Tuesday, August 28, 2007

If at first you don't succeed...

The tests are back. So, yesterday at 4pm
hCG was negative

Which, as far as I can tell means one of two wildly divergent things. Best case: second ovulation, and the egg is not even doomed yet. Worst case: revenge of the PCOS, with no ovulation this cycle at all. Which pretty much would mean that after years of working hard to minimize the number of doctors I have to have close, personal relationships with, or deal with at all, I would finally be forced to find an RE.

Way back when my PCOS was diagnosed, I had numbers you could put in a textbook-- insulin resistance, elevated testosterone and estrogen, and LH that stuttered into the half-on position and got stuck there, no ovulation, no passing go, no collecting $200. Nearly a year of dedicated low-carbing, vitamin and such taking, exercising, etc. later I finally started to ovulate, and my LH was doing what it is supposed to do-- start low, rise, fall, trigger ovulation, rinse, repeat.

With my jumpy thyroid (which mean jumpy body temps), charting would be much like Lady Macbeth getting up every morning and forgoing her morning cup of tea in favor of intentionally smearing blood all over her hands. Or nothing short of a recipe for driving myself mad, and fast. So I usually go by the symptoms. The symptoms that I learned to recognize by correlating them with results of blood tests, and thus, predicting LH behavior, not ovulation per se. So if I got stuck in this freakazoid position again, I don't really know what to do except find an RE. Which stresses me out because 1) I've had loads of bad luck finding doctors who I like, mostly, I admit, because 2) I refuse to not worry my pretty litte head about things; not to mention that 3) in my experience, wait times for good specialists around here what's the word?.. oh, yes-- suck, they suck, in that they tend to approach the length of the elephant gestation period.

Looking at this handy graphic and this most informative chart, I am worried that the relatively low progesterone number supports the raging PCOS hypothesis, rather than second ovulation hypothesis. On the other hand I am having weird sharpish pain in my left side, and I am trying to talk myself into believing it to be ovulation pain. And this, sad as it is, is what is keeping me relatively sane for now.

In the end, the plan from this point on is pretty simple: take another set of blood tests next Tuesday to see both what LH is doing and whether progesterone becomes elevated, which would indicate that ovulation took place. If it does, we wait to pee on yet another stick. If it doesn't, we drink more pink grapefruit margaritas (those are seriously good, yo) and look for an RE.


meg said...

Well, glad it's not ectopic, first of all.

You might be able to find a RE that you really like, maybe you could get someone to recommend one? The new guy we have is really great (what a huge difference from the last clinic). My naturopath recommended him and he is into the natural stuff too. Maybe check the message boards in your area--that's what I did too--people are truthful about the clinic they visit. And if your situation is explained to them, they might not make you wait as long (that's what happened to us, they took one look at our history and moved us way up on the list).

I hope the PCOS hasn't resurfaced. Is there anything besides vitamins and diet that can be done? (I admit, I don't know much about it)

niobe said...

I'm going to try and read up some more about PCOS, because, like Meg, I don't know much (and by that I mean anything) about it. But the whole thing sounds remarkably unpleasant and, as you say, crazy-making.

Beruriah said...

Not nice news. I'm sorry.

Hopefully the best case scenario will be true, or at worst something better than the worst. I can't believe the wait times for RE's - I so hope you don't have to go that route. There's no way to speed it up??

What more can I add to Niobe's sentiment?

Bon said...

oy. i'm sorry the news was both baffling and not particularly positive...particularly after all the work you've done.

i was diagnosed with PCOS almost seven years ago and went through the same process before we ever embarked on getting pregnant at all...it was such a strange, rough diagnosis because i felt like it was impossible to get a straight answer and an action plan. i never saw an RE because i was in Korea most of that period, but much as it may feel depressing to have to go that route...if they can help, let them help.

and in the meantime...let's hope for ovulation twinges, rather than PCOS ovarian twinges, and go, erm, have relations, woman!

Lori said...

Well I am amazed and impressed you were able to control your PCOS with diet, and to actually achieve natural ovulation. I was never able to do that, and my RE told me that with my "complicated ovaries" it wasn't likely. And, 14 years ago, when I was first starting to try to become pregnant, PCOS was relatively new and uncharted territory. Nobody even talked about things like insulin resistance, etc... It was sort of a foregone conclusion that you would need to see an RE. Thankfully, I found (after one disastrous fertility doc), the world's greatest RE. I wish you lived where I do, because then I would be able to tell you right where to go!

thrice said...

ivfconnections.com has great RE info. You need to register, but it is free.


Julia said...

Thanks, guys. I know that if I need an RE, I should get an RE, and I will be better of getting one. I was just having a little tantrum.

Lori, thanks, and I was actually pretty proud of myself for accomplishing this. Previously, I could actually hold any weight I was at with strict low carb diet, but needed medication to loose weight. I am gaining now, despite being on medication. Which also supports the revenge of PCOS hypothesis. :( So I am rather unhappy about all this. Trying to keep busy enough to make it to Tuesday without driving self mad. I had a day with not a second to breathe today, so I guess I am doing well so far.