Doctor's Appointment

So, I had my first appointment with Dr. York yesterday. She will be my OB-GYN now, helping us in our upcoming steps towards conceiving, and even delivering our baby once we actually get pregnant.

Jesse and I went in at 2:15 to the Women’s Care clinic. It didn’t occur to me before how many pregnant women would be there. In my head, I was thinking that it would be a quiet office, and that most people would be there either for infertility or just general exams. I was wrong! It was a busy office with about 20 people waiting in the small waiting room. And I’d say that half, if not more, were pretty pregnant. It made sense when I realized that it IS an OB-GYN’s office too, but I guess the fact that it is also an infertility specialist’s office threw me off. As I waited, I couldn’t help but hope that in the upcoming months I would become one of those pregnant women waiting in the room. Only time will tell what God has in store, though.

When they called me back, Jesse and I went back to the typical doctor’s room. I had already been weighed and had my height measured. I found out that I am 5’1 ½”. I SHRUNK!!! A whole ½ an inch!!! I can’t afford to lose inches! Anyways, I didn’t have time to be shocked because I was then asked a series of questions by the nurse concerning our medical histories and sexual history. She told me that I would probably be examined by Dr. York and may even have a PAP smear, but to not undress yet. She then had me wait for Dr. York to come in so that she could ask me more questions. I wasn’t really expecting to be examined. I thought I was just coming in for a consultation. But I figured that at least an exam would get some things out of the way rather than having to schedule another appointment to come back and do it later. When Dr. York came in, I found that she was a petite and pretty lady with a soft voice. First, she asked me a series of questions just as the nurse had done. She just went a little deeper into the questioning and asked Jesse some things as well. She also looked at all of my charts that I had brought in and asked questions about my cycles. She overall seemed easy to talk to, but she didn’t go into a lot of detail about things, and also didn’t seem to take some it very seriously. What I mean by that is she kept making comments like, “You haven’t really been married all that long. You’re still really young. You’ve got lots of good eggs left to still get pregnant. Only 80% of couples conceive within a year.” To me, it doesn’t matter how long we’ve been married. We made the decision to have kids because that’s what we felt was best for us. I don’t feel very young. I have the personal goal of wanting to start my family (at least being pregnant) by the time I’m 25. I only have 13 months to able to meet that goal. And, BECAUSE I am young, then that’s why it concerns me even more that it hasn’t happened yet. In addition, I may have many more eggs to conceive, but I don’t know yet how good they are. That’s part of the reason for beginning testing. And, finally, I don’t look at it as only 80% conceive within a year. 80% is a lot! And I’m in that bottom 20%. In addition, I mentioned to her that I’ve read that 93% of couples our age conceive within a year. She simply responded, “That sounds a bit high.” However, I even looked it up again. And these are the results I found:

According to this website, 94% of couples in their early 20’s conceive in 1 year. This website said, “At age 20, a couple has a 93% chance of getting pregnant without any trouble within a 12-month period.” And this site said, “The percentage failing to conceive within a year ranged from eight percent for 19 to 26-year-olds. And, I think it’s important to note that I didn’t seek out the answer I was looking for. I didn’t input any specific percentage. I was simply looking for the percentage of couples in their early 20’s that conceive within a year. These are the only results I found. So I also didn’t neglect to mention any contradictory sources. But these all say relatively the same thing.

So, my point is that I’ve done my research, and every single person I’ve ever known to experience infertility would agree that it is totally normal and within reason to seek fertility counseling after a year without conception. I think that Dr. York was trying to come across as optimistic, but it made me feel more that my concerns were not regarded as valid. Having said that, though, she didn’t, in any way, discourage us from going onto the next steps. She said there was no reason to wait any longer and that we could pursue further steps to try to progress our process.

After that, she asked me to strip down and put on the thinnest, papery outfit. You can’t even really call it an outfit. It was more of a thin, paper jacket that didn’t close and then a sheet of paper to cover my bottom half with! I figure I’ll have to get used to this lack of modesty, though, whether it’s because of the constant fertility tests and treatments or because of an upcoming pregnancy. I can expect these types of visits regularly for the next 6-12 months, at least.

During this un-dressing, Dr. York left the room for an unusually long amount of time. I’ve had to wait before, and it always seems long, but I think coupled with the nakedness and the impending (unexpected) exam, it seemed like an eternity. I was left to stare at the magnets strategically placed on the ceiling above me, while Jesse kept messing with me, tickling my feet or singing to me with the exam light as a microphone. He hadn’t really been expecting to partake in an exam like this either, so I think he was trying to find ways to occupy himself.

When Dr. York finally came in, she had her nurse come in to assist her as well. As far as exams go, it was really quick and relatively painless. She did the PAP smear and a breast exam at the same time. Jesse told me later, though, that he saw the speculum that they use for the exam and felt sorry for me. I agreed.

After that, she told me that everything looked really normal. She did mention the possibility of starting me on Clomid. I was a little confused about this since everyone I know only takes Clomid when they aren’t ovulating (and it’s clear that I do ovulate on my own), but she said that Clomid would help me to have stronger ovulation. I’m not sure in what way right now or how it would affect me. I did some research on it this morning and found many people who say that it doesn’t really help if you are already ovulating unless you are doing artificial forms of insemination with it. Maybe getting started on it soon will make me ready for that if we need to in the future, though. I’ve also heard that it does have some side effects which actually make conception harder, but if you aren’t ovulating, you can’t conceive at all, which is why it’s normally worth it. I’d rather not take it since I know I’m ovulating, but if we discuss it further and find that it’s worth it, then I’d be willing to do what it takes. After getting dressed, she told me that I could head to the lab to have a few blood tests done.

At this point, I didn’t even know what they were testing, but the technician said it was for my thyroid and prolactin levels. To explain, I found out that prolactin is the chemical secreted by your pituitary gland. It’s responsible for triggering many bodily processes, specifically to stimulate milk production in pregnant women to prepare for breastfeeding. And, this release of prolactin is actually triggered by a thyroid hormone. Serotonin also triggers prolactin, whereas dopamine blocks it. Prolactin also affects your ovulation and menstrual cycles, which is why it’s nearly impossible to get pregnant when you are breastfeeding. Prolactin inhibits your follicle stimulating hormone (FSH) and gonadotropin releasing hormone (GnRH). Both of these hormones are responsible for helping your eggs to develop and mature in the ovaries. Excessive prolactin can prevent ovulation causing infertility. So, these simple blood tests rule out any of these hormonal problems.

She also set Jesse up with a sperm analysis kit to take home. . There are very specific rules, though, which may mean that we’ll come back into the clinic and just do the test there. Jesse has to bring it in between 7:30-8am this Saturday morning, and it has to be less than 30 minutes old. It might just be too difficult to drive it from Thurston to Eugene that quickly. So, we may just come in early that morning.

And, finally, I was scheduled to come in for an ultrasound to look at the shape of my uterus and ovaries in about 10 days. This ultrasound would also show if I had a mature follicle from ovulation or not. So, now I just wait (not for very long, though). I should have the results of my blood tests in a few days, will submit the semen analysis test Saturday, and have my ultrasound next Thursday. When the results of all of these things come back, then we can determine where to go next.

In my research, though, I have found that about half of those who do not conceive within a year, DO conceive in the next year. One of the sites I mentioned earlier with the statistics also said, “Only three percent of 19 to 26-year-olds failed to conceive in the second year, provided the male partner was aged under 40.” So, it went from 8% who don’t conceive in the first year, to 3% who don’t conceive in the 2nd year. That makes 63% who conceive in the 2nd year (out of those who didn’t conceive before). Also, I found that many people who go through assisted reproductive therapies during their 2nd year of infertility, would’ve conceived naturally on their own without the assistance. In fact, according to one study, the percent of successful pregnancies is higher in those who don’t undergo artificial means of insemination than those who do. Plus, there are many health risks to undergoing such procedures.

At this point, I still feel like God brought us here for a reason. And I do believe this is the right timing to begin the testing process. I think it’s important to know whether there is something medically wrong with us. But, I think that after all of the testing, if we discovered that there was no medical diagnosis for our infertility, I would cease all treatment and just continue trying normally, knowing that God must have a reason for making us wait and will create a pregnancy in His timing, and knowing that, statistically, the numbers are on our side to become pregnant within the next year. I would like to say that this above statement of God is still true regardless of the diagnosis. I do believe that God has a reason for allowing us to go through a year of infertility and can create a baby regardless of any medical abnormalities, but I do also believe that God chooses to work through doctors and treatments as well. And He could just as easily be leading us to this point to receive a child through medical assistance. In the end, I feel confident that I will be pregnant in this next year- because of the things I feel God is speaking to me, because of the statistics being on my side now, because of the opportunity to discover now if there is something wrong with me, and because of the ability to be able to address such problems if we discover them along the way.

So, 2 hours after I initially came in, I left with a little less modesty, a band-aid on my arm, and a testing cup & a reminder of my next appointment in my hands. Now, we just wait :-)


My bruised arm from the blood tests


All of the things that go into making a baby, from the semen analysis to the dr's appointments to the insurance papers to the Basal Body Thermometer to the ovulation tests to the pregnancy tests!