I met with the doctor I will call Dr. Weight on June 27. The Office Manager took my blood pressure and it was very high - she's didn't blink. She weighed me and my weight was - well, let me just repeat that my BMI was 38.9 so it, too, was very high. Again, she didn't blink (thank goodness; I was tired of judgemental medical personnel). Next I met with Dr. Weight who spent an hour taking a very detailed history. She was so sympathetic to my concerns (both about losing weight and trying to get pregnant) and so reassuring that she could help me, that I felt hope for the first time in a long time. After scheduling blood work for early the next week, I left there and went straight to the hospital for my HSG.
Honestly, I expected the HSG to be awful (other blogs I'd read online referenced lots of pain); however, for me it was no big deal. In fact, I left MUCH happier than when I went in. Although I'd expected to be told my left fallopian tube was completely blocked (per laparoscopy when I was 27) and I suspected my right tube was at least partially blocked (cause of ectopic last summer), I was thrilled when the doctor indicated that my x-ray showed a normal uterine shape and the injected dye spilled freely from not just one but BOTH fallopian tubes!
The following week I went in for my blood work with Dr. Weight and I lost count of how many vials of blood they took. I got my initial diet plan which would serve as a starting point until my blood work came back. We talked a little more about coordinating with Dr. Awesome - specifically, that I was going to delay "trying" to conceive (and, in fact, purposely avoid) during the first 12 weeks of my highly calorically restricted diet, but that we could continue with any other tests he wanted us to do.
The end of that week "J" and I met with Dr. Awesome so go over the result of the four tests he'd ordered at our "Why Aren't We Pregnant Yet?" visit. We already knew the my Progesterone at 8.62 on CD 21 indicated that I was ovulating. He affirmed the HSG results showed that my uterus and fallopian tubes looked good (praise God!). Then we learned that "J's" semen analysis showed that he has NO problems... he's even better than "normal" (which made him ecstatic! He's so proud to have such good swimmers. I, too, was so relieved to learn we'd only be dealing with a "me" problem rather than a "me + him" problem). Finally, we talked about my AMH.
You may remember my first testing showed me at a 0.21. Well, my second result came back at 1.01 which - although in the "normal" range - still only put me at 25% for my age. Dr. Awesome proclaimed this as proof of lab error on the first round and said the second round was slightly disappointing but no big deal (he'd only be concerned if I was in the bottom 10th percentile). I pushed back a bit - we consider the first one wrong because we don't like the result but consider the second one right because the result is acceptable? No way; not when the results are supposed to be stable! He asked if I wanted a third test and I said I did.
Final AMH results?
Test 1: 0.21 (CD 21)
Test 2: 1.01 (CD 5)
Test 3: 0.49 (CD 16)
That's right. In the span of less that one month's time, the same lab returned three very different results. Test 2 leaves me with a little hope; tests one and three do not. Is this the reason we aren't getting pregnant? Do I have old, crappy eggs?
Dr. Awesome urged me not to freak out but, instead, to go spend 12 weeks working with Dr. Weight as we'd already discussed. He said sometimes losing even 5% of one's body weight can have a huge impact on fertility. He also assured me that if after 12 weeks I wanted to be more aggressive (think Clomid), that he was willing to talk about it. I left feeling slightly discouraged but mostly optimistic.
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I have now been working with Dr. Weight for almost six weeks. I have lost 29.5 pounds (30 tomorrow, I hope!) and my BMI is down to 33.8 (my blood pressure is way down, too!). My initial blood work results were quite alarming. According to Dr. Weight, I "could have been eating nothing but lettuce and not losing weight." Based on my blood work, she also was not at all surprised I was having a hard time getting pregnant. She basically told me to stick with her and not not only would she get the weight off of me, but she'd help me get pregnant, too! (She joked we could feel free to name the baby after her - at least a middle name.) Could it really be so easy?
So, there you have my background. Now will you walk with me day-to-day?
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