Wednesday, June 22, 2011

The doctor visit

I have an appointment with my OB this morning, and I have almost no idea what to expect.

There probably won't be a lot to report, as I imagine she'll just make me a bunch of appointments to ultrasound my lady parts and draw my blood. I've never had an abnormal papsmear, so I don't expect her to be peering into my nether regions and suddenly gasp Oh! Here's the problem! And pull out a sock or something.

It could answer the age-old question: Where do all the socks go? Vaginas.

I joke, of course. What I mean is that I don't expect her to find anything unusual, like a cyst or something.

Just recently I had a realization about something that might be affecting my fertility. I can't believe it never occurred to me before now. And also, I can't believe I'm about to write about it on the Internet.

The thing is, several years ago -- probably eight or nine years ago -- I got bacterial vaginosis. Don't get all grossed out; BV is just an overgrowth of the normal bacteria that lives in your hoo-haw. It is the most common vaginal infection in women of child-bearing age.

But at the time, I had no idea what it was. I thought it was a yeast infection, because I'd never had one of those, either. So I tried to treat it with some shit from the drug store, which didn't work. I may have waited a couple weeks before I finally sought professional treatment. The doctor diagnosed me in minutes and sent me on my way with antibiotics. 

Today I had to go and make myself extra paranoid by googling whether BV can affect fertility, and of course I stumbled across a page that said:

Additionally, bacterial vaginosis can permanently affect your fertility. If left untreated, bacteria from the vagina can travel into your uterus, causing serious damage to your fallopian tubes. This can leave you at risk for future ectopic pregnancies or for complete infertility.

I obviously treated the infection, so I'm not sure if I'm subject to this complication or not. 

Another site said it can lead to pelvic inflammatory disease. 

The CDC says:

Pelvic inflammatory disease (PID) refers to infection of the uterus (womb), fallopian tubes (tubes that carry eggs from the ovaries to the uterus) and other reproductive organs that causes symptoms such as lower abdominal pain.

Interesting. I am no stranger to lower abdominal pain, but my previous physician dismissed it as a torn muscle.

Now, I don't want to pre-diagnose myself, but while I'm on a roll, I went ahead and looked up PID in Making Babies. It led me to a section on Lutenized Unruptured Follicle Syndrome (LUFS), which occurs frequently in women who have had PID.

LUFS "... is a rare condition in which a follicle develops to mature an egg, but the follicle never breaks open to release the egg. LH spikes, the usual signal to start ovulation, but there's no ovulation..."

"LUFS is difficult to diagnose because it seems as if ovulation has occurred: BBT (basal body temperature) rises, progesterone goes up, and other hormone levels are normal."

Also interesting. My LH spikes every cycle, as does my temperature. The only difference is my temperature then usually bing-bongs all over the place after that. The book says the cure for this is simple: A couple of injections of hormones prompt release of the egg, and if the sperm is OK, you've got a winner.

And here's another interesting tidbit that should have any of us who are having fertility issues making appointments with our doctors, pronto:

"Studies have shown that about 25 to 30 percent of women seeking treatment for infertility carry microorganisms that can impair fertility." These can be as simple as the microorganisms from a yeast infection. You could be asymptomatic, but that junk could be throwing everything off. They can kill sperm or infect an embryo if an egg gets fertilized. If this is happening, both partners need to take antibiotics to kill that shit off.

So what I'm getting at is: I have no idea what's causing our infertility. I'll be requesting the full gamut of testing, and will be sending my husband in to have his sperm checked out.

If I have any updates after today's appointment, I'll put them at the bottom of this post later in the day. If not, I'll update next Wednesday!

Update: I can't even really begin to tell you about all the things I forgot to ask the doctor about, like my Vitamin D levels or my wonky temperatures. It was a very brief visit. I told her I'm having trouble getting pregnant, and she instructed me to get some blood drawn on the third day of my next period (I estimate this will be sometime around July 13). They'll be testing for hypothyroid, estradiol, FSH, and prolactin. I don't know what any of that means, so me and Google have a date for later this afternoon. 

I also have a lab sheet for my husband to have his semen tested. I'll wait for my period to start before I make him do that, as well. 

I did ask my doctor about the BV and she says it shouldn't be an issue. If I had PID, she says I'd know. With no history of STDs, I should be fine and probably will not need that test where they inject iodine into your lady parts and see if there are any obstructions. (I am definitely feeling like master of the overshare today).

Lastly, the exam went well, as expected. There were no socks or other foreign objects hiding out in my vagina and she pronounced that everything looked great. And if anyone out there is wondering what an actual professional says about frequency of sex during your fertile window -- my doc says every two days.


  1. Hi. I'm Lisa, and I'm infertile. Nice to meet you. My fallopian tubes are blocked (that's a pleasant test, DO NOT google HSG test), and my RE (reproductive endocrinologist, in case you haven't gotten all these acronyms down yet) said that it could have been caused by something like a mild, undiagnosed, case of appendicitis. Really? That can happen? I can have appendicitis and NOT EVEN KNOW? And then become infertile. Nice.

    Getting pregnant is not easy. They don't tell you that in health class.

    Good luck tomorrow. I hope they find a sock. If it's a Nike orange and white super expensive thin workout sock, it's mine.

  2. Lisa - getting pregnant is so not easy. My doc says: Sometimes it just takes some people a while! And I said: Yeah but most people I know gets pregnant right away. And she says: Screw them. :-)

    *sigh* I'm sorry about your blocked tubes. Would that it were just a sock.

  3. very interesting post. thanks for the info about hormone shots and microorganisms- i wasn't aware of either.

    i'm glad everything went well up to this point. and i hope the tests show up a very obvious culprit that is very easy to fix.

    i was so ecstatic when my doc diagnosed all of my problems with one easy answer. too bad that answer was endometriosis. i've already resigned myself to the fact that i'm going to have a mission ahead of me in creating a baby and it really bums me out. meanwhile, i just got news in the past three days that two people i know are pregnant. -two people who are already on baby #2 each.

    i hate everyone right now. and that's not an understatement.

  4. TILTE - I'm sorry. There are many days, and many moments in each day, when I feel like this is not fair. People who have diseases, people who are more out of shape than I am, people who are assholes -- they can all get pregnant, and I can't. It is absolutely the stupidest thing ever. BUT. You're not alone. My saving grace is people like you and Christina and Libby and other friends who are going through this. No one else can truly understand what this feels like.

  5. STDs are not the usual reason for an HSG. Is this an OB? I think it was...any RE would make you get one. Keep it in mind. A blocked tube can easily be unclogged:)

  6. Wildology - Yes, she's an OB. Since I'm in the very early investigative stage, I haven't been referred to an RE. She left me with the impression that STDs would necessitate the iodine thingy, but please know that I don't know anything about this stuff. :-) I'm sure there are a variety of reasons tubes can get clogged! And I'm open to any and all tests.

  7. erin, saw this and thought of you:

    you might know all of this already, and if so, just delete, but i thought maybe something might be new info.

  8. Thank you Holly! I am fascinated with all success stories and figure the information can only help!

  9. First of all, Lisa, I think that's how all of us should introduce ourselves from now on. Infertile and okay with it!

    Also, Erin I am anxious to hear what the doctor said. I had BV at a point too... But she never said anything about fertility. I thought it was only in severe cases. And no where in my fertility treatments did anyone even ask me about that.

  10. As a follow up, blocked tubes cannot be that easily opened up. Maybe if you know the reason for your blockage, and the date of your blockage, sure, go ahead and have a corkscrew shoved up there to open the path.

    Mine, since they are of an undetermined blockage, and from who the hell knows when, are NOT recommended for opening. As the second RE said "it's like opening a freeway that's been closed for 20+ years, you're just letting people drive on it, without fixing any of the problems on the freeway itself".

    Would just open myself up to risks of ectopic, etc. Sigh. Maybe I should have done that anyway?

    Now I'm miserable. Yay me.

  11. Wow. Just saw your update. Okay, no socks, or little green men, good.

    Remember, I'm not a fertility expert, I just play one on the internets.

    First, your OB should get props for knowing to do blood work on day 3. Yay! That will check your hormone levels and you can see if they're where they should be, in the right range, for that part of your cycle. If that goes well, she'll most likely talk to you about ovulation, etc. If you ovulate like a good little woman of child-bearing age, she'll just tell you to have timed intercourse. And don't let the name fool you, that gets old after the first month. Brings back so many great memories.

    If you have issues making eggs, she will probably prescribe Clomid, which helps you produce nice fat eggies. If you ovulate (release the egg) on your own, you'll again time your intercourse and go at it. If you have issues releasing your eggs, then she might either send you to an RE or prescribe a trigger shot, which you would give yourself to release your eggs, and then, you guessed it, timed sex.

    Anyway, at this point, I would google day three tests, wait for your period, and then those test results. Hope for some normalcy somewhere and you know, just get lucky in the meantime.

    Those are my favorite stories (read with much sarcasm)... the ones where "we were about to sign over the house for IVF and we had teary sex and got pregnant, yay us!"

    Snarky much, Lis?

  12. Libby - she says BV isn't a factor at all ... Guess my self-diagnosis was wrong! (again)

    Lisa - You sound like you've done this before! ;-) My OB asked if I was having timed intercourse, which I am. I explained to her that we've got the ovulation monitor that tells us when to do it. It sounds like I have some extra googling to do because I'm wondering again about my progesterone and whether any of that is going to be made clear in the upcoming testing. Probably not is my guess. Maybe this will be my lucky cycle and I won't have to worry about it?!?!?!? Hahahahhahah, right.

  13. I know how overwhelming all of this can get. For now, just be thankful for no HSG (ouch!) and trust the doc. If it's a hormonal issue, I'm sure it'll be an easy fix. BUT PID, if you had it at any point, can cause problems with your plumbing, and you don't want to go to all the trouble of hormones without making sure that all is clear in there, so maybe on second thought consider asking for an HSG. Better to have your bases covered (plus, they've been known to help conception) a couple of tylenol and 2 days of cramping. It may just be worth it. Keep us posted!

  14. Chiming in from many years working in an OB office (but not as an OB) -- the hysterosalpingogram can affect conception, which I always thought was odd, but I guess it makes sense if you think of it as a gentle sort of flushing out (just a possible upside if you end up having one). Some women say they are unpleasant; others say they are not a big deal. Also, about PID: I really think you would know if you had it. PID is incredibly painful for most people... the inflammation is causes pain that causes most people to run for the doc/hospital.
    So sorry about the unfairness of all this crap. It's so ridiculous that people who don't try very hard or don't care very much or don't even want to can get pregnant can.

  15. Good Information shared, But wondering too how people feel once they get to know they have diagnosed with such decease. God Forbid.