Due to some unusual cramping and bleeding, I went in to see my reproductive endocrinologist (RE), who is dually board certified as a gynecologist and an endocrinologist. If you have PCOS, and especially if you’ve ever tried to get pregnant and had a problem doing so, you have probably been referred to a RE. REs have a specialized understanding of the way our hormones affect our fertility, blood sugars, insulin resistance, and other PCOS-related conditions. They treat many PCOS patients, because PCOS is a primary cause of infertility.
One vaginal ultrasound and one pregnancy test later (the doctor and I duly noting that I am well over 40, infertile by all medical definitions, and just about as likely to be pregnant as Mother Teresa), it was determined that there’s a UFO in my uterus! Well, not really, but that’s what it looks like on the ultrasound screen. So, if it’s not a polyp, a cyst, a fibroid, or a baby, what is it?
Cancer comes to mind, and the possibility of cancer necessitated an endometrial biopsy, which is a very uncomfortable procedure in which the tissue in your uterus (the endometrium) is sampled (that’s medical-speak for pulled out in tiny chunks) and sent to the laboratory to be tested. Fortunately, no cancer was found. However, given that PCOS patients are much more prone than average to conditions such as hyperplasia (a proliferation of sometimes questionable looking cells) and endometrial cancers, the recommendation is almost always surgery to remove the tissue, be it a polyp, a cyst, or in this case, something unidentified. I am fortunate to have a highly skilled, aggressive doctor, who knows me and my condition very well, and I agree with this recommendation.
That was the good news, but then I learned the bad news – that my eggs had officially expired. While some doctors question the accuracy of the anti-mullerian hormone assessor, it’s a pretty accurate way to determine whether your eggs are still of use (and to what degree), or if you are pre-menopausal or post-menopausal. No longer having viable eggs was not unexpected, given my age. Nonetheless, there’s an emotional hit to all of this. There is a sense of loss, of unrealized potential, and a need to acknowledge that the door on having a biologically related child, created with my own eggs, has officially closed. At the same time, there is a surprising sense of freedom and relief accompanying this news. Given my personal and family medical history, I no longer have to make an active choice about passing on my genes. With assisted reproductive technology, the doors are open to carrying a pregnancy anytime up to age 53. I just know now for certain that, for me, a pregnancy would mean using donor eggs.
A visit to the RE can be painful or uncomfortable, confusing, enthralling, educational, inspiring, or worrisome – all at the same time. Surgical procedures and testing add to the complex mix of emotions aroused by having a condition or conditions you don’t entirely understand, an equally confusing array of treatment options, time pressures, and a host of medical practitioners, all with their own particular slant on what constitutes your best treatment plan, and why.
For me, that means surgery next month to remove the UFO, continued monitoring of my endometrial condition, and of course, more visits to the RE, especially should I decide to pursue a pregnancy with donor eggs in the future. I like the idea that I still have options, the immediately pressing medical concern is being addressed appropriately, and some aspects of my fertility still offer possibilities. PCOS has a rhythm and a flow of its own, shifting in prominence at various stages in your life and reproductive cycle, and contributes to a mix of emotional experiences. In choosing how to manage your care, your fertility, and your emotions, I hope you too are able to focus on the positive.
If you have not had the opportunity to hear Gretchen's interviews with pcoschallenge.com, please take the time to do so! Gretchen will also be hosting a PCOS expert webinar next Tuesday…to attend please contact www.pcoschallenge.net for more details on how to do so.