Into the Great Unknown

Unknown=Unexplained Infertility... BLAH!!! I had a pretty good idea we were headed this direction, and my doctor spent the better part of our consultation today trying to convince me that it's not as bad as it seems. But, Oh! I've been dreading this diagnosis! I don't want unexplained anything (well maybe pregnancy)!

So here is where we've been and how we got here. Keep in mind that I was never actually "diagnosed" before. It's always been the doctor "thinking" or "feeling".

Diagnosis #1: LPD- Luteal Phase Defect So the thought here, way back when, was that my cycles were not only irregular, but that the second half of my cycle (post ovulation) was super wonky. I'd get a 7 day luteal phase, then a 10 day, then a 12 day. Short, fine, beautiful... basically unpredictable. This has been thrown out. What looked bad when I first started charting, now seems like more of an anomaly. My average is 13 days = PERFECT. So NO.

Diagnosis #2: Anovulation I never really believed this one, but dear old fertility friend kept giving me charts that looked like this:

It seems like there was a shift, low's in the beginning, high's at the end, but where was it? I had three cycles in a row like this. Therefore, anovulation got tossed out there by my OBGYN in Augusta. However, my argument was that I got positive OPK's every month. My RE here says she's confident I'm ovulating almost every month. Scratch.

Diagnosis #3: PCOS-Polycystic Ovary Syndrome So, I honestly think that just about everyone gets tossed into the PCOS crowd at some point. Doctors seem to really like this diagnosis. It's mostly fixable, so why not? If you read 20 different accounts of infertility, it seems you'll find about 15 have PCOS. But there's no great, straight forward, black and white, yes or no test. So we tested lots of things. They want your LH to be more than your FSH for a diagnosis. Mine was normal. LH 4.6, FSH 8.1. They tested my AMH. Mine was slightly high... barely in the PCOS category, but my doctor said if can also be a sign of a young woman (that's me) with a great ovarian reserve (see, I'm supposed to have LOTS of babies). And lastly that counted my follicles. PCOS patients normally have lots of follicles. Both cycles I've had 16 total. No dice. 

So here we are. We've tested EVERYTHING. We've looked at EVERYTHING. The only thing we haven't done is a laparoscopy to check for endometriosis. My doctor thinks it's an unnecessary risk as her treatment plan wouldn't change unless I was level 4 (the worst) and she has seen no reason to believe I have it. So I'm just plain ol' unknown.

What does this mean? They don't have a clue what's wrong. The basics of getting pregnant all seem to be working fine... So it's some itty, bitty, hard to identify, quantify, qualify thing that's just not quite working in sync with everything else. How do you fix the unknown? "With time proven strategies." That's comforting. 

So we move forward. Round 2. We are changing one thing up this cycle. We are going to go with Femara instead of Clomid. The one and only thing that has been negative for us has been my uterine lining. So the doctor is hoping that it was an effect of Clomid and that Femara will fix it. Here goes!