So.

It was an interesting meeting.

Where to start? Oh yeah. Let's start at the whole "WTF? Why am I not pregnant?" question.

The short answer is we just don't know.

The long answer, which is considerably more palatable to a type A personality like myself is:

As he sees it, there are several areas of concern.

• First, I am having more pain before AF starts now compared to what I experienced pre-boys. There are some months I have pain for an entire week before bleeding actually begins. This does not make me a happy camper to say the least. This is a problem because in his experience, a majority of patients see a reduction in pain after a successful pregnancy.
• A second area of concern is that when I had my last retrieval in July, he found several chocolate cysts on my right ovary. On subsequent scans, I still have at least two more lingering cysts. The cysts are non-estrogen producing and continue to grow. His theory is that said cysts will also be of the chocolate variety.
• Area of concern numero tres is that there was slow spillage of my left tube. Couple that with the post op notes describing my tube being fused to my BOWEL and some UNKNOWN LOCATION! and all signs are pointing to an endometriosis issue. (He was quick to say that he does not think my tubes are leaking back into my uterus and preventing implantation problems. He just thinks that it is something we should investigate further just to be positive all is okay.)
• The fourth area of concern is my homogenous lining (pre-boys it was consistently triple striped). The thickness of my lining is excellent, and having homogenous lining in and of itself isn't really an issue. The issue that he wants to investigate is the change from triple striped to homogenous. (This can also simply be from a change in the position of my uterus post delivery--something about the change of view from the ultrasound wand.)

That leads him to want to do a laparoscopy and hysteroscopy before we do another cycle. Oh fun! There is endometriosis, but we aren't sure just how much. He figures while we are at it, he'd do the hysteroscopy just to rule things out with my uterus/cervix.

Frankly, I am okay with this. I would rather be safe than sorry. If this could potentially find something we can fix, I'd be ecstatic. If it does nothing more than rule things out, I am okay with that, too.

After that, the next option is really up to us. Theoretically, should all be found (or most likely made) sound with my girly bits, he thinks it wouldn't be unreasonable to try IUI's again. (GASP!)

Should he find issues with my girly bits we can't fix, at least we'd know that IVF was the way to go and no time would be wasted with other therapies.

And although we'd probably just go ahead and do another IVF route rather than IUI's, it would be nice to know that my body was in the best shape possible before we tried again.

He did bring up quite a few of the positive things we have going for us.

• He said for someone who had a higher than wanted FSH number, I really responded more like the average for my age groups (those without higher than wanted FSH numbers).
• My blasts looked really good in July when I had my last fresh cycle--with 50% of my embies making it to blast stage for transfer and the freezer!
• All of my blasts made it through the thaw in excellent to good condition (one of which made it through 2 freezes and thaws).
• I am still young (isn't he sweet)
• Is.aac's sperm count is great

I have already contacted my OBGYN to get the referral for the lap/hysteroscopy. They will probably label the procedure for pain rather than for fertility, just to ensure that it is covered. It is still unclear which of the doctors would actually do the procedures (OB or RE or together) and when it would be. We left on the note that we'd do it as soon as we could get it cleared through insurance. Once my girly bits are cleared for take off, we'd start the next cycle, probably April-ish.

So...

I guess there I go.

Oh, I did ask about the spotting. Did he think it was an actual UTI (the culture came back clear on the sample they sent out!) or implantation. He just didn't know nor did he make any guesses. He added it to my chart though.

But if it was implantation, why did I NEVER get a positive pee stick?

Sigh.

I haven't decided which is worse: to get a positive and have it declared a chemical or just to never get the positive.

I think it is a damn crappy tie.

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Can you believe this is my 700th post?