Stephanie & John's Next Steps

My first hormone panel back in April went from several days before peak to several days after peak. Btw, peak = ovulation, just so we're all clear :) We found that my periovulatory (aka pre peak) estradiol (aka estrogen) was rather low. However, after peak, my estradiol and progesterone were within the normal range. Since low periovulatory estradiol can cause problems with ovulation, my doc recommended an ultrasound series to see if I was actually ovulating. After about 2 weeks of ultrasounds, it was confirmed that it does at least look like I'm ovulating. Hooray! Go ovaries!

Fast forward to early July. My doctor wanted me to repeat just the pre peak hormone panel, to see if the low estradiol was perhaps a one time thing. He called me yesterday to discuss the results. And the results were the same as last time. My periovulatory estradiol is still rather low. And that's still a bit odd, knowing now that I at least look like I'm ovulating (based on the ultrasound series).

So what does that mean? Where do we go from here?

I give you Stephanie & John's next steps:

1.) Doxycycline.

I mentioned before that I had endometritis, an infection of the uterine lining. My doc discovered this a few months ago when he did a biopsy of the lining. It's something that could interfere with fertility, so we wanted to clear it up right away. He put me on 2 weeks of an antibiotic (doxycycline) for treatment and within days I noticed changes in my cycle - my cramps were far less painful and there was no more brown bleeding at the tail end of my period. I was pretty pumped to see that! Though, within a month, the symptoms started to return. Bummer. I started to wonder if maybe John and I were passing the infection back and forth to each other. John has a few possible symptoms of infection too. I mentioned this to the doctor yesterday and he agreed it would be best for both of us to do a(nother) dose of the doxycycline to clear things up for (hopefully) good.

2.) Laparoscopy.

Ahhhhhh! Surgery!

Though I'm mildly (okay, moderately) freaked about this, I know it's for the best. I went ahead and told the doctor that we're ready for it. I'm ready for it. We're talking about possibly the end of September. Please, please pray for me!

During the surgery, he'll go in to my abdominal cavity with teeny tiny incisions and look around with a scope for signs of endometriosis (when the lining of the uterus grows in the wrong places). If it's found, he'll remove it (assisted by a robot - everybody do the robot dance for a second, k thanks) unless it's a severe case. In severe cases, another, more invasive surgery needs to be scheduled to remove the endo. However, he says it's rare that endometriosis is that severe. And if endometriosis is not found, at least we'll know that it's not part of the issue. The surgery has a 1 - 2 week recovery and should give us a better idea of what's causing our hormone and infertility problems.

While I'm under, they'll also perform a selective HSG, where they shoot dye into my fallopian tubes to see if they're blocked, and another biopsy to check for infection. Just more steps to help us figure out our infertility.

3.) Clomid.

After this current cycle with antibiotics (we can't TTC while taking doxycycline) and my next cycle with surgery (no TTC right after surgery I'm guessing), we'll start trying Clomid to help raise my estradiol levels during the pre-peak phase of my cycles. Clomid is typically used for patients that aren't ovulating - Clomid tells the body that it's not producing any estradiol (even though it is), thus helping your body naturally produce more of its own estradiol - but it can also be used for patients with lower-than-normal estradiol who are ovulating. I'll be on a low dose (25 mg on cycle days 3, 4, and 5) which will hopefully be just enough to put my estradiol in the normal range. I hear it can also cause increased emotional changes (AKA angerrrrr and sassiness and moodiness and grrrrrrrrr at the world), so I'll be extra careful to notice these changes and hopefully not take it out on anyone.

Acupuncture and diet modification (avoiding wheat/gluten) can also possibly help improve hormone levels, though we've decided to start with Clomid first.

4.) Home study.

Though all of our steps are designed to help us achieve pregnancy (and also to heal my less-than-perfect body), we know that doesn't necessarily guarantee pregnancy. Call us impatient, call us crazy, call us what you will... we're ready to be parents and we're ready to open all avenues that can get us there.

As all of you who know a bit about adoption are aware, adoption doesn't happen over night. Sometimes it can be a year or two of waiting, even after the home study is complete. Instead of trying for pregnancy for the next few years only to find ourselves still childless and then having to wait another year or two for adoption, we're going to work on both at the same time - achieving a pregnancy and opening our hearts to adoption. Honestly, even if we get pregnant tomorrow and end up naturally having a bunch of precious babies, we'd still be open to adoption. The more I read about it, the more I'm drawn to this beautiful, love-filled opportunity. As is my lovely husband.

For all yous guys out there who don't know anything about adoption - a home study is the first big step in making adoption happen. After the appropriate paperwork is filled out an sent in, an adoption agency sends a social worker to your home to look around and make sure conditions are safe and sound for baby. They will also conduct an interview with us to make sure we're in a good place to be parents (emotionally, physically, financially, etc.). After our home study is hopefully approved (which could take up to 6 months), we'll be ready and waiting to adopt. And the thought of that makes me very happy.

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So there you have it, folks! This will likely be the plan for about the next 6 or so months. After surgery, Clomid is a 3 to 6 month thing, so if we're still not pregnant, we'll still have a handful of options - we can try things like the acupuncture or the diet modification or switching to Femara (an alternative to Clomid). We'll also (so long as all of our ducks are in a row) probably be approved to adopt by that point in time, so there will be plenty to look forward to.

Infertility can leave you quite hopeless at times, but as of right now, I'm quite alright with this plan :) Thank you, to God, to our awesome NaPro doctor, and to all our wonderful supporters out there, for getting us to this point. We are so blessed.

And now, I leave you with a teaser from John's surprise super hero themed 30th birthday party which took place this past Sunday. Expect a post with details and pictures soon...

Yes, he's wearing a cape.