Clomid Challenge Test Results

Today is Cycle Day 10! I had my appointment today at Dr Pinto's main office, which is much different than the Grapevine office....much more room, much more stylized decor. And a HUGE sonogram/exam room with a flat screen monitor on the wall! I guess the Infertility business pays well (insert 'duh' here).

First things first, CD3 bloodwork results. My FSH level is 6.4 - he wanted it under 8, so this is great! My estrogen level was at 25, which Amy, the nurse, said was good. Then she set me up for the sonogram and Dr Pinto came in to observe. I had 2 really good follicles, both around 14 mm, which is great - one in each ovary. She said they would probably give me an HCG shot later in the week if they continue to grow well. That way both ovaries will release and give us a better chance!

They did notice a small white-ish area in my uterus, which she said could be lesions of some sort or scar tissue from surgery (my C-Section). So, on Thursday, they want me to come in for a sono-histogram to check that out. If it is an area where the eggs are trying to implant, then it is probably preventing implantation. They'll also check my follicles again at that appointment, which will be CD 13.

Then, she took some more blood to check my FSH level again, to compare to CD 3. I should have those results on Thursday. She had some trouble getting in the vein, I think she did it too shallow, it kept stopping! But at least she didn't have to stick me again, and it was only one vial.

I've forgotten about the constant barrage of going to appointment after appointment and how hard it is to balance with work. I'm just glad to have a boss that is understanding and willing to work with me through this. Hopefully I don't have to put her through it for months upon months!

Dr. Pinto

Today was our first appointment with the Reproductive Specialist. It was a very informative appointment. We first met with Dr Pinto in his office. He went over our history and discussed the basics of fertility and fertility issues. He did some really cute hand drawings (upside down, no less!) showing us the progression of egg loss as women get older, and how the brain and ovaries work together (or not) and what effects PCOS can have on the ovulation process.

Side Bar

Did you know that when a female baby is in utero at about 16 weeks, she has about 6-8 million eggs! By the time the baby is born, she's down to about 1-2 million. By puberty, 350,000. From that point, we lose, for various reasons, about 3-11 eggs per month! And this greatly increases the older we get, along with diminished quality. Wow! That was eye-opening information for sure!

Okay, back to the post

Dr. Pinto then went over how he likes to start the process. First he wants to determine an approximation of my egg quality and quantity. This is done most easily by blood tests on specific cycle days, to check the FH and estrogen levels in my blood. Until that is determined, he doesn't really want to discuss possible treatments/procedures. He's definitely the type that will tell it to us straight and not waste our time. He'll go over all the results and give us a reasonable expectation on what he thinks our chances are. After the initial tests, if everything looks good, then Kevin will have his 'boys' tested and we'll decide on a plan of action!

He also wants to do a Clomid Challenge Test to see how my ovaries respond. I'm not worried about this, since I've used Clomid in the past; but just hearing him call it that conjures up images of games shows and booming voices! LOL!

Next, he did a sonogram and he didn't see anything that concerned him. He's confused as to why Dr Lopez's office is telling me I have a polyp on my ovary. He agrees with what I found online....polyps don't happen there, cysts do. So, he's not sure what they saw, and he hasn't received their records yet. He thinks it might have been ovulation-related because their sonogram was done on Day 15 (how cool would it be to see an egg as it's ovulating!!!). He said there were signs of possibly PCOS symptoms on my left ovary - about 7-8 follicle masses that weren't released, but nothing serious or harmful (maybe this is why the ovary felt enlarged to Dr Lopez?!?!) He had mentioned possibly doing a hysteroscopy to check out the condition of my uterus, too, but during the sonogram, he said he didn't see any fibrous tissues or anything else, so he's not going to do that yet.

He gave me orders for getting my blood drawn on cycle day 2 or 3 for checking the FSH and estrogen levels, and prescriptions for Clomid and Provera (to take in case I don't start my period on my own soon....I'm due anytime, but with the last few cycles being so whacked out....who knows). He said to do a home pregnancy test on Wednesday if still no sign of a period, and then call them, but more than likely he'd have me start the Provera then.

All in all, I really like him. He seems attentive, told us he'd give us his cell phone number in case we ever had any questions (didn't seem to get it though! Need to ask at next appt!). And he has 3 offices that are all fairly convenient to work (within 20 mins at least). So, we'll see what happens! I'm going to go ahead and start temping and charting again, too....couldn't hurt!

Sonogram Results

I received a call a little while ago from Judy, Dr Lopez's nurse with the results of the sonogram. She says I have a polyp on my left ovary. They recommend getting it removed, but it's not a major, must-deal-with-immediately concern. They know I have an appointment with Dr Pinto, the specialist, on the 24th, and she said I can either have it done in their office or wait to see if Dr Pinto wants to do it.

My first thought was to wait and discuss with Dr Pinto, but after discussing with Kevin, he wanted to have it taken care of as soon as possible. I called Judy back to discuss with her, and she spoke with Dr Lopez. They then confirmed that it's not as high risk as the impression Kevin has, and there is no problem waiting to discuss with Dr Pinto, so that's what we're going to do. Her reasoning, is that he may want to include it in his course of action for our infertility, as the removal process would probably involve a hysteroscopy, which also allows a fairly open view of the uterus, which would for an optimal time to make any other observations regarding the condition of my body and fertility issues. So, we're waiting......

The strange thing is that I feel things on my left side in the area of the ovary, as if I can 'feel' something in the way. Small twinges, occasional bits of discomfort. Amazing how the mind works at the smallest suggestion!

Oh, and internet searches of medical issues is not a smart thing to do. While I cannot find a single website the puts the words "ovary" and "polyp" side-by-side (most mention 'ovarian cysts' or 'uterine polyp'), the majority of items that are coming up are referring or ovarian cancer!!! I know if it was a major concern, she'd have me in right away, but it's still a little scary seeing all that! But what's the deal with the 'polyp' when there's no reference to anything like that on the internet!?!?!?

Sonogram

I was supposed to go in for a sonogram yesterday, but there were horrible storms overnight Wed/Thurs that knocked out some power in the area. The office called and rescheduled me for today. They must have been trying to play catch-up all in one day, because the waiting room was packed when I got there! I felt kinda bad that I got called back so soon when some of the women had obviously been waiting a while, but I ended up only seeing a sonogram technician and not my doctor, so that probably explains it.

I guess I was expecting her to kind of fill me in on what she was seeing. The only other times I had sonograms was when Dr Nokleberg was doing them years ago in Round 1 (that's what I'm going to refer to our initial infertility problems as from now on! LOL!) She would show me the screen and explain what she was seeing. This technician just quietly went about her work and only spoke to let me know when she was inserting or shifting or removing the sonogram wand. She looked at both the right and left ovaries, as well as took several shots of the uterus. At the end, she told me that she will give the information to Dr Lopez and Judy (Dr Lopez's nurse) to review and diagnose, and Judy would be giving me a call probably middle of next week. I'm sure she knows what she's doing and got sufficient pictures and data to give Dr Lopez everything she needs, but I guess it just makes me feel a little weird about it all. How can a doctor make a fully informed diagnosis if she's not seeing it first hand? I guess we'll see.