Infertility testing as medieval torture.

Have you ever looked at a picture of medieval torture devices? If so, you may have recognized some of those instruments as appearing in your local REs office. I swear, the tools they use could only have been developed by a man. There’s no way a woman ever would have wanted to develop a ‘cervical skin grabber’ and unleash it onto her fellow women. I just refuse to believe it.

So my biopsy went as well as an internal, still-awake-for-the-entire-thing procedure could go. My cervix was being particularly petulant and had decided that it didn’t want to come out to play like a good little cervix. So the RE had to use this terrible ‘pin-it-down’ device which then led to having to use the ‘cervical skin grabber’ (and I swear these are his terms, not mine) to force my cervix open. Yes, force was used. And yes, it hurt as much as you might imagine. Probably more. I nearly jumped off the table, but the nurse came and grabbed my hand and the RE told me to count down from ten, which at least got my mind off it. A few little suctions with a catheter lately and I was a few endometrial cells lighter.

After our little biopsy party, the RE had me meet him in his office to discuss the options for next cycle. He really wants to do an unmedicated, natural cycle so he can see what my body does after being on fertility drugs for almost a year. I’m not so keen on that option, but he seems sold on it. I’m still gunning for trying to replicate our September cycle where the lining got to 7.5mm, but even with that, he wants to try it with no estrogen. Once again, we differ. My body just doesn’t process estrogen the way it used to, so I’m thinking giving it that little extra boost with the Femara might be all that it needs to get that lining fat and then we can concentrate on getting it trilaminar. Decision, decisions. You know, it just should not have to take this much thought to get pregnant. It just shouldn’t. So, the options are as follows:

1. Do a natural, unmedicated cycle using only an OPK to time the blood work and ultrasounds. When I get my first peak reading, get blood work done to measure progesterone and other hormones (possibly estrogen and LH) and then once the progesterone gets to a certain level, schedule the transfer. Get pregnant.

2. Assist ovulation with letrizole (Femara, taken for five days) to force my body to make more follicles thereby making all those follicles make extra estrogen with the hope that it makes a nice thick lining early in my cycle; add extra estrogen for five days after ending the Femara to keep the estrogen-train going and hopefully getting that lining nice and thick. Induce ovulation, monitor with a few blood tests to make sure progesterone is high enough and schedule the transfer. Get pregnant.

3. Use injectable medications to perform the same task as the Femara, but at a higher, more potent doseage (not as high as an IVF cycle, but higher and more reliable than Femara). Do this with the hopes that all the extra follicles will make natural estrogen and a thicker lining. Induce ovulation, monitor with a few blood tests to make sure progesterone is high enough and schedule the transfer. Get pregnant.

4. Give up all hopes of ever having another child and get on with my life.

Right now, I’m leaning towards number 2, with number 4 as a strong back-up.

The RE wants me to take the weekend to think about it. In the meantime, he’s going to wait for the biopsy results. Which, of course, could change everything. Good results would throw me into choosing between number 1 and number 2. Bad results would force me to consider option 3 or 4.

Decisions, decisions.