Monday, April 22, 2013

Bloodwork results & next steps

Well, I got my blood work results and had a follow-up appointment with Dr. C, so here's the latest on the medical side of things.

Blood work

Dr. C said that my numbers were "good." Not necessarily "great," but good. For posterity's sake, and in case anyone is an expert in hormone numbers and wants to shed more light on my results, here are my numbers:

Peak -4: E 180, P .41

Peak -1: E 242.9, P 1.0

Peak +1: E 62.1, P 3.6

Peak +3: E 104.2, P 12.4

Peak +6: E 111.3, P 15.6

Peak +7: E 139.1, P 15.2

Peak +9: E 192.5, P 14.6

This cycle, I had less CM than usual. So I think it's reasonable to assume that my numbers might be a little better for a more "normal" month, when there's more CM.

I had irregular bleeding on peak -3 and peak -1. Dr. C said the numbers don't really help explain that. She did say that the estrogen decrease from peak -1 to peak +1 was more drastic than normal. Usually it cuts in half, I guess, and my estrogen went from 242.9 to 62.1, although that was over 3 days, so maybe the day in between had a normal reading?

Either way, the numbers don't give a strong indication of why I have mid-cycle bleeding, so that's disappointing.

Next steps

Dr. C had two suggestions for further treatment/diagnosis.

1.                  Sonohystogram

From what I gather, this is a procedure where a small balloon is inserted into the uterus, filled with water so the uterine cavity is distended, and then the doctor uses sonogram to look at the uterine lining. The goal for me is to see if there are polyps (again) that could be causing the irregular bleeding and possibly interfering with conception – or any other uterine irregularities.

Unlike an HSG, this test doesn't look at your tubes. But since mine were open last summer, and there's no reason to think they've closed, that's okay.

A plus is that Dr. C can do sonohystograms in her office, which makes me feel a lot more comfortable.

Does it hurt?? I wanted to know. She said it's less painful than an HSG, which I had last summer. I don't know – having a balloon stuck "up there" doesn't sound that comfortable...has anyone had this done? Was it worthwhile?

2.                  Tamoxifen

Option 2, which I can do at the same time as option 1 if I want, is start taking the drug tamoxifen. I guess this is a milder form of Clomid. It elevates FSH levels and so can help ovulation either happen (not a problem in my case) or be better. Unlike Clomid, it doesn't dry up CM and there's not a strong chance of twins.

Dr. C admitted that since my numbers are good, there's not a strong need for drugs like tamoxifen. BUT it couldn't hurt, I guess? I don't know – I'm hesitant to use hormonal drugs unless there's a really clear indication that they could be helpful. On the other hand, tamoxifen sounds pretty mild, so maybe I'll try it for a few cycles and see what happens?

(Other bloggers have commented on the frustrations of the "let's just try this and see what happens" approach to infertility treatment. That's kind of what the tamoxifen feels like – maybe it will help, maybe it won't. Might as well try.)

So that's that. I'd be grateful if anyone has tried either of these routes and has any advice for me! I'm waiting out my current cycle and discerning with Mr. M which route to take, or maybe both.


1 comment:

  1. When I thought I was going to have the sonohysterogram, the overwhelming suggestion was just to take some painkillers (aleve, advil, etc) before hand. It certainly doesn't sound fun - but hopefully it will give you some answers.

    I would only do the Tamoxifen if they are going to monitor your hormone levels to see if it is helping. But that's just me.

    Prayers for you as you decide!