Monday, January 16, 2006

OB Appointment

Finally, I survived until my OB appointment. Getting there was less than a smooth way. The Little Miss and I showed up at my friend JE's house to drop her off but there was noone there but the dogs. After several frantic phone calls, JE finally answered and admitted to having forgotten. Note to self: next time do just 12 hours notice rather than 48. Maybe even 6 hours notice. Anyway, my SIL lives next door and I happily caught her on her way to the running trail and she agreed to take the Little Miss while I was gone.

When I finally got in to the office, I went through all the normal stuff with the nurse. She said the doc could come in before I got undressed (I had to do my annual pap smear - the "purpose" of my visit). I said that would be great; what a relief not to have to discuss all this naked.

So in comes Dr. S. Pretty young - just finished her residency 2 years ago I think. Very nice. I briefed her on why I was really there and she jumped right in to things. I'll summarize.

We're going to start with some basic bloodwork for my thyroid levels and also my prolactin levels. I haven't heard much about prolactin abnormalities but from a brief search, it appears common to test for this as a first defense in infertility treatment. It also appears to be related to thyroid disease. If anyone can shed any more light on this, I'd love to hear from you.

The next step will be an HSG. Assuming I'm not pregnant this time around, it'll probably be scheduled the first week in February. She did mention Asherman's Syndrom related to my D&C in March, but she says that's not common and usually manifests itself in repeated miscarriages rather than the inability to get pregnant. But it's something to look for.

If all those tests are nominal, the next thing to consider will be Clomid. I must confess I'm rather afraid to go that route. I just can't imagine having twins. What I told her is that I'd like to try a cycle or two after the HSG since it seems that fertility is boosted for a while after the procedure before going on Clomid and she agreed that was an entirely reasonable course of action.

Of course, J will have to do the dreaded semen analysis. I already warned him that it will probably be required and his first reaction was "no way". Hopefully he was just kidding and I'm pretty sure he is since he knows how much this means to me. So, I'll probably corral him for that when he gets home Wednesday or Thursday.

I also talked to Dr. S about the progesterone testing. Her view is that if progesterone is low, it's usually an indication of weak ovulation which she didn't think was my problem. She said her treatment for it is Clomid which boosts progesterone levels by default. She said it was no problem to do the CD21 progesterone test but she doesn't treat with supplements. That's the only part of the visit that I didn't feel 100% about from everything I've read. On the other hand, there are widely varying opinions about the issue. So, I'll get it tested next week and go from there I guess.

At the very beginning of our conversation she started out by saying "What I'm going to have you do for the next 2 months is go ahead and chart your temperatures and intercourse timing and we can go from there on a treatment protocol." I tell you - I was never so glad that I had printed out the last 6 months of my FF charts, most of which had my temps. I think I surprised her by having that with me. I think it also told her that I was a more informed patient than average. I also probably bought myself 2 months of wasted time.

I gave her my chart printouts and she said she'd review them while I was undressing to make sure we were timing things right. So I'm sitting there half naked on the table and all of sudden from nowhere comes this thought: Oh my god, what if I misread the whole timing thing on FF and Taking Charge of Your Fertility and we have been totally off on our timing and there's no way I could have gotten pregnant the last 7 months and she's going to come back in here laughing her head off and have to explain the birds and the bees to me. Truly, I contemplated this for a good 5 minutes. I'm happy to report that Dr. S did come back in smiling and said that our timing was perfect in the majority of my cycles.

I must confess, I almost feel a sense of letdown and I really can't figure out why. Everything is going forward as I envisioned it. And there's always the possibility that none of it will be necessary. I'm so terrible at waiting.

No comments: