Clomiphene Challenge Part I

Last Sunday was the third day of my period, and the day that Dr. Hesla wanted me to come in to begin the Clomiphene Challenge. My appointment was bright and early at 8:00AM, and I am pretty sure that I was their first patient of the day. A nurse (the same one that took my vitals at my initial appointment a couple of weeks ago), drew my blood and then showed me into an examining room to get ready for the ultrasound. I assumed that a technician would be performing the ultrasound, and so was a bit surprised when Dr. Hesla walked in and said that he would be doing it. It makes sense though, to have him do the ultrasound so that he knows exactly what we are dealing with. He described everything he was seeing, both for my benefit as well as for an accurate record. A staff member stood nearby taking down information on a clipboard. He looked at my uterus first, and as usual, it was just fine (go, uterus!). The right ovary was next, and this time, I figured out that the large gray image on the screen was not supposed to be there. It was the biggest cyst he found and although I don't remember the exact measurements, the first number he said was 40mm, which Michael says is about 2 inches. The left ovary had several smaller cysts associated with it, and Dr. Hesla measured them all. Next he said he was going to see how many follicles he could find and count them. I hoped he would find a lot as that would indicate that I still have functioning ovaries, despite the cysts. Dr. Hesla found 6 follicles in the right ovary and 2 follicles in the left. And while I have no idea what the average number of follicles that develop each month might be, I think 8 is not too shabby for a girl with cysts. :) The only thing that really took me aback during the visit was Dr. Hesla saying that with my level of endometriosis, he wouldn't normally recommend IUI (artificial insemination). I was pretty sure we had gone over that during our initial consult and that everyone had agreed IUI was out and Michael and I would go straight to IVF if we seemed like good candidates. I'd like to give him the benefit of the doubt that he brings IUI up with every couple, as an option when taking the Clomiphene Challenge, but a part of me felt like he didn't remember us or hadn't taken the time to refresh his memory by looking through our file before the appointment. I am probably more than a little spoiled by eastern medicine and other natural health care modalities. I think I just have to come to terms with the fact that western medicine is not bad--just different, and that even though I might not get the same personalized attention from my fertility doctor as I do from my Chinese medicine doctor, that doesn't mean one is better than the other. I have to remember that both people are working in my best interest. After the ultrasound, I was free to go. I headed over to a Starbucks for breakfast and to write down my thoughts about the morning's appointment. By the time I left, about 10:30AM, I had already gotten a call back from the doctor's office with my blood test results. My FSH (follicle stimulating hormone) level was 9.79, which was fine. It just has to be less than 13 to be considered "good." My Estradiol (type of estrogen) level was fine too at 49. My TSH level was slightly elevated at 3.82. The nurse explained that if I looked it up online, I would likely find that it's a "normal" level, but that Dr. Hesla likes it to be 2.5 0r less before pregnancy occurs. He wants me to take 25mcg of Levothyroxine a day, which I was not all that happy about at first. I told the nurse that I used to take Naturthroid, a natural thyroid supplement which was prescribed by my naturopath, but she let me know in no uncertain terms that their office does not endorse the use of supplements. So . . . I will play by the rules and take the pills. If it brings me closer to my child(ren), then I am happy to do it. I can always make other choices later. I started taking the Clomid today and will take it through Saturday. Then I'll go back in on Sunday for another blood test to determine my FSH level once again. After the results are in, Dr. Hesla will give us his opinion on where we should go from here. I am excited to find out. P. S. Tomorrow I have yet another blood test to measure my level of AMH (Anti-Mullerian hormone), which will be another indicator of how well my ovaries are working.