Today, Tuesday, I went back this morning for my follow-up ultrasound a bit nervous, considering my left ovary seemed to be hiding behind a black shadow during my last one. They had me undress from the waist down and get on the exam table to wait with a sheet draped over me, like normal. Usually the doctor or nurse practitioner comes in right away, which is a nice thing, but this time I waited for 10 minutes and started wondering who would come (since I've had the nurse practitioner and both doctors perform ultrasounds in the past) and when.
The doctor walked in the door very cheerful and said hello. She said something to the effect of: "They sent me in! They weren't sure they could find your left ovary since they'd failed in the past, so I am going to try. Sometimes I can be an ovary whisperer - when others can't find it, I find it easily." This made me laugh because I imagined them having a little meeting during my 10 minute wait, with the nurse practitioner and one doctor voicing concerns and begging the other doctor to go in their place because they were scared.
After telling me the possible scenarios for the black shadow and missing left ovary (which included: endometriosis, tube scarring, how I may potentially need a laproscopy and other scary stuff) we were ready to proceed. She inserted the wand and immediately found my left ovary with ease. And, it was filled with follicles! Amazing! There was no black shadow, although it was slightly off to the side compared to my right ovary. My left ovary follicles measured at 14.4mm, 13.2mm, 13.0mm, and 12.2mm.
My right ovary also had multiple follicles, with one large contender! They measured 18.4mm, 16.6mm, 12.7mm, 12.3mm, and 12.1mm. There was also 3-4 follicles in each ovary that measured under 10mm. She then took out the wand and I immediately asked about how my lining looked. She said it looked good, but then realized that she hadn't taken a measurement. So she has to prepare the wand again (because she had already cleaned up) and in it went for a second time. My lining looked beautiful! It had a very distinct triple thickness and was a good thickness (I think 9mm? I can't remember).
We were all pleased! She felt that the clomid + follostim cycle was a success! I was so glad to hear this because I desperately do not want to try letrozole again. I had such a bad experience with it the only time I've taken it. She thinks the lining responded well to the follostim, and it counteracted the clomid, which is a very good thing because clomid can really deplete the lining and sticks around in the body for up to 6 weeks.
But all looked good!
The discussion turned to next steps. She asked how aggressive we wanted to be and suggested waiting a few days to trigger so that the leading follicles could develop until they're mature enough to have 3 release. She asked if we were OK with having a 6% chance of twins, and a low chance of triplets and we were on board with having twins, although triplets would be OK although not ideal. She also said that she would recommend an IUI since this increases the chance of pregnancy by 5% and increases the number of sperm that make it through the cervix from 20% to much higher. This would counteract having low amounts of cervical mucus because it would bypass the uterus.
Today is Tuesday and she recommended testing with LH strips twice a day - in the morning and before 4pm - to see if I would ovulate on my own. If I didn't have a surge by Friday I could take the ovidrell shot and have the IUI Sunday morning. Easter Sunday. Originally when this plan was made I told her we'd need to wait until next cycle to start with the IUI because I couldn't miss Easter morning. We received instructions on when the take the ovidrell if I didn't get a surge and when to have timed intercourse. But after our appointment my husband asked why were weren't doing the IUI. Shouldn't this be our first priority? All Easter plans and obligations can wait. As soon as he said this, this made sense to me. Obviously, we should proceed with the IUI - especially if we'll have three great follicles to work with! I'd be sad if we missed an IUI this cycle and then following cycles showed poor results. We can't miss this chance.
My husband will give his sample at 8:30am Sunday and then it takes an hour for it to be washed and prepared before my IUI at 9:30am. After a short wait after insemination we should be on our way by 10am. I hope it works! I can definitely feel the fullness inside of me, it is very apparent even as I sit and write this. Grow, follicles grow!
Plus the other benefit is that I read that the rates of pregnancy are increased after HSGs are performed (at least for a few months). I hope this still holds true for the bubble HSG that I had last Friday. I'm ready for all good things to align and that this will be our cycle! 5+ years of trying to conceive and we're so so ready.
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