OK, so both DH and I are so tired and "violated" right now (his term, not mine... after all, I'm used to the dildo cam), I figured I will relax a bit before getting my stuff together for my On-Site tomorrow (eek)! And by relax, I mean go online and post a blog about what we've learned so far.
The entire DA was very informative and educational!! We got there early enough to peruse Dr. Toth's latest book, Fertile vs. Infertile, and it is REALLY interesting!! Of course, being a pathologist and an ob/gyn, it speaks primarily of infection, bateria, and pathogens and their role in infertility- - which is why we were referred in the 1st place. Apparently there is a vertical means of infection transfer (through parents/generations) and a horizontal (through sexual partners). And infections that do not necessarily fit the definition of an STD can also be transferred through intercourse, but since they don't do much organic damage, they are rarely tested for (until someone experience IF).
So while reading the first 2 chapters of this book, DH was called in to give a semen sample. I really, really hated this, and wish I had known beforehand. The more I thought of it the more it made sense that the Dr would need one, but I didn't think it would have to be today. So, of course, being put on the spot, there really was no alternative method of collection in line with our beliefs. But DH was a trooper, and managed to get the job done. When he was finished, we were both called in to the office to go over medical history. This took about one whole hour. All kinds of questions that no one had ever asked us before, related to our nuclear families' pregnancies, births, etc. and our extended families' illnesses. Of course, also specifics about our TTC history, diagnoses, lab results, etc. During this hour, he also had us both take a look at a sample of DH's semen under the microscope. He immediately made a comment that put me at ease about DH's morphology: "WOW!! Look how many there are! With a count like this, it doesn't matter if 90% of them are amorphous, there are still PLENTY to get the job done!" Sure enough, there were more sperm swimming around in that sample than there were empty areas :) Shortly after (maybe 10 mins or so), the Dr looked at the sample again and asked me to come give him a "second opinion" on something. (He was quite the jokester, this Dr.) He wanted me to tell him what I saw, in laymen's terms. I looked and saw a cluster of sperm right in the middle of the slide. He said that this could be a sign of the sperm fighting against certain bacteria, like antibodies, that have formed in the semen as a defense against the infections. ((This was pretty scary at first to hear, because a) I didn't know if this could be fixed, and b) I wondered if this was our problem all along and no other SA could tell us that, which would have made me MAD!)) It turned out, after an hour, the slide showed only that small portion of clumping still, so he said there were millions of other sperm doing the right thing and that it didn't seem to be a case of antibodies. Phew!!
Then DH and I went into separate exam rooms to get some swab samples and u/ss. Poor DH :( I don't think he believed me when I told him he'd be getting an u/s. In his u/s, there was evidence of a slightly enlarged prostate, with areas of "infection" in various spots. (Any areas of gleaming white were areas of calcification, as it was explained to us. We could literally see it in the pictures!) There were also some areas of "white" infection along the ureter.
In me, the white was mainly concentrated ALL along the cervical canal. As I started to read in his book, the cervix is the first line of attack on infection entering the body through intercourse, so it probably started working overtime until it couldn't handle it anymore... and now it's full of the pathogens. There were areas around my ovaries, too. The good news is, when he poked around at the ovaries, they moved easily, showing good evidence of no major adhesions left from my surgery :) Thank GOD! Oh, and when he was taking swabs from my cervix, he apparently also had to take one from the uterus. He asked me if I knew which way my uterus flipped, and I said, "Uh, yeah. Anteverted I believe." Then he said, "you'll feel some cramping," and O.M.G. did I ever feel some cramping. Just HTH he got a swab from my uterus, through my cervix, is beyond me. But it hurt like a mother afterwards!
So after our exams, we went back to his office to discuss the findings. We looked at the pictures from the u/ss and he pointed out all the white spots. He then hypothesized how each of us may have come to get our infections, going back to our vertical lineage and then horizontal. Perhaps the most interesting part for me was hearing about the extent of my infection and its effects. Since I had started having signs and symptoms of PCOS before I was genitally active, it seems likely to the Dr that I have inherited the infection vertically first. After years of the infection not being "treated," it made its way up, up, up my reproductive tract and eventually attacked my ovaries. After that, my ovaries stopped communicating with my pituitary gland, and started pumping out eggs (not releasing them, mind you, just pumping out the follicles- PCOS), regardless of what the pituitary was telling it to do. So finally, I have some rhyme or reason to the background of my PCOS, which never made sense to me before!!
The Dr also said that while my ovarian wedge resection has restored ovarian function FOR NOW, if I had this infection go untreated, than it would inevitably attack the ovaries once again and I'd go right back to anovulation, excess androgens, etc. etc.
So we will have the results of the testing within 3 weeks time, at which point he will know exactly what course of treatment to go with. It could be a more extensive line of treatment if the infection itself has been brewing for many years. (DH asked me afterwards, "Did he mean extensive or expensive?" I said, "I'm sure with one comes the other!") Going back again to something I read in his book (those first few chapters were really informative!!), if a line of antibiotics is discontinued too early, it only heals the infection on one level, but not all levels. And eventually, it takes over once again.
Sooooo... that is our DA in a nutshell. (No, this is my DA in a nutshell: "Help! I'm in a nutshell! How did I get in this nutshell? What kind of shell has a nut this big?!")
Then we had a lovely dinner of ALMOST authentic Italian pizza, followed by a little treat for me from La Maison du Chocolat, and 2 macchiatos from the cafe next door. All in all, a productive day.
Oh, and the Dr's office asked for a copy of my insurance card- - they will be submitting the claims to them for me! Thank goodness! For some reason I think insurance co's take Dr's offices more seriously when entering claims than when it comes from the patient. Plus, they don't code it as IF work-up, but infection/bacteria work-up. So far, those prayers are workin'! Keep 'em coming!