Doctors are Confusing

Have you ever left an doctor's appointment (infertility or otherwise) going "huh"? That's how I felt from start to finish today. Today was supposed to be my consultation/pre-op. It turned into utter confusion. When I called several weeks ago, I talked with the nurse about my interest in possibly doing a laparoscopy. We had talked about it over, and over, and over again, with all of the doctors we've seen. Everyone's (wait, doctors agree?) initial consensus was postpone, not to do surgery, I'd get pregnant on my own. My doctor at ACRM eventually came around after the three failed IUI's to thinking an exploratory lap might be a good idea… and then I left. My current doctor at RBA initially said wait as he could not see any evidence of endo. But then my last appointment, after the CA-125 results came back, he felt more optimistic (err, justified?) in doing a lap. We discussed that I was in the gray zone and that there is just no way to know without surgery.

So I went back and forth for months, finally got the nerve to call, but wanted to chat about risks vs rewards before going under the knife. My nurse assured me the best method was to schedule surgery and set up a consultation. She then said if I decide to do the surgery, I can go ahead and have pre-op the same day. Thus today's appointment was born scheduled.

I got there and I swear, after "How are you?" came, "I'm not so sure about a lap". WHAT?!?!?! So we spent the entire consult talking about everything under the sun. I'm coming to the conclusion that unexplained patients should just be scheduled for two appointment blocks… there's too much to talk about when you know NOTHING and need to try EVERYTHING. By the time we discussed my cycles and pain levels and looked back through my charts, he had re-convinced himself that a laparoscopy is a viable option. He doesn't think it's necessary but he does think it would be nice to know one way or another.

And that's exactly where I sit. I'll feel like a fool if I have the surgery and he finds NOTHING. But, if I don't do the surgery, and we move onto IVF and it F-A-I-L-S, I'll always wonder if there was a reason it didn't implant. Doing the surgery will give me zero piece of mind until the surgery is over, but after, I'll know, and for me, I just gotta know.

But after we chatted about our favorite topics of Endo, PCOS, IVF, IUI's Varicocelectomies, and money, we had exceeded our allotted appointment time and I never got to the pre-op part. UGH! Thankfully, my surgery is scheduled at noon, so they let me squeeze it in that morning so I don't have to take any more time off from my new job. The minus is that I feel inadequately prepared going in. I never asked how many surgeries he's done, or what the risks are, or what to expect… nothing. The positive is this: the less I know, the less likely I am to back out. So I'm going to stay clear of blogs like my friend Erika's where she explains the process and the recovery… once back through was enough, I just need to remember she's still alive, and move on.

So what else did we come up with in that exceptionally confusing appointment? I'm so glad you're interested/nosy/concerned because I'm going to tell you:

• I'm going on something called Pregnitude. I had heard another blogger mention it, like, once… I was skeptical then, and I still am. I'll admit I'm not a big supplement girl. Some people love doctors who prescribe "alternative treatments". I like doctor's who prescribe medicine… or better yet, fix it with neither. I'm just not very big on taking pills of any kind beyond vitamins, and even then, I'm embarrassed to tell other TTCers what I take, because compared the their extensive lists, I take the equivalent of a Flintstone vitamin. But whatever, Dr. Slayden feels confident and says he's getting great results since he started using it (I failed to ask if that was last year of last week. Yay for being a guinea pig).
• We're moving ahead with the laparoscopy. Oh, and a hysteroscopy. Oh, and a D&C. I thought he didn't think he'd find anything. Go big or go home, I guess.
• We'll consider doing ovulation induction IMMEDIATELY following the lap. 

He said my greatest chance of getting pregnant without IVF will come from this combination:

Laparoscopy + D&C + Pregnitude + Metformin + Femara/Clomid + IUI

Apparently, endo or no endo, following a D&C, they see about a 10% increase in a woman's chances in the following cycle. So add all of that nonsense together, and well it seems like I should be at 50%, but it's probably more like 20%.

I haven't worked though my feelings on doing another IUI. My gut tells me no. We don't get great post wash counts and its expensive… it would just delay IVF. But the other stuff, I'm okay with. I left today with assurances that I'll be calling to cancel the Lap any day because I'm pregnant… Oh, Dr. Slayden, the eternal optimist.