One Doctor Can Change Everything

I’ve been told by several doctors that:

I am in diminished ovarian reserve.

I am running out of time.

I need to do IVF ASAP.

A few days ago, everything changed.

My endometriosis has progressed to the point where nothing I do or try helps to alleviate my pain. I went to a new doctor in our new city here. She is an endometriosis specialist. She does some work with infertility and the other doctor in the practice focuses on IVF. I had day three FSH, E2, and LH labs drawn. I also had an ultrasound done to take a look at my ovaries and uterus to rule out any new problems.

I went in to my consult with her expecting bad news. After all, it had been seven months since our failed IVF. I figured my FSH was up even more than it was from the 11 we saw a year and a half ago. I also wouldn’t have been surprised to see some endometriomas on the ultrasound.

Instead we received good news.

Awesome news.

Better than we could have ever dreamed of news.

FSH was 5.5. LH and E2 were also within normal limits. I wasn’t too excited about the labs as I knew levels can fluctuate, but we were so thankful that the levels were not higher than before.

Our good news was only getting started. Because then we did the ultrasound.

My ovaries are normal.

NORMAL.

As in, appropriate size for someone my age. Not little like you would expect in a DOR patient. Well, my right ovary was very normal; the left one may have some minor issues.

AND we have follicles. A decent amount of them. It was the middle of my cycle and the doctor counted at least 12 with most being on my right ovary.

Soooo…..WTF??

How do we go from doom and gloom to rainbows and butterflies?

Let’s back up a bit. Why did my old RE and the two REs’ I did phone consults with believe I was running out of eggs and time? Well, I had that FSH of 11. The second FSH I did six months later was 7.2, but my E2 was really high that month which can artificially suppress FSH levels. I also responded very poorly to IVF cycles. And my cycles have been running shorter around 23-26 days.

Those are all indicators of DOR. The one thing I don’t think my RE looked at too closely was my actual ovaries. And old RE never told me any of my antral follicle counts. The more I learn about IVF the more I think my old RE was not very up to date with current knowledge.

So how can I have so many symptoms of DOR, but not actually have DOR?

Elevated FSH – Upon looking at my left ovary during the recent ultrasound, there were not as many follicles growing on that side. Only a few compared to rock star right ovary. If something is going on with my left ovary it could explain why I had a high level.

Short cycles – Endometriosis can cause problems with your cycle. I never read much into that aspect because for the first few years after my diagnosis I was on birth control. Dr. Endo said that many times in her endometriosis patients she finds they have a shortened luteal phase. They sometimes also go quicker to ovulation. This would result in a shorter cycle.

Poor Responder to IVF – This one is starting to make more sense. Every time I have had pain meds for surgical procedures I have never been given enough to help my pain and so every recovery room visit I have hated. I am usually in tears from the pain and they have to give me extra doses and sometimes seem surprised at how much pain medicine I require. It seems my body metabolizes medications much quicker than the average person. (Rock star liver!) Looking back at medical interventions I have had, this is a very common theme of iv and oral meds not seeming to ever be a high enough dose for me. This may translate into why I don’t respond well to IVF meds. Dr. Endo said there are some people that are just genetically designed to where they don’t respond to injectable gonadotropins. This is very likely the case for me. If we remember, I responded very well to the lowest doses of clomid and femara. My ovaries liked those drugs and were happy to spit out 3-5 follicles each cycle. If I was truly in DOR Dr. Endo said I likely would not have responded so well to those drugs either.

So what does this all mean and where do we go from here?

We have HOPE.

We have TIME.

We still have OPTIONS.

Since this post is already so long, I will save our plan for another day.

We have many things to contemplate right now.

And we are so overwhelmed and thankful for the GLIMMER OF HOPE we have been blessed with.