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.

Well I'll Be...

I guess my doctor didn't like being on a break either. While yesterday I made peace with going to the fertility doctor, she was reconsidering. Turned out she called the Fertility doctor (the main guy not the one my appointment is with) and asked his take on my progesterone request.

He told her that he agrees that LPD (luteal phase defect) should be treated with clomid, but if I am insistent on progesterone supplements than "it isn't worth arguing about". He said it wouldn't do any harm and if it brought me peace than go for it.

So that means we aren't on a break! She said if I get a BFP I should come to her not the fertility doctor and I should cancel my fertility appointment.

But here is the catch, if I cancel that appointment my mother in law will personally drag me out of the house by my hair (making note not to hurt my healing uterus) and then my mom will roll over me in a semi truck. They are both thrilled that I am "finallllly" (to be read exasperatingly) seeing an expert.

What I realized is I don't know if I have LPD because I haven't tracked my cycle since my miscarriage in April and now I don't have the mutant fibroid. So all I want is to try the first cycle on my own, if I do get a BFP, bring on the progesterone need be, and if I don't I will take the clomid.

I am going to keep my appointment and at least get a game plan in case I do have LPD. And this way my mom won't live with the guilt of maiming her daughter.

Progesterone Supplements-is it too much to ask?

Today is a big day for me. I have my 2 week post-op appointment with my OB/GYN. My doctor and I have a fundamental difference about the use of progesterone in getting and sustaining pregnancy. I think it works and she thinks it doesn't.

Granted, she has an MD and I get squeamish at the sight of blood, but I have access to babycenter.com and have learned from other TTCers that progesterone helps.

Here is my case for why I want this magical elixir.

Fact:
1) Your body needs progesterone to have a normal leutal phase (14 days but at least 11)
2) Your body needs progesterone to support the pregnancy
3) When I would have progesterone draws 7 days after a positive ovulation test, they were always so low it shouldn't be able to support pregnancy
4) With both failed pregnancies I had bleeding immediately which later subsided, pointing to the fact that I didn't have enough progesterone
5)I haven't had a normal leutal phase since 11/08
6) My friend just had spotting at 6 weeks and got on progesterone, she is now 8 weeks and her HCG is going up appropriately, meaning the progesterone saved her pregnancy
7) Some friends from babycenter.com lost 2-3 pregnancies, took progesterone and now have babies

My Doctor's Beliefs
1) Studies show progesterone doesn't do anything
2) If you have a strong ovulation, you will produce enough progesterone
3) Progesterone just prolongs an unviable pregnancy
4) Progesterone has proven effective for people that have fertility treatments because there hormones have been manipulated so much but not others
5) Clomid (i.e. twin maker) can give you a stronger ovulation and then you shouldn't need progesterone

So before I left the hospital, the Fertility Dr came by to check on me and I asked her about this. She said in most cases my doc is right, but there are people with luteal issues that need progesterone to sustain pregnancy. LIKE ME!

I have been pumping myself up to be my own advocate with the doctor today and say I don't want to lose a third baby which could have been prevented by taking progesterone. Hopefully she will agree to either test me repeatedly for levels and if it looks borderline, give me the supplements. I don't want to say in an annoying way that the fertility doctor said I might need it but I want to make it known.

In other news, it has been two weeks and two days since my abdominal myomectomy (fibroid removal surgery) and I am feeling great. Not 100%, but have very limited pain. I am still not allowed to do much for 4 more weeks, but I feel strong.