We know what's wrong

Where to begin? I've decided that tonight I'm going to just post all the information I learned today at my appointment and not comment too much on it (or at least that's my plan). I just want to put it all out there and begin to process it. I will say, though, that I'm not sure how I feel about it right now. I go back and forth from being upset to being slightly hopeful. My husband, on the other hand, thinks everything we learned is great news, but I don't necessarily trust him. It's his job to say that. It's also kind of odd to finally, after all these years, know what is standing between me and having babies. Anyways, here goes...

I learned that from the blood taken at my last appointment on April 28, all my chemistry is good. I'm not anemic, my organs are good, and everything is normal. Also normal is my thyroid, my prolactin and my testosterone (my testosterone being normal was a big surprise because I thought that was high due to PCOS, which hadn't been treated at all when the blood was taken). It also showed that my LH and FSH ratio is still 2:1. That is bad and is a sign of PCOS.

We learned a lot from my saliva test (which was taken two cycles ago in May, and shows my hormones throughout the entire cycle). This is where it gets tricky, and this is where we learned what is truly the cause of my infertility. First off, I am ovulating (yes, I was shocked). At the beginning of the cycle, my estrogen starts good and my progesterone is low like it should be. Then all goes awry. You know how estrogen (or is it estradiol? whatever) goes down at the very same time that progesterone rises? I remember my Creighton teacher teaching me that and commenting on how amazing it is that God designed it so perfectly. Well, mine doesn't do that. My estradiol did whatever it's supposed to do to show that I'm ovulating, but then my progesterone didn't rise until about three days later. Three days! I think it's supposed to happen instantaneously. Then the progesterone got really high, like it's supposed to, but then it dropped off a few days before it should.

The doctor described my ovaries like this:

"You know how on Dancing With the Stars there's the really awesome couple who is smooth and in step and looks great? And then there's the goofy couple who is never quite in sync? Your ovaries are the goofy couple." He also used a golf analogy for my husband's benefit. Something about my ovaries not being like Tiger Wood's swing.

He said my ovaries are dysfunctional. I probably release an egg every month but instead of being this nice, smooth, precise process, it's slow and clunky and pretty messed up. So my ovaries are losers. They're ugly and dorky and probably get picked on by all my other organs.

He thinks the LH/FSH problem is causing it, and the whole ovarian dysfunction probably even caused my endometriosis.

It was at this point that he told me no one knows why this happens or how to treat it. He then said "this is when people do IVF" (he, of course, is against it, but just meant that this is when others would typically consider it their only option). So that was when I zoned out. I didn't hear much of anything else he said for a few minutes. I concentrated on holding back tears and I think I nodded my head a lot, probably inappropriately.

Somehow I came back around and picked back up when he was describing PCOS and insulin resistance. So I told him about my diet and weight loss (Oh my goodness! I didn't even tell you about my big weigh in! I did it! I met my goal, surpassed it even, and was down 16 pounds on his scale! Woo hoo!). His immediate response was "Praise the Lord!" He thought this was GREAT news and he thinks it is likely helping me already. He toyed with just treating me with diet and exercise. He had written out a prescription for metformin, and told me not to fill it right away. Then he changed his mind and said to fill it. He also doesn't think the drug will affect me negatively. He takes it himself and said it makes him feel whole again and will likely do the same for me. He also said that even if getting pregnant wasn't an issue for me, I need to treat this as a medical issue. It could lead to diabetes, heart disease or a heart attack at a younger than normal age.

On a sidenote, he said that metformin will likely make me lose even more weight, and faster. Looking forward to that! (And, hopefully, it won't be because I'm too nauseous to keep anything down! Please, Lord!)

So my doctor didn't come right out and say what my chances are of getting pregnant. He also didn't say it won't work. He basically just said that this happens to work for a lot of patients. He said it could take six to nine months to work, so we have a long wait ahead. He doesn't think surgery is in my future because apparently the wedge resection surgery is done to help lower the testosterone and, in turn, help the PCOS. Since my testosterone is already back to normal, that isn't my problem.

My next appointment is in four months. It's so far away that they're not even scheduling that far in advance, so I have to call in August. He also said that if by my next appointment it appears that the metformin is helping, he'll put me on either Clomid or Letrozole to help the ovulation. I'm hoping that combination will be what eventually leads to a pregnancy.

So that's it. I probably left some stuff out. For a recap: I am ovulating.. but my ovaries are bad.. my estrogen and progesterone don't switch off at the same time.. this somehow causes my egg to not do the right thing after leaving my ovary.. this is caused by my LH and FSH ratio being off.. this is all caused by insulin resistance (I didn't ask how).. and this is all part of PCOS.. my diet and exercise is likely helping to treat it already.. I'm going to start metformin tomorrow to help it as well.. but it will likely take at least six months before we even know if it's helping.. and if it is, he'll put me on clomid or something like it to help ovulation. I think that's it, but I have a feeling I'll remember something else in a little while and have to update this.

I would appreciate hearing what you think. Is this not that big of a deal? Have you ever heard of it (the estradiol/progesterone problem)? Is the situation more dire than I yet realize? Anyone know anyone who has fixed this problem and gotten pregnant?

I'm going to post tomorrow on how I feel about this. I will make a final observation, though. I left the appointment sure of one thing: If I do become pregnant, it will be through prayer. I feel now that nearly everything has been stripped away and I am left to lean on the Lord. I know I still have medication to try and my diet may help as well, but ultimately, whether any of that helps to correct my hormones is up to God. I know that it is always up to God, but for some reason I am now more accutely aware of this than ever before.