Sunday, July 13, 2008

Ultrasounds; next steps

I got a call from one of my RE's practice partners last Wednesday (my usual RE is out of town). He suggested I come in this past Friday to get an ultrasound to see where things stand for me. They were able to fit me in at 8am, which is great since I have to be at work a little ways away from the doctor's office. I went in (was late because I messed up getting there, another story, I was nervous etc.), got the bloodwork and ultrasound. It was fortunately a female doctor who did the wanding (I hadn't had one done in 4 years), which made it slightly less awkward.

She basically told me I had "stereotypically cystic PCOS ovaries with no dominant follicle" and that "there is no question you would benefit from medication, no question at all." Again, not anything that surprises me, but it's still not fun to hear. But, later that afternoon, she called me back and said my estradiol was a bit elevated, so there was some chance I could develop a dominant follicle sometime in the following week - neither she nor I expected that. (Although I wonder if she looked at the full blood profile closely enough - what if my estradiol is just elevated this cycle? My temps seem lower than in the previous cycle? Don't know for sure if there is a connection.)

So, I'm going in for another ultrasound on Thursday to see if by some chance I've developed a dominant follicle. I'm not holding my breath, but I guess we'll see.

My tentative plan is to ask them about Provera to start an AF very soon; do the HSG before we go away for a week (command performance with in-laws); then do the birth control pill for that month to calm down the cysts; then the Clomid. We'll see what the doctors say when I ask them what they think of my tentative plan! I want to maximize the chances that the Clomid will work (or at least not quickly cause large non-functional cyst issues that would lead to some time on the pill anyway), so this seems to make sense to me. Make sure my tube are open with the HSG, and calm down the "millions of little cysts" currently on my ovaries.

And in the meantime, I've decided (pretty much) what I'm going to do work-wise. My DH and I have drafted a letter to my boss, giving her far more detail about what I've been dealing with than I'd wanted to share... but I feel like I have no choice but to share more than I'm comfortable with to lay all my cards out, so to speak. I basically said that I didn't expect to be at the point of having to choose fertility treatments only 6 months after starting the job (I'd hoped to ovulate at least 2-3 times by now, but instead I last O'ed back in January); that emotionally this is especially difficult for me because of the loss of my late husband and the loss of having a family with my LH, and now I'm having "fertility challenges" with my new husband; that I have no choice but to have some of these appointments at times that will eat into standard work time, and with what she's said about how I would be allowed to make up some time, it would be extremely difficult to make up enough time if I start having a lot of appointments. And that the choices are either for us to work out SOMETHING in the way of time flexibility for me to have my appointments (unlikely for a variety of reasons); for her to help me find a job that is part time with benefits there and with some flexibility in the hours so I won't have to worry about that when I have appointments; or... I would have to quit (and find a part-time job somewhere else). I am not thrilled with the last option. The best choice would be the part-time gig somewhere at the company. But I don't know if it'll happen.

Nonetheless, I have decided I will make it work as long as I can (probably until shortly before I start Clomid, whenever it winds up being), and then give her the letter and see what happens. Although I am NOT looking forward to having to actually give it to her and have the inevitable super-awkward conversation, I've made some peace with knowing that this is the deal, and I have gone as far as I can with this.

Another week is starting... we'll see how this one is.

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