Our First Appointment with the Reproductive Endocrinologist

10 Jan

What does one wear when meeting their RE for the first time? This was my most pressing concern yesterday afternoon while preparing go to our appointment. It seems silly in retrospect, but provided the perfect distraction for my nerves. I felt like I was going to a job interview, that somehow this doctor would be assessing not only IF I could have a baby, but also if I am fit to do so.

Upon arriving at her office, I was immediately put at ease. I really like our RE. We are so fortunate to live near Johns Hopkins, home to some of the best doctors in the country and they have offices scattered all throughout our suburb. I am so thankful for that.

We started out with a family history and personal medical history for both my husband and I. Everything is pretty good there…I don’t know if infertility is genetic or not, but both sides of our family seem to have absolutely no problem reproducing. She looked at my hormone lab results and my BBT charts and said everything looks great there. Textbook, even.

Textbook. <— That’s a word that frightens me. I think some people might be comforted by the idea that everything is as it should be. And I am, for the most part. But there is also this small part of me that wants to find something wrong. Something simple and easily treated. I want a problem with a solution to serve as an explanation for why we haven’t gotten pregnant yet. My biggest fear is that our problems will be of the dreaded “unexplained” type.

Then we moved to another room for the exam. And this is where it gets awkward. The RE performed a trans-vaginal ultrasound in a room of no less than 5 people. Me, her, my husband, a nurse, and a Resident that was shadowing her for the day. I laughed, made a joke, and then kindly requested that the Resident stay up by my head and my husband stay where he couldn’t see what was going on in the stirrups. My RE obliged me, but told me I should probably get used to a room full of people looking at my lady parts. After all, WHEN I give birth there will be no such thing as privacy.In all fairness, however, she knows nothing of my birth plan.

Side note: Do they have to make those things look so penis-like? Complete with condom for sanitary purposes?

She started out by looking at my uterus, which she said was textbook. There’s that words again. She took a few measurements then located my ovaries. Both were present and accounted for. Then I got to see my future baby egg all locked, loaded, and ready to go. The egg was measuring at 15mm and usually decends for fertilization (or not) at 20mm. She told me I could expect to ovulate in 3-4 days, which was right on with my own calculations. This was so fascinating to me to have a picture of what was going on inside my body.

Just when she was about to finish up, she pushed down on the ultrasound wand and saw that it looked like my uterus was dividing in two. I saw it too. Again, fascinating! She said this could be indicative of a septum in my uterus. Instead of the uterus being round, there could be a septum at the top that is composed of hard tissue that gives the uterus more of a heart shape. The part where the septum comes down could be causing two problems:

1. An egg cannot attach to the septum because it doesn’t have a blood supply. Therefore, the septum would limit the surface are in which an egg can attach and grow. It also kind of divides the uterus so the egg only has access to half it, which leads me to…

2. If an egg were to somehow attach to the uterine wall and implant there simply isn’t enough room for a baby to grow.

Here is an example of a uterine septum, although at this point there is no way to tell how large (long?) the potential septum could be. I think this might be a picture of an extreme case, but who knows???

A lot of woman who have these do get pregnant, but it results in multiple miscarriages because there is no space for the baby to thrive. At least that’s how I understand it. If someone has more or better information, please feel free to enlighten me.

But for now, this is all hypothetical because it was hard to get a good look with a basic ultrasound. So further testing is needed. In about 3 weeks or so I will go to get an HSG test. That is where they inject dye into the uterus and use the contrast to see what (if anything) is going on in there. Is there a septum? If so, how large is it? Etc. If they find it, then an outpatient surgery should be able to correct it and I should be able to go on and get pregnant if that’s the only issue that we are dealing with.

The RE also said that she thinks my luteal phase may be just a little short, so she have me a progesterone prescription and told me I should start trying this month with the aid of the progesterone. Pardon my language, but that shit is expensive! And, of course, my insurance does not cover it.

So, the plan:

We are taking the month off from TTC. No progesterone for me, for now. The reason being is because if I were to somehow get pregnant this month before I know if I have a uterine septum or not, then I could just end up miscarrying if I do end up having it. Pregnancies in women who have septums are considered high risk and almost always end with a c-section. If given the opportunity (which I have) I would like to avoid this. What’s one more month in the grand scheme of things if it goes towards ensuring that when I do get pregnantΒ  I can carry a healthy baby in my healthy body to full term?

The RE also told me I can stop taking my BBT. She has all the information she needs from those charts. And while I am looking forward to no longer being a slave to my thermometer, I can’t help but feel like I am going to miss it a little. I like my charts and graphs filled with their data that somehow seem quantifiable to me. But now that we know for absolute sure that I am ovulating, the truth is that I don’t need to do that anymore. I think that’s progress.

So that’s where I am right now and I feel okay about it. I am dreading the HSG test (I heard it hurts?) but I am really looking forward to getting some more concrete answers. Progress!

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11 Responses to “Our First Appointment with the Reproductive Endocrinologist”

  1. amy January 11, 2012 at 9:31 pm #

    Well that is some interesting information that I know nothing about (septum uterus). But maybe this is why you haven’t gotten pregnant, so you are getting closer to answers πŸ™‚ I had an HSG, the anticipation was horrible, the test was not so bad…just the cramping! I also am pretty certain I have a short luteal phase and want to try progesterone…didnt know it was expensive 😦 Seeing that pretty little egg makes you feel hopeful…it’s gonna happen soon sweets!!

  2. K.Smitty January 11, 2012 at 8:24 pm #

    I’m so hopeful that this is the answer you’re looking for!

    I know different women have different experiences with HSGs, and I have not had one personally, but I have a friend who had one recently and she said it wasn’t nearly as bad as she expected, that it was more uncomfortable than excruciating.

    Girl I’m praying so hard that this solves your problems!! I have a good feeling!

  3. KatyBug January 11, 2012 at 9:40 am #

    I’m SO glad you like your RE … I love mine, and that makes *such* a difference.

    If we’re not pregnant in 3-4 months, I’m getting the HSG, and that’s the only test that makes me nervous (DH isn’t thrilled at the idea of an SA, but he’ll deal).

    Can’t wait to hear more good news.

    • Jenn January 11, 2012 at 12:09 pm #

      Thanks, I’m really glad we like her too! My husband isn’t thrilled about repeating his SA either, but he can definitely deal. I only wish I had to masturbate into a cup to find out what’s going on…easy as compared to what we have to go through πŸ™‚

  4. Christina @ According To C January 11, 2012 at 9:06 am #

    I’m so glad you’re on your way to answers! I’m like you; if there’s a problem I’d rather know what it is and deal with it. The uncertainty for me is worse than the actual issue itself.
    P.S. when I had a trans-vaginal ultrasound, they made me insert it myself! I felt so weird doing that.

    • Jenn January 11, 2012 at 12:10 pm #

      They made my friend do that at her first pregnancy ultrasound. So weird!

      Thanks πŸ™‚

  5. Kelly January 11, 2012 at 6:23 am #

    Hey! Of course I remember you…the best boss I ever had. I can’t wait to get caught up on what’s going on with you guys! I will go back and read your posts as soon as I have a moment! No worries, your secret is safe with me. No real people know I have a blog and I plan on keeping it that way!

    • Jenn January 11, 2012 at 12:10 pm #

      Best boss ever, huh? It’s been a while since I’ve heard that πŸ™‚ Can’t wait to catch up with you!

  6. Theresa January 10, 2012 at 10:22 pm #

    Well that sounds promising! Hopefully the septum is the only issue. The hsg will probably cause some cramping. I recommend taking some ibproufen beforehand and having some on hand afterwards. I thought those were to check the Fallopian tubes though…. They can see if the uterus has a septum with one? Interesting.
    Keep us posted!

    • Jenn January 11, 2012 at 12:16 pm #

      Apparently they can check for the septum. I really have no clue so I’m just going with what the RE says. They’ll also be able to check my tubes while they’re in there. So, two birds with one stone (and one insurance claim, haha).

      I’ll definitely keep you guys posted! Thanks πŸ™‚

Trackbacks/Pingbacks

  1. Questions Without Answers « The Future Fords - June 19, 2012

    […] this method has failed me before. I got my hopes up about the BBT charts, elevated prolactin, the potential uterine septum, the HSG, and my husband’s varicocele. I put my trust in Clomid, trigger shots, acupuncture, […]

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