The Fertility Doctor- A Ray of Sunshine

I heart my fertility doctor. I even granted my mother an "I told you so". Let her have her moment of maternal glory, she was right, I should have been dealing with a fertility doctor.

I got to the office which was actually inside the hospital. I can't say it is the swankiest office but the staff was nice. I notice people of all ages in the room. While I was at the front desk, a woman walked in who looked 48 came in and the receptionist asked how her baby was. So seems like they are having lots of success.

The doctor met me and took me into a room to talk, not an exam room which I appreciated.

Reasons I heart the fertility doctor:

1) she was the first person that admitted she thinks the fibroid was my problem, she said we don't know for sure but it majorly distorted my uterus.

2) she wants me to started getting my progesterone levels tested 7 days post ovulation and if it is low she will give me supplements to help support a pregnancy if indeed I were pregnant. She said there is a small subset of people that do need progesterone supplements. No more arguing this point.

3) she made several comments that given my age (31) she didn't want to jump to drugs or more aggressive treatments- meaning I am young.

4) they have screenings and blood tests between 7 and 8 in the morning so you get same day results so they can take action right away, like progesterone and HCG levels, which works out perfectly since I am impatient. They are open 7 days a week. When I had the first pregnancy I had took a beta test on friday and didn't get results back until Monday and couldn't get the second round results until Tuesday. I was so anxious.

The Plan

1. She told me to start taking one baby aspirin a day. Some minor blood disorders aren't picked up on a panel test and the aspirin will help.
2. She had me give blood for genetic diseases, a screening I didn't have yet
3. I have to schedule another HSG, ugh, as soon as my cycle starts so that we can see if that tube is still blocked post surgery and if the surgery caused scar tissue. Not looking forward to this but at least I know what to expect this time.
4. I will track ovulation and come in to get my progesteron measure, I will also chart to track my luteal phase.
5. Assuming LP and HSG are normal, I will try on my own to get pregnant for three or four cycles.
6. If not pregnant on my own, I will take clomid and be monitored. You go in on CD3 and get an ultrasound, take pills days 3-7, and get monitored a week later, get a trigger shot, and then can either get IUI or given my exceedingly young age (I know I am pushing it) go home and have "timed intercourse" for three days in a row. Then they monitor you after.

I left feeling very hopeful that she thinks I am going to get pregnant on my own and even if I can't she will get me pregnant. She didn't say as much, but she did say most people they do clomid for three months before moving on but because of my history of getting pregnant and age, she would go to six if I didn't want to try more aggressive methods. Also, I don't have fertility coverage through insurance, so we would rather try natural/clomid before tons of money for IUI, IVF.

The Frustrating Update

After all the testing, including the HSG, my OB had concluded that reason for my miscarriages was this mutant fibroid growing within me. Even though it meant a big surgery, I was looking forward to getting it out and on with my life.

Before my doctor would tell me the game plan, she said she wanted to review my information with a fertility doctor, just to make sure that they were in accord.

My doctor called me a few nights ago and said the fertility doctor said the fibroid wasn't my problem, because the babies would have been too small to be crowded by the fibroid. But I would still need to get it out because a full term baby wouldn't survive.

So I asked her what my problem was then, since I have tested negative for every ailment they have screened for. She said well if the egg implanted in the exact spot of the uterus that has the fibroid it would be my problem. Otherwise there is also bad luck (or something yet to be discovered). She reiterated that normally they don't do all this testing unless you have three miscarriages, and I have only had two. She said there is a reason for that, because it is so common.

Regardless, along with other weird cycle symptoms I had, I was sure it was the fibroid. I got off the phone with the doctor and called my best friend. She made a good point, she said look up how big a normal uterus it is. Google hooked me up with that info-8cm x 4 or 5cm. Well my fibroid is 8cm by 10cm. So twice as big. By the transitive property that I loosely remember from 9th grade geometry, that means, there is a good chance the union (area where fibroid and uterus overlap) might be fairly large and therefore not crazy to think the egg implanted in this area.

So now the fertility doctor wants me to get an MRI to get even another picture of the fibroid (add to 2 different ultrasound visits and an HSG). I am doing that Monday. They are trying to determine if I am a candidate for the Da Vinci surgery (you might know this surgery-assisting robot from the season finale of Grey's Anatomy).

All in all, this is pretty bad news, because now we don't know this is my problem or going to solve any problems.

I'm Down with HSG- Yeah You Know Me

Yesterday was the big day I have been building to for 1.5 months - the HSG.

I worked from home in the morning and then when I went to leave to pick my husband up, I couldn't find my keys. I looked around like a crazy person, called my husband accusing him of taking my keys, and then looked through the garbage. Turns out they were under a magazine on the kitchen counter. Point being, I was so nervous after what I had heard and read.

I might have mentioned it in a previous post but my friend at work told me to "bring a towel or stuffed animal to bite into (for the pain)" and that she screamed "get it out" during the procedure. And she is not a girly girl. She likes hiking and things don't seem to phase her much.

Okay, so we get to the hospital and my husband seems more concerned with getting something to eat than my apprehension. I told him to grab food and meet be back in the waiting room.

So the test is in the radiology department, not the OB department. They give you a pager, like you are at the Cheesecake Factory. Greg came back carrying a tray with tortellini and was lamenting that they advertised a taco salad but they ran out (his biggest concern of the day) and before I could get pissy, my pager went off.

Next I am escorted into a dingy locker room. They gave me a hospital gown to put on and sock booties. It was weird, because you put this stuff on and instantly feel like there is something wrong with you. After changing, you are ushered into the ladies locker room waiting area. I was there for about twenty minutes and they called me. BTW, at no point did I have the option of bringing in my husband- maybe because of the radiation.

As the escorting nurse led me through the hall, I looked like a scared sheep. She said, "you look nervous". I said, "I heard this is excruciating". She said, "I am not going to lie, it hurts, but you'll be okay." Unconvinced, I shuffled on in my hospital booties.

Once inside the room, my regular Ob was there, clad in a radiation vest you wear at the dentist.

You climb up on a stool and onto an x-ray table. They essentially put your butt on what looks like a puppy pad. The doctor told me the results would need to be discussed with a radiologist.

Getting back to the pain, the doctor said this will give me a glimpse into childbirth without an epidural and the nurse said if I have to practice my opera singing (meaning screaming), go ahead.

I asked the doctor if it would hurt the whole time or just when the fluid went in and she said the whole time but different types of pain.

That was then I started practicing the Lamaze breathing you see on TV. I had flashbacks to the Cosby Show episode when Alvin, Theo and Cliff were pregnant. You might recall one gave birth to a boat and one a sub-sandwich.

I have to say, given how this was built up, it wasn't that bad. It hurt but I kept breathing deeply. And before I knew it, it was over. I think it took 8 minutes.

Results: My fibroid is huge and covering a tube and part of my uterus. Since it is impinging on my uterus it has to come out via surgery.

Next steps: My doctor is going to consult with a fertility doctor (I haven't met with a fertility doctor yet, but my doctor will make the contact)this week and get back to me by end of week to tell me what their consensus is (type of surgery).

Afterwards, I felt crampy. But not horrible at all.

Bottom line was, it really isn't that bad. Take 2 Advil before you go in and try to relax during the procedure. I wouldn't rush to do it again, but if a friend had to have it, I would say, it isn't so bad, it will hurt for a couple minutes, but nothing you can't handle.

If you have questions I didn't address, drop a comment and I will get back to you.