RE Appointment 5/24

My appointment went good today.  We did get lost when we first arrived.  I asked the little Korean lady at the information desk where to go but she didn't know where the "fertility clinic" or "Reproductive Endocrinologist" was.  She gave me two options.  First being the OBGYN on the third floor, for pregnancy tests, pregnancy and giving birth.  No, that's not me.  Plus when I made my appointment I was told me ground floor or lower level.  The second option was the OBGYN on the ground floor.   Hmm, I don't think that is me, but it could be?  I walk down to the OBGYN clinic and as soon as I walked in the door I notice the waiting room full and there are tons of newborns and babies everywhere.  Fuck!  I really hope this isn't the place.  Sure enough he sends me a door down to the actual fertility clinic.  This waiting room just had a couple waiting alone and a few women.  Much more my taste.

Basic Appointment Testing

Source

• Medical History - They didn't seem to care about the records that have yet to arrive.  Just asked me questions.
• Ultrasound
• Uterine Lining - Measured 15mm, too thick.  Obviously it's been some time since AF.
• Ovaries - I've never had cysts before, at least they haven't been found.  She showed me the left ovary, covered in small cysts.  Then scanned to the right ovary, also covered in cysts.  It's nickname is Ring of Pearls.  Yup, the classic PCOS cysts.
• Blood Work - I go for that tomorrow morning.  I'm having glucose done along with a few other thing, mostly stuff I've had done in the past.
• Semen Analysis - She's a little worried about Bean's low results in the past.  I'm not too concerned, they could be worse & I seen PG with less.  They are not bad enough to send us to an Urologist.

Dr. C told me there is overweight PCOS and skinny PCOS.  I have skinny PCOS.  Even with my anovulation and cysts I still don't look PCOS.  Which is probably why I've made it so long without a diagnosis.  I'm not overweight enough and I don't have thinning hair, hair in strange places or darkening of the skin.  She also said no amount of weight loss will make my PCOS better.  Though I don't like to make excuses nor am I lazy, this is something I have thought about from time to time due to the fact that my problems began when I was 16 and underweight at the time.  I actually wasn't allowed to donate blood in high school because I didn't weigh enough.  If I see the same problems at a BMI of 18 and a BMI of 29, weight probably it's related to it.  

Cervix

The description of the my cervix from the RE looks bad.  I guess most of it is gone and it's very short.  I am at a great risk for cervical incompetence and a cervical cerclage is most likely going to be needed.  This also comes with bed rest.  This scares me because I am a military wife without family in the area and very few friends.  I will have to figure out a plan once I get pregnant.  This also isn't new news to me so no surprise about the cerclage.  

She is having me met with the high risk OBGYN even before pregnancy is achieved so I know what to expect.

Overall

Even with my failing cervix, my polycystic ovaries and Bean's 23 million sperm count we are ready to move forward with IUI.

Move to IUI

I began spotting this morning, randomly without any cramping.  Not sure if this is AF, but if it is then tomorrow or the following day should be CD1.

I need to have a beta PG test done to make sure I'm not PG.  This part really doesn't seem necessary.

On CD3 I'll start Clomid 50mg for five days.  I'm not a fan of Clomid, I didn't ovulate at 150mg, let along 50mg.  My five rounds of Clomid before were unmonitored they don't know how I responded to it, other than not releasing eggs.  This time I will have ultrasounds to show the number of eggs and their sizes, along with the trigger shot to manually release them when they are ready (vs waiting for if/when my body to do it).  So I guess it's better, but I still don't like Clomid.  I've just already been down the road before and see no hope there.  

Around CD12 I'll have my first ultrasound to check the size of my follicles.  Possibly a few ultrasounds after that until my follicles are large enough.

I'll be given the Ovidrel trigger shot.

Following that will be my IUI with Bean's fresh or frozen sperm, depending on if he is home or not.  If it is fresh sperm and Monday-Friday then I'll go to Tacoma, if it's frozen or fresh on Saturday or Sunday then I'll go to Seattle.  

Next Tuesday we drive to Seattle to "drop off" some sperm to be frozen. 

Cost 

Clomid & Ovidrel are covered by my insurance, along with any blood work or ultrasounds.

The IUI is $200 for the sperm washing and inseminating me.

Freezing sperm and keeping it frozen is $250 for the first three months, then $125 every three months after that.  

This is a pretty good deal.  There is about a 20-25% chance of it working each cycle.

I'm also on the list for IVF.  It's about a year wait and costs $6000.

-Selbe