So, as you know, I saw my new consultant yesterday. I don’t really know what to call him, as he wasn’t quite as suave in real life as he looked in his pictures. Hmmm, I’ll have to think about that one.
I haven’t really known what to write about the appointment, hence the lack of updates until now. I don’t really know how I feel about it, and if it went well, so I guess I’ll just state the facts and see what you all think.
Firstly, the good part was that he listened to my concerns, and I don’t think that there was anything I forgot to say. He seemed to know what he was talking about, in that the outcome was what I expected, and probably what I think should be done, if not what I want to be done (but then I don’t want any of this).
His thoughts were that my periods are light because 1) my hormone function might be screwed up, 2) there is a primary problem with the endometrial lining, or 3) this is just “the new me” after Asherman’s, and my periods are light, yes, but my endometrium is thick enough.
His plan is to exclude (1) by doing day 3 FSH/LH/Oestradiol bloods. He doesn’t think that this is the problem, but to be complete, and to make sure nothing obvious is being missed, he wants to do them. Fair enough. I did have a mid-cycle oestradiol done a few months ago which was “excellent” so he thinks these should be normal. He did point out that my ovaries are polycystic, but didn’t seem too bothered by this, thankfully (and wasn’t trying to blame my light periods on them!).
He wants to do a mid-cycle ultrasound (tomorrow) to see what my endometrium is like mid-cycle, and see what’s actually happening to it, what the pattern is etc. He’s scanning me himself (!) as he wants to be sure that he looks at it in depth. I’m scared. I know it’s going to be thin, so I don’t really know why I’m worried, but just the confirmation of fears I suppose. He said that if it is thin, he’ll probably scan me again in another cycle; he doesn’t want to take one reading and leave it at that. I think this is fair enough, I can see that if I was the treating doctor, I’d do the same, and I know he’s just trying to get all the information together to make a plan.
He’s requested an HSG, to see the contour of my uterus, see if my tubes are open (there’s a possibility they were scarred by the Asherman’s, or if there was an ascending infection that helped to cause the Asherman’s), and to see if there are any adhesions in my uterus. Again, I think this is a good plan. It has the benefit, as he said, of possibly breaking adhesions at the cervix etc without the need for further surgery. I’m not looking forward to it, but hey.
He listened to my stories of my cervical pain. He wondered about doing a hysteroscopy under GA and dilating my cervix even further. I wasn’t happy about this – this would be the 6th time my cervix has been dilated, and the thought of cervical incompetence is already weighing heavily on my mind. If we have to do it, we will, but as I wasn’t happy about it he agreed to leave it for now, on the basis that if blood can get out, sperm can get in. Whether it is preventing my endometrium from developing is another matter, that will hopefully be revealed by the other tests.
So: after all that, the plan obviously depends on the results of those tests. If it is a problem with the endometrium (which to be honest I think we can safely say it is) we’re looking at IVF, to see how my endometrium responds during a fresh cycle (he said that the fact of having lots of follicles means there is more oestrogen floating around, which can assist the endometrium) or if it’s not great, FET and “shitloads of drugs” as he put it. He mentioned oestrogen patches, injectable oestrogen, aspirin, vitamins C and E, something called pentoxyphylline (?sp) and said that it would be “hard work”.
He didn’t tell me to go and get a surrogate. He said it was possible to have a baby, but I suspect it’ll be a long and difficult road to get there. He told me the only reason having a baby would be impossible was if we had either no eggs or no sperm, and he’s fairly confident that isn’t the case. So I’m pleased that he shows no sign of giving up and that he’s willing to work with us. He seemed relatively positive to be honest, when I asked him what our chances were. The other two gynaecologists have been positive too. I don’t know whether to believe them or not, either they all agree because they’re all right, or they’re wrong because they haven’t been right so far, if that makes sense.
So, what do you all think? Good plan? Bad plan?