Last week, we flew to Chicago for my appt with Dr. K.wa.k-Ki.m. I had been praying that I would miraculously fall pregnant and wouldn't need to make the trip. However, God had different plans for me. It's been 6 months since my last miscarriage and I knew I had to do something to get pregnant and stay pregnant, and so I decided to keep the appt. I had been following the RI Yahoo Group for a while and so I had a vague idea what to expect for the appointment.
We reached her office at 8:30 in the morning and without any delay, they called me in for bloodwork. They took 22 vials of blood for all the RI tests I have never heard of. I was supposed to drink 32 oz water to have a full bladder for the ultrasound. I think I overdid that and I badly wanted to use the restroom. Thankfully, the sonographer didn't keep me waiting for long. She was the sweetest & kindest person I have ever met. I felt totally at ease with her. I was on P+15 and I had already tested to confirm that I wasn't pregnant. Ever since I began Metformin, my cycles have become more regular 28-29 days. Last cycle, I had 4-5 days of mucus and had my Peak around Day 13. I even had a confirmed rise in BBT and so I went ahead and took Progesterone. Since, I was on P+15, I expected my period to begin any minute and hoped that it wouldn't until the appointment was over.
During the ultrasound, she kept telling me that she couldn't find a Corpus Luteum which she normally finds in patients who have ovulated even if they are about to begin their next cycle. She could see layers in the endometrium which is normally not seen after ovulation. It either meant I didn't ovulate or I had a wimpy follicle and the corpus luteum died out too soon. My emotions were all over the place. So much for the mucus buildup and the rise in BBT! She found tiny cysts on both my ovaries and asked me if I had been on Clomid or Femara. I was on Femara for 3 unmonitored cycles and had stopped taking it from July. Either those could be leftover cysts from the Stimulated Cycles or it would mean that my ovaries were polycystic. I almost lost it and was on the verge of tears but I managed to put on a brave face. She checked the blood flow to my uterus and ovaries and it was something around .62 when it should have been around .4. My right ovary had poor blood flow and my left ovary seemed more dominant. That explained why I ovulated on my Left Side on Clomid cycles. I am not worried about that because my left side is the side I have my Fallopian Tube. I asked her if she could see any Endo and she said she didn't see any. Of course tiny Endo cells wouldn't be visible but otherwise, things looked good on the structural front. I also had a very detailed Thyroid Ultrasound and though one side looked a bit abnormal she didn't find anything significant.
After the ultrasound, the Nurse Practitioner discussed my Medial History and I had a Breast Examination. Next, we met with Dr. KK and she explained that my ovaries looked polycystic and the need to go on a Low Carb Diet. She asked me to lose 10 lbs to help with ovulation. Since I was diagnosed with Insulin Resitance by my NaPro doctor, she said it could be causing Poor Ovulation & Immature Follicles resulting in Implantation Failures. Also, I would need to take Lovenox shots to improve Bloodflow to the Uterus. I will have a phone appt with her once she has the results form the bloodwork. She was very realistic and didn't give me any false hopes. I asked her if I should get a Lap done to check for Endo or adhesions but she said that it wasn't needed as of now.
I have been having mixed emotions after the appt. All this while, I thought I was ovulating every cycle but it looks like I wasn't. If I am not ovulating regularly, it means my chances of conceiving are reduced which is the reason why I am sub-fertile. First and foremost, my body needs to have a healthy ovulation. Only then can I hope for a pregnancy. My NaPro doctor (who specializes in PCOS) & other doctors never found Polycystic Ovaries inspite of numerous ultrasounds. I am sure my Polycystic Ovaries and Insulin Resistance are all linked. I feel stupid for getting my hopes high each cycle thinking that I would be pregnant when I didn't even know if I ovulated or not. After each NaPro appt, I would get my hopes high thinking that Progesterone, Thyroid meds, Femara, Vitamin D or Metformin is going to help me. This appt reminded me that I was not in control and that God was the one who was in control. Even if I wanted to be pregnant, I couldn't do it as I wished. What do I do to have a healthy ovulation? I tried Clomid and still miscarried. I wish I had answers.
I am also waiting for my surgery date with PPVI. They have a long waiting time and the nurse told me that it would be atleast 4-5 months before I have a date. Meanwhile, I would need to ship my blood for the hormone panel. Now, I don't know if I want to go for the surgery since Dr. KK doesn't recommend it. How I wish life would have been easier.
My new cycle began on P+18 and I just had 3 days of light bleeding when I normally have 5 days of medium to heavy bleeding. Does it mean that I had a poor lining buildup because of poor ovulation? Since I took progesterone without ovulation, is that the reason for the light bleeding? I am freaking out over here. Do you gals have any idea what would happen if I took Progesterone before ovulation?
We reached her office at 8:30 in the morning and without any delay, they called me in for bloodwork. They took 22 vials of blood for all the RI tests I have never heard of. I was supposed to drink 32 oz water to have a full bladder for the ultrasound. I think I overdid that and I badly wanted to use the restroom. Thankfully, the sonographer didn't keep me waiting for long. She was the sweetest & kindest person I have ever met. I felt totally at ease with her. I was on P+15 and I had already tested to confirm that I wasn't pregnant. Ever since I began Metformin, my cycles have become more regular 28-29 days. Last cycle, I had 4-5 days of mucus and had my Peak around Day 13. I even had a confirmed rise in BBT and so I went ahead and took Progesterone. Since, I was on P+15, I expected my period to begin any minute and hoped that it wouldn't until the appointment was over.
During the ultrasound, she kept telling me that she couldn't find a Corpus Luteum which she normally finds in patients who have ovulated even if they are about to begin their next cycle. She could see layers in the endometrium which is normally not seen after ovulation. It either meant I didn't ovulate or I had a wimpy follicle and the corpus luteum died out too soon. My emotions were all over the place. So much for the mucus buildup and the rise in BBT! She found tiny cysts on both my ovaries and asked me if I had been on Clomid or Femara. I was on Femara for 3 unmonitored cycles and had stopped taking it from July. Either those could be leftover cysts from the Stimulated Cycles or it would mean that my ovaries were polycystic. I almost lost it and was on the verge of tears but I managed to put on a brave face. She checked the blood flow to my uterus and ovaries and it was something around .62 when it should have been around .4. My right ovary had poor blood flow and my left ovary seemed more dominant. That explained why I ovulated on my Left Side on Clomid cycles. I am not worried about that because my left side is the side I have my Fallopian Tube. I asked her if she could see any Endo and she said she didn't see any. Of course tiny Endo cells wouldn't be visible but otherwise, things looked good on the structural front. I also had a very detailed Thyroid Ultrasound and though one side looked a bit abnormal she didn't find anything significant.
After the ultrasound, the Nurse Practitioner discussed my Medial History and I had a Breast Examination. Next, we met with Dr. KK and she explained that my ovaries looked polycystic and the need to go on a Low Carb Diet. She asked me to lose 10 lbs to help with ovulation. Since I was diagnosed with Insulin Resitance by my NaPro doctor, she said it could be causing Poor Ovulation & Immature Follicles resulting in Implantation Failures. Also, I would need to take Lovenox shots to improve Bloodflow to the Uterus. I will have a phone appt with her once she has the results form the bloodwork. She was very realistic and didn't give me any false hopes. I asked her if I should get a Lap done to check for Endo or adhesions but she said that it wasn't needed as of now.
I have been having mixed emotions after the appt. All this while, I thought I was ovulating every cycle but it looks like I wasn't. If I am not ovulating regularly, it means my chances of conceiving are reduced which is the reason why I am sub-fertile. First and foremost, my body needs to have a healthy ovulation. Only then can I hope for a pregnancy. My NaPro doctor (who specializes in PCOS) & other doctors never found Polycystic Ovaries inspite of numerous ultrasounds. I am sure my Polycystic Ovaries and Insulin Resistance are all linked. I feel stupid for getting my hopes high each cycle thinking that I would be pregnant when I didn't even know if I ovulated or not. After each NaPro appt, I would get my hopes high thinking that Progesterone, Thyroid meds, Femara, Vitamin D or Metformin is going to help me. This appt reminded me that I was not in control and that God was the one who was in control. Even if I wanted to be pregnant, I couldn't do it as I wished. What do I do to have a healthy ovulation? I tried Clomid and still miscarried. I wish I had answers.
I am also waiting for my surgery date with PPVI. They have a long waiting time and the nurse told me that it would be atleast 4-5 months before I have a date. Meanwhile, I would need to ship my blood for the hormone panel. Now, I don't know if I want to go for the surgery since Dr. KK doesn't recommend it. How I wish life would have been easier.
My new cycle began on P+18 and I just had 3 days of light bleeding when I normally have 5 days of medium to heavy bleeding. Does it mean that I had a poor lining buildup because of poor ovulation? Since I took progesterone without ovulation, is that the reason for the light bleeding? I am freaking out over here. Do you gals have any idea what would happen if I took Progesterone before ovulation?
So sorry that your appointment didn't go as expected. Remember that Docs give a lot of opinions and a lot of times those opinions aren't reliable or accurate. I was told I wouldn't conceive unless I came back for another surgery 3 cycles later I was pregnant without all the protocol. It is good to go on a low carb diet regardless of insulin resistance etc. There is one lady who blogs who had so many miscarriages finally she went cold turkey and ate no sugar or wheat and she carried to term. Praying for you to be strong and keep fighting.
ReplyDeleteI have no advice on the hormone front. I've never heard of anyone taking Progesterone before ovulation...It sounds like she gave you some solid advice that might be one more piece of the puzzle. Since surgery is so far away, you have time to think about it and God will reveal what He wants you to do. Praying for you right now. ((((Hugs)))
ReplyDeleteYou found out 2 major problems- your ovulations aren't great and your bloodflow is poor- two problems that CAN improve. There may be others that show up in the bloodwork. Have you read "Is your body baby freindly?"? by Dr. Beer's? I didn't read it before having all the RI testing done and once I read it everything was much more understandable.
ReplyDeleteYou are on the right track with metformin. For me, that is my miracle drug. I went from a cd22 day ovulation to cd16 ovulation being on it for one cycle. And also, us PCOS sufferers can ovulate- it's just not all the time so perhaps you are having SOME anovulatory cycles and some not. Don't give up hope!!
To improve blood flow I suggest being on fish oil - a natural blood thinner. I am sure you will be put on a baby aspirin also as part of your protocol.
You could benefit from acupuncture or abdominal massage- it can greatly improve bloodflow.
I would also suggest that you have an u/s series done each month you are TTC to make sure you are ovulating and that you are timing progesterone or a trigger shot correctly. PCOS can be tricky esp. because we can have those fm buildups and I don't believe charting is enough to be sure. You really need to know.
Praying for you.
Thank you for the info! I am already on Baby Aspirin and Fish Oil. I will ask my NaPro doctor about monthly ultrasounds..
DeleteThe appointment gave you lost of info. Try not to feel stupid about past cycles, you were doing the best with what you have. It sounds like you are on the right track with dr. KK. Please post your blood results. UGH. Low carb diets are hard but can really help, I was on one for about 6 months prior to conceiving my daughter. Good luck!
ReplyDeleteWow that's a lot of blood! It seems like you got some answers which is great! Praying for continued answers.
ReplyDeleteI know all of this information can be overwhelming, but I am glad you are getting some answers. I"ll pray for you as you continue to figure out what to do.
ReplyDeleteYou are on the right track and in the right hands. I know its hard but lose 15 pounds and STAY AWAY from carbs and sugar as if they are poison!
ReplyDeleteLots of info! And lots of blood! Yikes!
ReplyDeleteI would do what Dr. KK says in between now and your surgeries with PPVI. I have read good things about her on the blogs. I'll keep you in prayer, especially as you begin your new diet. Something I struggle with too. :-)
There are so many new avenues to try, so maybe this is better than no answer or nothing left to try? (((hugs))) I know that doesn't help much.
Wow...what an appt. I'm so glad you went though. Think of all the new info you have now about your body and how to make it healthier. And yes, you can lose 10 lbs. I went on a low-carb, high protein, no sugar, no wheat, no dairy diet (some because of PCOS and some because of food intolerances). I lost weight (I also exercised and walked) and felt so much healthier, and I conceived and stayed pregnant 3 months after starting all of the above craziness. You can do it.
ReplyDeleteCan't wait to hear more about your bloodwork results. Oh, I was also on progesterone without ovulation. I would just take it CD 21 or P+7, whichever came first. CD 21 always came first. My Napro Dr. had me on it to try and get my body into a better rhythm because I wasn't ovulating. And some cycles, usually those I didn't ovulate, I did notice just light bleeding instead of a regular period type bleed. Feel free to email if you have questions or want to chat more.
I can't imagine getting on such a restrictive diet. I can avoid sugar and carbs but I am not sure if I can survive without wheat and diary too. What do I eat? Veggies and Meat? I will mail you.
Delete22 vials!! OMG- Your appt does sound thorough...I am glad you got more possible answers on why you are having difficulty conceiving/m/cing..I read all the comments and I have not been thru dr. KK protocols, but I hear nothing but great things about her! Sounds very hopeful!!!
ReplyDeleteSo glad you were able to go out there and get some new information. She really covers a lot of things that NAPRO doesn't, and maybe combining the two will finally get you to a full-term pregnancy. It might be good to request an ultrasound series from your NAPRO doc to see if you are having recurrent ovulation problems or if that was just a fluke cycle. If your period is normally stronger, maybe this was an isolated incident of not ovulating due to stress or somthing else and not necessarily PCOS. A low carb diet is definitely worth a shot. Have you ever read The Fertility Diet? It is a diet to help improve ovulation - basically low carb.
ReplyDeleteI haven't heard about the Fertility Diet. Thank you for mentioning it. I need to find a suitable diet!
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