Yesterday was my first appointment with an advanced reproductive specialist. He was an elderly middle eastern gentleman with 30 years of experience and a kindly face and demeanor. At the very start of the meeting, he asked me if I had any questions. I replied by saying that I wanted to know why I was spotting brown gunk before my period and why havent I been able to stay pregnant these past 2 years?
In his gentle accent he responded, "The spotting is one of two things. It is either caused by low progesterone or it is cause by an early ectopic pregnancy that my body is ridding itself of."
We both hope it is a progesterone issue, which is easily treated with medication. However, it could likely be the other because I have had a tubal ligation in 1999 then reversal in 2011. A HSG was done at that time and my tubes were clear but who knows what could happen in 2 years. He went on to explain the plan of action and I was excited by all he was saying because I was so afraid he wasnt going to put forth much of an effort in my case.
Here is the plan:
1. Go buy some Clear Blue ovulation tests. I told him that I was using a brand I found online and he asked me to try the CB ones because he has found they are more accurate. I completed this step last night. I splurged and bought the digital ones with the smiley faces just because I didnt want to deal with the "is this darker, well it kinda looks darker, should i hold it up to the light or photoshop it" scenarios.
2. Use the CB tests once a day from 12-4 pm (do not use morning urine even though the directions say to- per the nurse) She doesnt want the LH to build up overnight.
3. If I get a positive that day, do two things. One- call their office to schedule a post coital exam the next day and Two- BD with the hubby that night. I asked how this worked, "why would they want to see all the lazy sperm left who didnt get up and go where they were supposed to," the nurse told me that they check this to make sure they dont find dead sperm. If they do, then DH will need to have a full sperm analysis and they will address the issue further to make sure there is nothing wrong with my CM.
4. BD for 4 days or nights in a row (once per day) when I get a positive OPK.
5. Instead of waiting to find out if the progesterone is low, he is going to treat me as though he knows it is low due to my spotting issue that has been going on for over a year now. Sometimes I see brown discharge and tissue anywhere from 3-7 days before my period actually begins. He is going to use 100 mg Prometrium Capsules starting 4 days after the positive OPK.
6. 7 days after the positive OPK, go into the lab for bloodwork to test my progesterone level. While I am at the lab. I am also to get other tests done. (prolactin, thyroid, prenatal ABO/RH/ASBC, Rubella, and HCG)
7. If my period does begin after all that, then on CD3 I am to go in for more bloodwork and then schedule a HSG to see if my tubes are open.
Im so excited to have a plan instead of just the monotony of BD, test, fail ...month after month. I really like this doctor, but there is something about his staff. The ladies in the front office just seemed to have a negative vibe or something. One of the things I am not looking forward to is having to pay for all this. Well hubby will, as I am not working and am staying at home with the 2 homeschooled teens, TTC, and housework. Fun Fun !