a false reading so I went back in and had my blood drawn again on 2/11/13 and that level came back as 104.  Below is a chart of what normal FSH ranges are:

Phase	Level
Premenarchal	0 -- 4.0 mIU/ml
Through Puberty	0.3 -- 10.0 mIU/ml
Menstrual	4.7 -- 21.5 mIU/ml
Perimenopausal	Higher than 30 mIU/ml
Menopausal	Higher than 50 mIU/ml
Postmenopausal	30 -- 134.8 mIU/ml

So, what I was being told was that I am 29 years old and have postmenopausal levels.  Who even knew that could happen, it for sure wasn't me!

The first thing we do in today's day and age when finding out about something that we know nothing about is to Google it! My husband is the master of all googling, he can always find things that take me hours to find. He is a big researcher on anything that he is doing, purchasing, etc.  He was able to find a forum called fertile thoughts.  This forum has so many stories on specific diagnosis.  It helped us to understand what all the acronyms are with infertility and a slew of hormone levels.

The doctor also had me come back in to get additional blood drawn for a "Fragile X" test as a pre requisite in order to go to the Fertility Clinic in Tulsa.  This test was taken on 2/14/13.  The results came back as negative - meaning the reason for my POF was not Fragile X.

On 2/15/13 we were officially referred to Tulsa Fertility Center to set up our appointment.