Dr. T, My RE
Well I have an RE. I suppose if I were a really responsible person I’d shop around and get multiple opinions, but I don’t have the time or energy. Besides, Dr. T got very good reviews online, and he’s actually covered by my insurance (Ha! Yeah right. The consultation was covered but probably nothing else will be). He had a great bedside manner and seems like a really nice and approachable guy.
Our consultation didn’t go on very long. Mostly because I was dripping snot and coughing and having trouble breathing. And not even because I was emotional – I managed to keep the waterworks under control. This nasty cold of mine was throwing a wrench in the whole thing, though, and in the end he didn’t do a physical examination because he could see what rough shape I was in.
As for the actual consultation – he looked over my medical records, asked a few questions about John’s and my history (unfortunately John couldn’t come because he was stuck at work), asked about what we’ve done so far as far as fertility treatments go. Then he said that I obviously was “in charge” of my fertility and had done some reading, but he still wanted to take a step back and teach me a bit about hormones. I appreciated that, and I wish my head hadn’t been so foggy with cold germs so I might have actually retained all the information. But he told me a lot about FSH, LH, and E2. Don’t ask me to repeat it all, because I can’t. But that’s not his fault.
He said that based on my answers to his questions, he suspects I might have a mild case of PCOS. This freaked me out a little bit because my obgyn had supposedly ruled that out. But Dr. T said that the test that would really help to diagnose it was never done by my obgyn. Even if I do have it, he agreed that I am ovulating, just not as regularly as one would hope.
He explained the tests he’s going to want to do, which will have to wait until early next cycle. He is going to have a lot of bloodwork done for me on day 3 of my next cycle to help to determine whether I do have PCOS. Then I’ll come back around day 10 or so to have an HSG done and to make sure my uterus and fallopian tubes are in good working order. And my favorite part of all was that he gave the caveat that “Hopefully you won’t be coming back at all, because you’ll be pregnant this cycle!” A little optimism from a doctor goes a long way for me, folks.
Finally, the treatment plan. He is leaving the choice up to us, of course, but he said that for a healthy 30-year-old woman who has already tried Clomid + IUI, he would actually recommend that we jump to FSH injectables + IVF next. He said the middle ground of FSH + IUI might not be a good idea because there is a high risk of multiples, from triplets up to sextuplets!! (I seriously don’t know what I would do with sextuplets. GAH.) Whereas he said if we do IVF, he would wait 5 days before transfer so that they could see which two blastocysts looked the “hardiest.” And then our odds of anything more than twins would be very low.
Still, I think I’d rather go the IUI route first. He said that he could try a lower dose of FSH so that it wouldn’t produce too many follicles.
One thing though that will relieve my husband of any guilt he might have been feeling, is that I think it’s safe to say at this point that it’s not him, it’s me. My obgyn led me to believe that my husband had low morphology and that I was totally normal, so all along we’ve both been assuming that most of the “fault” (and of course none of this is anyone’s fault) lay with him. But Dr. T said that John’s sperm analysis all looked good, and that yes the morphology was a little low one of the two times, but nothing too out of the ordinary.
So yeah. It’s probably me. Whether I have PCOS or not. But don’t worry, I won’t go kicking myself for it. I know there’s nothing I could have done differently. My body is producing hormones in a weird way and there’s not a whole lot I can do about it.
I don’t proclaim to have much medical knowledge so I may have misspoken about some of this stuff, but it’s how I remember it in my germ-addled state. Bottom line is, I feel like we’re in good hands. This whole thing is going to be extremely expensive, and I’m scared shitless about it, so I can’t say I’m feeling good about having a plan (or a choice between two plans) just yet. Right now I’m just going to focus on riding out the rest of this two week wait, and then getting some kind of diagnosis next cycle if necessary.