I’m no mule!

This is part three in a series chronicling Chloe’s struggles with Polycystic Ovary Syndrome (PCOS), as well as with infertility as she embarks on a project to get pregnant. Many women struggle with the disease and Chloé hopes that by sharing her story, she can encourage other women to explore their options.

I have never been called mule to my face. But I instinctively know that I have been called one many times. Over the last 20 years, I have taken my nieces and nephews to the country very often, and I see the smirk on people’s faces when they ask, “Suh, yuh nah have one fi yuhself?” This is a most embarrassing and irritatingly frequent occurrence.

Nobody knows the pain I feel, when I am made to feel inadequate by these insensitive jerks.

My secret fantasy is to turn up in the district with a big belly, my face glowing like a green pear in the sunlight. I can hear them now: “Den missis why you wait suh lang?” I want to return shortly after clutching my little bundle of joy and say, ‘see how s/he looks like her/his grandma’?

My fertility journey

So now that my man has not decided to run for the hills and has assured me that he wants this baby as much I do, we have decided to go ahead with trying to get pregnant. I’m calling it my fertility journey.

I kid you not. The decision to try to get pregnant after all these years of knowing that having PCOS makes it impossible is quite scary. But I have support from a great guy who’s saying “let’s go for it”.

There is no doubt that this journey is filled with hurdles, these include the risk of complications. It’s been well documented that women over 35- years-old are more likely to develop complications from pregnancy than younger women. There is an increased risk of birth defects, miscarriages among other complications caused by hypertension and diabetes. I am 39-years-old, so time is winding down for me and there are also these hurdles to consider.

My gynaecologist has started me off on a drug called Clomiphene Citrate. This is a fairly common fertility drug which is also sold under the brand names Clomid, Milophene or Serophene. It has reportedly helped millions of women conceive.

Since PCOS is caused by resistance to insulin, I am taking the Clomiphene with the diabetes drug Metformin. Metformin usually works by increasing the sensitivity of muscle cells to insulin, the hormone that delivers glucose into your cells to be burned as fuel, or stored.

Women with PCOS frequently have “insulin resistance”, a condition where excessive amounts of insulin are required in order to get blood glucose moved into cells. Metformin helps to transport glucose with relatively less insulin. Chronically high levels of either glucose or insulin in the blood contribute to obesity, heart disease, infertility, and certain cancers, as well as the development of diabetes.

Metformin has been used in Europe for many years by women with PCOS, as it has been found to lower the levels of male hormone testosterone, reduce acne, hirsutism, abdominal obesity, amenorrhea and other symptoms.

Clomiphene is a potent hormone that reacts with all of the tissues in the body that have oestrogen receptors, such as the hypothalamus (part of the brain), pituitary glands, the ovaries, the lining of the womb, the vagina, and cervix. It is supposed to influence the way that the four hormones required for ovulation — gonadotropin-releasing hormone (GnRH), follicle-stimulating hormone (FSH), luteinising hormone (LH) and estradiol — interrelate. Clomiphene is the first choice of drug for ovulation induction in patients with PCOS and some other fertility disorders.

Clomiphene fools the body into believing that the oestrogen level is low. This altered feedback information causes the brain to make and release more GnRH which in turn causes the pituitary to make and release more FSH and LH. More FSH and more LH should result in the release of one or more mature eggs — ovulation.

As with many other medications, Clomiphene has some side effects. Some women have virtually no side effects. Others do, but they are more frequently related to moods or your emotional health. Other common physiological side effects may include multiple pregnancies (twins, triplets etc). Other side effects include hot flashes, and abdominal or pelvic pain, constipation, diarrhoea, fatigue and weight gain among others.

Getting busy

My gynaecologist Dr Donnette Simms-Stewart says it may take a few cycles to find this harmony of chemicals, but it should usually take three months for pregnancy to occur. There is some research that support a fourth, fifth or sixth month.

While the chemicals do their part, my job is to get busy in the bedroom. I cannot tell you how tiresome it is trying to have sex four consecutive nights. For me it’s difficult to manufacture the mood. I have found that it’s not a difficult thing for man to get in the mood, but I messed up on the final night by going to sleep before he even came to bed. I hope that we did not miss the boat on that fourth night. So until next week, keep your fingers crossed with mine.

Are there readers out there who suffer with PCOS and have managed to get pregnant? Tell me about it through allwoman@jamaicaobserver.com.

Facts on Clomphene from www.amazingpregnancy.com.