phase 2, part 4

this morning was the last test of the fertility workup: the endometrial biopsy. this is, as it sounds, a procedure that is done in order to examine a sample of the uterine lining for any abnormalities, cancerous cells, etc. i made the hubby come with me for this one, because i knew it would likely be the most uncomfortable part of the process. in actuality, it wasn't as bad as i expected. the cervical biopsies i've had in the past seem worse in my memory... but maybe i've just toughened up. :)

we had a different doctor again for this test, but she was great: an older russian woman with a great bedside manner. she first did a regular ultrasound to, once again, check things out in there and take more photos of my ovaries and whatever else. then she explained the procedure to me very simply: after inserting the speculum, she'd swab me with some betadine, then put in the catheter and use a tube to suck out some of the lining for 15 seconds. she told me those 15 seconds would be the worst part but that was it. i figured i can handle anything for 15 seconds. and it all happened so fast, i didn't even realize the 15 seconds were happening until she told me we were halfway done. she made me keep talking to her, and totally distracted me. excellent technique.

then the nurse took some more blood. you know, as if i have any left in my body after the past couple of weeks. they're going to check the hormone levels again to make sure they've dropped, now that it's a week after ovulation. i asked her to take it from right arm since my left one is still bruised... now i definitely looks like the reason i've missed so much school lately is due to my crack habit.

afterwards i stayed lying down for a few minutes until the cramping subsided. it hasn't been much of anything since then, though she did tell me i'd probably have some spotting for the next day or so, and NO SEX today or tomorrow. then we had to make our appointment for the results discussion with the doctor. we had a moment of panic when we thought we might not be able to schedule it prior to our trip to turkey in two weeks, but finally we were able to get an appointment for the wednesday before we leave, march 9. that still seems like a long time away to me, but by then at least i'll know for sure if i got pregnant this try, and we'll know what's up before our vacation... for better or worse.

then the hubby took me out for a lovely brooklyn diner breakfast, and now i'm spending the rest of this rainy day on the couch, catching up on work, reading, and probably napping. not a bad friday. and there's nothing else for me to think about or do at this point other than try to ignore the two-week wait. today is day 20, so in a week or so i'll either get my period... or not.

phase 2, part 3

if you want to know the secret to making sure that sex-on-demand happens as it needs to, i'll tell you: be sick for a week beforehand (coming off of your period) so your husband is severely deprived. we had no issues last night, other than him refusing to kiss me because i have been feeling so crappy and he didn't want to be exposed to more of my germs than necessary. also yesterday and today were my ovulation days, so we had double the incentive... hopefully i will be feeling well enough for the rest of the weekend to maximize these peak fertility days!

this morning i went in for the post-coital exam, which was the easiest part of this process yet. it was even less involved than a pap smear. all they needed to do was collect some mucus. speculum in, mucus sucked up, and done! for a pop culture reference on the subject, this is where things went wrong for charlotte on "sex and the city." her cervical mucus was attacking trey's sperm. hopefully this is not the case for me.

today's doctor was much more chatty and helpful than tuesday's, so i asked her something that i'd been wondering about about next week's biopsy. on the off-chance that i do get pregnant, would it be safe for them to be poking around in there and removing part of the uterine lining? she said that people ask that question a lot, but that yes, it is safe. she also told me that she had recently read a study that showed that in cases of early pregnancy when a biopsy is done it may actually cause the embryo to form an even stronger bond during implantation. go figure! she said that a lot of women end up getting pregnant during the fertility work-up, which i've heard and read before. who knows exactly why, but it's something to stay optimistic about, i suppose.

after that i went to a lab to have the additional bloodwork done. these were tests that have to be submitted as frozen samples for whatever reason, and the doctor's office doesn't have the technology to do that. i couldn't decipher anything on the form other than figuring out that one of the tests was for lupus. so i'm guessing these are just more of the same hormonal and genetic tests that they were collecting for last week. it was another 10 vials, not terrible.

so that's it until a week from today: the biopsy. that's the last stage of this process other than the results meeting with the doctor. hopefully we won't have to wait too long to schedule that. this has felt like a long process already.

phase 2, part 2

this morning i went in for the hysterosonography, so that the docs could get some pictures of the inside of my uterus. it wasn't too bad. in terms of discomfort, it was about the same as the hysterosalpingogram (the test that made sure my fallopian tubes were open and the ovaries were working correctly), and even a little less weird than that one since there were no balloons involved. they did the procedure in a regular exam room. first the doctor did a regular sonogram to get the lay of the land, and then she used a speculum and a catheter to inject a bunch of iodine-saline solution into my uterus. that felt crampy and weird, but not awful. then she did another sonogram, after the solution made it easier to see the actual surface of the uterus. i tried to watch on the monitor but it made me a little queasy watching the liquid slosh around in there. she snapped some photos and that was that.

now, this was not the fertility doctor that we met with before, just another doctor that i didn't know until today. so i'll cut her a little slack, i guess... but she left just saying that they'd go over the results with me at our "results appointment" that happens once all of the tests and procedures are done. after she was gone, the nurse told me to lie down for a few minutes to make sure i felt okay, and pointed to the monitor to show me the polyp they'd found. why on earth the doctor didn't share that nugget of information with me, i have no idea. i asked the nurse what that meant and she said sometimes they like to take them out, so they might want to do that, but i'd have to wait to see what the doctor said at my follow-up. but heck, at least she mentioned it. she was also super nice and made sure i wasn't dizzy before i sat up. she even smirked a little when she reminded me about the procedures required for my post-coital test this friday, and said she'd see me then. i appreciated that.

so i've done a little reading about polyps and what i know is that the experts don't even know that much about them. they're growths of cells that are attached to the walls of the uterus, caused by an overgrowth of cells in the lining. any time i hear about cells overproducing of course i think cancer, and apparently it's normal to test them and make sure that they're not cancerous. i suppose the endometrial biopsy that i'm having next week will also test for this. it seems that polyps can be caused by hormone issues, usually only occur in women in the 40s and 50s (ha! or... sigh), and may or may not affect fertility. Some studies have shown that removing the polyps has led to increased fertility in some women, so that's a bonus. it seems there are a couple of ways to deal with them and it doesn't sound awful... my guess is that if there's any chance it might help us conceive i'll have it done. details here: http://www.mayoclinic.com/health/uterine-polyps/DS00699/DSECTION=tests-and-diagnosis

so now -- with the memory of the fertility doctor talking about the possibility of prematurely aging eggs -- i'm having visions of my prematurely aging body experiencing early menopausal hormonal shifts and rebelling against ever getting pregnant. but i suppose there's not much to do but wait and see once all the results are in and the doctor has a chance to look over everything and come to some conclusions.

oh, and i have to go for more bloodwork. apparently they need some "frozen" samples and the fertility place doesn't do frozen samples, so i have to go to a lab to have it done... another 10 vials. i think i will go on friday after the post-coital exam, since that doesn't seem like it will be anything much and i'm going to be late to work anyway. as for today, i'm now at work so should probably try to ignore the slight cramps and iodine-saline solution discharging from my body and get some stuff done.

Phase 2

today my Full Fertility Work-up officially began. yes, that means i -- once again -- am not pregnant. and i have to say that this one hit me harder than it has in awhile... possibly the worst yet. but after i spent a good portion of yesterday in a miserable state of mind, i had no choice but to switch gears into Phase 2 of our TTC saga. we tried it on our own, now we enlist the help of the experts. i hoped it wouldn't come to this. i know that's part of the reason i was so, so upset when i got my period yesterday. i didn't want to have to go through this next round of tests and procedures. i would rather not run the risk that we simply have "unexplained infertility" and that we aren't able to rectify the situation easily. but what choice do i have?

i dug out the paperwork we got from the fertility institute and read that if i got my period over the weekend they just wanted me to come in first thing monday morning, so i got myself there at 7am not exactly sure what to expect. i thought i might just schedule all of the upcoming appointments, but they said they could do the bloodwork today (normally done on Day 3 of the cycle). they took 17 vials of blood, which was a bit crazy but not as bad as i worried it might be. they were testing my hormone levels (details here: http://www.fertilityplus.org/faq/hormonelevels.html#female), as well as doing some genetic tests (cystic fibrosis, i think, and something else that has slipped my mind already), and a mandatory HIV test. which makes sense, and would probably terrify me if it was my first but luckily (or unluckily, i guess) i've been tested for HIV several times in my life already. i won't get any of these results back until we have our "discussion meeting" after this whole battery of tests is done and the doc presents us with our options.

after they sucked out my blood and i had some time to rest in the waiting room, they scheduled the remaining three visits that i need to make over the next couple of weeks. since they open at 7am, i won't have to miss too much school, i'll just come in late a couple of days. next tuesday i go in for the hysterosonography, which is a sonogram that examines the uterus for any weirdness. shouldn't be too terrible. next friday is the super embarrassing post-coital test, which is not at all intrusive other than the fact that the hubby and i MUST have sex the night before so that they can make sure things are doing what they should be in the aftermath, and that kind of pressure doesn't always work well for him. but that *should* be right around ovulation time anyway, so hopefully we'll be in the groove already. and then the following friday is the one thing that i know won't be at all fun... the endometrial biopsy. i've had enough biopsies (and many in the nether regions) to know about what to expect from that procedure, and since it's a parent-teacher conference day i will just stay home after that one's over, and will have the weekend to recover.

progress always feels good, to an extent. it's certainly a brighter day than yesterday. of course i'd rather be pregnant right now. but i'm still optimistic that it can happen, and that -- one way or another -- we will be fine. i don't think i'd be handling any of this so well if it wasn't for the support system that i have. my family, friends, and co-workers and their love and understanding mean the world to me. not only does it make life brighter in general and help me to realize that even if we can't have children our lives have so much meaning, but it also helps so much to know how many people out there care for us and are sending us love and positive energy as we deal with this.

i found out this morning that my boss and his wife went through the same struggles trying to have their two daughters, and he assured me that he completely understands and that, especially in our field, "kids come first." while it might seem counterintuitive, being surrounded by so many beautiful and amazing children every day does help me to focus on the big picture. i'm making a difference in the world already. and while the fact that i don't have my own children sometimes breaks my heart, the fact that it's the one thing in life that i can honestly say is eluding me is more of a proud and grateful realization than a downer. i couldn't have a better situation in which to deal with all of this. so bring it on.