My appointment this morning was at 9:30. When I walked into the office, I was the only patient there-- something I saw as a good sign. My former ob/gyn's office always has at least 25 people in the waiting room and, as a result, always has at least a half hour wait. This time? Less than 5 minutes.
I met the nurse and she ushered me into the vital signs area where they weighed me and took my blood pressure which was (surprise, surprise) a bit high. Then I went into the exam room. Dr. M came in a few minutes later, introduced herself and said that she wanted to go through my paperwork with me. Together, we waded through the 10 page questionnaire that I filled out prior to the appointment, looked at my BBT charts, and sifted through my lab work that the ob/gyn did a few weeks ago.
She did a pelvic exam to check my ovaries (good!) and my cervix (also good!)-- I was glad to hear that there was no scaring or problems as a result of the cryosurgery I had about 5 years ago to treat cervical dysplasia. She went ahead and did my CD3 Bloodwork to check my FSH, LH & Estradiol levels. Then, we did a pelvic ultrasound to look at my ovaries and check my follicles. 7 on the left ovary, 5 on the right. All normal!
So, we sat back down, and made a plan:
1) TSH levels are too high. (Physical exam also showed that my thyroid is swollen.) Dr. M says that they should be no higher than 2.5 for a healthy pregnancy. She wrote me a prescription for Synthroid (25 mcg to start) and will test my levels again in 4-6 weeks. (I feel so vindicated, I knew it!)
2) I'm wavering between not ovulating at all and ovulating too late-- she wants to see me ovulate before CD21. She wrote me a prescription for Clomid (50mg) & I'll take my first pill tonight!
The timing of this appointment couldn't have been any better-- if we had been even ONE day off, it would have delayed our treatment a full cycle. But I was able to get all of my bloodwork done today, plus my baseline ultrasound, plus start our first (maybe only?!) cycle of Clomid. Maybe this is the beginning of our good luck on the baby-making front!
The thing that I loved about this appointment was that I felt like every possibility was covered, no matter what happens. She laid out all of our options so that I'm never left wondering what the next step will be. First cycle is 50mg of Clomid-- If we don't have success, we'll increase to 100mg. If no success, we'll move on to 150mg. If we don't get pregnant within 3 cycles of Clomid, she will order both an SA for Rob and an HSG for me, but otherwise, she left the timing up to me. I can do it now or wait and see what happens-- I think I'd like to wait.
If we don't have success after three cycles of Clomid, we'll move on to injectibles. She put the option of IUI out on the table and let me know she'd be happy to do one on whatever cycle I choose. I explained that I'm really not ready to give up on the idea that our baby could be created at home in our bed instead of with my feet in stirrups at the doctor's office-- she understood completely. She just wanted me to know what my options were. If we do move on to IUI, she mentioned that we could bank semen samples if needed, so that if Rob was out of town when I was ovulating, they could inseminate me with the frozen samples. (Obviously, fresh is preferable, but Rob travels for work and school, so it may be something for us to consider if we move on to IUI.)
We breezed over some IVF details, but I really wasn't interested in talking much about them. I'm so hopeful that these other options will work for us, that all we need is a little hormonal help to get everything aligned properly.
My experience was just so unbelievably positive-- I never felt rushed, I never felt like I was being pushed in any direction that I wasn't on board with, and I never felt like she was speaking down to me. She appreciated how much I knew about my body, how much I knew about my options & told me that she wishes all of her patients were as well prepared for their appointments as I was.
So, the immediate plan:
Take Synthroid every morning starting tomorrow, 30 minutes before breakfast.
Take 50mg Clomid from CD2 (Tonight) until CD6 (Friday). Use OPKs from CD10-CD17. She recommended ClearBlue Easy Digital OPKs which is awesome, because I have tons of test sticks from the CBEFM that I can use with it. The results show either a smiley face or no smiley face-- no interpreting how dark a line is, thank God. (She asked me to test between 11am-2pm each day, so I'm going to have to find a way to discreetly test at work.) The best news is that if I ovulate during those 7 days, I'll either get pregnant or get my period in a reasonable period of time. If I don't ovulate, they'll start a progesterone prescription to bring on my period and get things started-- either way, no more 60 day cycles.
I practically floated through my day, feeling giddy with the possibility that this cycle holds. And when I came home from work tonight, there was a beautiful bouquet of pink Gerber daisies on the counter (my favorite) next to a bottle of Biltmore Pinot Noir (where spent our engagement & honeymoon) in celebration of our first appointment.
I think the only thing better than being in love with your RE, is being in love with your husband.