I haven't posted in a few days simply because I haven't had much to write about. Our current cycle is proceeding as planned, and I will begin using OPKs daily on Tuesday. Not much to tell on that front until my mid-cycle u/s on Friday. (Oh, one quick minor complaint: the needles on the syringes provided with the Gonal-F are much larger than the needles I used with the Follistim pen. They are at least three times the length and about three times as big around, too. Ugh. I know that my little subcutaneous injections are nothing compared to what anyone who has done an IVF cycle has endured. . . . but I've still been unpleasantly surprised by the difference.)
Oddly, I thought quite a bit this weekend about taking a break after this cycle if I'm not pregnant. It's not so much that I feel the need for a break, physically or mentally, as it is that I'd like to focus on other things which are difficult to do while TTC.
For example, I need to lose weight. While I can do this slowly through a healthier diet and exercise, I'd like to have the ability to jump-start my weight loss with something like the hCG diet or MediFast. I think it would help me tremendously to see a large initial weight loss, and that is not realistic (or healthy) while I am TTC and taking fertility drugs. Honestly, given what I've read of others' weight gain on fertility drugs, I count myself fortunate that I weigh within 5 lbs of what I did when we started treatments (albeit still much more than I should weigh).
I also feel hesitant to exercise as vigorously as I'd like to while TTC, at least during the second half of my cycle. I have no problem doing intense aerobic workouts prior to ovulation and actually am of the belief that they probably help more than they hurt by increasing blood flow to my entire body, including my ovaries. After ovulation, though, our RE has cautioned me not to do anything that raises my body temperature, and I am afraid that any vigorous exercise also runs the risk of "jarring loose" an embryo who may be trying to implant. (Not sure if there is any science behind that second part, but it's my mind.) Given that I am in a part of the country where the daytime highs regularly hit 100 degrees and above this time of year, any exercise that makes me sweat at all seems risky during the 2WW.
Not being able to work out as intensely for half the month obviously adversely affects my ability to lose weight, even if I am eating healthfully. It doesn't make it impossible, but it does make it harder.
Along with being overweight, I also have high cholesterol. Losing weight would likely help to lower my cholesterol levels, but if it did not, my PCP has told me that I should be on a statin to lower my cholesterol. Statins cannot be taken by any woman who is "nursing, pregnant or may become pregnant," so until we give up TTC or I reach menopause, whatever comes first, they are not a treatment option for me.
Also, I think I've written here before about the fact that I suffer from migraines. (I have since I was 15). Given that hormone fluctuations are a known migraine trigger, it's probably not surprising that I have been having more migraines in the past year-and-a-half or so than I did before. I've mentioned in prior posts that I have had to give up all the drugs I used to rely on for migraine control since starting treatment--Advil, Imitrex, and even Excedrin--and how that has adversely affected me.
I would really like to get my migraines down to the infrequent level they had been at for many years prior to TTC, but I wonder if this is even possible while we are still undergoing treatment. Currently I am averaging at least one day of missed work a month due to migraines (not to mention the days I have migraines which don't occur during work hours). I know that this is not a high frequency compared to many migraine sufferers, but it is much higher than usual for me, and it's obvious that missing all this work is not a good thing.
Sure, I can modify my diet to eliminate as many triggers as possible--something I have already done to a large extent and am currently working on doing more diligently and completely--but I can't help but think that so long as I am putting drugs like Clomid into my body, no amount of dietary change is going to get rid of my migraines. I mean, Clomid works by "tricking" the body into thinking that estrogen levels are low and that it should produce more estrogen. Obviously taking it is going to increase the estrogen levels in my bloodstream. I'm not sure of the effects of the injectable gonadotropins I am also using, but I know that they affect the levels of some hormones in order to work.
I've cut out alcohol, caffeine and MSG. I am currently cutting out a whole list of other foods which have been identified as dietary triggers of migraine (many of which are foods I used to eat regularly). I am exercising regularly again, and I have always been good about staying hydrated and getting enough sleep. I just don't know if all this will be enough to cut down on the frequency and severity while I continue to use fertility drugs. . . . particularly given the fact that the most effective forms of drug treatment for migraines, anti-inflammatories, are off-limits while TTC.
And forget about any daily migraine preventatives while TTC. Those are off-limits as well.
Ironic as it sounds, I guess the bottom line is that I want to take a break after this cycle to take better care of myself. Losing weight and decreasing the frequency and severity of my migraines would only be good for me.
On the other hand, the clock is ticking. I am 39, and my eggs are not getting any younger. Even if we are successful in getting pregnant this cycle, I would be nearly 40 before I gave birth. (Side note: this cycle is our last chance to conceive a baby with a due date before my 40th birthday.) I feel very much that "time is of the essence" and that there isn't any time to spare.
I don't know. For now, I am just living each day as it comes and following my protocol for this cycle. If I don't get pregnant this cycle, I can give the idea of a break some more thought.
P.S. In reading back over this post, I think I have made myself sound very unhealthy, though I have never thought of myself that way. I have spent my entire adult life overweight to one degree or another, though I never had high cholesterol until the past two years, and my migraines are just something that I live with, like many people live with other chronic ailments like allergies or diabetes or irritable bowel syndrome.