"For I know the plans I have for you', declares the Lord..." Jeremiah 29:11

Saturday, April 28, 2012

Test results and findings thus far....

I have been holding off posting anything regarding test results, in hopes we would have heard something more by now. We have not, and that's ok. I will share results from the previous doctor and his interpretation, as well as our current doctor's interpretation of those results and any new findings from the current doctor. I know this is all very exciting stuff {sarcasm} as I am sure you are reading this on the edge of your seat. DISCLAIMER: I'll do my best to explain the tests and findings but let me take this opportunity to apologize if I'm misinforming based on my own understanding. You see, Dr. Internet doesn't issue PhDs in Reproductive Endocrinology just by researching for a couple of years, I have a few years of schooling ahead of me should I wish to be Genny Lawrence, MD. Off we go... (said in my best Simon Cowell voice)

As I had mentioned in a previous post, we weren't really given a detailed explanation of the tests and their results by our first doctor. He just stated everything looked normal. He did, however, comment on the test that indicates the age of my ovaries or my ovarian reserve. He also explained that a woman's ovarian age and her chronological age are not always the same. I don't know if this is the best way to explain this? Every woman goes through menopause long before their life has expired. So how would your chronological age ever be the same as your ovarian age? Unless of course, you're the extremely rare woman who can still give birth at the age of 90. Let me take a moment for a brief explanation. Every woman is born with a set number of eggs. You don't make more over time, what you have is what you get. Every menstrual cycle, you let go of one (sometimes more) of the little eggs in hopes of being fertilized and one day becoming a little person. As you get older, the number of eggs (the reserve) is obviously significantly less, in turn making it more difficult to get pregnant. As your reserve depletes you approach menopause, you are out of eggs and can no longer have children. What I believe Dr. T (previous doctor) was getting at is that the age of my ovaries, ovarian reserve or number of eggs I still have is that of someone much younger than 34. Praise God, right? Well, maybe. Dr. D's (current doctor) thoughts are, although this is great, there has to be a reason why. His concern is that my body is not allowing eggs to be released. Not only am I, myself stubborn, my eggs have decided to carry on that trait as well, that's just fantastic. This could be due to a lack of LH (luteinizing hormone - the hormone secreted by your brain to trigger egg release right before ovulation) which would be a simple fix using a hormone injection. I will have another blood test done to measure the amount of LH as well as FSH (follicular-stimulating hormone - also secreted by the pituitary gland to regulate the development of the follicles by which the eggs are released.) in the next couple of days. Those results to follow.

I have forgotten so many of the results that Dr. D went over based on Dr. T's testing but the next test I do recall is the progesterone test. Progesterone is the hormone your body releases post ovulation. It is measured on a scale of 1 to I don't even know how many. By way of a blood test. I do know, any test resulting in less than 10 likely means you did not ovulate. They like to see between 12 and 15. Above 15 and rising, post ovulation could be an indication of pregnancy, although they would never tell you that, as to not get your hopes up. My abnormally high ovarian reserve number could also have been indicative of me not ovulating at all. My result with Dr. T, approximately 7 days post ovulation, was 15. The result with Dr. D, also approximately 7 days post ovulation, was 17. Yay! At least we know we have confirmation I have ovulated 2 of the last 8 months. This is good news!!

The next test, which I have already discussed the findings, was the HSG test. This is the test done by shooting dye into my uterus, followed by a series of x-ray pictures taken to show whether or not there are any blockages in my fallopian tubes preventing the sperm from metting the egg. Dr. T's results were sent over, not on a disc but photocopied. If you have never seen a photocopy of an x-ray, allow me to be the one to tell you, it's worthless. Dr. T had, however, noted that there was possible blockage, inflammation or a collapsed right fallopian tube. Thus resulting in his recommendation to have the laprascopic surgery. The surgery is performed by making a small incision in my belly button by which a scope is inserted and used to travel down through the tube to see what is blocking it. If possible, the doctor will attempt to unblock it at that time. If all goes well, I would have 2 clear pathways for my eggs to travel. But, with every invasive, although minimally so, procedure there comes a caveat or 2. These caveats were never discussed by Dr. T. Dr. D, however, explained how the risk can often out weigh the reward when performing a procedure like this. You can often build up scar tissue having the reverse effect on the tubes, blocking them worse then before. He assured us, he would recommend this procedure only as a last resort and after he has seen for himself what is going on inside me. He went on to explain, people get pregnant every day with only 1 tube and he does not see this as the reason behind us not getting pregnant.

Both doctors also requested we have an ultrasound at our first appointment. As you may recall, both commented on my beautiful uterus. (thank you, thank you very much! just kidding) Makes me wonder what an ugly one looks like? Eek! Nothing else was noted during Dr. T's ultrasound, other than it was done just prior to ovulation and he was able to see a few follicles on each ovary. Dr. D's ultrasound was done during the first week of my cycle. He was fully prepared to see nothing at all until he scanned my right ovary. Attached to my right ovary was what appeared to be an egg hanging on for dear life. This egg would eventually fade away but should not be there based on where I was in my cycle. This may further support his theory of me having stubborn eggs. Interesting!

As mentioned in a previous post, Dr. D had order more blood work and had indicated there were other tests he would be doing that Dr. T had not. That blood work has been done and there is only one thing we have been made aware of to date. One of the tests he had done was to identify the presence of a gene mutation called MTHFR, and no, that's not short for a very bad word. It's short for methylenetetrahydrofolate reductase. I don't even know how to begin to pronounce that, so we'll stick with MTHFR. I have tested positive for the presence of MTHFR with a C mutation. The nurse did not get into explaining what this is, she just said I had to come in for a 2nd blood test. This blood test was done a week ago yesterday (Friday) and will identify whether the mutation is heterozygous or homozygous. She did however, explain that I would need more folic acid by way of injection or liquid. As well as the possibility of needing blood thinners when I finally do get pregnant. I did, of course, consult Dr. Internet to see what else I could find. From what I have gathered, the MTHFR gene mutation means I do not process the protein folate. Folic acid is critical for someone trying to get pregnant as it reduces the risk of having a baby with birth defects, spina bifada and downs syndrome. The fact that I do not process folate greatly increases the chances of having a baby with one of the aforementioned. This little genetically transfered mutation also can cause blood clotting increasing the chance of miscarrying, early onset Alzheimer's, heart conditions, stroke, and aneurisms. Although it sounds scary, it's easily controlled by taking a baby aspirin every day for the rest of my life. The last drawback to this mutation and most interesting to me at the present time is, it can also prevent a fertilized egg from implanting into the uterine lining. No implantation = no pregnancy. Although it may be premature to assume this is the answer to all our prayers, it does feel like we're getting somewhere with all of this. I am finally feeling at peace with our situation and I have the utmost confidence in our doctor and for that I feel blessed. (Praise God)

I have to schedule another blood test to be completed on day 2 or 3 of my cycle. Aunt Flo should be here today, although there are no signs of her arrival, she has a tendency to be very ninja like some months. I anticipate her to come at the most inopportune time, like right in the middle of warrior II in my 4 o'clock yoga class. Ugh! I will also have to schedule my 2nd HSG test to be completed on day 5-10 of my cycle. I will be very thankful when the test poking and prodding is completed and we have some answers. Or at least I pray we have some answers.

Until next time... Happy Saturday! xo