We knew even before we got married that we would have problems having children. We used to joke about how we would probably wind up with six or seven at once from fertility drugs and how we would just farm them out to family members! Of course, even when you know you’re in trouble, they still like you to try a while, so we gave it six months after stopping the Pill. I didn’t have a single period, not even spotting, nothing unexpected for me. Do you know how funny the expressions you get are when you walk into the doctor’s office in July in a size 12, they ask when your last period was, and you say “January 21?”
So we did get to start earlier than most people on the fertility treatments, because I had a long history of anovulation and amenorrhea, but due to Brian’s job change and getting the new insurance set up, we didn’t actually get started until October 1998. While we waited, I asked about a new treatment I had heard of, using Glucophage (metformin) to treat PCOS and restore fertility naturally. I was told this was too new and experimental, and I couldn’t try it. Instead, I was started on the standard first-level treatment, Clomid, or clomiphene citrate for the generic name. The chance of having twins on this drug is only about 5%, much less triplets or more. This is where having a mother who owns her own pharmacy came in handy, because she could get the drugs at a third of the price I was paying at the local stores.
Each month, I started with a sequence of Provera to induce a period. During my period, I had to take the Clomid for 5 days. Then about two weeks later, I went in for an ultrasound of my ovaries, to see if any follicles were developing. Month after month, nothing really happened. The most exciting month was January, when we got a follicle up to about 17 mm, but that still wasn’t big enough. Almost every month, my dosage of Clomid was increased, because I still had not ovulated at all. By the time we got to April, I was taking four times the original dosage, and if that didn’t work, I was going to have to move on to the second-line drugs. Those are injections, up to several times a day, at about $50 per shot!
In April, we got our hopes up for the first time. When I went in for my regular ultrasound, I had a follicle that was 24 mm. Even the doctor was impressed with this. I was scheduled to return in two days, on a Saturday no less, and if the follicle was still growing well, I would receive an HCG shot to stimulate ovulation. So Saturday I went in, and the follicle was 28mm. Absolutely huge! So I got the shot, and the countdown began. Do you know how much those things hurt? Apparently they work even better than I was originally told, because we ended up with four fertilized eggs.
After the triplets were born, I saw an endocrinologist who ran some bloodwork to confirm the PCOS diagnosis by looking for the trifecta of elevated insulin, elevated testosterone, and elevated triglycerides. I was able to start taking metformin, and within six months my fertility had returned and I was having regular periods for the first time in my life. Our last three children were conceived while taking metformin only, pretty much eliminating any risk of having another set of multiples. After my youngest weaned, I switched from metformin to cinnamon, something I had considered earlier but didn’t want to play around with while I was still growing babies. The cinnamon, at 1000 mg/day, seems to be working on my body just as well as the metformin was. If only I had know about that possibility 15 years ago!