it's sad that i've forgotten that doctors are supposed to be helpful and a good use of our time rather than a necessary hassle. i have come to think of my ob/gyn as a freak of nature in the medical profession, but i was reminded today that this should be the norm.
i am so glad that we (i! let me give myself credit where credit is due.) decided to see a fertility doctor. our consultation was this morning, and i realized within the first five minutes how much i was rushing to make sure that i got to say everything i needed to say before i slowly started to see that this guy wasn't pushing us out the door. this was so unlike most of my interactions with doctors in the recent past. he engaged us in conversation for over a half hour, going over both of our medical histories and our lifestyles and how we've been TTC so far. he was so helpful, and so nice, and truly seemed to want to work with us rather than just checking off some boxes on a form and shuttling us off for mindless procedures.
we shared the results of the hubby's semen analysis, and he said that from his perspective he's not seeing why it should keep us from conceiving. it seems that my ob/gyn, not being an expert in the boy stuff, may have simply looked at the percentages when he went over the initial results and didn't take into account the fact that the total sperm count is way above average (which is pretty much what the urologist and our common sense said). the fertility doc said he feels the high concentration of sperm outweighs any negatives and that even though the morphology is on the low side, he doesn't think it should matter. he said by the end of our talk that he actually doesn't think it's "male factor" infertility at all, and he's curious to see what else may be going on with me. sigh.
so get this -- even though today was scheduled as a consultation, we got to do some initial tests! i was shocked by this. when he started talking about our next steps, I assumed I'd have to make another appointment to get things rolling, but we wasted no time. after our talk, we went into an exam room where he did an ultrasound to showed us my cervix, uterus, and ovaries and explained what everything was and how it was supposed to look. everything looked perfect. he said the ultrasound allowed him to see that there wasn't any obvious endometriosis, but that may be something we'd have to revisit later. he also did some cultures; i'm not exactly sure what they were all for, but i'm guessing they may have been STD-infection kind of tests. which i know i've been tested for in the past, but it doesn't hurt, i guess. and then he prescribed me some prenatal vitamins and folic acid, and wants me to get some other vitamins that will improve my egg quality. whew.
this week is ovulation, so he wants us to "try our best!" (obviously) and if we aren't successful, we start a "full fertility workup" when i get my period (probably around the beginning of february). the workup normally includes a couple of things we've already had done (the semen analysis and the hysterosalpingogram), so we won't repeat those. but we will do a bunch of other things. it looks like this:
1. 3rd day of period i have a blood test... a big one. 17 vials of blood, they said. yikes.
2. soon thereafter: i have a hysterosonography, which checks the uterine lining for polyps and fibroids.
3. next: we have a post-coital test, which is an exam 9-12 hours after intercourse to see how my body is dealing with the sperm and such. (the hubby will likely feel a lot of pressure about that specific timeline... we might need some strategies there...)
4. when i ovulate again: i have an endometrial biopsy to check my the quality of my endometrial tissue.
5. when we have a discussion appointment to go over all of the results. all of this will happen within my next cycle... assuming we don't get pregnant this time.
but maybe we will! he was rather optimistic, which i suppose we should be. so we'll do our best this week... i should probably ovulate within the next few days. all in all, it just feels like the right thing to do to have this expert on our side and for us to stop jumping to conclusions that the internet or a pay-service lab suggests. all of these tests are totally covered by my insurance, so we can get as much information possible before we start making big decisions. maybe it will turn out that IUI is still a great option for us, but in the meantime i do not feel badly about taking our time with this most-important process. and now it's a week of "trying" to look forward to... woo hoo!
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