Sunday, May 15, 2011

Infertility Resume Continued-2007

My referral was sent from my OB to the HRE (horrid reproductive endocrinologist) on February 5, 2007.  My first appointment with the HRE was on February 15, 2007.  At the time I did not realize how great that was.  It took months for me to get into my WRE (wonderful reproductive endocrinologist).  Well worth the wait....but that is another post.

Looking back at the notes from my HRE just reiterated to me why we chose to go to another clinic.  I'm pretty sure I've already said this, but I think typing out these next two years is going to be tough.  I have a lot of regrets.  I really wish I had educated myself more.  Now that I read back through the doctors notes, I read the numbers and wonder why I ever had my hopes up.  I didn't know those weren't good follicle sizes.  I didn't know that it is not medically possible for me to get pregnant with that endo lining.  

Anyway, at least I know now.  It took me a while to accept my infertility.  It took this experience to learn that all doctors are not all knowing and can and will get your hopes up when there is no reason for them to be.  I learned that in future experiences I need to educate myself more and ask more questions.  I learned to follow my gut, and even though it may seem like everything is pointing towards one direction it may not be the right one. 

Back to my first appointment.  It was very anti-climatic.  The HRE asked a lot of questions, but did not give much information.  In his notes, it says "has some, but not all, features of PCOS."  He didn't tell me that that day.  Well, and thanks to fertility treatments and trying on my own I now have all symptoms of PCOS.  Ugh.  Being on BC keep most of my symptoms dormant before we started TTC. And this was fairly close to the beginning of our journey. 

I keep thinking back to "what if I had known what I know now,"  "What if we had just saved all of that money and done IVF a long time ago," "what if I had just really accepted that something was wrong?"  (To my defense, every doctor I talked to [OB and all 3 HRE's] did not think I should have any problem getting pregnant.  No one understood why I wasn't responding better to the meds.)  

What if I had taken Metformin from the beginning?  What if I had done Weight Watchers and lost weight before trying any treatments?

I guess I will never know. 

I blame myself for not being more educated.  I blame my HRE for not really getting to the bottom of my problems.

Okay, back to my first appointment again...The Plan:
progesterone, TSH, prolactin sent today (Day 26)
SA on husband
HSG after next period (ouch)
Day 3 lab with next period
Return after above to discuss treatment plan

Sounds pretty reasonable, right?  I thought so.

2-16-07--started my period on CD 27 (not too bad for me)
2-19-07--had day 3 blood work (HRE's nurses absolutely stink at drawing blood.  So, maybe I have horrible veins, but they really stink!  I had more horrible bruises from blood draws.  I was stuck 3 and 4 times most visits.  For the record, at my WRE-never been stuck more than once, so it isn't all my veins fault.  ha)
2-19-07-called to get blood work results and of course it was not normal.  It showed that my body was not producing enough of the right hormones and too much of the wrong hormones.  Scheduled my HSG for the next week.
2-27-07--HSG.  (Ouch)  Results were normal.  Uterine Cavity:  Normal
Left Fallopian Tube:  Free Spill, normal ampulla
Right Fallopian Tube:  Free Spill, normal ampulla
Normal HSG

I am thankful it was normal.  I hope it still is.  But, it was just another question as to why the meds weren't working and why I wasn't pregnant yet.

3-1-07--I called and made an appointment to review the results with my doctor.  (they never called me.  I called them and was not told to.  you will see this is a trend.)

3-8-07--follow up appointment.  This is where we learned the results from all of the tests.  Husband's SA-great!  (One less thing we have to worry about-but another question...why am I not pregnant yet?)
My blood work was not good.  Of course.  
Plan:  With next period start clomid 200 mgs day 3-7 and dexamethasone days 3-12.
Then Midcycle scan.

Not sure when I started the meds-it's not in the note.  I called on 3-21-07 to see when to come in for MSUS (Mid cycle ultrasound).  
3-31-07--MCUS and lab work-My results from the MCUS were not on the notes.  My lab work was okay, but not good.  It was ordered to have Ovidrel on 3-31-07.  (I had the craziest of the 3 HRE's for this appointment.  He came into the room without even looking at my chart.  He didn't know my name.  He started talking about insemination and I honestly didn't even know what that was.  It hadn't even been discussed with us.  Talk about stressing a girl out!  The nurse had to point out to him that our plan was timed intercourse.  Ugh to crazy doctors!)

4-2-07--I called to find out the next step.  No one told me at my appointment on 3-31-07.  Turns out I was supposed to be on progesterone and no one told me.  Great.  They called in the prescription.

4-17-07--cycle day 1.  In other words--BFN.

4-20-07--Day 3 ultrasound.  "Ultrasound today shows multiple cysts on left ovary.  Findings reviewed with patient.  Questions answered.  Not sure why patient was not better despite good pre-ovulatory follicle size.  Would recommend repeating clomid next cycle and recheck patient 1 week post ovulation.  
Plan:  No stimulation this cycle.  (I was SO disappointed!!)
Take BC for one month  (Another disappointment!)
In 3 weeks repeat scan
Next cycle:  clomid 200 mg+dex+progesterone

4-30-07--my hair started falling out in chunks!  It was scary!  I called and no one could explain to me why.  The HRE called me himself and couldn't explain why.  He said it might be the PCOS.  "PCOS?"  He hadn't even told me he thought I had PCOS.  I was devastated.  This problem I had had a name.  Ugh.  I googled it and that was not the best idea.  That is never the best idea!
(I found out later that the hormone change, especially the progesterone, makes my hair fall out.  No, it doesn't happen in everyone....just lucky me!  And yes, it all grew back.  And yes, it happened with every fertility treatment.  My hair is still coming back from my last treatment.  It is getting really thick because I haven't had a treatment in so long!  Ha!  After it came back the first time I pretty much quit freaking out about it because I know it will come back.)

5-11-07--Went back for ultrasound to check cyst size.  It was 2/3 gone.  Recommended not to do treatment again this month.  Ugh.

5-29-07--I called to schedule follow-up appointment.  No one called me back.

6-4-07--I called to try to schedule a follow-up appointment.  Told me to wait for period.  (Would have been nice if someone would have taken the time to explain things to me!)

6-14-07--called with cycle day 1

6-15-07-- went in for day 3 ultrasound.  Right cyst still present, but decided to proceed with treatment?  (I still have that cyst)  Same as last time 200 mg clomid, dex, progesterone.  Labs drawn of course.

6-26-07--I remember this appointment so well.  Had the really crazy HRE.  He couldn't tell if he was seeing the cyst from before or a follicle.  One measured 20mm one measured 17mm.  I had to go back the next day and pay the same amount for another ultrasound.  Ugh.  

6-27-07--left ovary-22.2 mm, 18.3 mm
right ovary-15.3 mm
Endo lining-6.54 (ugh)

More lab work-shows I need HCG (ovidrel)

6-28-07--I called and was told to start progesterone on Saturday.  Once again, what if I hadn't called??

7-19-07--BFN again.  Decided to take a break.

My follicles had been great for both cycles.  At the time I didn't know my lining was the problem.  I didn't know that mattered.  I should have had clueless stamped on my forehead!  
I'll work on this some more tomorrow.  

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