Ovulation or Nah?

Today was my follow-up appointment with the fertility doctor. Since it was unclear from the ultrasound at my first appointment whether I had just ovulated or was about to ovulate, the doctor asked me to come back a few days later to take another look.

At this ultrasound he measured the largest follicle and found that it had grown to 18 mm, which means that I’ll probably be ovulating within the next few days. Since my cervical mucus should be approaching fertile-quality at this point he took another sample to test the thickness a second time. I wouldn’t say it hurt, but it wasn’t particularly comfortable either… and then he held aloft a GIGANTIC hemostat covered in cervical fluid so that he could show me what it looks like over the drape!

Ouch.

Ultimately, he found what he had anticipated: the mucus was still quite thick; probably too thick for sperm to get through. But, since I appear to be ovulating normally, he recommended that we stick with the low-intervention plan of simple Intrauterine Insemination (IUI) to start. That should bypass the thickened cervical mucus to give the sperm a fighting chance.

I still can’t get over how amazing it was to see my ovaries with follicles on the ultrasound! I wish I’d asked for a picture. Here’s a similar one from Google (the follicles are the dark spots):

Ovary
Ovary

And here’s one (also from Google) showing a uterus. I never realized how thick the walls are. The doctor measured my endometrial lining at about 7mm today. From what I’ve read that may be on the low side, but he didn’t seem worried about it.

Uterus
Uterus

Today the lab also drew my blood for the genetic, infectious disease, and hormone tests the doctor recommended. They’ll be checking my level of prolactin (which can suppress ovulation) as well as a number of other hormones I can’t remember.

The thing I’m still feeling uneasy about at this point is my increasing cycle lengths. My cycles used to be pretty consistently 26-29 days, but the last few cycles have been 35-40 days in length. On this particular cycle it’s already day 21 and I’m just now getting ready to ovulate. The doctor told me he wasn’t really concerned about it since I’m still ovulating and having periods, but I’m not sure what to make of it. I have this suspicion that I may be moving into PCOS: my cycles are getting longer, the doctor noticed 11 follicles on one of my ovaries (12+ is often a sign of PCOS according to Dr. Google), and my last glucose tolerance test in August was on the very high end of normal. I asked the doctor at this appointment and he said while it’s possible, he doesn’t think we should be concerned about it at this point. So I’m going to try not to dwell on it.

So, what now? Well, my “homework” is to continue charting my temperatures and to start taking ovulation tests. This will help establish a schedule of when I’m ovulating so that when we decide to do the first IUI we’ll have a target date to shoot for.

My husband still needs to go into get his blood drawn and drop off his… sample. Results from some of our tests (including the hormone and semen tests) will come back pretty quickly but the genetic tests take a few weeks, so we’ve got a ways to go before that’s all checked off the list.

I’m also working on getting an appointment with the high-risk OB/GYN for preconception counseling, and I have an appointment with my CF care team next week so that I can update my doctors and ask about whether any of my meds will need to be changed once we start the IUI cycle(s).

As I was leaving today the doctor said we could schedule the first IUI attempt as soon as my next cycle… wow. It’s happening faster than I expected! I told him we’re looking to hold off for a few more cycles since I don’t want to give birth before my classes end in May 2016. Our ideal timeline would be to get pregnant in September or October of this year for a birth next summer.

I talked about all of this with my sister today and she was so excited and supportive. I’m so grateful to have her in my life. My husband and I have decided not to share any of this with anyone else yet, though. Since everything is still so preliminary we would prefer to wait to tell our families and friends until I’m actually pregnant, and ideally into my second trimester. Hopefully the IUI will work, but if this becomes a much longer and more involved process than we anticipate, we would rather not have everyone asking for updates and giving unsolicited advice. We know they’ll be excited for us if/when it finally happens!

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