Thursday, October 29, 2009

Always look on the bright side...

In the spirit of positivity, let me just say, "YAY! My doctor called with the results from my last round of bloodwork today!!" I would like to point out that last time, it took a week. Here we are, 3 days later and they have already called. Go, efficiency.

So here's the deal: I was told that all bloodwork looked normal. This time I asked for the specific numbers the first time, so I wouldn't drive myself crazy wondering, then have to call back. (The one thing I didn't ask were the incriments of measurement. Oh well.)

TSH = 3.397
T3= 29
T4= 8.9
P4 = 0.79

How my TSH went from 5.51 down to 3.397 in two weeks, I don't quite understand. When I mentioned it to the nurse she said that perhaps the first lab made an error. If that's the case, then couldn't the second lab have made an error? While I'm happy to see that the levels detected this time are much closer to normal, I'm not so sure I can let this rest. I haven't decided what to do yet, but I may ask them to retest the next time I go to the office. I'm still considering a trip to the endocrinologist.

As for my progesterone results, yep, that 0.79 is an indication that I didn't ovulate-- shocking, I know. (Levels should be around 10.0 if ovulation did occur.)

So, what does this mean? Well, the nurse told me that I need to chart one additional cycle. They'd like me to come in on CD21 again next cycle for another round of progesterone bloodwork (if I do end up ovulating late in my cycle, I'll certainly give them the heads up), then come in on Dec 1st for my yearly pap smear.

I was told that at this appointment we'd talk again and that the plan was to start Clomid. The nurse also gave me the heads up that they might be referring me to a fertility specialist.

How do I feel about this, you ask?

Well, I'm happy that the bloodtests are showing what I already knew-- I'm not ovulating and now this isn't in question. What I'm not happy about, is that no one seems to want to look into this any further to figure out why. Part of me is thrilled to know that there's a plan and that Clomid just may be the thing to help me ovulate. The other part of me wonders why we're not doing additional testing before starting fertility meds. I haven't had any ultrasounds to look at my ovaries or an HSG. Rob hasn't had an SA done. It seems to me that we would want these tests done first to rule out any other potential issues before pumping me full of these powerful drugs.

Rob and I talked about all of this today, and he would also like to get to the bottom of the issue of why I'm not ovulating, but he's comfortable starting the Clomid in Dec (might be Jan, depending on where I am in my cycle at the time of the appointment) if we decide to hold off on any further testing for now. The problem is that our insurance doesn't cover anything "infertility" related, so I have a feeling that I might have some long conversations with Blue Cross/Blue Shield in my future regarding billing codes, what tests are covered and what's not. The Clomid prescription shouldn't cost us much (except maybe time) but these tests could get very expensive if they are all out of pocket.

Instead of worrying about all that I don't know right now, I'm going to try to use this next month to make a list of all of the questions that I have about tests I feel are necessary so that I'll be very prepared for the conversation with my doctor. If anyone has any insight about what to include on that list, I'd love some feedback!!


  1. First of all, yay for a plan and some answers! Clomid has dones such wonderful things for so many people, and it seems like a reasonable place to start.

    Secondly, I agree that Rob should get an SA. It seems ill advised to put you on a powerful medication to correct your ovulation issue while knowing nothing of the state of his reproductive health. You could be putting your body through a stressful process without correcting the underlying problem. And from what I understand, it's an easy and reasonably cheap test to do.

  2. Thanks, Colleen! I agree-- the HSG is a pretty invasive procedure (and painful and expensive, I've heard) but at the very least an SA is easy and cheap. Hell, it's even pleasurable.

  3. Yay stef! I'm so glad you got some answers you were looking for!!!

  4. Yes! So frustrating! I had this very same issue with a TSH reading. In April, it was a healthy 1.8. In August, it was 4.9 (flagged for potential hypothyroidism). Two weeks later, in a TSH panel test, it was back down to 3.3! I asked how this number can fluctuate so much and they basically said, "it just does, no particular reason."

    I'm on my first round of Clomid, and no ovulation as of today (CD14) so I can't say how amazing it is, but here's hoping! There are so many success stories floating around, it gives me hope that this is the little nudge I need to ovulate.