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.

Where There Is Hope...

I found this quote and it is so true for me this week...

Through our entire journey I have tried to never give up hope. That is the one thing about it, always something to hold on to. When we decided to start our adoption journey after struggling through our infertility journey we had to lay some things to rest. 

Things that most people our age don't have to do. Infertility is such a grieving process. I don't think you truly know unless you have gone through it. You have to grieve a baby you may never have. Just like a death. Except you have to say goodbye to someone that you never even got a chance to meet. Which may sound crazy to most people, but it is the truth. And it is so sad, you never know when the end of the road is. There is always that little glimmer of hope that you just can't give up on.

When you are growing up you picture what your family will look like when you are grown. That your children will look like part of you and part of your husband. You hear it all the time; he/she looks so much like you. That is one of the many things that infertility strips from you. That we may never have someone say that to us about our future children.

This Monday was a HUGE day. After 2 years and 10 months of nothing, no signs whatsoever of my fertile years. I got my cycle back. So many emotions have been involved. I cried, was in disbelief, complete and udder shock. 

I have had two reproductive endocrinologists and two OBGYN's tell me that this will never happen. That I would never get my cycle back because I am in full blow menopause. We have tried everything for almost two years. Countless herbs, supplements, fertility tea, castor oil packs, drinking the nastiest tasting thing I have ever had; wheat grass! And all in one day, everything changed. Just like that. 

I don't know what made it happen, will probably never know. But, I do know that after all of our hard work; it feels like it has finally paid off. 

I am still getting my massages and I feel like that has a lot to do with it. When I called my massage therapist to tell her the news I had tears in my eyes. She was so thrilled for me as well. And has stood behind me every step of the way. Always going the extra mile to help me out and to help me get answers. I am so indebted to her for being my cheerleader. I know that God puts people in your life for a reason and I truly believe she was put in mine for a reason.

One of the things that I have researched that if I ever did get my cycle back was to get cycle day 3 (CD3) testing. I went to the doctor on Wednesday and had that done. Very hopeful for good results. All of my numbers have improved, greatly from what they have ever been before. My FSH which is one of the big factors, the number has always been off the charts. 114, 104 and 94, my CD3 test came back as 58. That is by far the lowest I have ever seen in my results. I wasn't very happy about it at first because it is not what it is supposed to be. It has to be under 10 for a chance of pregnancy. And I feel like I am a long way from that. But, if I look at it as glass half full, it has gone down substantially.

While talking to my sister on the phone that day she told me to celebrate my victories, no matter what they are. I love her and the support she gives me each and every day.

While sitting at dinner on Thursday night after the roller coaster of emotions from the beginning of the week, Benji and I were talking about it. I was being hard on myself and feeling not so happy about the results because they are not what they are "supposed" to be. He is another person that I am so grateful for. He is here for me in the day in and day out of it. And never waivers, always giving me the boost I need. Telling me how proud he was of me and how far I have come, it brought me to tears.

This is a HUGE victory for me. And for that I am thankful. 

Where there is hope, there is faith. Where there is faith, miracles happen. 

So now I get to count my cycle days, something that I have never been able to do since I have been diagnosed. And to still have hope for our little miracle.

I don't know what next month will bring, if it will come back or be non existent again. But I am choosing to be grateful for our victory.

Our Next Step

We have been taking a break from everything to do with infertility. Just taking the time to be a couple without the stress of everything. This is easier said than done though, especially with me. I take supplements in the morning and at night, as well as my thyroid medication and HRT. This is an everyday reminder to me of what I have.

Ever since being diagnosed we have fought with everything we have to be able to reverse this nasty disease. However, during the course of the last two years we have chatted about adoption a time or two. Always saying that we would come back to it when and if we are ready. 

When we were on our vacation in July at the beach we had a date night. That night after we got back to the condo we walked down to the beach and sat in some chairs and just talked. Talked about where we have been in regards to being childless, what we are currently doing and what the future looked like for both of us. We both know that we do not want to live our lives without kids. So, after about an hour we decided that we wanted to look in to adoption and see what it was all about, since neither of us know much about it, just the normal things you hear from people. The high cost of it and the long waits for child placement.

After arriving back home to our normal everyday routines, I had been looking online through the state's website. You can sign up through there and submit your application online. That starts the process, then you go through a home study, about 30 hours of classes as a couple and then you are open to get children. 

I wanted so badly to fill out the application and submit it, we were ready for the next step. All that was standing between us was that one little submit button. Before hitting it, we talked about it again and decided we just weren't ready. One thing about marriage is that there is an ebb and flow, you have to compromise, be on the same page. Especially about life altering decisions. So we waited. And thought more and more about it.

One thing that infertility will teach you is to be patient. And I have a feeling through the adoption process we will be learning more and more about patience.

We were sitting out on our deck one night, just chatting about life. And I brought up the whole adoption discussion again. We talked about the things that we are both scared of. We talked about the joy that it will bring us. 

I do believe the two additional months that we both waited and reflected made us even more ready for our journey ahead. 

Since then I had been reading a lot about the differences in state adoption and private adoption. State adoption you normally get older kids, you do have a chance of younger but not a big one. With private you are able to get an infant. 

That saying that "everything happens for a reason" is so true, especially in this case. I think that we would have rushed the thought and actions the two months prior so I am so glad we waited. 

That brings me to where we are today. We are going to adopt, preferably an infant, a child that we can raise with our own morals and values. A child that we can show them the value of family, growing up with the two great families that we are blessed to be a part of.

We are so excited about our future and what the coming months will hold for us. We are happy to announce that we have officially begun our journey to adopt!

Hormone Replacement Therapy - HRT

Since being diagnosed with Osteopenia, my doctors have stressed the importance of Hormone Replacement Therapy (HRT). Since my body is in premature menopause my estrogen is low which normally happens much later in life. With me being so young it is important that my bones are protected since they will be without it for much longer.

I am the type of person that likes to think things out. These are big decisions in my life, taking something for the rest of my life. I was on birth control for 12 years, I don't know for a fact if that had anything to do with my POF, but my body was being tricked each month by hormones that I wasn't actually producing myself. So, I have been thinking about what to do since the end of July.

Since this journey started I have taken a more natural approach, because that is what I believe in. I do not want to force something if it isn't going to happen on it's own naturally. But with saying that I do want to be able to live a long and healthy life the best I can.

My thyroid doctor offers bio-identical hormone replacement. The thyroid medication that I am taking, prescribed by him, is natural instead of synthetic as well.

Natural or bio-identical hormones are the exact same molecular form of the hormones that humans naturally make. They are made from a natural hormone in sweet potatoes or soy beans that is easily converted to natural human hormones.

Based on this information I knew this was the therapy for me.

I made an appointment and went in on Wednesday, 10/1. We discussed the different options, since I had already researched it some we were able to talk awhile about it. One thing that I love about Dr. O is that he takes the time to explain things to me. There is nothing more I don't like than a doctor not willing to talk to me and treat me like a number. He is the exact opposite of that.

I had my blood drawn to check my Estradiol and Progesterone. He also wanted to check my vitamin D, I have been taking this in supplement form as well as calcium and magnesium for my optimal bone health.

• Vitamin D, 25-Hydroxy came back as 86.3 ng/mL, this was in range
• Estradiol came back as 49.5 pg/mL, this should be in between 60 and 100
• Progesterone came back as .4 ng/mL, this should be in between 10 and 20

Not really alarming news to me, when I have had my estrogen and progesterone tested before they always came back low. So, I wasn't expecting any different.

After speaking with the doctor he went ahead and put two prescriptions for me, one for estradiol - .5 mg and one for progesterone - 100mg. We are starting out low and slow to see how my body reacts to it and then will increase the dosages if needed. 

That brings me to today. 

I went by the pharmacy to pick up my prescriptions so I could start taking them. Since it is Friday I decided to just go through the drive thru so I could get home since we had plans for the night.

The lady grabs the two prescriptions, then gets on the speaker. She apologized first, I am guessing because she can see that I am younger, then she said I have to ask you a question in order to be able to give these to you. From the moment she said that, I already knew...

Are you pregnant? 

I swallowed hard and simply said no. This is such a heartbreaking thing for me to answer. Then I got to thinking, crap...I am going to have to answer this every time I am guessing. 

She apologized again, she was a very sweet lady. Stating that by law she has to ask the question. I get it, I understand...but that doesn't make it easier.

As she was sending them out, I asked her if there was a way they could put something on my file. She said no, there was a place to put if you ARE pregnant but there is no where for her to put if you aren't/can't become pregnant. Wonderful news! Oh the joys of infertility.

So, that is one set of prescriptions I will be sure my husband picks up!

Endo Appointment and What Next?

I went to my long awaited endocrinology appointment today. When I originally called back in April, they told me it was a 2.5 month wait. I swear sometimes nothing can be easy. If there is anything I have learned through this journey, it is patience.

I had been researching and reading about the pituitary gland. It interested me because there are 6 hormones that are secreted from it. Three of them that I had previously tested and had issues with.

• Human Growth Hormone (HGH) - I don't have any signs or symptoms of this
• Thyroid Stimulating Hormone (TSH) - I was diagnosed in January with hypothyroidism
• Andrenocorticotropic Hormone (ACTH) - the reproductive endo in Little Rock had checked these levels and they came back in range
• Prolactin (PRL) - I don't have any signs or symptoms of this - my blood test levels came back normal on this when tested
• Luteinizing Hormone (LH) - all of my test results from this have been high
• Follicle Stimulating Hormone (FSH) - all of my test results from this have been high (this is how I was originally diagnosed with POF as well)

We began the appointment by going through my pages of test results. I have a one inch binder that I carry around with me to all my appointments. It has all of my medical records, research and inspiration in it. I am sure all of the doctors think I am crazy! 

The doctor was very nice, he explained everything to me. I like this and I like being able to understand what everything means. 

He read through my original thyroid results and noticed that each thing that was tested showed in range. I had never looked at it when I first got it. My thyroid doctor told me that my levels were mildly under active so I went with that. I think this whole time I have wanted something to blame my infertility on. And this was just one piece to blame. It was like a dagger to my heart to hear that there is probably nothing wrong with my thyroid. I know that may sound extremely weird to someone, but when you are told you have a problem, you want to fix it. You want to have a reason. Frustrating doesn't even begin to explain it. Now I am to the point that I don't know who to trust. What doctor is telling me the truth? 

After that blow, he went through my other hormone levels that were off. Since my LH and FSH have always been so high he said that means my pituitary is working on overdrive. So, there is no need to test it or look in to it any further. If there was something wrong with it the number would be low. They are the opposite. Since my ovaries aren't responding they just keep secreting the hormones, causing the levels to elevate. 

I usually do pretty good in my appointments now a days. But, once someone starts giving me sympathy it makes me so emotional. I of course started crying, then once I get worked up about it I usually can't stop. Nothing like a little awkwardness! 

He also did a physical exam, checked my reflexes, eyes, throat, thyroid, lungs, etc.

He explained just as the other doctors have that most of the time with my diagnosis there just isn't a cause for the disease. It makes me feel so helpless. I have tried everything that I know to do. 

For a year and a half. In the grand scheme of things that doesn't seem like that long. But when you are living it every single day it seems like an eternity. I have never wanted something so bad in my entire life. 

In my head this was the last thing that I had to get checked out and I was just sure that was it. Each doctor I go to, I am just sure they can give me a reason. 

I think the time has come that I just accept that I may never know the reason. 

That isn't easy for me to say. That doesn't mean I will ever give up on it or myself. Or my future family. I will fight this until the day I die. I may not know why now, but I know that everything happens for a reason. And maybe I just can't see the big picture right now. 

We have a busy couple of months coming up. I plan to spend that time taking a break from all of the research/medical records. Constantly asking why...I just need to let myself breathe and relax. Take time for me and take time for us as a couple. Slow down and enjoy family and life in general. I feel like once we have the time to do that we will know what the next step will be in our journey.

I will always lean on hope and know that this will only make me stronger.

I found these two quotes and I absolutely love them.

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. 

Hormones Rechecked

I have been doing my daily regimen of herbs and supplements.  Eating better, exercising more frequently. Going to bi weekly appointments of acupuncture.  I also go to the chiropractor once a month.

We decided to get my hormone levels re checked to see if there had been any positive improvements.  It has been exactly 3 months since I started my natural process.

I called my doctor here and asked to get my blood work taken, they told me for the tests I was wanting I would have to go to the local hospital.  I went in this morning and had my blood taken.

I feel like there is a lot riding on this.  I have made many changes that I believe in and not to mention the financial part of it; all the pills that I purchased and appointments.  It all adds up.