RE Appt. Update

SND1231 · October 2014

OK ladies.. I finally met with my RE today. My wonderful DH came with me and I am very glad he did. I met with my doctor for the first time and was warned he didn't have a great bedside manner, but he was actually pretty nice. We went over my history etc and he was concerned about my ovaries and if they were damaged and afraid I wouldn't have many if any eggs left. We then did a vaginal ultrasound (UGHH) and he was surprised to find that one ovary had quite a few decent sized follicles and the other had some smaller ones. He did not give me numbers or measurements. After all the measurements etc he told me that my ovaries are measuring a little small but that it was probably due to chemo, the weight loss then weight gain and weight loss of chemo, or another underlying issue as I had numerous female issues before cancer and the disappearance of AF. But he was pretty sure it was due to cancer. He said the size wouldn't be too big of a concern since they did have follicles and appeared to functioning. He then did some b/w and wrote a referral for DH to have a SA. He gets to do it at home and we will take it to clinic soon ( I didn't know that they required abstinence for 3-5 days before a SA). He scheduled me for a followup pending the results of my blood work today on Nov. 11. He said our treatment plan will be as following as long as my blood levels are decent (as he is expecting them to be a little on the low side) and DH SA is good.. Treatment: Provera to induce AF, Clomid to induce O, Maybe a Trigger (depending on ultrasound during cycle) and TI. He feels pretty confident that we will be able to conceive with this treatment approach or something modified along these lines. I do not have statistics of our success rate or dosage of meds, timeframe etc until my followup on Nov. 11. I am still very shocked and actually feel a little hope, but am scared to let myself until the blood work comes back. My doctor actually said the words that he was "cautiously optimistic" at this point. I think that describes exactly how I feel. I know this won't be an easy journey or a quick one but I am so glad to start the process and have a treatment in sight! Thanks ladies...

Question: Hope this isn't TMI or a stupid question, but is it normal to bleed a little after the vaginal u/s? They had to really move around alot to see and measure my left ovary.

What is a normal amount of follicles?

LindseyM2012 · October 2014

So glad you are starting to get answers. Yay for functional ovaries! I hope your b/w and your husband's SA comes back good and your treatment plan doesn't change! Sounds like he wants to take the least invasive approach first.

I was told it is normal to have some spotting after an ultrasound, especially if it has been a long time since your last period. Some blood can just get dislodged. If it contines for an extended time or gets heavier, call your nurse.

SND1231 · October 2014

@LindseyM2012 Thank you! He wanted to try TI and meds first since I am so young and DH really wants to try the most natural way we can at first. If b/w or SA show any more issues we will move to more invasive options. My insurance also only covers meds and monitoring, no IUI or IVF, so we want to try a few cheaper options first. Thanks for the advice on the bleeding.

BandM14 · October 2014

That's so great that your ovaries are functioning and that you have a plan now!! I haven't had any spotting after ultrasounds but I would assume it is normal since the wand could irritate your cervix. As for number of follicles, I'm not sure what is considered normal... I did a mid cycle u/s before I was on meds and I had one dominant follicle and a few tiny ones, and when I went for a mid cycle after Femara I had 3 large follicles. Good luck with the b/w results and SA, fingers crossed for good news!

dancerspose · October 2014

So glad you have a plan and are moving forward!

My RE is hoping to do TI with us instead of IUI assuming there are no surprises next week. From what I understand if you likely have good egg quality (high AMH) and normal SA there isn't a big difference (maybe a few percentages) between IUI and TI.

Good luck with the rest of the tests!

gcbean · October 2014

Yay for functioning ovaries and a start to a plan! Good luck with the rest of your tests. FX for more good news as you continue on your journey.

emmuffy · October 2014

Glad it sounds like the news was mostly good today. Good luck moving forward with your plan Was the RE measuring your antral follicle count?

MustangChic · October 2014

Glad your first appointment went well and your RE is cautiously optimistic! Good luck and FX that all the test results come back with good news!

SND1231 · October 2014

@shafwilson thank you. I have heard that IUI and TI are about the same percentage as well as long as there is no MFI or poor egg quality. Good luck to you as well.

@emmuffy I am sorry but I do not know. I am very new at all of this, so am unsure. All I know is that he did a vaginal ultrasound and was able to see follicles in both of my ovaries. I am not on any meds to induce ovulation and no AF in over 3 years. From what I read which could be wrong, antral follicle count is done on CD3, so I guess the answer is no.. Sorry I am not sure, my body is a bit wacky.

@rainbowbridge14 thank you! I hadn't thought much about it but that is a great point and definitely helps put my mind at ease about the cost just in case we have to go the IUI route!

@BlueFairy5 thank you! I agree about doctors trying not to get our hopes up. He actually smiled at the end of our appointment and it definitely helped me to hear those optimistic words. I was terrified there would be no eggs and nothing we could do.. I know it is not a perfect situation but the dr seemed like it was totally treatable and that is all I needed to hear! Also he did not mention wanting a HSG at this point. He never brought it up and I was honestly a little too overwhelmed to even ask the list of questions on my phone lol! I will bring it up to him at our next appointment. Do you think that a HSG is necessary?

Thanks for all the input and support ladies! I am feel like a giant pressure is finally off my chest.

SND1231 · October 2014

Ok I just got online on my clinics website and found the results on my chart thing.. anyhow they saw a 8 and 7 mm follicle on my left ovary and 5-10 under 10 mm. The right ovary had an 11 and a 9 mm follicle and 5-10 under 10mm.. From what I have read on everyone else pages these are small, but the doctor said they were good considering I don't have AF or O on my own.. They are testing LH, TSH, Estradiol, FSH, HCG and Prolactin

DSculley1824 · October 2014

So glad your appointment went well! To second what @BlueFairy5‌ said I would for sure ask for a HSG before you start any meds (especially Clomid). From my understanding from all the wonderful ladies in this group it is very, very important to do that. Believe me, I feel your pain. I finally just finished all of my testing (2 months worth of testing) and I'm starting my first medicated cycle in hopefully two weeks. My RE demanded a HSG, SIS, two SA from DH (3 months apart), probably about 20 vials of blood (total) to check lots and lots of different things, and many internal sonograms at different points throughout my cycle before medication was even discussed.

@iPutKetchupOnKetchup‌ is the one who warned me all about what to do before Clomid and what to do while on Clomid. Hopefully she can add some wise info...she was super helpful to me

Edited: to tag Ketchup!

BunnyBerry · October 2014

I'm so glad your ovaries are looking so good!! That's wonderful news. Hope you get good SA results and TI can do the trick.

I often bleed a bit after the vag cam, especially when I've had a camming a few times in a week along with TI!!

SND1231 · October 2014

Thanks ladies.. The docs were honestly expecting to find no follies at all so even though they are small we are both very happy there were some we can work with.

@BunnyBerry thanks, glad I am not totally crazy.

@DSculley1824 I will talk to my dr about the HSG I am not sure of his reasoning behind not wanting one, maybe because my cause of IF is already known or all the scans I have had?? Not sure.. But I will find out. I do know that the reason we aren't doing a ton of testing is because with my cancer history and other health issue I have already been tested for all outside issues of IF, the only things that are left are hormone issues, so that is the reasoning for that.

DSculley1824 · October 2014

@SND1231‌ still great news about your follies! So happy you are starting to have a plan! Yeah, for sure just double check with your RE. The HSG will check for a blocked tube(s)....Correct me if I'm wrong ladies but I don't think any bloodwork, etc will be able to tell you that. Just the catheter being inserted and pushing dye through. Better to be safe than sorry! FX everything continues to go smoothly with you

Edited: I obviously can't spell lol

mshandlebar · October 2014

I am glad you have a plan! I would be encouraged by the number and size of your follies. Way to go ovaries!

I hope the SA comes back clear, and everything goes smoothly from there.

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