Overwhelmed

There is no other word to describe how we are feeling right now.

This morning I had my cd14 ultrasound, which I was told was just to check egg quality. The ultrasound was done by an RN in the Dr's office. She walked in the room and asked if anyone had called us regarding the SA results (which they hadn't) so I immediately got nervous. This is how our appointment started,

Nurse: "well, numbers and motility are good, but morphology is poor. So, depending on the maturity of your egg, we can proceed with an insemination today."

Huh???

Fortunately, I've been reading up on infertility and have been following many blogs so I know what she's talking about, but didn't anticipate that at all! Without waiting for us to respond she shoves (literally) the ultrasound "wand" in me and says, "Well, the right side has a couple follicles (eggs) but none of those are mature, so let's hope the left side has a mature one."

Wow, way to have a comforting bed-side manner.

"oh, there's one that's maturing. It's only 15mm though, so it's not ready yet. We'll repeat the ultrasound when you come in Wednesday to see Dr. D and then he can decide when to do the IUI. It's possible he'll give you a trigger shot to do at home to induce ovulation so we can time your insemination."

I'm going to give all of a you a courtesy our nurse did not give us, Background information.

What all of this means is that while B's sperm are plentiful and speedy, they're shaped wrong. In his words, "They're shaped like hammerhead sharks instead of tadpols" :)  This means that only 4% of 1,000,000 of his sperm are capable of fertilization. Not super great odds, which is why they often recommend an IUI (intrauterine insemination) to get the sperm as close to the egg as possible.

Also, since my maturing follicle is only 15mm, and to be considered fully mature is should be at least 18mm and typically is about 20-24mm by the time of ovulation, I probably won't ovulate for another 2-4 days.  This is the reason for the possible use of the trigger shot. This is an injection I'd give myself in my abdomen and it would cause me to ovulate within 30-36 hours so that an IUI could be timed perfectly.

Something I'm concerned about, that the nurse didn't touch on at all, is the fact that I'm ovulating so late in my cycle. Today is already day 14, if I don't ovulate until day 18, the chances of me being able to have a viable pregnancy (assuming the IUI worked) would be very slim. A woman's luteal phase (the time between ovulation and start of menstration) needs to be at least 10 days (minimum) for implantation to occur. And my cycle, more than likely, won't be that long.

Luckily, there are treatment options for short luteal phases. I believe the most common is progesterone suppositories (yuck!) because the elevated progesterone is necessary to lenghthen the luteal phase.

Sorry for all of the medical ramblings, I just wanted to explain what everything means and I know it would have been nice for us for the nurse to have made sure we had all this information.

At the very end of the appointment, I think she could tell we looked overwhelmed because she said, "Well, if you feel this is moving to quickly you could always see what happens naturally this cycle and then do the IUI next cycle. And, if you decided to wait then Dr. D could start you on clomid too."

Side note: Clomid is a prescription medication that causes a woman's ovaries to produce multiple follicles so she can ovulate multiple eggs, thereby increasing the chances of conception (and yes, it does increase the odds of conceiving multiples).

When we got in the car we just sat there staring blankly. Neither one of us knew what to say. After a few minutes I started explaining to B what all everything ment... We're still trying to decide what to think and how to feel.

We weren't planning on having the option of any treatments this month. This appointment was supposed to just be an ultrasound to check egg quality and now they're saying we could be doing an IUI in 2 days. I figured, with it being day 14, I'd have already ovulated or be about to ovulate thereby making any treatment options impossible.... apparently not though.

I have to go back in this afternoon for some routine bloodwork because they want everything done prior to my consult on Wednesday so that we can move forward, if we decide to.

Sorry this post is so long, it's just nice to be able to put everything down in words to process it.

B and I have a lot to think about between now and Wednesday.