Where do I begin?
First, we discussed the surgery. He told me the surgery was very successful in that all the endometriosis was excised (cut out), instead of burned. Dr. L and his partner are the only REs in J that excise endometriosis compared to just burning it. The benefit in excising verses burning is that when endometriosis is excised, the chances of it returning are very slim. Which brings me to our discussion of the next step towards pregnancy.
Dr. L told me that once a patient has had endometriosis, the concern after the endometriosis is surgically removed, shifts to egg quality. This is because endometriosis tends to decline a woman’s egg quality sooner in someone who has or had endometriosis. The average woman’s (with no endometriosis) egg quality typically begins to decline at the age of 32. Throw endometriosis into the mix and egg quality begins to decline in the late-20’s.
One of the best qualities in Dr. L is that he doesn’t just throw a treatment plan (such as IVF) on the table and tell us this is our only option. The patient’s best interest is his ultimate goal. So he will sit there with you to the point that you feel you are a team working together to figure out the best possible treatment plan that is unique to you. Being a former teacher, the push in education philosophy was always individualized instruction. I believe it is no different for an RE prescribing a treatment plan to his/her patient – it should be individualized to meet the infertility needs of that particular couple.
And that is precisely what Dr. L does.
So, what’s next?
I’m going to do a Clomid Challenge Test to check my FSH levels, which will tell the quality of my eggs. Dr. L told me this test isn’t a must-do and he expects my levels to be just fine. (Back in March, when Dr. L did my initial blood work, my FSH level was 4.5. Anything less than 10 is a normal range for a pre-menopausal woman.) I chose to do the test because I like to be completely informed and know as much as I can about what is going on within my body!
The Clomid Challenge Test requires me to take Clomid on Cycle Days 5-9. My FSH levels would be tested through blood work on Cycle Days 3 and 10. I am not sure which cycle I will do this test. I need to pray and see what God tells me.
I told Dr. L of our plans to do no treatments until the New Year because God just may want to allow it to happen naturally.
So the plan is to see what happens from now until the end of the year. If needed, we will probably do another IUI in January 2009, regardless of the results from the Clomid Challenge Test. Dr. L told me that even if my levels are above 10, that will not automatically mean our only option will be IVF.
Please keep praying another treatment will not be necessary … if it be God’s Will.