Ultrasounds, Tests and Results...Oh My!!

I know it has been awhile since I have last updated, but between life, dr's appointments, death in the family, computers dying,......sigh, it's been alot!

So, I have had my TSH (Thyroid Stimulating Hormone) tested and even though my symptoms all point to HYPOthyroid, (too MUCH) it came back on the low end of normal, .53, but would indicate HYPERthyroidism. (too LITTLE) So, we're not treating it, but instead will monitor it and have it rechecked in a few months.

My old doctor retired, :'( and I finally got my appointment with the new practice. There are several MD's within this practice and I saw a NP. (Nurse Practioner) WTF?!?! So pretty much all she did is confirm 1) that I don't want to go back to HER, 2)my 5 months waiting to get seen was waste of time. I wanted lab work ran, like all of my hormones, etc. She completely dismissed it as being too expensive. I asked for Clomid, she said it is out of her scope of practice and that I would have to see an OB or a fertility specialist. I DID however get an ultrasound to SEE what is going on inside there and a script for Provera so I can induce AF, instead of going months and months without one.

My ultrasound....very interesting stuff. Kidneys and liver look good. Uterus is tilted, which I already knew. What I didn't know is that I have a Bicornuate Uterus. Which means, instead of my uterus being round and smooth at the top, mine is separated into two chambers and looks like a heart. WTH?!?! All of these years, and I had NO idea that I had that. My right horn (as the radiologist kept calling it) is much bigger then the left, and she said most likely is the one that "homed" both of my girls. Isn't it pretty?

The heart shaped object in the center is my uterus. The right horn is much bigger then the left due to that is where both of my girls hung out during their stays. Notice the deep separation, separating my uterus into two, making it much smaller then a normal uterus.

The scary part about a Bicornuate Unterus is, it can cause miscarriages, if the baby implants on the smaller side. It may not be an early miscarriage either. It could cause growth restriction problems, (due to no space to grow) and cause a late term miscarriage, preterm births and breech babies. Interesting thing is, my oldest daughter was born 8 weeks preemie and was breech and we never had a reason as to why!! She was breech throughout the whole pregnancy, and now I know why!! She didn't have any room to turn head down!! Of course this revelation now makes any future pregnancies high risk and will have to be closely monitored for growth problems and proper placement.

Ovaries are enlarged, but not too much so, and are COVERED in immature follicles. So much so, she didn't even count how many. So, this pretty much confirms it, PCOS (PolyCystic Ovarian Syndrome) it is. There was no fibroids or ovarian cysts, so that is good.

As far as I know, next step in PCOS protocol since I'm already on Metformin (for insulin resistance) is either Birth Control Pills (if NOT Trying To Conceive) to try to shrink the cysts or Clomid to induce ovulation. I feel like I am hitting a brick wall with getting the Clomid though. I have seen 2 different docs in the last 6 months hoping to get a script for Clomid, but both have said it is out of their scope of practice. Why is it so difficult to get a script for it, when it is so obvious it is what I NEED?

I WANT to get in to see a Reproductive Endocrinologist, but the nearest one to me is OVER 3 hours away, one way. That and since I am not insured, everything is out of pocket for me. At this point, we're just not prepared to go into debt to get my body figured out. I did a search the other day for OB's in my area who specialize in infertility and there was 1 that popped up. Coincidentally, it was MY last OB!! :) So, if this doc I'm seeing in August can't help me any further, I guess I will be making an appointment with my old OB.

So the game plan is as follows. I am on CD 84, still no ovulation and on my 9th day of 10, of Provera to induce a period. After AF leaves, on CD 10 I will be taking one dose of Folliculinum, and again waiting (and crossing fingers) for ovulation.

Meds/Herbals for next cycle: 

Vitamin D, 2,000 iu/day

Calcium, 1,000 mg/day

Metformin, 500 mg/BID

Liquid B Complex 1/day

Kelp, 325 mg/day

Fish Oil, 300 mg/day

Folliculinum, CD 10 only

Provera, *if no Ovulation, CD's 35-45

Dr Appointment-Follow Up

Had my follow up appointment yesterday and it went very well!! I cannot say enough how much I love this doctor and am so sad that my next appointment, in 3 months, will be my last with her. It's gonna be a long one, so get comfy. :D

We're keeping my Metformin dosage where it is at since my body is still having a hard time getting adjusted to it. (ie., gastric upset) She asked me if I had taken the P.O.P BCP's that she gave me last time, which I had not. I wanted to do one cycle with just the Met to see what it would do to my cycle. Since I didn't O, I brought on AF with NPC (which she is VERY supportive of doing) and did NPC throughout this cycle. I wasn't keen on putting synthetic hormones on my body, which again she was very supportive of. She did explain to me that just the progesterone will not help me in my situation.

We discussed how women with PCOS have too little amounts of estrogen. The estrogen levels slowly increase at the beginning of the cycle, until they reach a peak. During that peak, is when an egg is released. It made soooooooo much sense for my situation, despite the fact that I have always read that women with PCOS have estrogen dominance, aka too much estrogen. I told her that I seem to be stuck at the stage where a follie grows (I can feel it taking place) but it never releases, hence all my fake out O's. She agreed even more once I told her that, that my estrogen levels are too low, and suggested that I go on a estrogen/progesterone combo pill. I am reluctant just b/c I am TTC. She took one look at my charts and confirmed the low estrogen, with all the waves of my body trying to O, but never being successful.

Then, we got to talking about Vit D and bone health. Estrogen also plays a role in good bone health. Top that off with low calcium and low Vit D levels (which she said that most ALL people who live in the NW are, so much so, they quit testing for it, and just tell everybody to take 2,000IU/day of Vit D/day, which I've been doing for the last 2 weeks) that it is a recipe for osteoporosis. My mom was diagnosed with osteoporosis at the age of 35 after she twisted her ankle and shattered it into tiny little pieces!! So, she wants me to get in the estrogen BCPs if nothing else for my bone health.

I was more receptive to taking the BCP's, b/c of what she said about my bone health and how well she explained the PCOS/O connection. It made so much sense. I was on the Nuvaring for 2 cycles prior to getting PG with Em. So, something (most likely the estrogen) helped reset my body, and now that I know what I know about too little of estrogen, it makes sense!!

So, gonna finish out this cycle with the NPC, only have 2 more days of taking it, and will stop to let AF come. Then I will start the BCP's while continuing the Metformin, Vit D and now starting on a calcium supplement. I go back for a follow up in 3 months, which will be my last appointment with her, since she is retiring. I'm still on the new patient waiting list at the place she referred me to. I will continue my care there, once I can get an appointment.

Again, she told me that I need to teach others all my knowledge of FAM/NFP and charting. She mentioned the local Christian church teaches NFP, and I should look into doing that. Then after finding out that I'm not religious, she figured it might not work with the church. SO she suggested instead to hold a conference type meeting, charging 35-$40 per person and teaching a FAM/NFP course. That made my wheels start turning!! (and my DH's after I told him) That would definitely be something I would LOVE to do!!