The End is Near! {36 Week Pregnancy Update}

The last couple of weeks has been a tumultuous one.
At my 34+5 week prenatal appointment with my OBGYN, I advised her of what I thought was some dislodging of my mucous plug the days before and after a quick internal check, she did advise me that I was already 1 cm dilated.
Clearly this was something that threw me off a bit because of the risk of preterm labor given my history (PCOS) and also family history.  I was mentally and physically exhausted but my unborn son's overall health was of utmost importance and concern to me.  I wanted him to keep bakin' a little longer before his grand entrance.

How long till I can potentially go into labor? Was my first question to her.
50/50 she replied. It's only natural for women, especially after having had a baby already to be slightly dilated/effaced at this point in the pregnancy.
Some can be dilated for hours, days, weeks before they go into active labor.

So of course, being the natural worry-wart that I am, I was walking on egg shells that whole day and the days after making sure to stay off my feet as much as possible. Ha! Easier said than done when you have a 3 and a half year old.

Well, days passed and no signs of labor. *phew*
Then just last week, I came down with probably one of the nastiest cold viruses I've had in years which lasted for about a week.  I am just finally getting over it 100% now.
So bad in fact, that we had to call upon the help of SUPERMOM (yes, I believe that my mom is a Super Mom), to take a day off her work to stay and care for me (or at least keep an eye on the little one) as I wrestled my way back to health.

36 weeks! 

I'm now into my 36th week and hoping I can reach my 38th-39th week when I have my scheduled C-section (due to previous C-section). I'd be just as happy to hit my 37th.
That way I can rest assured that at least my son is officially full-term.

Evenings, especially bed time have been execrable to say the least.
Not so much the heart burn (thankfully I didn't suffer from it as badly as I did with Ava), but more so that fact that I very little space left to catch a full breath.  I have to literally channel my inner yogi for about 15-20 minutes each night before bed + lots of water to help ease this arduous breathing issue in order to settle for the night.

My meals have been dissected into about 6 very small meals throughout the day so that my pea-size of stomach space I have left in there can actually digest well.  This I find the ironic part of pregnancy -- you tend to be more hungry nearing the end of your pregnancy and ready to eat almost everything in sight, yet you have little space left to play with so you have to portion and down-size the amount you can actually indulge in.

*Hold on, Braxton Hicks*

That's another thing that I've noticed has started, good ol' Braxton Hicks.
Not so bad though to the point where it's way uncomfortable.  Just feel my stomach get super tight for a few seconds, like a rock.

Baby boy has also proved to me that he is either practicing to be a Line-Backer or an Irish Folk Dancer.
His jabs and turns have become much more rough and prominent and there are some days when I feel like he is doing the River Dance on my cervix!

Everything has gotten a little puffy, especially my feet.  I pretty much know every single retailer within a 20 km radius courtesy of my frequent bathroom stop-off's.  And my hips, back, lungs, and everything else are pretty much screaming, "Are we there yet?!" like an impatient toddler.
I hear you, I hear you!

I'll be 37 weeks this Saturday and as much as I'm feeling such excitement and anticipation for our son's arrival, I'm soooo ready to be back to normal again.  Normal being able to see my feet again and not having to roll like a log off the bed every morning and frequent times at night for a bathroom break (although the rolling like a log part's always fun...)

Both hubby and I have got our hospital bags packed, baby-sitting arrangements have been made and secured for Ava and everyone's cellphones are on alert.

The end is near! Can't wait to meet you, Son!
The question now is... when?
Countdown on.

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Walking on Eggshells

It's been about 4 and a half weeks since I discovered the wonderful news that I was expecting.

As much as it's been a effervescent time for me, it's also been quite stressful.

From the moment I found out I was pregnant, I've been on progesterone suppositories.  Without these suppositories, I'd probably be an even bigger mess of worry.  They've brought me a whole lot of reassurance and calm despite their "ickyness".

For those that have used them, you know what I mean.

I've also been asked to do limited activity at this sensitive time and rest often.  I'm not as tired as I was in the first couple of weeks, so having to limit my activity and lie in bed most hours is, in all honesty... boring.

I know every pregnancy is different, but I can't help but compare this one with my 1st.  I have to say, this one is like walking on a cloud compared to before.

Food diversions and nausea is virtually non-existent (only have sporadic bouts of them here and there), no headaches or extreme tiredness, my lady humps are not sore anymore -- I'm actually feeling normal. In other words: I don't feel pregnant.

And that, my friends, is what is causing my burden and anxiety.  I also blame the Internet for instigating more of this uneasiness.

I know we all like to play doctor with access to the Internet, but word of advice: Avoid the Internet! Just ask your doctor if you have any concerns at all so they can give you better answers.

I'm such a hypocrite because I live off the Internet.  In many ways, it's helped me! It has answered a lot of things I needed quick answers to and gave me some consolation.  But at the same time it also brought along a lot of questions and over-analyzing every little thing that is going on in my body.

I'm taking my prenatal vitamins everyday (have been for months before conception), I eat pretty well (I eat a whole lot to be exact! :p), and I rest as often as I can.

I have a great support system in my husband and family (which is a HUGE help).

And according to all my records and appointments thus far (incl. a 7 week ultrasound that showed a heartbeat), everything is A-OK.

So why do I continue to walk on egg shells?

I don't think I will stop worrying.  Even once I hit my 12th week which marks the end of this scary 1st trimester.  

Pregnancy is a beautiful thing but it's also a very, VERY unnerving thing as well.

Perhaps it's the motherly predisposition in us that never goes away even when our children are adults? 

I don't know.

But what I do know is that I'm very excited that I'll be hitting my 10th week this Sunday which means 2 more weeks of my first trimester and... let us eat cake! I plan to celebrate, that's for sure. :)

For now, I will dig into this tapioca pudding that I have been eyeing the past 5 minutes and then snuggle up under my warm blanket with my little girl with some pretzels, chocolate almonds and milk and watch a fun movie. 

Remembering that I am still a mother right now and I have a little girl that needs me to be strong and happy for her. So that, I shall be.

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We've got some news...

For many of you that have been following my blog for a while and for those that know me, you know that the past year has been somewhat of a crazy journey for me and my family.  We've had our shares of ups and downs as we struggled with infertility (due to my PCOS), coming in and out of expensive treatments praying and hoping endlessly to give our little girl a sibling.

When I conceived Ava, I also went through a similar, although less of a longer time, conceiving her.

She changed our world.  She was a miracle baby to us.

I've always wanted to be a mother. To be able to create, carry, birth and raise wonderfully smart, beautiful and humble children. 

I'm very blessed with our daughter and couldn't be more proud and gratified to have her in our lives. 

But, she's been asking and asking and asking for a sister or brother.  She's getting older (we just enrolled her in Kindergarten!) and we thought it would be a perfect time for another little blessing.

After many, many BFN's (Big Fat Negative's), to my pleasant surprise, I finally saw this...

I'm Pregnant!!!!!!!!!!!!!!!!!!!!!!!!

Tears of joy, exhaustion and surprise streamed down my face as I shared the excitement with my husband.

We were SO happy! And so relieved.

To be honest, this pregnancy is very different than with Ava.

I was sick constantly with Ava and with this pregnancy I'm only having bouts of nausea here and there.  As weird as this may sound, I actually was hoping for the vomit and the food diversions.  I wanted to feel pregnant.

You see, I had a prior miscarriage before Ava and with Ava, I had low progesterone in the first trimester so I had to take Progesterone suppositories to help sustain the pregnancy.  I'm doing the same with this pregnancy now as well.

I was also monitored every week to two weeks with Ava at Mount Sinai's Special Pregnancy Unit due to risk of Incompetent/Shortening Cervix.

My pregnancies are not easy.  In fact, as wonderful as they are, they are very, very scary for me.

I'm constantly worried.

So, a couple of days ago, after experiencing spotting and minor cramps, I was put on strict bed rest.

Yeah, that's not very easy considering I have a 3 year old that I need to care for during the day.

Just a 2 days before the bleeding began, I had a first trimester ultrasound and we saw our little baby and it's heartbeat! 125bpm at 7 weeks 2 days.  What a sigh of relief.

So you can imagine how terrified I was when I began to spot. No pregnant woman, no matter how many times you've done this before, wants to see blood, especially in the first trimester, especially with a higher risk pregnancy.  I spent the entire day in tears because I was so concerned.

So here I am. 8 weeks as of tomorrow and resting up on my comfy bed. 

I am so grateful to my husband for his unconditional support, my mom, mother-in-law, sister, and rest of family and friends that have attempted to make this easy for me and provide their helping hands.

I am so, so thankful.

I will be continuing my progesterone and limited activity until after the 13th week (1st trimester). And then at least I can breathe a little better.

You're probably wondering why I am sharing this before the first trimester is over. Well, I was actually planning on NOT saying anything until we were in the safe zone, but because I've shared my rough infertility journey on my blog with my devoted followers, many woman going through very similar situations, I thought it's only fair and considerate to share this journey - no matter where it turns.

We continue to pray and trust that God is in control and will help us get through this, healthy and happy.

If he sees you to it, he'll bring you through it.
Where would I be without my faith? 

Here's to a happy and healthy 9 1/2 months!

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Onto the next one...

So a quick update on my roller coaster ride to baby #2.
After 4 rounds of clomid, the specialist had decided to switch me to a different medication which is suppose to do the same thing as Clomid, but with the advantage of not thinning out your endometrial lining like Clomid does.
The new med is called Letrazole or Femara. It's pretty new in the Fertility game. It's been around 10 years and was initially created for women with breast cancer to lower their hormonal levels (estrogen).
It's been proven to also be a benefit and aid in infertility as well. Specifically with women that have PCOS, like me.
I've read so many times that women with PCOS undergoing fertility treatments that took clomid and never worked for them, ended up taking Letrazole with success.
This is the case for me as well.
With my first round of Letrazole (at the lowest dose of 2.5mg), I ovulated. Unfortunately, this wasn't the cycle because Aunt Flo came along.
I just finished my 2nd round (2.5mg) a week and a half ago and they didn't see any production, so as of yesterday I began 3rd round at a dose higher (5mg). On top of that, my specialist has increased my metformin intake to the highest (2000mg), 4 tablets a day. Prior to that I was at 1500, 3 tablets a day.
So far I am not having any bad side effects to the increase in metformin so that's good. Met is known to give terrible nausea and stomach upset.

I'm crossing my fingers and praying hard that we won't have to go through this anymore soon.
It's been so tough -- emotionally, physically and financially.
I'm so happy to have such a supportive husband and family members that have contributed their time in helping me when I needed it.
One of the most important things any woman going through a fertility struggle will need in her life is a strong support system. They make such a tough process more bearable and offer the hope you need to get through.

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September is PCOS Awareness Month

So as you may already know (having read my previous posts or following me on twitter/facebook) that I suffer with a condition called PCOS - Polycystic Ovarian Sydrome. I was diagnosed in 2007 after a year of struggles trying to conceive our firstborn daughter. I didn't fit the usual characteristics of someone with PCOS, except for the irregular periods and infertility, so my doctor took a while to diagnose me. She sent me to a fertility specialist and that's where I was properly diagnosed. I am writing this post in hopes that someone out there that is reading this with unexplained infertility and irregular periods (amongst the other noted symptoms) will better understand what this condition is and get tested.
It's been such an emotional and exhausting roller coaster (that I'm still on), but I always have faith that there is a light at the end of the tunnel. And that light will come with 2am and 4am feedings. :)

What is PCOS?

Polycystic Ovarian Syndrome (PCOS) is a health disorder that often affects a woman’s ability to ovulate and conceive.  Somewhere around one in ten women of reproductive age have been diagnosed as having PCOS. Some young women will receive this diagnosis during their teenaged years but many women will not realize that they in fact have this disorder until they try to get pregnant, and can’t.  While the cause of PCOS has not as yet been identified, several factors do seem to play a role, including family history, ethnic origin and genetics.

PCOS is technically a hormonal imbalance, earmarked by any two of the following three characteristics: overproduction of androgens (male hormones); irregular menstrual cycles; and an ultrasound demonstrating polycystic appearing ovaries.  While all women have some level of male hormone in their systems, many women with PCOS produce an overabundance of them.  

Some women with this disorder experience a degree of insulin resistance as well.  Insulin is a hormone which is manufactured in the pancreas.  Insulin’s job is to transport glucose (sugar) out of the blood and into muscle tissue, fat and liver cells. People who are insulin resistant need more insulin than usual to regulate the amount of glucose in in their blood and since insulin is also a growth hormone, insulin resistance causes many women who suffer from this disorder to gain weight as well.  In addition, when too much insulin is present in the body the ovaries respond to this by pumping out even larger quantities of male hormones.
PCOS can develop or become more symptomatic after you have already had children. (This is known as secondary infertility.) With my daughter, I conceived with only metformin (the easy way!), but it wasn't until now since the beginning of this year have I realized I indeed needed more help in trying to conceive for my 2nd child. The metformin alone was not cutting it. Many failed Clomid cycles also didn't do the trick.


Also, while many women with PCOS deal with infertility, many of them can and do achieve pregnancy with treatment. Not everyone will have pregnancy success. But a good number will. There's reason for hope.


Learn more about PCOS, and common PCOS treatments, here:

PCOS: Symptoms, Diagnosis, and Treatment

Quiz: Do You Have PCOS Symptoms?

Can a PCOS Diet Help?

Metformin Treatment for PCOS

Do Irregular Periods Always Mean PCOS?

Quiz: Is Your Period Normal?

Anovulation

Clomid

When Clomid Doesn't Work

Gonadotropin Treatment

There is this amazing show called PCOS Challenge created by Sasha Ottey, designed to inform people about Polycystic Ovarian Syndrome and other related diseases and conditions.  PCOS Challenge follows ten women with PCOS as they have their lives transformed by naturopathic and allopathic medical experts and three coaches — registered dietitian Rebecca Mohning, fitness trainer Josef Brandenburg, and clinical psychologist Ruth Wittersgreen. The show addresses common PCOS symptoms and related conditions including infertility, diabetes, obesity, heart disease, anxiety and depression, and hirsutism.
You should definitely check it out!

Credits: http://infertility.about.com, 
Photo Credits: PCOS Hope awareness image is courtesy of www.gifts4Awareness.com and merchandise can be purchased through this site.

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Here we go again...

So today was yet another day 3 ultrasound. Aunt Flo showed up (fast & furious!) and today I had the regular Day 3 cycle monitoring appointment. Having gone to these appointments continuously since March of this year, I'm pretty much use to everything -- ultrasound, poked in the arm for blood and a meeting with the specialist.
This appointment Dr.Cheng advised me that there is some growth and I have 2 growing (larger sized) follicles which is a good thing. Yay! So I'm happy about that. Now, in terms of meds, I was advised to start clomid again (and for the last time) at the highest possible dose (200mg). I am hoping and praying that this is it. We cannot afford to move onto injectables which cost thousands out of our pocket (health coverage isn't so great when it comes to fertility treatments which is unfortunate).
We'll see what God has planned for us. I'll just leave it in his hands.
Tonight I start the clomid for 5 days and then go back in for Cycle day 10 monitoring and see if there are any mature follicles that can be triggered with an hcg shot (another $85).
Here's hoping!

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Baked Cinnamon Sugar Bites

We all know (or most of us know) that Cinnamon has some great health benefits.
Being a "Cyster" (pre-diabetic), cinnamon is, in fact, a great ingredient to add to our diet as it reduces glucose levels.
Other benefits?

• It has been medically observed that cinnamon has been found useful since it provides relief for women experiencing menstrual cramps and other feminine discomforts.
• In a way, it is used as a natural birth control since it delays the menstruation of women after the delivery of the child when cinnamon is regularly consumed.  Hence, avoids the conception of another child.
• It helps in the discharge of breast milk.

So when I came across these delicious cinnamon bites from one of my all-time favorite sites, The Tomkat Studio, I knew I just had to share it.

Kids or no kids, these delicious cinnamon and sugar bites make for a great summer time {or anytime} snack! Whether you’re packing snacks for the pool, or entertaining the neighborhood crew, these can be served as appetizers, desserts or just a sweet snack.
They’re easy and fun to make with kids and the good news, they’re baked, not fried so there’s no feeling guilty. You can also experiment with whole wheat, gluten-free, or various flour tortillas, depending on your preference.
Continue reading for all the different ways you can enjoy this sugary bites.

Have fun and cut them into different shapes and sizes using either a cookie cutter or sharp knife.

Serve and enjoy with any of the following…

• scoop(s) of ice cream
• fresh fruit salsa
• whipped cream or cool whip
• diced strawberries

or enjoy as is!

Cinnamon and Sugar Bites Recipe

Ingredients

• 10-12 [small] flour tortillas
• 1/2 cup butter, melted
• Cinnamon and sugar mixture (1/4 cup sugar + 1 tbsp cinnamon)

Directions

• Preheat oven to 350 degrees F
• In a small pan [or microwave] melt butter over low heat.
• Brush 1 side tortilla with butter. You may be generous with the butter, please. Sprinkle cinnamon sugar, as little or as much as you’d like. With a pizza cutter, cut the tortilla in half and then into fourths. Place tortillas, sugar side up, on baking sheet. Repeat with remaining tortillas.
• Bake for about 8-10 minutes, until the tortillas have puffed up.

Let tortillas cool, best enjoyed same day.

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Weighty Wednesday

So instead of a Wordless Wednesday (very hard for me to be "wordless"), I decided to make this a Weighty Wednesday. Yes, that would be me. Not holding my breath, trying to look, well, weighty. :p
I don't need to try because I really do feel frumpy and I'm definite that I packed on some pounds the past few days. Not only has my workout regimen been inanimate the past few days (I use to workout everyday!), my lazy butt has been consuming foods that are not even close to being healthy.
You think I'm exaggerating? Seriously, cupcakes, chocolates, pasta, white rice, soda, cocktails... shall I continue? You get the picture. Bad food.
And what you probably don't know (or you may know) is that I suffer from PCOS (Polycystic Ovarian Syndrome) which is an endocrine disorder that makes it twice as hard to lose weight.  It's basically as if I was pre-diabetic.
I shouldn't be touching too many sweets and carbohydrates at all!
Starting today I shall begin what I call my "detox". Please consult your physician before doing anything I mention because I'm no doctor and this isn't a detox that I can guarantee will in fact, detoxify. It's just something I kinda, sorta, made-up on my own but it works for me!

I am huge on Bolthouse Farms Green Goodness smoothies. They are packed with veggies and fruits to last you a whole day in a cup!

I sip on this drink throughout the day and eliminate carbohydrates (well, I can have very little), up my fiber intake and drink lots of water in between. Plenty of small meals/snacks throughout the day so my body doesn't shut down on me. And coffee is allowed!
I do this for 2-3 days until my system no longer craves the bad food. And it really does work for me!
It's all a mind thing. Tricking my body to not being so hungry and craving the bad stuff.
We'll see how it goes. Can't guarantee anything because the upcoming weekends are jam-packed with gatherings and fun (which includes tons of yummy food). *sigh*

What do you usually do to detoxify?

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On to the next...

I've been through an emotional fertility roller coaster trying to conceive my 2nd child the past few months and it didn't get any easier.
After taking 3 rounds of clomid at the highest dose (150mg), the specialist found it wasn't working for me as I wasn't producing large enough folli's each time (only once but that was a bust), so he suggested I come in August 10th for a review and to discuss the next step, which are injectables.
Not only was this hard for me to swallow because of the fact the clomid definitely affected my system but mostly because I'm disappointed that my body is against me and that I actually believed that clomid would do the trick. I'm not functioning normally and my hormones are out of whack. Such a tough thing for a woman to take.
On top of all these emotional battles, our family bank account it being heavily affected. Sure we have insurance and good coverage, but not good enough! Injectables cost anywhere between $1000 - $5000  depending on the dosage. And I think insurance doesn't cover enough of it. Also, the specialist fee's and injectable management fee aren't cheap either.
This is becoming too much for me and my hubby to handle. I thought it would be easier than this because I never had to deal with all this with Ava. :( We are a one person income household as it's only my hubby working at the moment so this is a real financial burden. We also just bought our new house and renovated so our pocketbook got hit pretty nicely the past few weeks. I don't know how much longer I can take of all this.

I will show up to that review on Aug 10th and pray that the cost's aren't as hefty as we're thinking they're going to be. And most importantly, that we will be blessed with a healthy pregnancy sooner than later.
I just have to keep my hopes up despite how hard it is and keep my faith in the Lord. It's not in my hands after all.

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The 2WW...

Ty and I (and Ava) went in last Friday to see the specialist for regular cycle monitoring and the doc informed us that my mature folli was now at 2.3mm (was only 1.8mm the day before)! That's crazy! So he highly recommended I go an hcg shot to trigger ovulation because the follicle is getting too big.
So, I went ahead and paid the $85 for the hcg shot, went into a private room with a nurse and got the shot injected on the back of my left hip. Didn't hurt one bit, just a quick pinch.
A few hours later at home,  I felt extremely nauseated. Googled info and found that it was a rare side effect of the hcg trigger shot. I honestly felt sick to my stomach.  Thank God it only lasted a few hours. As the day went on, my nausea went away.
Sunday morning we returned to the clinic and was informed that I did ovulate! :) So now it's just the waiting game. They said if I don't get a period by July 21st, to take a PG test and to schedule an appt to come into the clinic again. If I do get a period, I still have to schedule an appt on day 1 to start a new round of clomid on day 3.  We are hoping and praying that this is the month and we see NO period and a positive pregnancy test! Please continue to keep us in your prayers.
I'm not going to lie... this whole fertility thing is really dampening my spirits and making me a little sad. Not only is it physically draining (having to come in and out of the clinic for monitoring and all the meds I have to take) but also mentally and emotionally draining as well.  I'm not trying to compare my situation or myself to any other woman but everywhere I turn, my friends and those around me are getting preggo. And so quickly. It's like all their husband has to do is look at them and bam! Sorry, hormones talking.

I'm very grateful for the support I have from my husband and family and friends and the great clinic I attend with good specialist's and nurses. But I just want it to be over. I just want my body to cooperate with me for once and be normal. I want to feel a baby growing inside me again.

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Come on follicle! You can do it!

Today I was in (way too) early for yet another cycle monitor and they found that I did not have an LH surge yet so I'm back in tomorrow. I could've paid money to get an hcg shot then and there but I didn't want to have to pay. So Canada day in the specialist's office getting another vaginal ultrasound, blood work and doc meeting. Not.Fun. Come on follicle! Just burst already! Please?

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The 411 on Follicles, Cyst's, PCOS, etc...

Okay so for people reading this that don't understand what everything means that I talk about sometimes. One question people ask me a lot is "What's the difference between a cyst, an egg, and a follicle?". I found a good article about this exact question and it explained the difference very well. I'll put it into layman's terms so that it doesn't get even more confusing that it was before.

The EGG is that all-important biological specimen that contains half a woman’s genetic information. A woman randomly shuffles all her DNA (the stuff that influences her body to develop blue eyes, a cute little nose and a fondness for puppies) and packages exactly half of it into each egg. The goal then, is for the egg to unite with one of her husband’s sperm, which very coincidentally contains half of HIS genetic information. The final product is a baby, a tiny person with genetic information from both parents. We can’t see eggs on ultrasound, because eggs are smaller than a speck of dust. What we CAN see are FOLLICLES. Imagine a follicle to be like a water balloon with a speck of magic dust (the egg) inside it. A woman is born with about a million of these packed inside her ovaries. Each month after she reaches puberty, some of these follicles start to fill up with water like expanding water balloons. Most will grow just a little and then fizzle out. However, the biggest one, which gets crowned with the title of THE DOMINANT FOLLICLE will grow from microscopic size up to about 20mm, roughly half the diameter of a golf ball. Once it reaches that size, it should burst and let the egg fly out. Under ideal conditions, the egg gets slurped up into the Fallopian tubes where it can hopefully meet a nice eligible sperm and then off they go into the uterus to implant.

So when doing ultrasounds, a doctor may say, “Great news! You are growing two eggs in each ovary for a total of four, giving you four chances at pregnancy this month! Right now they are still a few days away from being ready.” How does a doctor know this? Based on the measurements. This is where the patients naturally assume that by measurement, the doctor is talking about the size of the eggs. But as you probably realize now after having paid attention to what I just wrote, they're actually talking about the size of the follicles.

Now that we have clarified the relationship between an egg and a follicle, where does the term CYST come into all this? A cyst can be defined as a CLOSED SAC, sometimes filled with a substance like fluid, air or blood.. So actually, follicles are cysts. They happen to be GOOD cysts as opposed to bad cysts. So medically, CYST is the term doctors use to generically refer to many different sac-like structures, not just dust-filled water balloons. Cysts can be found in many places like in breasts, under the skin, in the cervix or in the brain. Furthermore, ovarian cysts can be the good kind (follicle) or bad kinds, such as endometriomas which are harmful cysts filled with fluid that looks like chocolate syrup.

Now here’s the tricky part. A follicle and a simple cyst look identical on ultrasound. So using just one single ultrasound, nobody can say for sure whether they see a good follicle or some other type of cystic structure. However, if you look again on ultrasound three days later and see that the water balloon has grown from 14mm to 19mm, then you get a pretty good idea that it is a growing follicle. If instead, the repeat ultrasound shows nothing, then it turns out that it was most likely a cyst which has gone away on its own.

The typical protocol for patients who are taking strong fertility drugs is to do a cyst check prior to starting the stimulation medications. This is an ultrasound done on about day #3 of the cycle. The doctor wants to see nothing. What they don’t want to see, but sometimes do, are cysts and if they are big enough, it tells the doctor that this is not a good month to do a cycle, so they postpone things.

Finally, let’s go back to the idea of how it’s normal each month for a single healthy water balloon to grow to a mature size and ovulate its precious contents. Remember, I alluded to this being the dominant contender out of several contestants which start the race, meaning most women will start growing a lot of potential follicles each month, but without medications, they should just ovulate one (or occasionally two). The other follicles should quickly all fizzle out and not even grow to a visible size. However, there are some women with a common medical condition in which the ovulation process goes haywire. Instead of one dominant follicle emerging and the others all shrinking to nothingness, what happens is that a whole bunch of the follicles keep growing, but none really make it to mature size. So instead of seeing one large 20mm water balloon and nothing else, you see a whole bunch of 12mm follicles stagnated in their growth. Some of you have probably already guessed that this condition in which multiple small ungrowing non-ovulating follicles are seen in the ovary is called POLY-CYSTIC OVARY SYNDROME (what I have). I'll get into more details of what PCOS is and what it does to your body another day.

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