Thursday, April 11, 2013

Unexpected Next Steps

This morning I had an update appointment of sorts with my doctor which didn't go quite as planned. I went into the appointment fully expecting to talk with Dr. B about either trying a few more cycles naturally or starting on Clomid. However, he had a different plan.

At the beginning of the appointment, I was taken back for my date with the dildo cam, and was told that I still have a 1 cm cyst on my left ovary. This stubborn cyst has been there for my last three appointments, so since at least December/January. Neither the ultrasound tech, or Dr. B was too worried about it. The good news is that I had a corpus luteum which means that I for sure ovulated this cycle! I wasn't told which side it was on, but nonetheless I'm happy.

After a small sit in the waiting room, I was taken back to talk to Dr. B. His nurse came, took my weight, blood pressure, and my cycle charts that I had printed out. A quick flip through a magazine brought Dr B into the room. He first commented on the fact that he was happy that I had ovulated during my last two cycles which is a huge step forward. He nicely told me that I had a 5 pound increase in my weight and that I need to make sure that I'm sticking to my low carb diet (the bane of my existence,) and to work out at least 30 minutes each day. He then got serious.

He said that he wanted to talk about our next steps. He doesn't want to put me on an ovulation enhancing drug like Clomid because the Metformin is allowing my body to ovulate on its own. He then said that they typically don't do a full infertility work up until a couple has been trying for a year, however, we are a "special case" (I'm assuming because of my PCOS.) He asked if we were interested in doing the work up and said that it doesn't have to be done right now if we don't want to. I told him that I'd rather get it done sooner than later because I don't see the point of trying for another year if male factor infertility or blocked tubes would hinder us conceiving. Dr. B agreed and said that he was going to send Keegan for a semen analysis.

I was totally taken aback by this suggestion. I was expecting to do some more tests on me and have Keegan looked at down the road. The only "problem" with the semen analysis is that the hospital at which I see Dr. B (which is in our town,) doesn't do them. We (well Keegan,) either have to go to Dr. B's sister hospital in Amory, MS which is about 45 minutes away, or another hospital in Starkville, MS which is also a 45 minute drive. If we lived closer to Amory, the lab would allow Keegan to give his sample at home and then drive it to them as long as we could get there within 30 minutes. The lab in Starkville only allows samples to be given in the hospital. Since Keegan works about 20 minutes from Starkville, I figured that would be the easiest for him to get there either after work or at his lunch break, so that's where I had the request written for.

Since we hadn't previously discussed the idea of this, Keegan was quite shocked when I told him. I stressed to him that we don't have to do this right now, it would just give us piece of mind that there wasn't an additional problem hindering us. Throughout the day, we've been talking about it on Google chat and from what I can tell, he is most freaked out about the idea that people are going to be touching his man parts. I told him (while laughing to myself,) that all he has to do is ejaculate into a sterile cup and give it to the lab tech so that they can make sure his swimmers are nice and healthy. Sometimes I forget that he hasn't done all of the research or read all of the blogs that I have, so I can see how he automatically went to the "turn your head a cough" scenario.

It would be awesome if you ladies could leave some stories of how your partner's semen analysis went. I think that with time, Keegan will warm up to the idea (well as much as someone can,) and will see the value of the information we can gain from the process, but a few "it wasn't that bad," stories can't hurt.

As for me, Dr. B told me to call his nurse whenever I start my period so that he can schedule when I'll be coming back. I'm not sure if my next appointment will just be another follow up, or if he's going to run a few tests. I know that I'll have blood work done before the appointment so that we can check my insulin levels as well as my cholesterol because they was abnormally high the last two times. Basically, I just have to keep trucking along, doing what I've been doing until told otherwise. For the first time ever, my Metformin dosage wasn't increased so I'm still taking 2000 mg/day.

To end the appointment, Dr. B said that if I don't start my period by Wednesday, take another pregnancy test and call with the positive results. I looked at him and laughed. If the 5 tests I've taken so far haven't come up positive, I'm not expecting anything different on Wednesday.

So ladies, if you would be so kind to leave any stories or advice about a semen analysis, that would be great. I'm still not sure if we're going to go through with it, but it would be nice to know what we're potentially getting ourselves into.

I hope you ladies are having a less rainy day than we are!

*Edit:* Question regarding the pregnancy comment: If I was pregnant, wouldn't the ultrasound have shown that? I mean, I know that the tech went straight to the ovaries, but wouldn't it have been obvious? Or, is 13dpo too soon for there to be anything "substantial?" I'm leaning towards the idea that there's nothing there this early, but I just wanted to pick the brains of you helpful ladies! 


  1. It's raining here too! Boo! as for the S/A, Scott was a little nervous the first time. I went with him and sat in the waiting room. He says its awkward but that's about it! the last time he had to give his sample for our IUI he was in and out in 8 minutes! I think he thinks he is a pro now! :) Plus a little talk about how us woman have to be prodded with a dildo cam more than we would like and the fact that we get no pleasure out of it, seemed to help make him understand that his part really isn't all that bad!!!

  2. My hubby does his thing at home and brings it in. He has done in 3 times now. One for a SA and twice for IUI. He did say that I need to buy him a magazine or something because its hard to do it starting at a wall! LOL. His SA was normal in 2011 and at both IUIs the nurse was very please with his sample. I think it is great the Metformin is working for you! To answer your question about my met-- I have been on 1500mg for a year now and normally I do really well, so I am thinking I ate something bad. I feel better today!

  3. i wondered the same about the u/s showing anything now too as i was reading along! i remember my first u/s was at 5w5d or so and they told me there was a huge chance that we wouldnt be able to see anything just yet. however, we did!
    isaiah took a SA. it was one of the first things we did when we met with our fertility specialist dr. he was able to work up his sample at home and drive it in to the clinic where he just dropped it off on his way to work in the morning. they gave him a special bag and strict instructions for it, i was super nervous! i dont know if he was nervous about any of it. if he was, he never let it show. he took it like a champ and was like yep this is my job. and all things came back more than great for him.
    i am so glad your horse pills werent increased - and that you ovulated all on your own! that is so awesome! i am totally pushing for you and i just KNOW that you wont have to go through 22 cycles like i did! happy thoughts mama. whatever you and keegan decide to do, it will work out for you and be the best choice! (you both have fantastic names by the way, jealous!)