Dysfunctional Ovaries, or The Big Infertile Elephant in the Room

*this post is about infertility and our struggle to get me knocked up; it definitely borders the realm of TMI, so feel free to skip this post entirely, but I promise I don't talk about things like cervical mucus or anything specific about our private life; the readers' digest version:  we've been trying for a long time, finally went to a doctor, got a diagnosis, and I am now about to start taking meds to help things along*


Today, I posted this picture on my photo a day blog.  Not that many anyone reads that blog, but just to stop any rumors, I am not, at this moment, pregnant.  If you know me in real life, you know that my life is an open book and I almost never hesitate to talk about anything in my life.  Including the fact that Den and I are trying to have a baby and we are having difficulties getting me pregnant.  All our friends know we are trying, and every time I eat too much and my stomach pooches out, they point and ask if I'm pregnant.  I just sigh and say, nope, not pregnant, just fat.

ultrasound machine


For a long time, I suspected we would run into problems conceiving.  Den and I have been together for ten and a half years and have never, um, "been careful", and we have no happy accidents to show for it.  For about the last eighteen months, we have been actively trying to get me impregnated with no luck.  As soon as we started trying, I wanted to see a doctor about possible fertility issues; I just kind of knew we were going to face some sort of roadblock, but we weren't married yet and I didn't have any insurance.  And besides, most fertility specialists won't even see you until you've been trying for at least a year.  I hoped we wouldn't need a fertility specialist and that we would just get pregnant within a few months, but I accepted this probably wouldn't be our reality.  And I was okay with it.  Some people get pregnant easily, others don't.  I would get my hopes up each month, of course, but I wasn't devastated when I would start my period.  Frustrated, but not devastated.

As we neared the year mark of trying, I made an appointment with an OB/GYN for a very overdue general checkup (due to no health insurance and no problems).  The only other time I had seen an OB/GYN was nine years prior and it was due to complications from an ovarian cyst on my left ovary the size of a grapefruit.  Everything checked out fine this time and I told the doctor we were having trouble getting pregnant and wanted to know what to do about it.  This is where she gave me the worst advice I've ever been given on the subject of conception.  She sat across from us at her desk, and with a straight face said, "Get an ovulation predictor kit and try harder."  Try harder?!?  Worst f-ing advice EVER!!!  That's as bad as saying if you just relax, it'll happen.  Then she told us to come back in 4 months if we weren't pregnant and we'd "figure something out."

I was completely dumbfounded.  I can't believe I kept a straight face in her office and didn't reach across the desk and give her a good slap.  We left and I was totally speechless.  Her "advice" was the last thing I needed to hear at the time.  And it's the last thing anyone having problems getting pregnant ever needs to hear.  I wanted a baby, damn it!  And I knew there was a problem.  Even though my cycle was like clockwork, there was a problem.  Otherwise there would be a baby.  I felt defeated.  We tried for a year, just like we were supposed to in order to be able to see a specialist, and she tells us to try harder instead of referring us to someone.  So we did the only thing we could do.  We got an ovulation predictor kit and tried harder.

Three months into "trying harder", I got a phone call from a good friend of mine who happens to be a reproductive endocrinologist.  I had been avoiding  him for several months because his job is to make babies and making babies was one of the only things on my mind at the time.  I didn't want all of our conversations to revolve around my infertility; it didn't seem fair since we're friends and not doctor/patient.  He told me I was crazy and to come in to see him.  And that I should've reached across the desk and slapped that other doctor.

Two days later, Den and I were sitting in his office.  We went through an entire month of awkward testing--it's really weird to have a friend stick a probe into you.  But I felt confident that we would get a diagnosis and finally (finally!) proceed to treatment.  I had to come in each week for blood work to check my hormone levels and to see if I actually ovulated.  All normal, except for slightly elevated adrenal androgens, but nothing weird enough to lead to any diagnosis.  I had weekly ultrasounds, too.  Again, all normal; no cysts, fibroids, or endometriosis.  I had a hysterosalpingogram.  Mostly normal.  My right fallopian tube was open and clear, my left was blocked.  No great surprise considering the grapefruit sized cyst from nearly a decade earlier.  Apparently, you only need one tube, though, and only having one open doesn't diminish your fertility at all.  Den had a semen analysis.  Normal.  Normal.  Normal.  All normal.  So why, why weren't we pregnant?!!?  Why???

I couldn't believe it.  All this time trying, an entire month of testing, and still, no real diagnosis.  I thought my head might explode.  In all the months of trying this was the first time I really felt hopeless and lost.  And angry and frustrated.  And defeated.  I was sure we would end up with a reason why things weren't working and could just fix it.  Our doctor recommended Clomid to us and told us if we wanted to start treatment, I needed to come in on day 3 of my cycle.  Unfortunately, I was already on day 5.  Yet another month down the drain.  Since my cycle is very predictable, I went ahead and made an appointment for the next month on day 3 of my cycle.

plum sized cyst on my left ovary


We went in right before Christmas certain we would leave with a prescription and instructions, and finally be on our way to a baby.  One quick ultrasound later, and we found a plum sized cyst on my damn left ovary.  What the what?!?  I. Was. Devastated.  But the doctor wasn't phased at all.  He told me it was actually a good thing we found the cyst because it now led him to believe my diagnosis falls somewhere between polycystic ovarian syndrome, unexplained infertility (yes, that's actually a diagnosis), and general ovarian dysfunction.  He put me on one month of birth control to shrink the cyst and told me to come back in 2 weeks for a follow up.  What a crazy feeling to be put on birth control to help with infertility.

Two weeks later (yesterday), we're back in his office, and the cyst is gone!  I walk out of there with a prescription for Clomid and Ovidrel, and very specific directions for their use.  Our doctor also recommended intrauterine insemination to give us the best possible chance of making a baby.  So we are finally on our way.  I left the doctor's office full of hope and possibility.  This is going to work.  I can feel it.  And I'm pretty sure it will work on the first try.  There's a sense of impending pregnancy; I can feel it right around the corner, and I am so very, very happy.
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