Previously on Self-Made Motherhood Blog, our heroine was peeing on all the sticks trying to figure out exactly when she would ovulate so she could figure out exactly when to inseminate. Long story short: Nothing came of it.
Moving on. So, after that (was that January?), I took February off to collect some finances, etc. I went for it again in March, taking Clomid again, with nothing to show for it. March was my fourth Clomid cycle and, judging by my very sparse cm of any kind the whole cycle, I concluded that, even if the Clomid was giving me decent eggs, it was also thinning my lining to the point where nothing could stick even if it wanted to. My 41st birthday was coming up soon (tick-tock! get a baby in there already, right???). I did a ton of research and reading and decided I wanted to switch to Femara/Letrozol. From everything I'd read (both actual scientific studies and anecdotes), women who don't respond well to Clomid sometimes respond better (and get pregnant) with Femara. Plus, Femara doesn't have the side effect of thinning the uterine lining. I was somehow able to snag an appointment with my gyno on March 31st (exactly one week before my birthday). I was on cd3 and eager to get on the Femara in time to do an insem for that cycle (coincidentally ovulating sometime over my birthday weekend). PLOT TWIST! My gyno said she didn't prescribe Femara because, in her opinion, it requires monitoring and she doesn't do that kind of close monitoring. I cried for just a second, but then mentally resolved to just go for it drug-free for April cycle anyway (I kept that to myself). She referred me out to a new RE (I'd told her how I'd been treated at my first RE and she said she wasn't really surprised because they're such a big practice, they can pick and choose their patients and focus all their energy on their IVF success rates. Anyone that doesn't fall in line with their program is a necessary casualty). The one thing I did like about my former, crappy, rude RE was that they had early morning monitoring hours starting at 6:30am, so I could go in for blood work or whatever and still make it to work on time. I was worried that this new place might not be so accommodating to my work scheduling needs. I made the appointment anyway (figuring if I got pregnant with April cycle, then they could confirm and monitor. If not, then we could talk next steps).
Side note: I did snag this extremely dope video of my donor's swimmers swimming like crazy (so I think we can definitively say my un-pregnant-ness from January and going forward is a me-problem and not a him-problem). I mean, LOOK AT'EM GO!!!
Obviously I'm not pregnant, so we talked about next steps at my May 5th appointment. The new RE seemed very straightforward, but warm. Didn't seem to be drawing any hard conclusions about my state of health based on my weight alone (it's always nice to not be stereotyped for being both Black and overweight at the same time). I told her about my hopes to try out Femara. She really feels like it's a lateral move from Clomid and doesn't think it will do me any good (she'll go forward with it if that's what I want, but it's not what she is advising). She suggested injectable FSH with monitoring for egg development/size and a trigger shot, followed with in-clinic IUI. I let her know that, because of my job, I can't do a lot of monitoring appointments unless I can be in and out in time to get to work (from Newark, as opposed to old, crappy RE that was very conveniently situated in West Orange). She said she'll work with me in whatever capacity makes me most comfortable, but she has to tell me her best recommendations. She also suggested doing a laparoscopy to check for endometriosis, or any other adhesions that might possibly be blocking an ovulated egg or a fertilized one from entering the fallopian tubes. She said we could go forward with the FSH for a cycle and do the lap if I didn't get pregnant, OR do the lap first and then proceed with the FSH if they didn't find anything. It was a lot to think about to say the least. Next came "the exam". SUPERFUNTIMEZ! Who doesn't love a transvaginal ultrasound? Am I right? My AFC (antral follicle count) is definitely down from where it was last year this time (I think I had 15 total last year. This year closer to 10). There's the same fibroid in the back wall of my uterus, but on the outside and not obstructing anything. PLOT TWIST! She found another fibroid in there and couldn't tell if it was inside or outside. And a third "something" near the bottom of my uterus that could be a fibroid, or could be just a little flap of endometrium waiting to get shed with my period (since I'd just ovulated a couple days before). In order to tell, she'll need to do a saline sonogram, which is like an HSG. HSG uses blue dye and takes an x-ray of your uterus and tubes to see if everything flows out how it's supposed to. Saline sonogram uses saline (hence the name) to fill up the uterus and tubes so that the doc can get a better 3D image of the topography of the uterus (letting her know if that fibroid is inside or outside, for instance). They both have the advantage of flushing out the tubes (if there's no major blockage and the tubes are, in fact, flushable), possibly clearing the path for fertilization and implantation to happen.
So....because my cycle is like clockwork, I called ahead of its arrival to schedule the saline sonogram for the 22nd (a Monday, not the most convenient day for me, but it's all they had within my window - it has to be done after menses, but before ovulation) at 11:30am (a decidedly inconvenient time of day for me to need to disappear from work). I finally had to come (partially) clean at work. I decided on an email to my lady boss (because talking about my uterus isn't a conversation I really ever want to have with my guy boss). I told her about the appointment time I needed off on Monday (which was still two weeks away at the time). And then I explained that once you hit 40 and haven't used your uterus for anything, everyone is pretty sure it's going to turn against you (which is generally true). Mine isn't (at least we don't think so), but I do have a couple of suspicious fibroids that they'd like to get a better look at to see if there's anything going on (which is true). And said that the reason I'm doing so many appointments is because I had to be referred out to a specialist (which is true), and that we want to do all of the tests and screenings before the Turnip in Chief and his cronies in DC make having health insurance a non-option for me (which is also true for me - I really don't think the doctors care at all as long as they're getting paid). So, I told her everything except for the trying to get knocked up part. Bless her, she was really great about it and just wants me to make sure I'm "getting the care that [I] need", and even offered to discuss them providing healthcare or getting some kind of healthcare deduction through work, etc (I adore this work fam so much y'all. I really do).
So! That brings us up to the present. I have my saline sonogram tomorrow (and probably also bloodwork because I was so dehydrated at the last appointment that they couldn't find a vein - and oh, how they tried! Ouch!). Hopefully, all fibroids are outside the uterus and not interfering with anything baby-making related (and also that the last suspicious something is gone, flushed out with my period). Hopefully the tubes are all clear. Directly after the appointment, I'm going to call The Bank to schedule shipment of one vial to arrive on Wednesday (cd11), so I'll be ready for ovulation with my newly flushed out tubes.
Fingers crossed! Stay tuned....