Getting back in the stirrups

Not my awesome Doc......nor my legs 'sigh'

First off, sorry about the graphic title...and the image. I clearly have issues that go beyond infertility.

Yesterdays meeting with our fabulous RE went pretty much according to plan. Maybe it's because I know what a fantastic doctor he is, or maybe I don't set my sights too high, but I swear we spent an hour and a half like a couple of friends just hanging out laughing. I'm honestly surprised we didn't bust out with some beers, although Doc did have himself Circle K 100oz coozie though, so I guess that was hilarious enough.
To kickoff the appointment, even though he knows most of our history, we went over a more in depth questionnaire regarding our health and our family health. I was able to tell him that thyroid issues run in my family, along with diabetes, and that my grandmother had some mild issues with conceiving as well. He immediately set up tests for my thyroid and a 2 hour glucose test, similar to the gestational diabetes test. Since I have PCOS there is a very good chance I am insulin resistant. Not diabetic, but definitely issues with the way my body processes sugars and takes in calories. He said that he and I could both eat a 1000 calorie burger, but my body would take in about 800 calories while his would take on around 600. We're both pretty sure that I will need to be on Metformin, but I'm taking the test to confirm it before just taking it to see what it does like last time. I'm not exactly looking forward to chugging down that sugar loaded concoction, but let's be honest, I've gone through worse during this process!
Apparently some answers I gave during the history questionnaire leads him to think I may have a mild case of Endometriosis as well, some scarring could be the reason my uterus is tilted, but from what he remembers on ultrasounds, he doesn't think it would be enough to require surgery or anything like that. I know how rough Endo is and when he said it could be possible my heart dropped in to my stomach, but he reassured me that it small amounts of Endo can be common (1 out of 36, I think) and that few benefit from surgery (1 in 25). He's gonna be sure that we keep an eye out for it for the time being.
The doctor also discussed my weight. I've never hid the fact that I am overweight, or at least I've tried not to. I've known it and I've struggled with it, but I've not been able to go full force with making a life change. He explained to me that if you took me, the way I am right now, and took away the PCOS, I would have no trouble conceiving. Then he said that if you took me as I am now, with the PCOS, and you took away 10-15% body weight, I would again have no trouble conceiving, so he is wanting to work with me on getting the weight under control to in turn get the PCOS to ease up a bit. We plan to meet after my tests come back and we'll discuss the Metformin and a more specific diet plan. I'll go in to more depth on this issue after that meeting.
Then, we got in to our protocol discussion. With PCOS, we need a plan that gives us a bit more control over the amount of eggs I produce as well as the quality. You see, Clomid tricks the brain in to producing MORE eggs, but it does nothing as far as the quality of them. Injectables (injected hormones) can control the amount as well as the quality. He said that women with PCOS tend to have trouble with ovulation and also the quality of their eggs, so we needed to go at these next rounds with more control (have I said control enough??). He is suggesting that we do 3 rounds of Intrauterine Insemination using Clomid and Injectables. Knowing our situation with insurance and that everything we pay is out of pocket, he says this is a good option for both our wallets and the extra bump we need to get the ol' uterus a working.
I brought up a statistic I heard about the difference between the success rates of IUI's and IVF's being only 15%. If we're doing IUI's with injectables, that can run a pretty penny, and we try for 3 rounds with no success, why not just save that money and go straight for IVF? He reiterated that PCOS can tend to effect the quality of the eggs, meaning that I could produce 20 mature follicles, but I could have only a few, at most, end up fertilized. Doc also said that while he's an aggressive treater, but he is confident that an IUI can get us where we need to go. Of course, we need to get one under our belt and see how my ovaries react, but if after 3 times we get no pregnancies, we will discuss moving on to IVF. I trust his judgement, so I have no problem following his lead.

And, as usual, everything with Curtis is going great. His sperm is fine, he has no family history that is disconcerting, etc. etc, blah blah. That ass ALWAYS has it easy!

Like I mentioned earlier, my doctor is fantastic. We discussed trying to work around my job schedule and the location difference, doing as much as we can in our little town, but also trying to ease up on the financial stuff. It's nice when someone understands that we're middle-class people that still have bills and such, and we can't just drop thousands out of our butts for this. It's also great to hear that, yes Curtis and I are young, but after 3 years of this, something isn't right. So while we wait for my next cycle to begin, we have about 3 weeks, we're going to do the thyroid & glucose testing, get my diet on track, and gear up for our first IUI round to begin!

As always, thanks for reading my absurdly long post (even though I'm sure you're glad it wasn't chock full of my ridiculous quips) and if you're on this roller coaster with me, Baby Dust and good thoughts your way!

xoxo, Lindsay Lou

P.S. I can see that I'm getting quite a bit of traffic, but my followers count is holding steady. Please don't be shy or be afraid to comment. I love meeting new people and I wouldn't mind answering any questions or snide remarks. All I ask is that you be nice, k?