Wednesday, February 6, 2013

A test cycle

So, to pick up where we left off.  I did in fact cancel the 2nd RE appointment because I liked the 1st RE so much.  He was very much on booard with the plan.  So the first step for him is to see what one of my cycles looks like.  So, we run all the tests for the a normal cycle and see how it looks. 

The first step is CD 3 (CD=cycle day).  This can actually happen anywhere from cd 2-4 and since 3 wouldve been a Saturday I came in on CD 2.  They do an ultrasound and bloodwork.  The ultrasound showed that my uterus and ovaries look good.  No cysts, no malformations or anything like that.  No surprises.  The bloodwork was as follows: 

Estrogen - 27           This should be 25-75 with lower being better. 
LH - 4.3                  Should be less than 7. 
FSH - 4.8                Under 6 is excellent, 6-9 is good, 9-10 is fair, 10-13 is poor, over 13 is very bad. 
Progesterone - 1.8   Should be less than 1.5.  hhmmmm

Now for anyone who knows what all that means you'll notice that the FSH is excellent.  Really all the numbers are excellent especially for a 37 year old!  But, any FSH under 6 is considered excellent if I was 20 years old.  I was hoping for anything under 10 which would be only OK.  So, I was pleasantly surprised with such a great number.  It's also important to note that my estrogen was low and my LH was similar and slightly lower than my FSH.  All good signs.  The progesterone may have still been falling form the end of my last cycle, so I'm not too worried about that. 

The next step was a HSG on CD 7-10.  I went in on CD 9.  I'm kinda annoyed that the doc wanted this test since it was clear there was nothing wrong with my ability to get pregnant, only stay pregnant.  Anyways, this (as you all know) looks at the shape of the uterus and if the fallopian tubes are open.  Perfect and yes.  Moving right along...

Next is the "CD 14" tests.  CD 14 should be about ovulation day.  Since my cycles are pretty regular cd 14 does, in fact, tend to be ovulation day.  I had not had an LH surge by CD 14 so the office had me come in anyways for an ultrasound and bloodwork.  The ultrasound showed a perfect lining of 10.5 and one dominant follicle measuring 20x21 with fuzzy edges, which means it's about to ovulate or in the process of ovulating.  This is slightly odd since the OPK was negative that morning.  But, I guess the LH just hadn't made it to my urine yet because.... they also did bloodwork:

Estrogen - 258          Should be 200-600 per mature follicle
LH - 27.8                 Over 20 is considered the LH surge
Progesterone - 2.8    The nurse said this shows I ovulated. 

The last bit seems odd to me.  Maybe it's just rising as I ovulate?  But, honestly, this all seemed to happen too fast.  Shouldn't the LH surge first and then ovulation happen 24-48 hours later?  Yes, it should.  So, did this whole testing moment just catch the moment of ovulation?  I think the nurse was a little confused.  I think progesterone was only starting to rise.  Since the follicle hadn't collapsed yet and the surge was still occuring, I think ovulation will actually happen tonight or tomorrow. 

One annoying thing is that I guess they're used to speaking to the lowest common denominator.  I get that, but that's not me.  Today the nurse (different nurse) said as she measuring the endometrium, "That's the uterus - it's the place where the baby's going to be."  Um, yeah.  I think I got that part.  I just laughed and asked the exact measurement of my endometrium.  The I think she understood then she wasn't talking to a rookie. 

So, anyways, the next step is the "cd 21" testing.  It's really 7 dpo, but since my ovulation date is going to be almost "perfect" at cd 14, cd 21 is close enough.  By then they want to see the progesteorne at about a 15.  This is where I may not meet their standards.  My progesteorne tends to be a little low.  But, that's fine.  I really want to be supplemented with progesterone (which I think they'd do no matter what anyways).  There's some evidence that progesteorne helps the body not over react to an implanting embryo, so it's a good thing anyways. 

Well, the most interesting thing about this latest bout of information was that the IVF nurse said that if it all checks out (and it does) the doc could easily start the IVF cycle right away.  Like as in next cycle!!!!!  ARGH!!!  All this was only talk, but now it could actually happen!!!!!

1 comment:

  1. I think (I could be wrong) that a progesterone over 5 shows you ovulated (and they like to see it closer to 10 I think) so you definitely hadn't ovulated at that point. She was just confused.