December 17, 2005

My RE’s appt

Posted in TTC woes at 5:44 pm by Erin

Typepad was down for much of yesterday, so I haven’t had a chance to post my update until now.  I woke up around 12:30 on Friday morning in serious pain–my ovaries, which normally twinge noticeably but not painfully when I ovulate, felt like they were trying to punch through my abdomen.  Really just the left one, but still.  J came up to bed as I was lying there, quietly whimpering to myself, "I did natural childbirth.  How can ovulation hurt more than natural childbirth?"  I was able to fall back to sleep about an hour later, when it let up enough for me to relax, and by 6:30 when the alarm clock went off, I was fine again.

It was weird.  I got a peak on my monitor on Thursday, d16, so I knew it was coming.  But normally I feel twinges in my ovary/pelvic region for at least a week before I actually O.  This time, there was nada until a twinge or two right before I went to bed at 11.  And then an hour and a half later, WHAM!  Ovary!  Popping an egg the size of a beach ball!  Wow.  Anyway, we did all we could and we’ll know around New Year’s.

We went to see our RE on Friday.  We talked to him and told him what was going on, and all sorts of fun stuff.  He said that since the progesterone test was fine, the spotting might be related to mild endometriosis.  I have some pelvic pain sometimes, although I normally ignore it–I never even thought about endometriosis.  I don’t often have pain during intercourse, but occasionally I do.  And the fact that we seem to be having some trouble getting pg again, although he didn’t want to be alarmist about that since he said that maybe it’s just bad luck this time and things just haven’t quite worked yet.  He was happy to hear that such a low dose of Clomid has gotten me O’ing so early.  He said that he doesn’t see the benefit of laproscopic surgery for the endo at this point, since apparently the rates of pregnancy only go from 3% with untreated endo to 6% after laproscopic surgery.  And since my little bit of pain isn’t disturbing my life, there’s really no reason to do that now.

He said that what he’d like to do is this: have a progesterone test done next Thursday to make sure that the Clomid gave me a good ovulation (he’d like to see around a 20).  Then, if I’m not pg this cycle, do d3 bloodwork next cycle and have a u/s to check my ovaries and make sure my PCOS isn’t too bad, be on Clomid at the same dose (assuming the progesterone was good, otherwise go up to 50), have an HSG, and do a post-coital test next cycle.  He also wants J to have another SA done–he said it’s unlikely that J’s sperm quality has gone down so much in the last 3 years, since he’s still young, but it never hurts to test that.  Lucky him–I DREAD having another HSG.  I almost passed out both during and after the last one.  But I bled for so long after having P that I’m worried that they left a piece of the placenta behind (delivery of P’s placenta was medically managed with Pitocin and pulling rather than naturally, and it was excruciatingly painful–I’d just had P and thought that was WAY less painful than the placenta, which is supposed to be painless), and there might be some scarring or tube blockage.  (He wanted to do one anyway, and I think there’s definitely a good reason.)  Also, another fairly easy test and will help rule some serious issues.

It sounded like a good plan.  He said if we’re in a hurry, we can add in IUI but unless the post-coital shows that my cervical mucus is really bad, there’s no reason not to just try the Clomid or Femara for a few cycles.  He said that it usually takes no more than 2 or 3 cycles, and that there’s not a whole lot of increase in success if it doesn’t work by then.  Then we would move onto other options, but he didn’t want to get into those until we know what we’re dealing with and see how these work out.

The only thing that we’ll probably change is that I think we’ll take next cycle off.  I’ll be defending my dissertation somewhere during it, and I don’t want to be dealing with fertility issues while I’m doing that.  The Clomid seriously messed with my brain this cycle–I need those brain cells to convince them to give me my Ph.D!  Plus, we’ll be doing a lot more than that to do all the testing, and I don’t want to have all those things running around in my head–what if we get bad news and then I’m trying to defend my dissertation while having just heard that my uterus is badly scarred and there’s basically no chance that I’ll ever carry another pregnancy?  Nope, as much as I like to rush into things, I can wait through one more cycle.  And I’m even going to take it a step further–no temping, no monitor.  I’ll feel O pains, I’ll know where I am in my cycle, but I’m not going to think about it constantly the way I am now.

Anyway, so that’s my update.  Nothing really earth-shattering, but I’m glad to know that we can do all of that testing within one cycle and not have to wait several of them.

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