The bumpy road

Who would have thought I'd have a fertility problem? I've always had regular cycles, I've never taken ANYTHING to inhibit fertility in any way (no birth control pills or hormones for me!). And yet, here I am...a healthy, 30-year-old woman who has been "TTC" for 2 years with no success.

Luckily, I am a devoted user of the FertilityCare System, a form of Natural Family Planning based in medical science. So after 5 months of TTC with no success, my doctor ordered a few tests.

The first test in these situations is almost always a test of the man's fertility, so after my husband's tests came back fine and it was obvious that he was not the problem, I underwent a series of diagnostic things.

First there were the hormone tests, which came back on the low end of normal for progesterone and estradiol. TSH was also on the low end.

The second test was a hysterosalpingogram (HSG), which is a really long name for shooting dye through the tubes and taking x-rays to see if the tubes are open. That test showed that both tubes were open, but were "sluggish" which meant that it took a bit of pressure from the dye-shooting mechanism to make the dye go through.

Finally, my family doctor (a FertilityCare-trained physician) decided that it was time to refer to a specialist. Unfortunately, this is a tricky area. Many Ob/Gyns will move swiftly from diagnostic testing to recommendations for artificial reproductive technologies, which we won't consider, and so we likely would have been "dropped" swiftly without ever discovering the cause of the problem. So my doctor referred me to an Ob/Gyn in a city three hours away...one who is a trained FertilityCare Medical Consultant and specialist.

My first meeting with Dr. D took place in June of 2006. Although I had a long drive to get there and then spent a long time in the waiting room, it was worth it because he spent over an hour talking to me and going over my charting of my cycles. He determined quite a bit from those charts, and after my physical exam revealed a retroverted uterus, he became concerned that endometriosis was involved. He sent me home with a prescription for thyroid supplements and orders for a bunch of tests.

The next few months consisted of another series of tests. I had several different hormonal blood tests to check the various reproductive hormone levels. I had a fasting blood glucose and blood insulin level checked, and then did the "sugar test" that so many pregnant women are familiar with. I also had a pelvic ultrasound.

The results of all of these ruled out a strong possibility of PCOS (no evidence of insulin resistance, which is one of the big signs of PCOS). But there were still other mysteries that couldn't be cleared up with all these tests. Dr. D recommended laparoscopy to check for endometriosis.

In October 2006, I traveled with my husband to the hospital where Dr. D practices to undergo laparoscopy. Dr. D was FANTASTIC. He really put us both at ease and even prayed with me before going into surgery. Surgery turned out to be quite revealing. Dr. D found LOTS of endometriosis, on the ovaries, bladder and tubes. There were lesions that were fusing the tubes to the round ligament (which may have accounted for the tubes being partially blocked and "sluggish). He lasered the adhesions and sent me home to heal and see if the ovulatory hormones would bounce back on their own.

Now here we are, 6 months later, and still no pregnancy. After my appointment yesterday and more review of the charts and more discussion, Dr. D suspects that I have a luteal phase defect. So, starting this cycle I will begin Clomid and some mucus enhancers each cycle, followed by a targeted blood test post-ovulation to see how the Clomid is affecting my other hormones. The hope is that we can "push" the hormones into behaving properly, which will cause ovulation to happen.

So goes the next part of our journey...