Sunday, April 11, 2010

First visit to an ob/gyn

Thanks for joining me again. I'm still in catch-up mode, writing stuff down to help bring you up to speed on where I'm at now.

I went to my first appointment with the ob/gyn to discuss the polyp. The GP had suggested that it was most probably benign, but could in some cases act a bit like an IUD and interfere with any pregnancy attempts. The ob/gyn confirmed this, but he was far more interested in the fact that I was diabetic! And trying to get pregnant! And with a hubby with a 9yr-old vasectomy! How thoroughly interesting! He's a nice chap and put me at ease straight away.

Ob/gyn explained that there were no local fertility services in my city, and that I would have to make the 3 hour trip to another city for treatment should I wish to proceed. He kind of assumed it was all go, although I still thought I was just investigating options.

He wrote letters to the fertility clinic asking them for advice on my case, and we waited a month.

This last week we got a letter back, and I returned to hear the news.

Ob/gyn had basically good news for me. The fertility clinic had recommended not a vasectomy reversal as we had expected, but rather IVF and ICSI (say "icksy"). A vasectomy reversal would have only about a 30% success rate in the first 12 months for us, whereas the IVF/ICSI method would have closer to a 60% success rate.

Of course it's never that simple. With IVF, I would have to take hormonal drugs, which are expensive, and hubby would have to have what's known as a sperm retrieval operation to get sperm for the ICSI procedure.

The doctor went on to explain how the fertility clinic recommended I proceed with getting the (benign) polyp removed from my uterus. The operation, a hysteroscopy, involves general aneasthesia which makes me nervous, as I have reacted badly to local aneasthetic in the past. Also, the idea of giving someone else control of my diabetes for any length of time makes me nervous. I don't care how well the aneasthetist is trained! But that is a hurdle I will deal with when I come to it.

All these things sound expensive, because they are. We're not rich, so the first question out was "how much is all this going to cost?" The doc smiled and told me that in New Zealand the government funds the cost of the first round of fertility treatment. And as a bonus, the hysteroscopy operation would be government funded too. I would have to go on a waitlist for the op, and the fertility clinic would give more details about the treatment.

Ob/gyn wrote official application letters to the fertility clinic, requesting an initial appointment. He also used up most of the rest of his blood-test order forms. I have 3 sets of blood tests to do, and hubby has one. I also have to get the hysteroscopy done before appointment. That's a lot of stuff to do over the next month and a bit!

On top of all that, I want to go back and talk with my endocrinologist and diabetes education nurse. I am quite sure that they had not considered the idea that I would ever have to undergo IVF. (Google suggest that the IVF drugs can screw with type 1 diabetes.) The endo tends to forget the details of my case between 6-monthly visits, so has taken to asking me if I am pregnant, and each time I politely remind him of hubby's vasectomy. sigh. ohwellnevermind. Endo has mentioned that I may be eligible for an funded insulin pump. So I want to ask him a million questions about that, like, if I get pregnant will I need to go on a pump? Should I get on a pump now to get a better HbA1c number? (Currently 8.1, the highest ever :( in my entire life), will consumables be funded? Can I look at getting a CGM too? My diabetes educator actually wears an insulin pump. A rare sight in NZ and even rarer in my small city. Hers was actually the first one I ever saw.

And as a last thought, should I start taking pre-natal vitamins? Is that jumping the gun a bit? :P I don't want to freak hubby out. Although he has agreed to the idea of a child in principle, this whole IVF/operations for both of us thing has completely changed the mix. We both want to meet with the fertility specialist and discuss options and what it all means before committing to this course of action. Although it promises to be cheaper that I had originally imagined, we will still have plenty of travel, time of work, and accommodation to pay for to get to the clinic in the other city. And pretty much every blog I read says that it's a trying and tiring time, which will either bring you together as a couple, or drive you apart. I am really worried about that, as we are happily married and love being together. I know he's a wonderful Dad already, and I am enjoying being a part-time step-mum to his 3 kiddlies. I really hope we can have kid/s of our own.

Wow that's heaps of words, are you feeling as tired as I am? Whew! I am going to make a glossary, as there are plenty of confusing words and acronyms, and just plain kiwi-isms which you may not know.

Thanks for reading, catch you next time.


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