You've Come a Long Way, Baby

I started this process a year ago. While I had been thinking of it for ages, I consider October 2003 as my official start with a trip to my primary care physician (PCP), for my annual well women exam. My OBGYN had retired suddenly a few years ago with heart trouble and I never found a new one. I really like that guy. I still miss him. He was an old crusty one that had been around forever and was slowly retiring before heart trouble caused him to close his practice. When I called my PCP to get a referral, I was told me PCP could do the exam. I took the lazy route and just saw her instead of finding a new one. When I was in for my October 2002 visit, I broached the subject of single motherhood to her. She was not shocked or outraged or even fazed by the topic. I wasn’t ready to make a final decision or commit yet in 2002, but my 2003 appointment got the ball rolling with a blood work up, a trans vaginal u/s to look at my fibroids, and a trip to the OBGYN I was referred to. The OBGYN was a bit surprised and even went as far as to ask me if I had considered adoption. She said she had done inseminations, but only with fresh sperm and was unfamiliar with the process/procedure for working with frozen donor sperm. After talking and hearing my reasons for wanting to proceed, she said that she wouldn’t have any problem assisting me as she felt that I had really thought things out. She wanted to get a baseline u/s of my kidneys because I was born without the tube between my bladder and kidney and had a kidney infection for the first 10 years or so of my life. So, back for more tests.

At the same time, I had started the search for a sperm bank and a sperm donor. I had decided that I would really like to have a donor who was willing to be ID Released when the child turned 18. While personally, I could care less, I have heard in a lot of adoption cases where the child wishes that they could contact their biological parents and for some this was a real issue. If my child cares, I want them to have the opportunity or at least to know that I did what I could to ensure that happened. Who knows, the guy could not stay in contact with the sperm bank or die, but at least I have done what I could from my end. I found a bank that I really liked and had my initial consultation and narrowed my search. By this time, I had decided to have the nurse practitioner (NP) at the sperm bank do the inter uterine inseminations (IUI) figuring that she would have way more practice than my OBGYN. I came to the consult with the results from my previous tests including the film of the fibroids from the u/s. The NP said she was happy to help, but really felt that I should have my fibroids looked at by an RE to ensure that they were not in a place that could impede pregnancy and gave me a referral to the clinic and dr. I have been using.

I had a consult with my RE and just knew that this was “right”. I really felt comfortable with his skills and knowledge and that he could help me reach my dream of motherhood. After reviewing everything with him, it turns out that the blood workup from my PCP was worthless because 1) It was not done on day 2/3 of my cycle and 2) I was still taking BCP’s at the time. I just have to laugh about how ignorant I was about the whole process back then and how fortunate that I ultimately ended up in good hands.

My blood work was re-done, but that presented challenges in and of itself because I had taken a new job at work and was doing quite a bit of traveling at the time. My cd3 blood work was actually done in a lab outside of Dallas early morning before meetings. Let me tell you what a joy that was to arrange and organize. On 3/23/2004 at 8:20 CT, my blood was drawn indicating that my FSH was 6.5, my Estradiol was 31, and that I don’t have HIV, Hepatitis, and the various other things they test for. I have learned since that these are decent numbers for my age group.

I was also scheduled for a fluid u/s so that my new RE could check on the placement of the fibroids to determine if they would be a problem. At that time it was determined that the size, placement, and position would not be a problem and that what I thought was one fibroid was actually 2. However, the dr. did see a polyp which needed to be removed prior to proceeding. I was scheduled for minor outpatient surgery to remove it.

Finally, after 6 months of prep work and planning, I am ready and set to go for IUI #1.

This years well women exam was actually done by the nurse practitioner at my PCP’s office. I was really hoping to get into see the new OBGYN recommended to me by my RE and that I has switched medical groups to be able to see within the HMO portion of my POS (point of service) insurance coverage, but couldn’t get an appointment with him until December. Since I needed this done along with a few other tests for my RE for my November IVF cycle, this just wouldn’t do. And, since I couldn’t get into see my PCP until the middle of November, I ended up seeing the nurse practitioner at my PCP’s office. I suppose I could have had my RE do it all, but when I see him I am under the PPO portion of my POS benefits which means that I pay 20% of the contracted rate for all service. By going to my PCP’s office, I had a $15 co-pay. Much more economical.

It was amazing to me when talking to the NP about how much more knowledgeable I was than she on the whole reproductive endocrinology and assisted reproductive therapy. As I went through the lab slips from my RE, I was explaining everything to her and why it was needed. She was really very nice and accommodating and included in everything I needed with the normal yearly well women labs that they do. As I lay in the stirrup’s in a position that has become all to familiar to me by now, I REALLY had to fight the urge to break into uncontrollable laughter as she guided me through the process. “I am going to touch you now. I am going to open you up now. I am inserting the speculum. I am going to get the culture now.” As I lay there getting the play by play trying not to laugh, I thought…”You’ve come a long way, baby”. The NP was very concerned that blood was present and kept asking if I was sure that I was not on my period or expecting it. She was so concerned that she actually showed me the blood on the collection swab. She also said that I had a zit or pimple like thing on my cervix (which my RE later told me was probably a benign cyst called a nabothian cyst) and that she was going to do an additional test as a result. A year ago, I would have been freaked out or worried by this. This year, I couldn’t even muster the energy to be truly concerned. I knew more at this point than the NP in the PCP’s office. What’s a little blood or a zit on the cervix? Shoot, with all of the extra hormones I have been on, I have had zits in all kinds of strange and interesting places. Why not the cervix too?

Yes, I’ve come a long way baby.