A Diagnosis

I’ve reviewed the moments leading up to my diagnosis over and over again in my mind over the last several months, as though by reviewing them I might change the outcome.  Did I suspect I was going to have problems conceiving when I started?  I think the answer, honestly, is “no”.  The first thing I did when I chucked the birth control in eager anticipation of trying to conceive was buy a couple of pairs of maternity scrubs for work, and Arthur and I worked on sorting our den and even went to IKEA to buy some bookcases that would fit better if we had to put a crib in the room.  I don’t think we would have done that if I’d genuinely thought we were going to end up here. 

By the time my cycles had been all screwed up for four out of five months of trying to conceive was when the infertility specter started to haunt my mind.  I pushed it out as forcefully as I could.  Until one day, I couldn’t stand it anymore. 

To this day, I’m still not entirely certain what pushed me to phone my OB/GYN office on the fateful September day when I got my period.  Again.  We’d been trying for about five months at that point, and while I’ve written about some of the issues I’d encountered here on the blog, I was also very cognizant of the fact that I felt incredibly silly.  It could, I had read, take up to a year for even healthy couples to conceive.  Here I was, five months into the process, already essentially begging for some sort of test and worrying intensely.

I’d finished that month of low dose birth control with the odd pregnancy test blip in the middle, and finally, all the bleeding that had plagued me for literally months after getting off the initial birth control stopped.  I pulled my good underwear out of storage and rejoiced.  I started using ovulation predictor kits.  It seemed like things were back to normal.  Cycle days 1-17 flew by.  I waited, checked the sticks constantly, tried to decipher if that line was maybe just a little darker than the day before, and sat in general anticipation of a positive LH surge. 

Then day 18 came, and still no surge.  I kept testing because I couldn’t think of anything else to do.  Maybe my body was just adjusting again.  Maybe I was having an anovulatory cycle.  But finally, on day 22, lo and behold, the OPK was positive.  I ran to the store and bought a different brand of OPK, sat for four hours, saved up and used both brands.  Both were unambiguously positive.  I was overjoyed.  It had just happened late.  It was okay.  This worry about all the odd bleeding, the random and messed up cycles, it was all for nothing.  I breathed a sigh of relief.

Arthur and I were leaving to attend a family wedding that weekend, but we’d done our thing, and both of us were in a generally jovial frame of mind.  I prayed pretty much constantly through the long car ride “please let me be pregnant, please let this be it, I know everything happened at the right time, please let this be it.”  We had a good time socializing with everyone, and headed home.

We stopped on the way back for a quick break, and I ran into the bathroom and stopped short as I looked down.  I was bleeding.  Very lightly, very little, but bleeding nonetheless.  This was only five days after the positive OPK.  I prayed in silence it was that implantation bleeding I’d read about, just a tiny bit of spotting, but deep down, I knew.  Over the next few days, the bleeding got heavier and finally there was absolutely no denying that it was a period. 

I knew that there were supposed to be at least ten days after ovulation before menstruation, and that a normal luteal phase was around fourteen days long.  Something was clearly not right.  I was demoralized.  The impulses warred.  Call the doctor’s office?  See if this next cycle was more on target?  What should I do? 

I opted to make the phone call to the doctor’s office.  Given all the abnormalities of the previous months and now this, I reminded myself Dr. A had told me to give the office a call if things weren’t better after the appointment in July.  When the nurse called me back, she listened, and said the words that would change my life: “You need to come in.  I’ll help get you an appointment with one of the partners who works with fertility problems specifically.  I’m not saying that’s what’s going on, but given all that you’re describing, I think you need some further tests.”  I hemmed and hawed.  I’d only been trying five months.  Maybe I was being impatient.  “No,” she replied, “You and Dr. A tried an appropriate treatment and it didn’t clear up the problem.  What you’re describing needs to be evaluated further now.”  To this day, I am so grateful for that nurse for taking me seriously. 

So I went for a first appointment with Dr. B, the resident infertility point physician, who was very kind and helpful (just as Dr. A was, I consider myself very fortunate to have some wonderful physicians) and started to order some preliminary tests.  I had blood work to see if I’d ovulated.  I had some tests for androgens and cholesterol and blood glucose.  I had FSH and LH levels taken.  I had a transvaginal ultrasound. 

Finally, when all the test results were in, I went back to Dr. B to review them.  The blood work revealed that I had definitely not ovulated that month and some of the other tests were normal or slightly borderline.  It was the ultrasound report, though, that was the kicker.  My ovaries were enlarged, and they were polycystic.  With the messy cycles, irregular bleeding, the absent ovulation, the other tests and the polycystic ovaries, Dr. B said she suspected polycystic ovarian syndrome due to the overall clinical picture. 


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