next steps

I know I owe a post about our second pregnancy that subsequently ended in miscarriage. I haven't forgotten about it, but these days I find myself recovered from my second D&C and thinking more about NOW then about THEN. I do plan to post details eventually but for now, let's talk about NOW.

So my D&C was 2.6.09. AF finally arrived on 3.24.09. I was getting anxious because it was taking so long so I emailed the nurse at the RE's office and wouldn't you know it, AF showed that very night.

My plan was to pick up where we left off. A saline/fluid sonogram would check out the protrusion found in the HSG films and would also provide an explanation for a possible uterine septum that was mentioned by TWO different ultrasound techs during my second pregnancy.

I had the saline sono this past Monday. Results were great. My RE told me he saw nothing and nada. He must've sensed my anxiety because he said a definitive answer would be a pelvic MRI. I told him I was okay with his diagnosis but he seemed to encourage getting the MRI just to eliminate the gray area. I started to think he doesn't trust his OWN diagnosis. I agreed to get the MRI and did so because I'd have a heart attack if we lost another pregnancy and THEN found out if was a septum issue. Definitive answer equals a happy me.

So MRI is scheduled for a week from this Friday. I am waiting on my new insurance card though so fingers crossed that it arrives and authorization happens fast. I want to get into that machine BEFORE ovulation this month. The RE said we could go ahead and try this month if we wanted to and gave me progesterone to start using 3dpo (it's too late to take clomid this cycle). 

My jaw must've dropped to the floor because this is the same doctor that DENIED me of progesterone when I asked about it back in December (the cycle I ended up getting pregnant and miscarrying, hmmm, maybe because of low progesterone? We'll never know but the thought is there).  Anyway, if the MRI is all clear and I have it before ovulation then we could have a successful month. Anything is possible -- we've definitely figured that one out.

On another note, we also went over my RPL (recurrent pregnancy loss) blood work and all came back "within normal ranges". I was happy to hear this but the tiniest part of me wanted the tiniest thing to be wrong.  Other than my short luteal phase and a tiny bit of male factor, we are NORMAL. 

My RE has yet to officially diagnose me w/ LPD (luteal phase defect) but I'm diagnosing myself. I basically diagnosed myself with this late last summer after charting for a few months. Consistent 9 day luteal phase. 

How does one fix this though? I've read WAY too much. It can be treated by simply supplementing progesterone during the luteal phase if it's poor corpus luteum development or it could be poor follicle development, which would require a drug that stimulates follicle production (such as clomid). 

Ultimately, if you're producing a higher quality egg, it's more likely that the corpus luteum will be adequate. Therefore it seems better to treat during follicular development.

After doing some reading, it seems I should suggest a mid-cycle ultrasound to check follicle development as well as a blood test for estrogen. This would ultimately determine if it's only progesterone that I need or if I need the clomid.  Has my RE suggested any of this? No. (This leads to a whole other story on how I've felt like the doctor during my RE appointments, however, I won't go into that now and I am not sure I have it in me to change REs at this point.) 

My RE suggested next month that we do clomid with an injectable. Although, instead of IUI, DH and I decided that we'd try the old fashioned way. They call it a medicated/timed intercourse cycle. You're probably wondering why we just don't go for the full monty. Go ahead and shoot the goods closer to the egg because it'll probably give us an extra 10% chance of getting that BFP. I don't know. Maybe I'm not at that stage yet since we've gotten pregnant on our own twice. 

Maybe after we spend bucks on these meds and it fails, we'll realize what idiots we are and sign up immediately for the baster.