Phone consultation

Our free phone consultation with the new doctor, let's call him Dr C, was rescheduled and took place today. He asked few questions, some of which I have already answered in their clinic questionnaire. He seems to think that the best way to go would be an aggressive stimulation IVF with immunology prep beforehand. He does not do natural IVF since he doesn't think the efforts required are justifiable with too low success rate.
He suggested that I cut out dairy (yogurt is thankfully okay), gluten (and I'd just had pasta for lunch), and alcohol completely (and he calls it a life). He also recommends to up the daily dose of CoQ10, Vitamin D, and to add Omega-3 and prenatals (I can't even describe how much I hate taking prenatals while not being pregnant). He also wants me to do blood tests for NK cells, cytokines and antiphosphilipid panel. He does not believe that my husband needs to do a Sperm Chromatine Structure Assay for his low (2%) morphology, as it was recommended by my second Dr (let's call him Dr J). He was quite adamant on this issue (but again, so was Dr J).
So, we're off for the tests on Monday. Depending on the results, we'll see whether we need IVF or we could treat immune issues and try naturally. Frankly, cards are stacked against us on all counts. We're dealing with female issues, male issues, immune issues, and we would probably have no money for IVF. And even if we had, having this endometrioma as an after-effect of Femara, I don't know if I want to risk anything like this happening again.

No good news

So yes, the endometrioma is back, possibly gotten a push from Letrozole, and is just slightly smaller than it was before the surgery in February. Not only that, but my CA-125 is higher than it was before the surgery. I am not back to square one, I am back to ground zero. I just cannot win. Such a neat double whammy: no pregnancy, but a bunch of potentially dangerous cysts, that threaten the whole possibility of me ever getting pregnant again.

I realize that all this time, I've been waiting for a miracle. Like you know, deus ex machina, light saving the darkest hour, this kind of thing. But apparently the miracles do not apply to us anymore. We had our miracle 6 years ago, only we did not understand just how great and singular it was.

And of course I am angry. At the surgeon - did she do her job well? At Dr who prescribed Letrozole - how could he not take into account my history, being told about it repeatedly? He said "you're in a good place right now", and then proceeded to put me in a much shittier place. At myself - if I wasn't so impatient, I would not have taken Letrozole, and maybe I'd have had another shot at miracle. At my body, which is failing me again and again.

Ultrasound results

So the results are in, and they don't make much sense - except for the confirmation that yes, I do have cysts, and I also have some "free fluid with debris" flowing around down there. Ain't it just peachy - I know I am full of awesomeness. Moreover, somehow the radiologist decided to compare the results with the ones I had in December, before the surgery. So his/her sorry exercise looked like: um, yes, the lesions got smaller etc. What. The. Fuck. S/he didn't even measure their sizes, how about that? And then my hurried surgeon emailed me "good news, your cysts are smaller and we don't have to do a follow up". Excuse me? Haven't you, you know, cut the whole shit out?! My OB/GYN said that "um, the endometriosis always comes back, so the cysts just had rearranged themselves". My uneducated take was that it's a few leftover cysts from Letrozole which could still go away, but no one seems to really think about it. They think that yes, this is the same old endometriosis back so soon. Which is very weird. Does it really, as the radiologist implied, has roughly the same configuration as before? How could this be?! Did they just forget to cut it out, having better things to do while I was sleeping? I don't know what to think, I am just pissed off and depressed even more.

Surgery

So, my surgery was yesterday. It was a stressful week: what with a sick kid at home, me listening intently to every little nerve in my body and with us trying to sanitize the hell out of everything so I wouldn't end up sick too - which would have had cancelled the surgery, and frankly the thought of waiting another two months was unbearable.
Still, the day came, and there I was. I started crying when they started poking needles and inserting IV's and such - just out of sheer helplessness and the sad familiarity of this situation. In 2008, I've been in the same hospital, having to do pretty much the same surgery instead of getting pregnant and having a baby, as we planned. That fall was one of the darkest moments of my life, but then we got lucky. We got our baby, and now we want to give her a sibling - and look where I am, again.
The doctor didn't come to talk to me after I came out of anesthesia - the nurses told me she's going to call me today, but she did not, it being Saturday. She did call my husband after my surgery ended, though. Basically she told him that everything went smoothly, that there was nothing unexpected to be found, that she found "a bit of" endometriosis, but not much, and treated it, and that my tubes are clear. She took out the endometrioma, and "also something from the left side". The latter makes me uneasy. We did not discuss what to do if there is some other cyst on my other ovary. My ovaries tend to form cysts, most of them disappear within one or two cycles. Why would she take away some harmless cyst and thereby decrease my precious ovarian tissue even more? Why would she do that, especially since we did talk in detail about how worried I am about the ovarian reserve?! Was it something else, or is it just a reflection on how surgeons think - "let's cut out everything extra" - as opposed to normal people? I need to talk to her about it, but I feel quite aggravated now, when I think about it.
I am also childishly disappointed in this whole lack of answers. For some reason, I thought that she would find a lot of endometriosis there, which would have explained fertility issues, spotting between periods, weird sensations and basically all the symptoms in this particular area. Since it wasn't the case, and since nothing she found there looks like it could be the culprit, we are back to square one. Try, try again.
Once the results of all tests come back, I am going to start on the vitamins, supplements, and Doxycycline again, and if everything goes well, we will start trying next cycle. Hitting the same wall again, expecting different results - now this is what passes for sanity in our household...

Holiday spirit

I cried myself to sleep the day before yesterday.
And I cried all day yesterday.
And I am crying now.
There was something weird going on over the weekend, so I requested an ultrasound - they repeat it every 6 months and was almost due for another one anyway. So now my ob/gyn wants me to have a surgery in January, to remove endometrioma that grew a bit too big and had almost taken over one of my ovaries. The good news is they would also check for endometriosis and remove it if it's there. The bad news is that doing all this shit with my ovary might leave me with no ovarian reserve to speak of. So yeah, I might end up with a nice clean uterus and nothing to put in. The good news is that the other ovary looks pretty good. Nobody knows, of course. But all this puts us out of baby-making business for another two months, at least.
So when I saw a woman complaining online that she's not having much fun this holiday season because she has a kid and she is heavily pregnant, I saw red. She doesn't even know how incredibly lucky she is.

Endometriosis

So I emailed my regular ob/gyn (not really in the mood of talking to my RE anymore) re:endometriosis as a possible cause.

She thinks it might be the case.

This just threw me over.

I remember asking her and my RE if endometrioma on my ovary could be the reason for my miscarriages. They all said no it isn't. No one of them fucking elaborated re: endometriosis, which apparently is a given since I have endometrioma as well. No one ever told me that. Until now. I cried and I feel like I was deliberately left to hit the wall for a year for nothing. A fucking year. I cried and kept telling my husband that I COULD HAVE HAD OUR SECOND BABY ALREADY. If only these stupid cows thought a bit more. This is so unfair and so hard. Of course then I Googled and apparently the connection is kinda wonky, and of course the second-opinion-can't-say-anything-against-party-line RE guy emailed me to say that it's not supported by the fucking association of the reproductive assholes or whatever its name is... but it just feels that if I had this surgery a year ago I could have been in a different place right now. Of course truth is that Dr. is not pushing for surgery just yet. And even if he was it would be problematic since we might not have money for it, and our insurance wouldn't cover it, again.

I am also expecting my period and this makes me incredibly sad for so many reasons.