Surpise! Vaginal Ultrasound!

Before I start the story, I’d like to let you know that this blog automatically puts the “Protected:” before my titles when I set the password…it drives me crazy.  Moving on…

The doctor’s office called yesterday and said they had my test results.  I missed their call, but returned it as soon as they opened this morning at 7:30.  I scheduled an appointment for 9:30, came in to work to check a few emails and totally rearrange my morning meetings, and then met Mark at the office.

When we walked into the office every person on staff was sitting in the waiting room, just hanging out.  They sheepishly went back to their positions- must have been a slow day!  They joked about it; everyone is so friendly.  I really like everyone we’ve worked with so far.  Today we met with the nurse practitioner, Jen.  I love Jen.  She is 35 but looks younger.  Skinny with messy hair about my length.  Very perky, I think we would be friends outside of all of this.  She met her husband at Mizzou so we bonded over that.  She took us back to the office- the one with the squeamish reproductive models.

She laid a sheet of paper on the desk and we reviewed my numbers.  The test measured several hormones and I was in the normal range of nearly all of them.  The we focused in on two specific hormones, LH and FSH.  Warning:  Those of you with no interest in medicine will get very bored here.  Those of you with an interest in it will find it fascinating, and those of you with a background in it will probably be laughing at how my simple mind understand this complex body.

My FSH was 9.  She said that was good; anything below 10 is good.  She said it doesn’t matter if it’s a 4 or a 10, just as long as it’s not over 10.  Please don’t ask me what FSH stands for because I don’t know.  My LH was 12.8.  RED FLAG.  Your LH should not be more than your FSH.

You may have heard of PolyCystic Ovarian Syndrom (PCOS).  This is a common source of infertility in women.  I do not have PCOS- women who suffer from that are typically overweight and struggle with acne.  She said I was PCOS-ish.  In order to be diagnosed with PCOS, the LH level used to have to be double the FSH level, and now it’s triple.  However, my body reacts in a similar way as women with PCOS bodies do.

In normal women, the brain tells the ovaries to start preparing an egg to be released for ovulation.  This egg grows and grows until it is eventually released.  When your LH level is higher than your FSH level, that doesn’t happen.  My egg never grows.  It is eventually released- sometimes- but it’s next to impossible to predict when, and then when it does it’s not a super fertile egg.

So how do we fix this?  She said for years, the golden standard was Clomid, but that they rarely use it.  She said Clomid makes people really moody, one time a husband even called the office and said that if they give his wife any more Clomid that she is going to have to come live with them.  Now they prescribe a drug called Fumara.  I don’t really know exactly what it is, but it’s supposed to make my ovaries select an egg to grow and then release it on a schedule.

Now we ran into another hurdle.  You typically start taking Fumara on cycle day three, and I am on day seven.  I really did not want to wait a whole nother cycle.  Jen said that some people are like “this is all happening so quickly” while others say “Let’s do everything we can now!”  I’m definitely the second type, and I told her that.

She said she could prescribe it now, but wanted to make sure that nothing was going on down there…so that we would need to do an ultrasound today.  One thing I really like about the office is that they are really cost-conscious.  They always tell you how much something costs without you asking, and don’t pressure you into trying something you don’t want to do.  I am so very thankful for my insurance.  It is very good for this.  We are paying relatively very little out of pocket.  I can’t imagine how much more complicated and emotional this process gets when you have to worry about that piece of it too.

After that discussion, we headed back to an exam room to do an ultrasound.  I’ve never had one like that before, it’s just a wand with goo stuck up your hoo haw.  But it was soo cool!!!  On the screen she pointe out the uterine lining, which was very very thin.  She said that as you get closer to ovulation that really thickens up.  Then we looked at my ovaries and saw my eggs.  They were just a bunch of little black dots.  When you ovulate, you can tell which egg will be released because it is much bigger than all the others.  Since I had no signs of ovulating soon, she prescribed the medicine and I will start tonight.  I will then go back on May 3rd to do another ultrasound.  That one should look very different from the one today; she’ll be able to tell if my body is responding like it is supposed to.  If it is (fingers crossed), then that week will be our lucky week.

So, I am optimistic after talking to her.  She was optimistic too. She said this is a common problem and that it is easy to fix, which is exactly what I was hoping for.  She did caution that sometimes it can take three or four cycles for it to start working, which puts us all the way into August before they would try something different.  But hopefully we don’t get that far.  I am definitely excited and hopeful, but I’m also trying to keep myself in check.  I definitely don’t want to get my hopes up too high because then it hurts that much more when they come crashing down.  So, I am excited but also realistic.

Tomorrow we head to St. Louis for a college friend’s wedding and I can’t wait.  We’re going to see a lot of old college friends, even staying with a good one- one of the ushers in our wedding- that we haven’t been as close with since graduating.  No one in St. Louis knows about all this and it will be a nice escape.  Although I am sure that we will have to answer the “when are you guys having kids?” question a billion times.  How do I answer that?  Thoughts?  Usually I just say ‘oh someday’ or ‘we enjoy our freedom.’  Maybe I’ll get business cards with the link to this blog printed up and just hand them out in response.

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