Thursday, January 21, 2010

Provera, we meet again

I had blood work done yesterday because my period still hasn't started. Surprise, Surprise - my progesterone levels are low again so I get to start taking Provera again. The upside is that it will start my period and then I can get my Clomid Challenge Test. The downside, it will probably be about another month before that will be done. This waiting is so torturous. I can barely stand it.

I did take the opportunity to ask the nurse a few questions about some of the results from my previous blood work. My biggest concern was my AMH level (Anti-Mullerian Hormone). A very basic explanation is that AMH blood levels indicate the size of the remaining egg supply - the ovarian reserve. Normal AMH levels are over 1.0 ng/ml. My level was 0.2 ng/ml. This is very low, dismally low. It looks like I have an egg quantity issue. The nurse, however, said that they can still help me as long as my FSH levels (Follicle stimulating hormone) are low. FSH is the hormone that helps produce mature eggs by stimulating the ovaries to get follicles to develop. Immature eggs rest inside follicles, stimulate the follicle and you stimulate the immature egg to develop. Higher levels mean the body is having to work harder to get the follicle to develop. High levels are not good. So if I have low AMH and high FSH, it means I would have poor egg quantity and quality - premature ovarian failure. You normally see high FSH levels in menopausal women. The higher the FSH, the likelihood of responding to infertility treatments like IVF is poor. As long as my FSH levels are within an acceptable range, I could still respond to fertility drugs, though I would probably have to take inject able drugs as opposed to the oral kind. The inject able drugs (inject able gonadotropins) are the same hormones as FSH. So very scientific. Basically, I have an egg issue in addition to a hormone issue. How bad the egg issue is will determine if fertility treatments are even an option for me. The Clomid Challenge Test will determine my FSH and where we go from here.

Now, T and I are practicing patience and playing the waiting game. I want to know my levels BUT, I don't want to know. T says hope is still alive right now and we need to hold on to that. Unfortunately, I am having trouble staying optimistic. T is a glass half full kind of guy and I am the glass is half empty fill the damn thing up kind of gal. Optimism has never been my strong point. I have all these scenarios going through my brain, none of them good. I am afraid to hope, I think. Because if I hope and we get bad news, it will crush me. As long as I believe it is going to be bad, if we get good news, I can be surprised and ecstatic. If it is bad, then I have already started preparing myself for it. See - glass half empty but with the expectation that it can be filled up.

I think I need to back off on my research for a bit and take a breather. Reading all this stuff that can happen or what things might mean is just stressing me out. I am filling my handy dandy note book up with so much stuff to ask the RE that he is going to freak when he sees me walk in with all these pages. I remember when I went to one of our early pediatrician appointments with B and I was full of questions I had gleaned from various parenting magazines and books. I was so worried about milestones and her development and kind of freaking out. I remember the doctor sat me down and said the first thing we need to do was throw away all those books. Charts and levels and standards do not make a child and each child is an individual and they don't develop on a time line. I think I need to adopt that philosophy to this situation and step back, take a breather and wait for all our results to come in. Easier said then done. I guess I need to work on my practicing patience.

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