Thursday, June 3, 2010

1st Infertility Appointment

Today was my first visit to my gynecologist's office to officially discuss infertility. I handed over my three months of charts and told him exactly what was wrong. Fortunately, I did my homework. I probably would have been completely lost, or the appointment would have lasted 2 hours if I didn't already know what I know. I told him how long my luteal phase is and how I found out. He told me that I might be having a surge of LH but there is no way of knowing if I was really ovulating. Apparently a common problem for people with endometriosis is not fully developing eggs. The ovary begins the development but instead of measuring 20mm (good egg) they are only about 14-16mm (poor egg). It is a lot harder to fertilize a tiny 14mm egg than a big ol' 20mm egg. He gave me a couple of options. Due to my high blood sugar one option is to put me on metformin. This would help regulate my blood sugar levels which apparently have an adverse affect on my ovaries. I took this drug (in the form of Glucophage) at the beginning of my college days. I honestly do not remember any affect on my endometriosis, but then again, I wasn't trying to get pregnant then. The second option is to try and work with my progesterone. That is more along the lines of what I was thinking of when I made the appointment. I know the issue is a short luteal phase, so let's correct the luteal phase problem. As I have mentioned before, every period I have makes my endometriosis worse, so I would like to stop messing around. His idea is to put me on 50mg of Clomid for days 3-7 of my cycle, followed by Estradiol twice daily for days 8-12 of my cycle. Around day 14 he wants me to come into his office for an ultrasound to see if my ovaries are producing eggs and how big they are. Then we will determine when to "trigger" ovulation and I will be given progesterone. From what I know about people who have IVF this routine sounds similar, although I am sure they are not the same at all since I am taking pills not getting shots. The third option, which he would like to leave off the table for now, is to do another laparoscopy to "treat" the endometriosis and while there he would drill into my ovaries. That sounds horrible. I don't like my parts being drilled into. He said the purpose of that would be to change the chemical makeup of my ovaries. I asked if it would be like a "restart" button. He said yes. I decided to go with option 2. We will try this combination of medicines for 3-6 months. After 6 months the odds of success really drop off. Also, these medicines may cause my endometriosis to progress faster. I am very nervous about that. I don't really like pain, but I can manage. I am really afraid that my endometriosis will get really bad and I won't be able to get pregnant from it. He didn't seem too concerned about that, only the pain. If it means a baby, I can deal with the pain. When I begin my next cycle I need to call my doctor's office to set up my ultrasound appt. and begin my medicine regimen.
Oh yeah, and the Clomid increases my chances of having twins by 10%. That really doesn't sound like a huge percent...but twins might be a lot of fun. I mean we got two puppies so Sparky and I could each hold one! (I may regret typing that later!)


Amy said...

Go hang out on the Moms of Multiples board on the bump, especially the moms of 6+ month olds, once the teeth starts, crawling, walking, separation anxiety, and sleep regression starts... you will regret it. Especially as much as you like sleep!!! I've always wanted twins too, after having one and the sleep deprived nights lately I can't imagine how moms with twins survive, especially this age!!!! Kudos to moms of twins!!!! So glad you have everything figured out though!!! I've read lots of success stories with clomid!!!!

Anonymous said...

I liked clomid. It was the one time during all that stuff that I felt "normal".
You know I am here and how to get ahold of me!
Love you -

BTW - my word verification for this was blessess. Maybe that means lots of blessings to come!