Fertility Evaluation

My toes in the Usambara Mountains of Tanzania

For anyone that missed it, for my first ICLW week I decided to recap the course of my journey before I started this blog.  A couple of days ago I posted about deciding to become a Choice Mom.  Today, I'm blogging about my first visits with my RE; I think my next blog will be about choosing my donor, and then in the next day or so I'll write about my first 3 IUIs, and how crazy they made me.  It's been fun writing these; time really does have a way of putting things in a different perspective!

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By the time I had an appointment with my RE, the summer after I turned 37, I knew all about IUIs, OPKs and BFPs, thanks to my hours spent on SMC discussion boards. My choice of an RE was easy; one of my best friends is an OB, and she said her patients always had the best results with this particular doctor, and so that’s who I went with. At the start of our evaluation, he was optimistic that, based on my history of normal periods, all would be great. He even recommended we start with non-medicated cycles

He did want me to have a full fertility evaluation done first, though, and so I had my Day 3 labs done with an ultrasound, an AMH level and an HSG. My HSG looked great (aside from a wonky cervix that required a balloon catheter to get through – ouch!), but the rest of my labs were not so great. My AMH level was low at 0.49, with an FSH running just a tad high at 9 with a good estradiol level, and my antral follicle count was on the low side.

I got all these results over the phone from the nurse; because of a scheduling conflict I couldn’t get in to see the RE until a month after we’d finished all the tests. It embarrasses me a little now to admit how I felt then, but I had a major freak out. I guess because I look younger than I am, I expected my ovaries to act younger than they are, too. I was so sure my fertility evaluation was going to be perfect, and when I found out it wasn’t, I was terrified. I went from imagining a couple of IUIs, to anticipating multiple BFNs, IVF, huge bills and the potential for no baby at all. In retrospect, I overreacted, imagining problems and obstacles that might never materialize. As my RE had pointed out in our first visit, nothing shows what your fertility status is like actually TTC.

Which is what he reminded me of when we had our first post-evaluation visit. He told me that if I’d come to him after a year of TTC on my own, we would be talking about going straight to IVF. But since I’d never tried to conceive on my own, he thought that 3 IUI cycles with Clomid would be reasonable, and then reassessing after that, based on my response. “Your labs are only indicators of a potential problem. They don’t tell us the whole story.”

I was a little comforted by our appointment, but I still worried. One wonderful result of that worry was an appointment with an acupuncturist who specializes in fertility. I honestly think that my weekly appointments with her helped to restore my sanity. And they probably helped with my fertility as well. But even if it turns out that traditional Chinese medicine does nothing at all for fertility, I feel so much better, so much more like myself as a result of working with her, that I don’t really care.

I happily took all my herbs, did my fertility yoga, ate organic and lost 15 pounds over the course of the next six months, looking forward to my last vacation before starting the IUI process in January 2010. I was ready for the thought that it was going to take me a few tries to be successful. I was optimistic, with a healthy dose of pessimism mixed in, so I was sure I was going to sail through TTC with no major problems, no weight gain and just joyful anticipation.

I was wrong about that! I think that’s what I’ll cover in my one of my next posts.  :)

ETA:  I just realized that I have 99 days left until my due date....and this was my 99th blog entry.  This makes the third crazy number thing this pregnancy (after a conception date of 8/9/10 and 111 days left on 1/11/11) - I wonder if he's going to be a math genius?

In the Beginning

Me standing in Ngorongoro Crater

Welcome IComLeavWe'rs!  As you can see by my profile, I’m a 39 year old single mom by choice, currently 25 weeks pregnant after 4 IUIs and1 miscarriage.  Most of my bloggy friends are other SMCs, or women on the road to becoming SMCs, but I’ve randomly found other non-SMC blogs that I enjoy following, which led me to decide to sign up for ICLW this month so I could find some more.

I started this blog less than a week after my miscarriage in May. It initially started as a blog about loss and grief, then turned into a TTC blog, and now it’s become a pregnancy blog.  The one unifying theme throughout all these entries is the fact that I’m doing this as a single woman, and I try to remember to talk about that aspect of things as I write, though it can be surprisingly hard to remember to cover those feelings while writing about ultrasounds and IUIs! 

Because of when I started this blog, I never really covered much of anything that came before my miscarriage.  So I’ve decided to take this week to write about things like how I decided to pursue this path, choosing a donor, and talking a little about my first few IUIs when facing the diagnosis of diminished ovarian reserve. 

Welcome, and I’m looking forward to reading your stories, as well!

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The first time I can remember consciously deciding I was considering the SMC route was about 9 years ago, when I was a medicine resident, sitting in the ICU with a sick patient, chatting with Dr. C, one of the nephrology attendings.  She was also single, and I’m guessing she was not much older than I am now.  I’m not sure exactly how the subject came up, but I remember saying to her, “I thinking of adopting if I’m still single by the time I’m in my late 30s.”  Dr. C said, “I always thought the same thing, but I just never did it, and I guess it’s too late now.”  That was one of the saddest things I’ve ever heard, and then and there I vowed I would never let myself get to the point where I felt like it was too late to pursue my dreams.

But then suddenly I was 36, with no husband, no boyfriend and no baby.  I had dated – I tried a couple of online dating sites (and went on a lot of dates), joined clubs, took photography classes, traveled the world and accepted every blind date that was offered to me, with no success.  I know that many of my friends think I should have done more with the online dating, but I really hated it, and while I tried several times to make myself sign up for one of the sites one more time, I just couldn’t do it.  But I also couldn’t commit myself to going further with adoption, even though I still really wanted to be a mom. And it was then that I realized that I really wanted the chance to be pregnant, and my plans changed. 

I talked to my Gyn at my next appointment with her, and she was full of advice and information, since she herself had twins through IUI with an anonymous donor.  Armed with the names a couple of sperm banks, I started googling, and discovered the online world of SMCs.  I also told my parents, who were surprisingly supportive and excited, and my sister, who promptly asked if she could be my birthing coach when the time came.  I also told my closest friends, who encouraged me to go forward with my plans, and to hurry up already!

I had to put things off a bit, though.  I was still hopeful I would meet Mr. Right, and thought I probably had more time to wait before my eggs really started to age.  I also had some traveling to do.  I love to travel, and I just wasn’t ready to give that up in favor of being a mom.  My plan was to make it to all seven continents before trying to conceive, which would have led to me having my first IUI this past fall, after I turned 39. 

My visit to the RE accelerated those plans a little, and led to me knocking Australia off the list of travel destinations so I could start TTC in January of 2010 instead.  I think that part of the story deserves another entry, though, so I’ll stop writing for now, and start reading some new-to-me blogs!