From Bad to Worse...

Well, on Monday June 1 we had our consultation with Dr. P.  We went in hopeful, but with realistic expectations based on our test results throughout the “observation month”.  It didn’t help that my period was a day late (was due on Sunday), so we were already extra hopeful.

Well, Dr. P officially declared it: unexplained infertility.  Based on our data and the time we’ve been trying, the likelihood of conceiving on our own is only 1-3%.  That was a bummer to hear, but we tried to stay positive.  She said that if I wasn’t pregnant, the recommended course of action at this point would be to start Clomid and try IUI, intrauterine insemination.  This would increase our chances up to 10–15%.  The only issue would be the cyst on my left ovary.  If it was gone, or even the same size, then we could move forward.  However, if it was bigger, then surgery would likely be required before we could start a treatment cycle, because treatment would likely make the cyst grow.

For those of you who don’t know, my birthday is coming up at the end of August, and at that point I will have to get off my parents insurance.  They have been extremely generous in allowing me to stay on their plan, and it has great coverage for infertility treatments.  I’ve met most if not all of the applicable deductibles, so we’ve been hoping that we could get pregnant before I turn 26 and we have to start a new insurance plan.  The idea of adding surgery to the schedule really threw us for a loop, so we left the appointment nervous, but still hopeful that either A) I was pregnant! Or B) the cyst was gone.

That hope literally lasted about 15 minutes past the appointment, as I got my period soon after.  However, we were still holding out hope that the cyst would be gone and we could start Clomid and try IUI.  I called the clinic that evening to set up an appointment for an ultrasound to check for the cyst the next morning.

I went in for the ultrasound feeling hopeful that the cyst would be gone.  They seemed surprised when they orginally found it that I hadn’t had pain with it, and since I still didn’t have any significant pain, I figured it was gone!  So, legs up, butt down, hello Mr. Happy Wand!

Right ovary first, looks good.  There’s a second screen that faces the bed so I can see what the NP sees.  She switches to look at the left ovary, and immediately my heart sinks.  It’s bigger.  I don’t even fully understand what I’m looking at but I can tell that compared to the right one, the left ovary is much larger, and mostly a different color.  The NP’s face drops, she knows this wasn’t the news I was hoping for.  It went from 2.75 to 3.7 cm.  She told me I could get dressed and left to see if Dr. P was available to come talk to me.

Dr. P was on call and with another patient, so the NP told me that they would call me later with next steps, but that based on our conversation the day before, it would likely need to be surgery.  I was devastated.  This wasn’t part of the plan.  Not that any of this was, not that I ever in a million years imagined we’d be unable to conceive naturally on our own, but we had come to terms with the idea of medication and insemination, but not surgery.  Surgery that would cost a lot, and push back our first treatment cycle, when we’re already feeling the pressure of time for insurance reasons.

A lot of tears were shed that morning.  I went home instead of going straight to work to talk to Kory and try to pull myself together, and I could tell he was disappointed too.  Not in me, just in the entire situation.  But he had a test to get ready for (interview process) and I had to get to work, so I dried my eyes and put on a smile.  Now we just have to wait for the phone call from Dr. P to discuss surgery.

The HSG

Before I get into the details of this particular procedure, I wanted to backtrack for one second.  Everyone knows it takes 2 to make a baby, and you'll notice that up to this point all the testing and tracking has been focused on me.  After my initial blood-work in December, and before our appointment in April, I asked Kory to set up a test for himself, since the process of testing for him is really no different than any other random afternoon he has off (besides the drop off I suppose).  He called the clinic to ask about male fertility testing, and was told he couldn't be tested until I was enrolled in their infertility program.  I couldn't believe it!  I felt that this was not only sexist, but also unfair for any man who wants to be more informed about his health!  What if a man in a same-sex relationship wanted to be tested because they wanted to have a child?  Anyhow, I digress.

The point is, they did have Kory submit a sample before my HSG, because this is a more invasive test and it makes sense to rule out any problems he may have before moving on with this procedure.  All his test results came back "within the normal range."  It did bother me that he wasn't given any specific numbers, but I plan on asking about that at our next consultation.  So with his normal results, we move on to the HSG.

HSG stands for hysterosalpingogram.  Basically, it's an X-ray of the uterus, and more importantly, the fallopian tubes.  However, fallopian tubes are, according to my radiographer, about the size of a pencil line.  Not a pencil, but a line drawn BY a pencil.  This means they're basically invisible unless you light them up, and you can't really see if they're blocked unless you have something to look for that's getting through.  So, they insert a catheter and inject dye into the uterus, then take pictures as the dye travels up the fallopian tubes and hopefully spills out into the body cavity at the ends.

When I scheduled my HSG, they told me they often recommend people take the day off, as they can experience some discomfort throughout the day.  Also, I was to report one hour early for an injection of icantrememberwhat.  I had asked the scheduler if this was something my hubby could come to, since he's trying to be very involved and for moral support, and she said it wouldn't be a problem, so Kory planned on coming.

Well, the morning of the appointment came, and Kory worked an overnight shift the night before.  He was super tired, so we decided he would sleep the extra hour that I was just waiting, then come for the actual procedure.  I got my injection, which I found out was basically a high dose of liquid Tylenol in my tookus, and was told that I should probably eat a little something before the procedure if I hadn't yet.  That would have been super nice to know before hand, because not only had I not had breakfast, I had forgotten to grab my purse.  Luckily, for some reason the main desk at the entrance of the clinic had a basket full of packets of saltines.  Score!  Kory came a few minutes before I was called (granola bar in hand for me, love that man!) and we went back.

Now, for anyone who has never been to a radiologist, their rooms are VERY different from a regular doctors.  A high, long metal table in a big room full of big equipment.  Then, we were informed that they prefer no extra people be in the room during the procedure, because they'll be moving around, I'll be moving (what?!) and they don't want to expose anyone to unnecessary radiation (which makes sense I suppose).  So poor sleep deprived Kory had to wait in the waiting room, but we told them to bring him in before discussing any results.  So, Kory specifically asked me to let readers know that if you're ever in this situation, men do not need to be at this appointment.  It's great if they have nothing else going on, but in his case, the extra sleep would have been time better spent.

So, Kory leaves, and I'm instructed to "assume the position" which any woman who's been to a gynecology appointment knows means feet in the stirrups, bottom at the edge of the table.  Only in the radiology department, they have no stirrups, so I was told to put my heels on the pieces of tape on the corners of the table.  Not really official, but effective.  The doctor inserted the speculum, then the catheter.  I told there might be some pressure, it might be uncomfortable, but I felt fine.  Hey, maybe this won't be so bad!  Maybe those woman on the Glow app don't have as high a pain tolerance as me!  Ha!  So naive...

So, speculum and catheter in place, I am instructed to "scoot" up towards the middle of the table, without moving my legs too much.  This ended up being a group effort, as the nurse pulled the sheet, the doctor held the tools, and I wiggled my way up.  Definitely one of my less dignified moments; I sure am glad I have a sense of humor and don't get embarrassed too easily.

Now I'm in the middle of the table, the X-ray is positioned over me, and the doctor starts injecting the dye.  I'm told to expect "a little pressure"...I'm OK.  "A little more pressure..." HOLY CRAP there it is!  Like the worst period cramps, but concentrated in a smaller area and sharper.  This isn't to scare anyone, just being honest, it sucked, and I was holding back tears.  It didn't take too long though, and then it was done.  Kory was brought in after I got dressed and we were told that, big surprise, everything looks normal!  Official results wouldn't be given for 72 hours, but from what he could see it all looked good.

While happy with the positive results, we couldn't help but be frustrated.  Test after test was saying everything was "normal".  Why can't we get pregnant?!  Also, lesson learned: always double check if you should eat or have an empty stomach or if it matters before going in for tests.