For the lucky 100th post, we learn about The Appointment.
I was so NOT ready for the alarm to go off at 5:45 AM, but I had scheduled a 7:15 appointment when later ones were available in order to interfere with DH's workday as little as possible. After dealing with all of the new patient stuff, we met with Dr. McKeeby. He looked at our paperwork, and we pointed out the most pertinent parts.
We discussed the possibility of PCOS that had been raised by my OB, and he said that PCOS does not appear to be the problem. I could still have polycystic ovaries, since PCOS is a symptom of insulin resistance rather than the other way around, but the 18 months of basal body temp charts with LH surges marked indicate that I am ovulating the way I should be. Plus, I don't have any of the other symptoms of PCOS. I'm going to continue to take the Metformin that my PCP had given me, but he prescribed it to help prevent/delay the metabolic syndrome that I don't have yet but am at risk for, rather than for infertility.
OK, so if it's not PCOS, what is it? Dr. McKeeby said that DH's previous results look close enough to normal to not be a concern, although he is of course going to have to repeat the testing. We both have to have bloodwork (a repeat for me) to make sure we don't have HIV, Hepatitis B or C or syphilis (insert Grey's Anatomy Season 1 joke here). The more key things, however, will be the tests I'll have done in the next couple of weeks. Day 3 bloodwork (testing FSH, TSH, estrogen, and prolactin levels) and another pelvic ultrasound, and several days later a hysterosalpinogram (HSG). For those who don't know infertility terminology, that involves putting dye into my anatomy to look for problems, especially with the fallopian tubes. From what I hear, I will be very definitely taking a couple of Aleve ahead of time, because it hurts. Not like a sprain or break hurts or anything, but enough for me to want the meds. DH wants to be there with me for it, which I thought was really sweet. Fortunately for us both, we can get it done at a non-Shady Grove facility in Annapolis rather than going all the way to the main SG office in Rockville. One thing that I love so far about SG is that they will call me later that day (or Monday if it's on a weekend) with results of bloodwork and other tests...almost no waiting!
Based on all this, we'll be looking at either Intra-Uterine Insemination (IUI) or IVF. IUI is less invasive in a lot of ways and involves few if any needles going into me. It does have an increased risk of twins, but not much risk of higher-order multiples, and we wouldn't mind twins. IVF has for people like us about triple the success rate of IUI and more control over how many babies are likely, but it involves a lot more needles and hormones and anesthesia.
Our nurse, Crystal, then came in. Yes, we get one designated nurse to work with through all of this rather than just dealing with whoever's available at any given time. So far, I am loving the service! She went over the testing with us, as well as how to get it done. Once I hit Day 1, I'll call her and she'll schedule me for my testing. She also told me to go ahead and start taking prenatal vitamins again (if you remember, I stopped taking them months back when I lost hope completely). That felt kinda weird tonight, digging the bottle back out from the bottom of the bin where we keep medications and first aid stuff.
Crystal then took us to Darlene, who handles the finances. She had talked to my insurance company when we were with Dr. McKeeby and Crystal, and she found out that my insurance apparently doesn't cover IUI. I had thought that all of the mainline IF treatments were covered, but looking back at my emails when I got to work, I saw that the insurance broker had said the policy didn't mention IUI one way or the other and that she would need to look up the procedure codes. I called Darlene and got the codes from her, and the insurance broker will get back to me by the end of the week on whether they're covered.
DH and I talked about the possibility of IUI not being covered on the way to the cars. My main feeling was that I would hate to have to go with a more intense and invasive procedure just because of money and insurance coverage. DH pointed out the higher success rate of IVF and noted that it might not be that bad. So we'll see. I'm sure there will be many conversations about this.
Next stop on the Magical Bodily Tour, the vampires of the opera (or at least of the doctor's office).