Wednesday, June 5, 2013

The Plan

This morning I went to see Dr. M to discuss the results of my HSG. It was pretty overwhelming. I had been feeling pretty good about it since I felt like I prepared myself for many different possibilities, but as I sat in the waiting room I started to panic a little bit. Seth couldn't be there with me today because he's teaching and he's taking the day off to go to another (unrelated) appointment with me tomorrow. Anyway, I survived the twenty minute wait and then one of the nurses took me back to an office where I met with Dr. M.

First he reviewed the ultrasound results from CD2. Everything looked great on there. My uterus is the correct size, shape, and thickness. I have plenty of follicular cysts (14, I think), but no harmful or unusual cysts. No large endometrioma. Nothing to be concerned about. Great!

Next, he pulled up the x-ray film from the HSG. Deep breaths. Dr. M showed me the right tube, how it's long and thin and had puffs of dye pouring out the end. Then he shows me how the left tube starts to fill up like a balloon. You don't see the long, thin line of dye like with the right tube. The black balloon starts to puff up right near my uterus, but you can still see a little bit of dye coming out. Dr. M said he does not believe the tube was blocked. He explained that when you see a balloon like that, it is more likely an abnormal tube. It could be misshapen - wide in some parts, narrow in others - or maybe it's just in a funny orientation, such as coiled up on itself. Either way, he said that because the dye was cleared on the final x-rays, there is no reason to believe that it's not functioning properly! AND even if it's not working perfectly he said it is possible for the right tube to pick up an egg from either ovary. I did ask how they know that the dye didn't go back out the way it came and he said that the tube is too narrow. The only way they get dye to go in to begin with is from the pressure of the injection.

WOOHOO! I am so relieved. I was so sure that the results were bad and that Dr. M was going to recommend surgery right away. That's not what he suggested at all. He believes that it is still very likely that I have endometriosis (the HSG results do nothing to confirm or refute this) but since my priority right now if getting pregnant and not managing the pain, he doesn't think we need to start with the lap.

The first step will be for Seth to have a semen analysis to make sure everything looks good with him. If the results are good, we will just continue doing what we're doing and hope that we're one of the lucky couples who get pregnant soon after an HSG. If there is anything abnormal about Seth, Dr. M recommended that we start trying intrauterine insemination (IUI) with or without a medication that would stimulate my ovaries to produce more or better quality eggs. This would help to increase our chances of getting pregnant if, for example, Seth had a low sperm count.

Either way, I think I'm going to choose to have the laparoscopic surgery in August if I don't get pregnant before then. Since I quit my job, my insurance will be changing in mid-August and I'd like to do the surgery before that happens while I know I still have good coverage (plus I already met my deductible for this year). That still gives us three cycles (including the one I'm in right now) to get pregnant after the HSG like Dr. M and I originally discussed. It also puts us past the dreaded official one-year mark. After August 4th, we'd probably start pursuing infertility treatments even if we didn't suspect I had endo.

Overall, I feel much better than I thought I would feel. Obviously, it's great news that my tubes are clear. It worries me a little bit because, like I mentioned in an earlier post, if they're clear then I'm afraid there must be something else that's keeping me from getting pregnant. I can't worry about it now though. That won't help at all. For now, I'm just going to try to stay hopeful. If it doesn't work this cycle, it might work next month or the cycle after that. If it doesn't work, at least we have a plan. It's kind of bittersweet. I'm happy that we have this plan, but I'm definitely not thrilled about what the plan includes. It's just not that perfect "love, marriage, baby" model that most people assume they'll experience. Such is life.

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