And the story unfolds....

Well today was my first RE appointment and all in all I think it went well.  The appointment was definitely a little different than what I was expecting considering we met with the doctor the entire time.  The office was also much quieter than I was expecting. 

On my first appointment I am pretty sure I saw someone that I know also but not to sure because I was reading some papers and happened to look up as she was leaving the office.

Ok so on to the appointment.  My DH and I sat and talked with the doctor and told him our history.  He said that even though we have been ttc for 2 years he is labeling us as 5 years infertile since we have never used any form of protection in preventing a pregnancy, fair enough.  Then we talked about our one BFP that we had in February, how it lasted 6 weeks and when my blood was drawn my hcg and progesterone were very low and how on exam that day I had a lot of rebound right sided tenderness.  I told him how my regular doctor was initially concerned about ectopic, repeated my hcg and p4 two days later and determined it was just a miscarriage.  My RE asked me if my OBGYN ever did an ultrasound during that time and I told him no.  He was not happy about that and feels that it probably was an ectopic pregnancy.

We also discussed my menstrual cramps and how I hoard drugs from previous procedures in order to have pain medication for when I really need it, my period.  He saw that I take lortab and/or ultram to get through the really bad days of cramps, which is usually only one or two a month.  I explained to him that after my surgery for my vocal cord that I saved my lortab for a time I needed it more since the pain in my neck was no where near as bad as the pain I experience most months.  So he figures I very well may have endometriosis, however he doesn't think I need to have surgery to get rid of it.

I told him about how ever since the miscarriage I have had a lot of right sided pain (during my period) and that it feels like tugging, and twisting.  He said well lets go do an ultrasound.  There ultrasound room had a nice big screen tv so we could watch everything as it was happening.  The doctor was the one who performed the ultrasound and he had an LPN in there with him.  He could see an old corpus luteum so we know that I did in fact ovulate last month, which is always good to know.  Then since today has become just like I expected he counted the follicles that I already have brewing for this cycle.  This seriously made my jaw drop.  In my right ovary on CD 1 I have at least 20 follicles and in my left the counted 16.  Are you F***ing kidding me!!!  Prior to the ultrasound we had discussed medicated IUI's and IVF.  He was telling me that for the first round of IVF they give lots of stim meds in order to increase follicle counts so they can harvest more eggs and freeze them for future cycles.  He said when they do that they hope for 15-20 follicles in each ovary.  I already have that and its only CD1!  What would happen if they did stim me???

So at this point I will have CD 3 labs, however he said after seeing my ovaries today he expects them all to come back perfectly normal.  Then after my period is over I will have an HSG.  He is not concerned about getting another P4 level because he already saw an old corpus luteum so he knows I ovulated and I have had a P4 level before and it was normal.  He said we could start fertility treatments this month but DH and I decided to wait until all the test results come back and then move forward next cycle.  I don't want to feel rushed to get all of these things done and move into fertility treatments at the same time.

So the plan is that once we get labs and an HSG then next month I will start clomid and have an IUI barring that there is nothing terribly wrong with my tests that would move us straight towards IVF, like nearly blocked tubes. 

I do have to say the clomid discussion happened before we saw 36 Folli's so I don't know if that would change the plan at all.  I did read up on clomid with IUI's a little while ago and it did say that when clomid was used with an IUI it increased the chance of conception with someone with endometriosis.  So I may still want to try it that way even if I end up with a gazillion follicles.... 

Now we wait and see.... as the story unfolds...