This blog is meant to be like a journal of our infertility journey, and about growing our family. My views may not be the same as everyone's, and my feelings are expressed in this blog without filters. The feelings and things that come along with infertility aren't fun, they're not pretty and sometimes they're downright ugly. That said, it is not my intention to offend anyone.
I have to go get Jack from school, but real quick. After Dr. A booked me for 11/11/10 for surgery I called my insurance company only to find out that we'd owe 20% of our bill for her and for the hospital where the surgery would take place. No way! But it would be covered 100% if the surgery was at the hospital where I work or one affiliated with us. SOOOO, I called Dr. M who referred me to a doc where I work. I have an appointment with him on 11/1/10, and then I called today with my pity story, told them I was a NICU nurse at our hospital, etc., and the very nice surgery scheduler checked throughout the day for a cancellation this coming Monday. When there were none, she called the doc on his cell phone, gave him my story, and he told her to put me on at another affiliated hospital where he performs surgery for 11/16/10!!! Ok people, I have a surgery date, and it's only about 26 days away now!!!! :) :) :)
I have no idea if Dr. A got my fax that said I wanted this hydro taken care of ASAP or if she got the report from Dr. M, but she just called me and she is going to take that tube out of my body here shortly. She said I will have to be out of work for at least a week to 10 days (I thought only a day or two!) which completely sucks. She is going to have her secretary call me tomorrow at the latest to set up my pre-op stuff, and get this ball rolling. I guess I will either have to use some of my vacation time for this recovery period unless I can finagle my shifts to be grouped together right before my surgery and right after in the hopes that I don't have to use too much of my time. It could be tricky, but we shall see what happens.
This is a flower called Impatiens, which is much prettier than my Type A personality and the trait that I exhibit called impatience. I called Dr. A's office yesterday to try and get a consult or whatever scheduled for this hydrosalpinx to be removed and they requested that I have Dr. M's office send over the HSG report. I called Dr. M's office and the nurse told me that when the radiology office sends it up to them they will send it over. I told her that the results were in our hospital-wide computer system and she said she has to wait for radiology to send it. Yeah, I'm not patient enough for "whenever" that may be. So I came into work tonight, promptly printed it out and faxed it over myself with the explanation of why I was faxing it (to get this hydro removed ASAP so we can proceed with our cycle), and Dr. M's number in case they need to contact him. I figure, it's my health info, it's not like the results haven't been discussed with me, and damn it, someone needs to be on the ball. So what if that someone just happens to be me?! Mrs. Impatient! :)
We met with Dr. M this afternoon. I decided I wanted to talk about what I thought to be positive info first-the SA results. So last cycle we had 9.5 mil sperm and this time around 14 mil. Great! Then last time we had 31% motile sperm, this time 42%. Great! However, of the washed sperm, only 1% were motile- 500,000. I can't remember what it was last time but he said it was less this time than it had been previously. He would consider these SA results perhaps slightly better than last time. So perhaps not as positive info as I thought!!!
Then we moved onto the elephant in the room-the stupid hydrosalpinx. I always thought our little boy was a miracle. Now I know it! I pulled up research articles that had been published and with a hydro, chances of pregnancy are cut in half and that is with IVF, and if you consider that the fact that anyone gets pregnant on any given month, that's crap. Dr. M hit the nail on the head when we were discussing whether or not to correct this problem before proceeding with our cycle when he said, "If you don't fix it and the cycle doesn't work, you will think it was because of this." Damn if that isn't right! Sure, it could just be a failed cycle, happens all the time. But if I didn't have the hydro corrected I KNOW that I would think it must have been that, and even if I wasn't totally convinced of that irrational thought, I would always wonder "what if?"
So, the decision has been made and Dr. M is completely backing us. I will call my OB/GYN in the AM and try to get a surgery date set up ASAP to have this thing either removed or at least have that tube tied. Which brings me to my next issue to deal with emotionally and physically. The consequences of taking care of this issue. I asked about something I had read online on a forum about hydros where multiple people said that they not only had to have their tube removed but the corresponding ovary as well. This is a problem! So we discussed that and Dr. M didn't really feel that that was a necessary evil, but he did bring up something I had not considered. I figured if they had to remove the ovary then obviously I would have less eggs to retrieve when it came down to it. I just sort of figured that if the ovary was left in we would have those eggs as well. Not necessarily. The fallopian tube and ovary share a blood supply, so if we clamp the tube, we may be risking any follicles and resulting eggs from that ovary. It is an unfortunate situation, but I think I'd rather risk losing the response from that ovary than having fluid leak into my uterus and giving us dismal odds at pregnancy.
I will have the surgery, and per Dr. M request that Dr. A or whoever ends up doing my surgery try to preserve my right ovary as best as possible. Dr. M said that we could contact him as early as a month post-op to setup our mock transfer appointment and begin an IVF cycle. He tends to be a little more aggressive than some docs, he said that others would recommend waiting at least 8 weeks post-op to see if you get pregnant on your own. But given our male factor infertility issues, I think getting pregnant on our own may not be very feasible.
Please pray that we can get scheduled quickly and that the surgery is as atraumatic as possible!
"The Man" has said I can post results from yesterday's SA on the blog but not on Facebook. Facebook was never an issue because I don't want everyone from work knowing what we're doing anyway, not to mention probably only 8 of my "friends" on facebook (some of those 8 include family members who know what we're doing) actually have a clue what's going on with us at this point IVF-wise anyway.
It was the best SA (semen analysis) results we've ever had!!! We don't have alot of specifics yet except for on morphology and count, and both were better than ever before so this is really encouraging on "The Man's" end. For reference, our last SA before last year's cycle included a sperm count of 9 million (as opposed to 3 million when we did our first IVF cycle 4 years ago); and normal morphology was less than 1% previously. Yesterday we had 14 million sperm and 6% with normal morphology.
I am still having trouble accepting that I have this hydrosalpinx which could be a big part of what has prevented us from ever getting pregnant in the first place. And for all I know whatever MFI issues we had previously are slowly resolving and then our lack of pregnancy would be all my own body's fault. Ain't that a kick in the mouth? Jack must have been one determined embryo from the start to stick in there at all and for almost 38 weeks!
Hydrosalpinx (big ugly dilated looking thing on the left side of the screen) on the patient's right side, and an occluded tube on the left (my left tube is patent and resembles the tubes on the picture below).
Normal HSG with both tubes patent
I had my HSG this morning. It was not painful initially until they injected the dye, and then it was very painful. Alot of cramping which persisted until about an hour and a half after the procedure and oddly enough radiating down my leg. I didn't freak out about that too much since I used to have extremely painful periods and would have that same leg pain, it was more of an annoyance than anything really. I came home, put my heating pad on my belly and took some motrin. I laid there wishing I would just throw up since the doxycycline is not sitting well on my stomach and unfortunately I still have alot of doses left to take!
Last time I had an HSG (2006) it showed my right side was blocked or a hydrosalpinx. I was sent for an ultrasound which didn't show much so we continued on with my cycle. It was explained to me at that time that they believed it was a blocked tube or they would have expected to see more of a dilated tube on ultrasound. If it had been a hydrosalpinx, there would be a lower chance of pregnancy, and a higher risk of miscarriage if pregnancy did occur. This was because in a hydrosalpinx there is fluid that leaks from it which can make it hard for an embryo to implant, and could contain debris or other harmful things which could be detrimental to a fetus. Luckily, I got pregnant, and delivered Jack at 37 6/7 weeks. No complaints here!
So today when I went in, I prayed that our HSG would be no different than it had been last time. Well, I could see on the screen that my right tube looked bigger. Uh oh. I heard Dr. M and the radiologist talking about a hydro. Great. I got dressed, went out to meet Dr. M and he showed me my pictures which indeed showed a hydrosalpinx on the right. He said they are sure it is a hydrosalpinx. I asked what that meant for us and he reiterated the things we already know about a lower chance of pregnancy, higher risk of miscarriage, and then added, "but you've gotten pregnant with it before and had a full term baby." So he thinks I should be ok. I felt torn leaving him because I could in theory be ok, but what if I'm not. Our plan was that we weren't going to do this again if this cycle fails. Do I want to risk it on this problem tube?
I came home and looked up a few things on it, specifically pregnancy rates, etc in some studies. 40% in the control group vs. 19.65% in the hydrosalpinx group...50% less chance. If you think about it, we did get pregnant before, but would I have allowed them to try a cycle on me if I knew it was for sure a hydrosalpinx???? Probably not, I probably would have elected to have it removed or ligated. Archie and I were discussing it when I got home, and he doesn't want to delay our cycle further, if we do, we'll be looking at procedures around Christmas this year and that's no good. I understand his thought process for sure, I don't want to delay it either, I'm excited and ready to go now! But I also don't want to waste what might be our last cycle.
After obsessing over this quite a bit, I called our IVF nurse (Sonya) and told her I was sorry to bother her with the thoughts in my mind, but I just don't know what to do or think about this. She asked if Archie had done his analysis and I told her he was going to do it tomorrow (appt in the AM). She told me that we have to have a follow up appointment anyway, so to call and schedule the appointment for next week, and we could discuss it further with Dr. M then and if we still didn't feel good about proceeding with our cycle we could decide about how to take care of it at that point. There are a few different ways to "take care of it" including tying the tubes, ligating or removal of the tube completely. Some of it can be done laparoscopically (sp?) and we could probably proceed with our cycle in December.
If you remember, I had planned this whole thing with the thought of using the last part of my maternity leave for a Disney vacation for Jack. If we don't do this until January, I will be pregnant when we go to Disney or we'll be going at Thanksgiving time (my holiday to work next year). I know we shouldn't plan like that, but I was planning like that because I am an infertile and since I can't get pregnant on my own, it is a perk to knowing when you may or may not be getting pregnant. So sue me!
I guess we'll see what Dr. M has to say next week. I'm a little depressed about it definitely being a hydrosalpinx, but I'm trying not to let it put a damper on things.
Just so you all know, I imported my old blog and moved all of my posts over here so I can delete the old blog. If you're new to my blog this means now you can look back at all of my old posts in one place, and not have to go between blogs. Hope it's easier!
Ok, so it's not day 3 of my cycle. Today should have in theory been day 1, however, my cycle is rarely "normal". I think when we started charting to try to conceive the first time I found that I had cycles ranging from 23-35 days. Granted it's not as wonky as some charts I've seen, but I had never really noticed how irregular the length of my cycles was. It's been better since having Jack, I pretty much stick to a cycle of 27-28 days, except this month. Like I said, today should have been day 1, but instead, it is day 4, LOL. Yup, my period showed up 3 days early this time around, which means I will have two of them in October. Yippee!
Anyway, Tuesday morning I went for my cycle day 3 bloodwork and ultrasound. Fun stuff right there, I had just begun to forget! Anyway, no doubt my prolactin will be high again (it was with our last cycle consistently with the screen and the actual cycle month, and they think this is my new norm since it was normal on the first go around) since the bloodwork is supposed to be fasting but I had to work all night, and thus, snack and eat throughout the night. They said if it is really off they will just recheck it. My nurse was out of the office yesterday afternoon so I am waiting for a phone call from her with my lab results which I will post when I know. The great news is that my ultrasound showed my ovaries looked normal! This is great news because I know with our first cycle, I had to be on lupron a long time thanks to a cyst that didn't want to go away. I am hoping the ultrasound looks the same next month so this doesn't drag out.
Next Tuesday is my next step-my HSG. I seem to remember being really uncomfortable with this last time. I can't say it was really painful although it had it's moments (thanks to a blocked tube they insisted on trying to force fluid through), but it was just more uncomfortable trying to move around on an x-ray table with all that going on. I'm sure it will be fine though. I hope everything looks normal and we get a green light for next cycle!
I probably won't post until next week simply because I'm working or signed up for overtime almost everyday between now and the HSG anyway, and our work computers don't allow me to post on blogger, just read it! Please pray for the HSG to yield normal results for me!
***Update*** Our nurse called and all of my labwork was normal including my prolactin!!! It was 4.4 and this time before our second cycle it was 9.8, so I'm happy!