Ready, set, wait?

** Initially written 01/10/11**

5 years. We've been married for 5 years now, 5 and a 1/2 almost. After the 1st 4 yrs, our families have stopped asking us "When?". In that time, all 3 of his brothers have married, 2 of them already have kids (1 of those 2 has 2 little girls). His 3rd and younger brother is expecting his 1st with his wife; she's due mid-May. As for my family, my oldest sister has had her 3rd kid, who is on his way to 4yrs. My younger sister has a 2yr old. Thankfully, my youngest sister is finishing school and all that.

By coincidence, when they stopped asking us was when we were ready to start. "When you're good and ready" was when we were finally ready. Boy, were we ready. My "biological clock" started ticking like a gong. I started "aww"ing at babies and little kids, at least to myself if not out loud. The thought of my belly swelling with our child almost brought tears to my eyes, and at this point it does. Our minds jumped miles down the road to picking out names, planning to redoing the guest room into a nursery, and more. In no time, we'll be expecting our 1st sweet child.

But as I said before, how wrong were we! The 1st cycle I wasn't really paying attention, but the 2nd, and 3rd, and 4th... 7d LP? Really? All my studies and classes about fertility and reproduction, how was I not prepared for this? But at least I knew something wasn't right. Off to the Ob/Gyn I go. I know how lucky I am that my Dr listens to me and treats me as an equal partner in my health and care. My blood work showed my TSH or thyroid level was just over 3 (normal is 0.5 to 4 or 5), everything else was clear, except my prolactin level. That's right, the hormone that promotes lactation was elevated and I've never been pregnant or breastfeeding. 29. Normal is less than 25, but ideally under 16. I could have a pituitary tumor or cyst. Or all my hormones could just be screwed up thanks to 10 years of various forms of birth control.

I get a referral to see a Reproductive Endocrinology specialist. After 3 months of TTC, we were seeing an RE. Something most couples with issues have to wait a year to do. I would say we are lucky, but no couple dealing with fertility issues is lucky. Quick little consultation and I have Rx for Letrozole if I choose to take it, orders for a semen analysis for Chris, and more blood work requested. I officially have a luteal phase defect. LPD. An insufficient amount of progesterone, the main hormone I spent 2 yrs studying, and I don't have enough of it to to have a normal cycle let alone sustain a pregnancy. Also, my thyroid levels are higher than their office likes to see in women that are TTC. I'm over 3 and they like them under 2.5. Hypothyroidism. My body is making extra TSH to try and signal my thyroid to get its act together. I've had several of those symptoms for months, almost a year, but my levels were always in "normal range". So I'm not technically hypothyroid, I'm sub-clinical hypothyroid. Not really much different in symptoms or treatments.

The 1st cycle on Letrozole/Femara was a bust. Still just 7d long. Next LP, I request a "CD21" work up. That involves an internal ultrasound to visualize the ovaries and corpus luteum (what release the progesterone) and blood work to check my hormone levels. My uterus and right ovary confirm that I did ovulate, like I have each month, but the ultrasound can't say if it was a good, strong ovulation. That is what the progesterone blood work does. Good ovulation registers over 10, medicated cycles are generally over 15. Mine was 8.9. Add in progesterone supplements to the meds I am taking to get pregnant.

So for the next handful of cycles, I'm continuing to take my Letrozole cd4-8, wait for ovulation, start taking my progesterone supplements after confirming ovulation, and wait to see if I either am pregnant or start my period. Wait to wait to wait to try again and wait. What other choice do we have?