Tuesday, November 22, 2005

The short list of things to rule out

Still working on taking my break. Aside from marking down my period on my charting program and taking my first temp of the cycle (just to make sure it dropped appropriately) I haven't been charting or temping this cycle. Feels a little liberating.

I was talking to my partner the other day, and I told him that I feel as though there is something fundamentally wrong with our fertility -- though I don't know what it is. I see gals with fibroids getting pregnant on enough boards to know that fibroids alone aren't necessarily the only thing that causes infertility, though I know enough post myo gals to know that lots of them are having similar experiences to mine as well.

I've probably done this before but here's my list of things that might be possibly impacting our fertility without going out on too much of a tangent.

Anemia - low ferritin
Low Progesterone
SCSA - sperm DNA fragmentation
Repeat semen analysis (#8?)

I don't want to go in for a consult right now as that would make me cry and I'm trying to not put myself in situations like that right now. I called over to my favorite assistant at the RE's office and asked her to see about my getting my ferritin rechecked (since all evidence I've found online indicates that a level less than 40 can impair fertility) and a pooled progesterone test.

I can get the ferritin done at a lab, totally innocuous and generic place that I've been to before -- I think that will be less emotionally loaded for me. As it turns out the lab is way faster than the hospital lab was the last time I had it checked. I've heard that you can get your blood work done whereever -- and particularly for standard tests, as many hospitals and clinics are sending their lab work out of state because it's better for them, you as the patient might want to intervene and make sure that those cost-savings are yours or at least you are getting the benefit of the quick local turn-around. My ferritin test in July took about 3 weeks to get back. This lab can get it within a day or so -- they run the ferritin tests daily.

Then the pooled progesterone test, the assistant told me that my RE said that she didn't think that a pooled progesterone test was indicated by our infertility but that if I wanted to do it she would order it. I explained to the assistant that I had seen other REs, specifically as my first RE left the state, and that one RE in particular thought that I would need progesterone support on any cycle I was to conceive and that all of my progesterone tests had been on the low side. She said that was why working with more than one RE was difficult as they would of course have differing opinions. Still, I was welcome to do it if I felt like it would be helpful to me -- and evidently the other RE working in the same practice as my RE does do them frequently. I told the assistant that I would probably wait until the new year but at least I've gotten that sorted out.

So, I've got an RE not on the up and up with progesterone -- or rather definately not in the progesterone camp. Is that enough to consider working with someone else? Or should I just stick with her and just demand the care that would make me feel more secure -- particularly if I get pregnant again -- such as weekly progesterone draws until I'm out of the danger zone? Why does it have to be this difficult?

Then for all my spinning of wheels, it might not be me, it could still be the poor sperm morphology that's challenging things. Ugh, but with all that blood loss last June from the last miscarriage and how awful I felt subsequently, plus a couple of cycles that don't make sense (did something happen but not take hold?) I should at least rule out the impact my anemia might be having.

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