In my search for a new Reproductive Endocrinologist, I chose a practice recommended by my regular gynecologist. Ironically, I was given this recommendation way before I went to Dr. No, but ignored the advice because the latter had better reported pregnancy statistics. Lesson Learned.
Dr. Christopher Lipari has only been in Jacksonville a short nine months, moving here from the Baltimore area where he attended Johns Hopkins. I knew immediately upon meeting him that he would be the RE with whom I would work to have a baby. He was bright, intelligent, articulate and best of all, positive! It's not that he walked in and promised me that I would certainly have a baby and nothing would ever go wrong but he just had the attitude I had: let's try everything we can to make a baby! Of course we discussed the age factor and the possibility that I would have to use a donor egg and IVF, but it didn't feel like a sad eventuality - the way it had with my first RE. Perhaps it was my attitude and approach or perhaps I just clicked better with Dr. Lipari. Whatever the reason, we had excellent chemistry and I found what I was looking for -- a doctor I consider my partner on this journey.
After covering all of the positive and negative possibilities, the doctor advised that I spend my next cycle, the month of April, doing detailed fertility testing. He feels that it makes more sense to do the tests that are covered by insurance first to make sure that there are no impediments to my getting pregnant, rather than jumping right into expensive insemination - not covered by insurance - and possibly waste thousands of dollars in sperm because of an unknown condition! This felt like the right course of action, as opposed to plunging right into insemination after one blood test as my first RE suggested.
I was given a sheet which outlined every medication I would take, preparation I would make and each test or examination I would undergo. Just reading it I was overwhelmed! I was scared I'd surely forget to take a dose or show up for a blood draw!
It all kicked off with another Day 3 blood test and something called a hysterosalpingogram. Yeah, from here on out, we'll just call that an HSG. This is a test of the uterus and fallopian tubes to check for blockages, growths or abnormalities. If a tube is blocked, the egg can't make it's way into the uterus. So doctors take a catheter of special dye and inject it into the uterus, then open a balloon in the uterus which pushes the dye out through the fallopian tubes -- if they aren't blocked. All this, while you are having an xray of the procedure to see if the dye spills out of the tubes or gets backed-up in them. I can tell you that this was one of the most unpleasant medical procedures I've ever had ... and I've had quite a few! It was just plain uncomfortable until they opened the balloon in my uterus -- then it quickly crossed over into feeling like I'd burst. Thankfully, I had no blockages and the test was over after three photos. Had there been a problem, they would have had me hold several poses and possibly commit a murder! The most important thing to remember, if your doctor orders you to have one of these HSGs is that it is over quickly. Unlike labor, any pain will stop immediately. Next up was the Clomid Challenge Test. I would take Clomiphene Citrate pills for five days and hopefully, my ovaries would work overtime to make bigger, better follicles which would then hopefully turn into more Grade A, jumbo, farm fresh eggs!
Yes, this is one of those drugs that make some women conceive multiples. We, however, were just going to count the eggs, not fertilize them this month - so no harm. That is, until I had a charming little side effect. My ovaries blew up to the size of grapefruit and my belly grew to look like I was at least five months pregnant! In fact, I made the mistake of browsing the children's aisle at Old Navy in St. John's Town Center and was asked my due date! (Why do people still do that? It's fraught with danger! Stop it!)
The doctor did an ultrasound and I'd produced two mature follicles by ovulation time. That is, apparently, just the right response to the test. I had blood drawn two more times, had a pelvic exam and a physical and finally sat down to talk with Dr. Lipari about all of my test results at the end of the month.
This consultation is known as a Plan of Treatment appointment. The doctor gives you the prognosis and you decide how to proceed. In my results, there was only one negative result and that was one of my hormone levels. It was not out of the ordinary for a woman abut to turn 40, but a little higher than is ideal for trying to conceive. Still not a deal breaker!
We are a go!
Dr. Lipari and I decided together to start trying to conceive with this next cycle (May). He recommended (and I completely agreed) that we should go right in, guns a' blazin'! We're gonna load me up with fertility drugs which will ensure follicle stimulation, egg production and development, timed ovulation, fertilization and the maximum chance of avoiding miscarriage. Yes, there are medications to do all of that! And I intend to take 'em!
For the first time since my miscarriage in January, I felt truly happy. My brain must have been releasing endorphins or some other fantastic substance, because I was on such a natural high for the rest of that day! I'd forgotten how great it feels to be happy. It was a confirmation that I was headed in the right direction, and after the month I've had, I needed that!
