May 1st was my six year dating anniversary with Col, if I hadn’t been so stubborn and just said ‘yes’ when he first asked, it’d be six and a half years!

What better way to spend our date-iversary than at a fertility specialist’s office?

I described it as ‘going to see a man about a baby’.  I’d been referred to Dr Dunn by a good friend of mine, she herself had trouble with fertility and after becoming Dr Dunn’s patient had herself a healthy pregnancy.  My OBGYN had referred me to a Reproductive Endocrinologist, but we’d decided to go with someone that we had a personal referral from someone that’s had first hand experience with him.

As you can see, Col came with me…I won’t lie, I was nervous.  I’d not slept very well in about two weeks and while I’d love to say my appointment had nothing to do with that, I don’t like lying to my readers.  It’s not so much that I was afraid of the appointment, I guessed that he’d take bloods and would probably want an up to date ultrasound (I’d not had an ultrasound done since 2009) but that no major procedures would be done at our first meeting – so nothing *really* to worry about.

What bothered me most, however, was the mere fact that the appointment had to happen at all.

Rational or not, I shouldn’t *need* help to get pregnant, let alone need to go to my third doctor on this journey, a man, to help me figure out what bits of my female self are broken – and potentially how to fix myself.

The office staff were very nice, the lady that called me from the main waiting room was the same lady that waved me off to get bloods done at the end.  I liked that, there was a lot of changing rooms:

Sign in, wait in waiting room, blood pressure and weight taken, back to waiting room,  appointment with the doctor in his office, move forward through the maze to a red couch where you wait for ultrasound tech to call you to another waiting room, ultrasound room, and back full circle to check out desk.  But the whole time you have the same nurse with you – it was certainly reassuring.

Let me tell you what I learned (or at least remembered) from my appointment with Dr Dunn: (it’ll be quicker to bullet-point it, than to try and recount what I can remember!)

• PCOS is the single most common endocrine ‘defect’ in women all across the globe.
• Dr’s and OBGYN’s tend to count cysts of a certain size or bigger (usually 1cm) to diagnose PCOS, reproductive endocrinologists and fertility specialists? They count all cysts.
• It’s likely that PCOS and insulin resistance was partially to blame for my gallbladder issues in 2010.
• For a guy, taking a darily multi-vitamin can notably help improve the quality of sperm.
• While many pre-natal vitamins contain folic acid, it’s recommended that you take additional amounts of folic acid.  It’s been clinically proven that those women who take higher amounts of folic acid are less likely to have babies with spine and heart defects.
• You can’t take too much folic acid, you can’t overdose.  He said that you can essentially go home and swallow the entire bottle and the only downside would be that you have very expensive pee!
• One of the easiest ways of telling that someone has insulin resistance is to look at the base of their neck/top of their spine (or underarm) as that’s where the insulin tends to be deposited.  The skin will look darker.  He said that next time I’m out grocery shopping and in a line, to have a sneaky look at the people I’m surrounded by, it’s more noticeable in darker skin than my pasty Irish stuffs!
• My doctor, when she gave me Metformin from Dee Why company, she was trying to treat me with a ‘diabetic’ dose of metformin.  I gained 25lbs on it and gave up after 2-3 months.  Apparently for PCOS, the dose of metformin needs to be higher to improve how your body processes insulin, so I agreed to try his method for a while and see how that goes.
• I learned that with PCOS (tests will mostly confirm this diagnosis), my body is producing insulin but doesn’t really know what to do with it.  So it keeps requesting that more and more is produced – which, in turn, produces more male hormone (potentially the reason we’re having trouble getting pregnant).  He said if I ate the same thing as many of you, you’d produce ‘x’ amount of insulin to process it, whereas for me, I’d produce two or three times the amount of insulin to process the same food.  It takes longer, my blood sugar will spike higher, take longer to return to normal and will be more inclined to drop below baseline (hence the suggestion below for my diet changes).
• He asked if I’d ever tested beyond a positive ovulation test, to see if I have ever ovulated twice in one month – which, I haven’t.  It’s not something I’ve ever considered!
• Obesity exacerbates insulin resistance, and insulin resistance can lead to obesity – it’s a catch 22, never-ending circle, or, as Dr Dunn said, ‘the snowball rolling down the hill’.

When you’re in this situation, it’s all about the little things that help you through it, (for example, the socks on the stirrups in the picture above).  When you’re lying back and thinking of vacation, chocolate and puppies – anything other than what’s actually happening to you – and here at the Fertility Specialists of Houston, this is what you see when you’re staring at the ceiling:

It’s a mobile, the pieces all move slowly, methodically and are quite soothing to keep your attention north of the border – genius!

Outcomes of the appointment:

• My bloods were taken after my chat with the doctor.  I have since had a call from them to say they want to talk about my Vitamin D levels, but I can’t seem to get hold of them to find out what the issue is.
• I had my first internal ultrasound, which was even more unpleasant than I anticipated because one of my ovaries were playing hide and seek!  I’ve been told to make friends with this nifty ‘little’ device, because I’m going to be very familiar with it by the time I’m done!
• Went home with a prescription for Metformin (gradually building up to 1500mg/day) and folic acid.
• He recommended I try to drastically change my lifestyle habits, progressing to 6 small meals per day totalling between 1600-1800 cals.
• Col will get re-tested in 4 weeks, his last test was July 2012.
• Fasting blood test and 2hrs later a glucose test will be done when we get back from vacation.
• On day 1 of my next cycle, I’ll have another round of blood work done.
• Follow-up appointment will be in 6 weeks.

It was emotionally draining for sure, my appointment with the doctor lasted for about 70 minutes – but it flew by, when we’d finished I couldn’t believe the time on the clock.  My husband came with me, it was recommended by my friend – partially for emotional support, but partially because it’s beneficial to have him there for questioning with the doctor, it’s like a two-for-one thing.  You both get to ask and answer questions and it helps to have a second brain on-hand, because you’re so worked up about the whole thing, that he can often remember things that you may not.

Make a list of questions to bring with you – things that come to you at stupid o’clock during the night, or in the bath, or in the aisles of the grocery store – don’t be afraid to ask questions, even if you’ve asked them to ten different doctors, ten times over.  Sometimes, you’ll get the ‘right’ answer from the eleventh doctor!

I also did something else this time, many of you will feel like me, like everything that makes you inherently female, your total feminine essence is broken, has let you down.  Like you’re a defective woman.  Ahead of this appointment, I went for a mani-pedi, something totally girlie and feminine to help me feel better and for after the appointment, I scheduled afternoon tea with some of my girlies and it really helped.  It was nice to do something girlie, relaxing and distracting from the short-comings of my femininity.

The next time I do see Dr Dunn, he’ll have 4 different types of blood results to go through, a sperm analysis and an ultrasound.  Plus I’ll have had 6 weeks of Metformin, so I’ll be up to full dose of 1500mg/day for and will be making huge adjustments to my eating habits when I get back from vacation.

Fingers crossed that this is the door down the path to being healthier and losing weight and hopefully to getting pregnant!