You guys are smarter than doctors and I need your opinions

theOceanicSix · 11-06-2009, 12:35 AM

Ok, so I have been pregnant once (and miscarried) on my first round of Clomid last year. Since then I've done 5 more rounds (well, almost done the 5th round. should be getting my period today.) and I've ovulated all times but no pregnancy.

Here's the deal with me: I don't like fertility drugs. I don't even like Clomid but I was willing to at least try it. But anything beyond that - injects, ivf, ANYthing - is out of the question for me. I like to do things naturally if possible. I eat well and I exercise, and I even ovulate using a very low dose of Soy Isoflavones. So I may even ovulate on my own. I've had bloodwork done and besides my thyroid and androgens being just a bit elevated, my numbers are good. Also, hubby's semen is great.

My question is, should I bother getting a laparoscopy as my next and last step? I'm leaning towards yes and hoping to get one in December but I just want to make sure it's something that I should do. I have almost no pain during my periods or at any other time of the month. I did have bad cramps as a kid but those went away, and stayed away, since I took BCP when I got married. I got off BCP about 4 years ago and have had really only mild cramps during my periods since then.

On the other hand, I've read that a woman can have severe endometriosis with NO pain at all. So it's worth a shot to do the lap, right?

Samie · 11-06-2009, 12:49 AM

My honest opinion?
Yes! Absolutely Yes! I am thankful every single day of my life now that my dr insisted on doing the lap. It wasn't for TTC stuff, but he did discover lots and lots of issues that would have made it much more difficult and probably downright dangerous if we had started ttc before the lap.
I did have moderate endo, more than he thought I was going to, and my left tube was scarred up beyond saving.
With the lap, he "cleaned" me up, and made my womb and girlie parts a much more hospitable place for a baby so to speak.
There was way more going on than he thought originally.
So what's my point
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?
If you are not planning on doing anything beyond Clomid, then get the lap done. If everything's great, ...great! You will have that peace of mind, and assurance. That in itself can be a mighty powerful thing.
If not, then you need to know what's going on, etc., and give your doctor the chance to fix whatever may be wrong.
Good Luck with whatever you decide. As for me, like I said before...completely grateful that my doctor insisted on it.

theOceanicSix · 11-06-2009, 01:17 AM

Cool, I was hoping you'd reply, you always seem well-educated on reproductive matters.
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So why did your doc "insist" on doing the lap? Did you have a lot of pain during the month/during AF?

Samie · 11-06-2009, 01:52 AM

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He insisted on the lap, because, I've a history of abnormal cell growth w/ my paps. I think of all the ones I've had since I've gotten them, half have alwasy come back abnormal. But never more than atypical until Apr.2008. That one came back w/ moderate dysplasia, and it had only been a year since a "normal" one..
So he did a LEEP in June 2008. I have to see him every 4 months for a pap. Sooo, during the last year and a half, occasionally I was bleeding after we would dtd...
I casually brought it up during my last one in the beginning of June, and they were not overly concerned, but we decided to do an u/s just to make sure it wasn't something.
Well, it was something. They found a polyp, and then swung over to my ovaries, and I had a 5 cm cyst (yeah, in addition to my pearly ones) on my left ovary. Well, I then mentioned..OH that's why I've been having discomfort mid cycle...and the conversation went from there. I've had a history of extremely painful periods when I was younger, and had pretty much been told to suck it up. So I did, I learned to have really high pain tolerance. Like almost dangerously high pain tolerance. And then after my csection with my oldest son (my last natural child), when AF resumed after breastfeeding, it wasn't severe anymore. Well that might have had to do with the fact that they probably severed several major nerves during it.
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What struck my doctor as needing to do the lap asap, were a couple of other factors. 1) I was on BCP and had been for over 2yrs, I shouldn't have a cyst that size, nor be experiencing mid cycle pain
2) I have a family history of early uterine cancer
3) I've always downplayed just how much pain I'd been in. To me, it wasn't severe as it used to be years ago, but I didn't realize to a "normal" woman, the pain I was going through every month was abnormal.
My doctor didn't want to wait. At all, in fact he made me cancel a business trip because he wanted to get me in asap.
So all together, he found endo, ALL over my ovaries, tubes, uterus, etc. He removed it, and had to remove about 1/2 of my left fallopian tube. He removed the polyp, drained the cyst, and threw ovarian drilling in there too for safe measure
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Which is why our TTC timetable got sped up a year or two.
My last pap came back atypical, but he doesn't seem too worried about it, as I've had a history of those, and he thinks the polyp may have misled the results.
I know this is a book, but I think that if my doctor and his nurse practitioner hadn't been as proactive about it, I know I would be in worse shape than I already am.
He's an awesome doctor, but we both have acknowledged that he basically bought me a few good years, and I am fully aware I will probably have to have a partial hysterectomy by the time I'm 40.

~Traci~ · 11-06-2009, 01:09 PM

For the exact reasons Samie stated, I say get the lap. I got a lap (& hysteroscopy) after multiple unexplained m/c's. Nothing was found during mine but I at least had peace of mind that there wasn't anything physically causing them. For the shear knowledge of knowing your body is ok is awesome. If there is something wrong the Dr. can fix it then or at least have a better understand of your body.

Seriously, I personally think everyone should get a lap before TTC so they & their Dr. know what's going on inside!

Samie · 11-06-2009, 01:12 PM

Quote:

Originally Posted by ~Traci~
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Seriously, I personally think everyone should get a lap before TTC so they & their Dr. know what's going on inside!

I agree! Especially if they have been trying for more than 6 months and aren't successful.

July · 11-06-2009, 02:23 PM

Quote:

Originally Posted by theOceanicSix
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I've had bloodwork done and besides my thyroid and androgens being just a bit elevated, my numbers are good.

Oceanic, why not give metformin or inositol a try? It's supposed to help with your estrogen:androgen ratio (I'm not sure if inositol has this effect too, but I know metformin does). I remember you opened a thread about low estradiol a little while ago too.

Like you I prefer the natural approach but if I want it to have a similar effect as to what met can do for you it would mean I would always have to be sooo strict about what I eat. I'm having troubles finding a doctor who will write me a prescription but when I find one I'd love to give met a try for 6 months. I'd still eat healthy but it would be because I want to and not because my fertility would go down the drain whenever I have some chocolate.

Ofcourse I'm hoping AF doesn't want to come near you for the next 9 months
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NightAngelX · 11-06-2009, 02:28 PM

I think a lap would definitely be the next step. It always kinda bothered me that doctors just give drugs in case something's wrong but they have no real way of knowing without 'going in.' Of course most people don't want surgery, but it sounds like in your case it is definitely the way to go.

Good luck and baby dust!!

theOceanicSix · 11-06-2009, 11:34 PM

Thanks for the advice, girls! I will DEFINITELY be calling my doctor to schedule one once (and if) my period shows up this cycle. I'm just crossing my fingers that I can get in before Jan 1 for deductible reasons!

Samie, wow! I'm amazed you got pregnant with all that going on with your repro system. Quite a story.

July, good buddy! I've tried Metformin, actually, and it was a *****! Once I got to 1500mg I was pretty much either ON the toilet or leaning OVER the toilet 23 hours a day. I took cinnamon and chromium instead (and exercised) and got my fasting insulin to a normal range by doing so.
And I actually just started a new B complex vitamin that has Inositol in it. What is it supposed to do?

July · 11-07-2009, 07:36 AM

Oceanic, lol, I know it's supposed to do the same thing as met. Don't really know the details. I just noticed it helps me keep my weight stable and I know many women have lost weight on it but I'm fine the way I am so that's not a goal for me. I'm still looking for an answer to the question if inositol also helps with estrogen:androgen ratio but at least I've heard that many women get more regular cycles or start O'ing on it. (But honestly, I can look up almost any alternative remedy and find stories from women who got AF or started O'ing) Inositol is a bit more promising to me because it's not a herb but a vitamin-thingy and it's like DCI. Inositol is/was cheaper but some women get DCI for very reasonable prices now I've heard. I'm on it for a little over a month now and I'm happy with it. I think it's helped clearing up my skin. (Ofcourse) there's a thread (even several) so you can check it out if you feel like it. How much inositol is in your B-complex? I take 2000mg with 1250mg of inositol seperately.

P.s. I'm excited that your temp went up yesterday! Let's hope it keeps going up, up!
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enigma80 · 11-07-2009, 01:02 PM

dont have anything more than the ladies to add... just wanted to say GOOD LUCK!!!! Laps really arent that bad. I have had 2 one to remove stage 1 endo and one to remove stage 4....

your soreness will be based upon how much they toss thigs around in there. MY OB did my first one and was very gentle... My RE did my 2nd one.. had no mercy and really removed EVERYTHING lolol the 1st i was up and bouncing the next day.. they 2nd within 2 days

theOceanicSix · 11-07-2009, 01:16 PM

Thanks, enigma! I'm actually looking forward to it just so I know what the hay is going on with my insides!

July, 2000mg! My B vit only has 50mg of inositol. So yeah, it's probably not going to do much for me.
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I'm hesitant to take any other supplements though, just because I'm already so sick of taking the ones I have. lol!
But I'm taking N-acetyl Cysteine, which is supposed to help with androgens, so that's good.

July · 11-07-2009, 01:25 PM

Oceanic, my insulin and glucose are both fine too
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But the way Samie explained me a little bit about insulin and pcos, the problem with pcos-ers lies on a cell-level. So you don't have to have elevated insulin and glucose to still have a problem with it. But hey, you're ovulating so I think you're good
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NOW WILL YOU PLEASE UPDATE YOUR CHART??
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theOceanicSix · 11-07-2009, 01:27 PM

You and Samie are geniuses, did you know that?
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My temp fell today (98.1 about an hour earlier than I usually temp). I'm literally too sad to add it to today's chart. How pathetic is that!

July · 11-07-2009, 01:35 PM

Nah, Oceanic, Samie is.
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I just repeat what she says and try to get some credit for it
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And the dropping temp sucks, boo! I totally get how you would want to refuse to put it on your chart. Okay, *puts on happy cap* could you have a really late implantation dip? You know what they say, huh, about it not being over until..!