I wrote a little while ago about Molly and I beginning to pursue the initial steps of trying to conceive again. We had initially decided to use the reproductive services through our health insurance provider, because we had known some folks who got pregnant through them without having to pay out of pocket for all of the expensive medications, procedures, etc. However, during the first cycle after filling out the paperwork last November, Molly (again) had trouble scheduling the hysterosalpingogram (HSG) they were requiring before they would even let us meet with one of their doctors for a consultation. This scheduling trouble immediately brought back the frustrations of scheduling with radiology we had time and time again during the pregnancy with the twins so we decided to contact the fertility clinic we ended up using last go-around. We both really liked our doctor there and were very much looking forward to working with him again; however, upon calling to make the consultation, we learned that our previous reproductive endocrinologist no longer works there, but of course they would be happy to set us up with someone else in their practice.
So about a month ago, we went ahead and made a consultation appointment, because, after all, it couldn’t hurt. We’ve had to wait this long just to schedule the HSG with our health insurance carrier anyway. Upon making the appointment, Molly was given a list of all the blood tests that need to be updated so she’s gotten most of those done already. The actual consultation was today, and I’m really happy we decided to go back to the fertility clinic. It’s a great atmosphere, and the doctors and nurses make you feel like you matter as an individual patient, and not that you are just a number in their system. I really like our new doctor, too. My trans* status didn’t come up directly, but I imagine he knew, because he had obviously reviewed all of Molly’s records from the last time we were there. We talked about the various options, and we were all in agreement that we would try gonadotropins again, because that is what worked for us last time. Due to the PCOS, last time we started with a fairly low, conservative dose of gonadotropins, then actually decreased it a little bit, then ended up increasing it back to the conservative dose during the cycle, based on the follicle development. Our new doctor suggested using the same conservative starting dose, but (in his words, Molly is “a few years older,” haha) instead of decreasing the dose this time, we could just stay on that dose the whole time and see what we get. Last time there were three follicles present that all ovulated…and we ended up with twins. Considering we would ideally like a singleton this time around (though if we end up with another set of twins, we certainly would be elated), the low dose, conservative approach sounds perfect. We’d do the same plan of monitor follicle development with ultrasounds, a shot of Ovidrel to induce ovulation, then two intrauterine inseminations (IUIs) 24 hours apart.
Our new reproductive endocrinologist did a quick ultrasound just to make sure all was good, and there were plenty of small follicles present, indicating good ovarian reserve as well as PCOS, which we already knew about. It turns out that he also suggests getting an HSG as well due to Molly having had a C-section. It’s better to know that the fallopian tubes are open and there are no blockages there, especially because we have such a limited supply (5 vials) of our donor left. There’s a whole separate set of thoughts and feelings on the subject of our limited donor supply so I’ll save that for a later post. The HSG will be scheduled for sometime soon, hopefully in time to start trying sooner rather than later.