October 29th 2012: Having committed to openly blogging about my side of our journey towards having a baby, I think today’s appointment at the fertility specialist, warrants a mention.  I may not blog it right away, but I want it documented so I can eventually share it with y’all. (October 30th, having run it past my hubby to make sure it’s ‘fit for the public’ I’ve decided to publish it!)

Today was my first step down the path of fertility treatment.  I don’t have an OBGYN here in Houston.  I went to one when I first arrived, but I didn’t like her, so I didn’t go back.  I have my girlie yearly appointment with my regular GP.  A couple weeks ago, I did a google search for an OBGYN, within a 20 mile radius of our house, I wanted someone with a fertility specialty and reproductive endocrinology, so after going through a somewhat extensive filtering system, I ended up with this one lady.  Though her page said she didn’t accept my insurance, I just felt it in my gut that this lady was someone I wanted to see.

From there, to avoid any further disappointment about who was covered by our insurance and who wasn’t, I went on to our insurance providers website and started a search there.  You start with almost 1,000 OBGYN’s within the radius I set out with.  So, using the same process, I reduced the number by checking different boxes in the filtering system.  I got it down to 3 OBGYN’s in a 20 mile radius and low and behold, the same gal who came up in my Google search, came up in this search too.

I figured it was fate, maybe I saw signs where none existed, but out of over 900 OBGYN’s, to get her name to come out without thinking she was on the list to begin with, was impressive to me.

So, I made an appointment.  Then proceeded to start the mountain of paperwork that they sent to me, and quickly realised that she was based in IVF Houston – just for the record, we are nowhere near IVF stage, I haven’t even had basic testing done to make sure all my ‘plumbing’ works right or not.

I had a minor freak out, sent a late night email to the receptionist telling her that the forms were freaking me the hell out and she wrote back reassuring me that there were many, many, many steps we could try before we went to the IVF step.

A little calmer, I filled out the paperwork, Col faxed it in work on Thursday (it needed faxed 72hrs before the appointment), they verified my insurance and we were given the green light.  The appointment was happening.

I’ll tell you what I told the Doc, we haven’t *really* been trying for a long period of time, I’ve been unprotected for a substantial period of time, but we tend to ‘try’ in little bundles of months, I track, I plan, I monitor, then ‘day 1’ of my cycle rolls around, I realise with fear, anger and sadness, that I’ve failed at getting pregnant, once again, and I can really only take a few months of that before I get obsessive about it and need a time-out to cool off.

It’s intense.

Especially since people all around me keep announcing they are pregnant.  The last few weeks, for example, we had two newborns and three pregnancy announcements in our sphere of friends and family – that’s a lot to take in and, as I said in my last post about fertility, ‘Every path has it’s puddle‘, most days, I’m perfectly ok with it all.  So, given that we have a few hundred ‘extra’ dollars on our flex card (add this to the list of things people never say!) that needs to be spent before January or we’ll lose it.  I figured, what the heck? There’s no harm in starting the ball rolling and perhaps going in to the new year with a renewed sense of hope, determination, and perhaps even some answers about what I’ve been doing incorrectly and how to perhaps change things up, to increase our chances of becoming pregnant.

I’ll admit it though, I was scared, nervous and also worried.  On one hand, you want to know answers – either way, it’s good to know, so you can stop beating yourself up every month when you discover you’re not pregnant.  That’s true.  But, on the other hand, what if there IS a problem? What if it’s not ‘just timing’? Am I really ready to hear the words ‘inadequate to conceive’?

I don’t think so.

Are you ever ready to hear something like that?

I don’t think so.

In spite of my hesitation and concerns, I got myself to the Houston IVF center, with enough time to find the right parking garage, find the right floor, and fill in any remaining paperwork (which thankfully, happened to be minimal) – which I think in itself deserves a Blue Peter badge, because I left the gang at lunch at almost 1.20pm for my 2pm appointment!

I checked in, gave over my driving license and medical insurance card for them to copy and took a seat.  After a short wait, kind lady named CJ took me to Doc’s office where she was waiting to meet me, hand outstretched and smile on face.

As soon as she said ‘hi’, I was immediately feeling better.  She took a brief history (why are you here?) though she already had my patient history in the paperwork we’d faxed over and she set out explaining that it was rather unusual for someone of my age to begin treatment with her, that over 90% of her patients have gone through the mill a bit and are ready for IVF treatment, but that she was thrilled to have me as a patient and was determined to get me pregnant.

She immediately recommended me, the choice of two OBGYN’s depending on where in the city I wanted to get treated and she laid it out plainly for me;

“My job is to get you pregnant, once you get to 10 weeks along in your pregnancy and everything is normal and healthy, then you’ll leave us and go to your OBGYN, so you will need to choose an OBGYN, set up your next well-woman appointment with her, make an introduction and tell her you’re seeking fertility treatment and that you hope to be paying her a visit soon”

That’s essentially how she started the consultation ‘when you get pregnant, you’ll need an OBGYN’.

I liked her confidence.  I listened on.

She said that a very small number of people, my age, leave her office without having conceived and delivered a child.  She said that any for problems that come up in my test results, most of them have a solution.

She also said, she’d give it to me straight, if I’m going to be in the minority of people she can’t help, she won’t lie to me or string me along.

Candor, I liked that too.

We discussed a treatment plan and timetable, here’s kind of what it looked like:

Today (before my cycle starts) blood drawn for full blood panel which includes a full female blood panel, a hormone panel for AMH, TSH and Prolactin as well as genetic testing for CF, SMA and Fragile X (the genetic testing was something they offered to do if I wanted to, and, given that my mother is adopted and we don’t know her full family history, it made sense to tick the box).  This resulted in a 40 minute wait at their blood-drawing nurses office, followed by 10 vials of blood being drawn from me.

The lady drawing my blood made the assumption that I moved to Houston specifically for IVF/Fertility testing, which took me by surprise a little.  I informed her that no, my husband and I have lived here for three years with his job.  Apparently flying to Houston for treatment isn’t an unheard of thing.

For those of you unaware, Houston is home to the Texas Medical Center, the largest medical center in the world, with a local economic impact of $10 billion. More than 52,000 people work within its facilities, which encompass 21 million square feet. Altogether 4.8 million patients visit them each year (source here). People can check this company website , for the best home improvement advice.

My arm is somewhat sore from the tourniquet this evening and I’m glad I pocketed two jolly ranchers from their basket, because I did feel a tad light headed when she was done, even though I’d had a big lunch!

Day 1 

On day 1 of my cycle, they want me to call to set up an appointment.  They want more bloods drawn for tests (including HSG level) and she wants to do an ultrasound to check for signs of PCOS so she can give me an official diagnosis (til now, it’s only something my GP has suspected).  I have a feeling that my body will betray me on this one and it’ll be next week, I have a short trip coming up and I don’t think I’ll be in town on day 1! Murphy’s law!

Day 6-10

During this time-frame, they want to perform what’s called a Hysterosalpingogram (a HSG for short), this is an x-ray type of procedure, to investigate the shape of the uterus and the shape and functionality of my fallopian tubes.  In short, they’ll shoot dye through my plumbing and take pictures to make sure the dye goes where it’s supposed to, doesn’t get blocked and doesn’t leak out.

They’d also like me to start treatment at the same time as they are diagnosing, beginning taking clomid on day 5 of my cycle for 4-5 days on the lowest dose of 50mg.  However, I’m putting that off for this cycle, I want to get the results of tests back, before we proceed with the medication – partly because it’s $1,000 to pay for, it’s not at all covered by insurance and with Christmas round the corner, it’s just not feasible to uncover that kind of cash.

For those of you unaware about Clomid, Clomid is a fertility medication, available in three different dosages, 50mg, 100mg and 150mg, Dr McKenzie told me today that if I fail to get pregnant on all three levels of clomid, my only option left, will be IVF.

Of women who take Clomid for anovulation, about 75% to 80% will ovulate.  This, of course, does not guarantee they will have a successful conception, however. Of those patients who successfully ovulate as a result of taking Clomid, somewhere around half of those will have a successful conception within six months.

One of the best known risks of Clomid is the chance of getting pregnant with twins, or more. Triplets and higher-order multiples are possible, but unlikely. Getting pregnant with twins, however, isn’t that uncommon.

Plus, perhaps the first stages of tests will turn up something that’s easier to ‘fix’ than needing to fork out $1,000 (I can but hope, eh?) and, if not, then we can hit the new year with a ‘bang’ and fork out the money – not that I’m putting a monetary ‘value’ on getting pregnant, it’s just that, in spite of me being considered an almost ‘old’ mother-in-waiting compared to other mothers (my own mother was 19 when she had me), I don’t feel particularly rushed at ‘only’ 27 years old.  Many women conceive in their 30’s and if that’s what it takes, I’m happy to wait a little while longer.  I want to be thorough and hopefully not miss anything.  The doctor today also told me that she’d not start worrying about IVF with me until I was either very late 30’s or early 40’s.  She, too, emphasised that I do have time and I don’t need to rush through things.

Don’t get me wrong, I’m very keen to be a mother, but, I also want to know what exactly helps me get pregnant – for next time.  I mean, if I try everything at the one time, then I’ll probably have to do the same again when we opt for baby number 2, right? If I do things one step at a time, then I’ll be more inclined to know what ‘change’ was the one that gave us a kick in the right direction.

For those of you who know me ‘in real life’, I’d really appreciate you don’t ‘pry’ to deeply into how things are going,  I suck at lying, if I happen to get pregnant soon (which I was told today is entirely possible).  I’d appreciate being given that 12-16 weeks of ‘privacy’ to get our would-be child to a ‘safe’ viability.  I do have a couple of friends who just come right out and ask ‘so, are you pregnant yet?’ every time they see me.  If I am pregnant (which I’m not!) and haven’t told you, it’s for a reason 😛  Otherwise, keep an eye on my blog, I’ll give you all you need to know on here!

Today I’m exhausted, my arm is a little tender and bruised, but I’m emotionally drained.  Yesterday (as my friend Amber will attest to) was a mah-oosive step for me.  I worked myself up into knots about the whole thing – and last week I was threatening to quit the whole damn lot.

It’s an emotional roller coaster and the ride has barely started!

I’m glad I went to see Doc, she explained a few things to me, took my questions on board (and didn’t make me feel like a total idiot for asking them), helped set me at ease a bit, and very importantly, gave me back a smidge of hope that this door isn’t shut completely, which I was starting to believe was the case.

I know lots of people who don’t like the success walls, but seeing these dotted throughout my Doc’s office, made me confident that these people are now working for me and on me, the people who helped make all these babies, are now on my side, helping me.

Have questions about infertility? Here‘s a pretty good resource that a friend shared with me recently, they have a pretty good fact sheet here, called ‘an overview of infertility’.

As always, let me know if you want to share your story 🙂