Today I took a big step. With a referral letter from my GP in hand, I picked up the phone and made an appointment to see a fertility specialist.
This story begins in July 2008, when after getting married I stopped the pill but failed to resume my periods. I had always been irregular and my husband and I were not actively trying to conceive so at first I did not get concerned. In December I decided to see my GP. Based on my past history of irregular periods I suspected I may have PCOS (Polycystic Ovarian Syndrome) and wanted an ultrasound to confirm this. My GP gave me the ultrasound request and also took some blood to look for some common causes of amenorrhoea.
I had to wait two weeks for my ultrasound. In the interim I had a surprising call from my GP to let me know we had found the cause for my lack of periods – my Prolactin (a hormone released from the pituitary gland at the base of the brain) was elevated to 10-15 times above normal. With my medical background I knew the most likely cause for this was a pituitary adenoma – a small, benign and usually relatively harmless tumour. My GP quickly referred me to an endocrinologist for assessment and treatment. Although I was surprised by the news I was not particularly upset. I knew that pituitary adenomas are relatively common and the likely treatment was a daily tablet to suppress the overproduced hormone. What’s the big deal? That said I did have to be careful how I explained this to my husband because the term ‘brain tumour’ does tend to – justifiably – cause a little panic!
Since the pelvic ultrasound was already booked my GP and I decided I should proceed with it. My husband and I knew we would probably start thinking about having kids in the next few years so it seemed sensible just to make sure all my bits and pieces looked tip-top. So I put on my nicest pair of underwear and headed off to the appointment, confident that there would be nothing to find.
I was wrong.
The sonogrpaher was very experienced, and probably because she knew about my medical background she was very open about what she saw on the ultrasound.
“Oh yes, you do have a lots of cysts… I can’t even count them… more than thirty on each ovary”.
Lying there, with an ultrasound probe up my unmentionable and my pink bits on display, I had to fight back tears, and I can’t really explain why. After all, this is the result I was originally expecting, right? But somehow, having PCO on top of a pituitary adenoma just seemed… a little unfair. And all in one week.
I managed to hold back my tears until I left the radiology department and called my husband, at which point I promptly burst into sobs, scaring an elderly gentleman who happened to be passing through the hospital lobby.
My lovely husband told me not to move; he was coming to pick me up. Clearly I sounded too upset to get home safely without assistance! Fifteen minutes later Husband arrived, and knowing how much I love Christmas he had a huge Christmas tree in the back seat. Although distracted by the lovely pine smell coming from the back of the car I did manage to sob out the usual “you shouldn’t have married me; I’m defective” line which Husband quickly and firmly put an end to. I do love Christmas, but I love my husband more.
The upshot of all this drama was that once we knew we would likely have trouble conceiving, the desire to start a family hit us full-force.
The first step was a visit to an Endocrinologist who arranged further blood tests and a MRI of my brain. The MRI pinpointed a 4mm area in my pituitary as the likely culprit. Amazingly however, repeat blood tests showed that my PRL level was back in the normal range! While my specialist had no explanation for my ‘recovery’ (it was only the second time it has happened in his career) my husband and I were thrilled that I didn’t need treatment and could avoid the associated possible side effects – one of which is psychosis. (The husband was particularly pleased about that – although he did say that he didn’t think a bit of psychosis would make much of an impact on my usual level of crazy).
So that just leaves the PCOS to deal with. I initially started taking Metformin (commonly used to help acheive pregnancy in PCOS) but had to stop because of side effects. At the time of writing we have been trying to conceive naturally for 9 months but with cycle lengths of anywhere from 60 to 120 days (!) it is time to start down the ART (assisted reproductive technology) pathway…