Our History, Part II – The ob/gyn appointment

I had my annual exam October 2008. At this time, I pressed the issue with my ob/gyn regarding next steps aiding our fertility. I was disappointed by her knowledge, or lack thereof, of both male and female fertility issues. This doctor is one of the most reputed in Northern California, and has been mine since I was 17 years old. When I asked her a few (in my opinion) basic questions, she was unable to answer them to my satisfaction. In general, I found her answers vague, uninformed and lacksidasical.

A few of the questions I asked:

• Is there any concerns that my previous inclination toward cyst development is impeding my ability to get pregnant?
• Has the amount of / duration of time I have taken birth control pills affected my ability to ovulate, and thus get pregnant?
• What do you make of my cycle length(s)? (They were erratic for the first 4 months, then regulated at 24/25 days)
• Are there dietary or environmental changes I can make to affect potential conception?

At the end of the exam, based on my short cycle length, my doctor recommended we begin a course of Clomid treatment for 3-6 months. Should this be ineffective, she recommended we see a specialist. She briefly explained to me that Clomid is the most common first-line fertility treatment used, roughly in about 25% of women with trouble conceiving. The purpose of Clomid is to establish a regular ovulation pattern. Unlike many other fertility medications which promote the production of more eggs from follicles, Clomid focuses on regular development of a single egg.

I left my appointment a bit frustrated by my doctor’s lack of knowledge, but excited to have a direction. I was off to my computer to do a little research. Google can be both a blessing and a curse in these situations.

MY ADVICE: Always proceed with caution! There is a TON of information out there, and at a certain point, you have to shut it all out and have a direct conversation with your provider to understand the best course of action for your case.

None the less…after a bit of research, my husband and I concluded that there were several tests that were supposed to be ordered prior to Clomid therapy. Additionally, I was suspect as to whether or not Clomid was the right course. After several messages to my doctor’s office, I was able to speak with her. She ordered the following tests:

• Day 3 FSH levels
• Day 7 LH and Thyroid

I went into the office the following day to pick up the blood work order. Attached to it was a form checklist / cover page with the title “Infertility Testing”. {I HAVE TO SAY: I actually paused, albeit the briefest of moments, when I read that walking down the hallway. It hit me that after all these years of dreaming of my perfect husband and beautiful children, all the years of loving my nephews unconditionally, all the years of gushing over my friends’ children, I was the one who was going to have trouble having a baby. All the late nights I had worked, the fantastic trips I had taken, the unbelievable experiences I had slipped away in one breath knowing I may have waited too long.}

This checklist included the description of 6 different tests the doctor may run to determine initial fertility issues. I wondered why we hadn’t discussed this previously? I read all of them, and their descriptions, noted the ones with “X” by them indicated I needed to complete, and then studied the others crossed off-as though I wouldn’t need to worry myself with those. Oddly, I did. I read them, and googled them to get an idea of the trajectory of testing ahead.

THE CHECKLIST

1. Day 3 FSH (Follicle Stimulating Hormone) blood test
2. Day 7-10 LH (Luteinizing Hormone) blood test
3. Hysterosalpingogram (HSG)
4. Hysteroscopy
5. Exploratory Laproscopy
6. Semen Analysis (PHEW! One that wasn’t for me!)

When I asked about the other tests, I was told that I would likely not need any of them. When I talked to my husband, mother and father about them, they told me I was being dramatic, and not to get ahead of myself. I just felt something was off.

At this time, I was VERY adamant with my husband that he get the semen analysis order from his doctor. I wanted to know on both sides what we were dealing with.

So, we were off! Testing was under way. We continued to have sex, during the right and “wrong” times 🙂 We used the mucous test and the First Response Ovulation Predictor Kits to determine my ovulation. When it was time, we had sex every other day. Based on my husband’s age (42) we were told he needed a day to regenerate good sperm.