Houston, We Have a Problem

For months I have been repeatedly requesting further testing. After all, how can you be diagnosed with "unexplained infertility" if you haven't been tested for everything? My RE's office assured me that everything was fine and that since I'm "so young" and my cycles are regular that it would be really rare for me to have any hormonal issues. They were wrong and they couldn't even be bothered to call me with the results themsevles.

Yesterday I went to post to pick up my prescription for Femara. I drove the 40 minutes to the hospital only for there to be nothing in the system--the nurse didn't put in the order. So I had to track down the nurse but the doctor wasn't available to sign the script since he was in surgery. While I was waiting I went to Outpatient Records and requested a copy of all my charts pertaining to the infertility clinic. It was an intersting read--no one ever told me that my HSG showed I had a "filling defect," whatever that is.  My hysteroscopy was clear though so the HSG results don't really matter. The most interesting part was my lab results from two weeks ago. Remember the "proactive doctor?" I thought he was checking me for the CF mutation and checking my thyroid levels. The good news is that I am negative for the CF mutation. The bad news is that he didn't check my thyroid but he checked my AMH instead.  AMH is one of the tests that I have been requesting because it is standard for ANY fertility work up.

AMH stands for Anti-Mullerian Hormone. Women are born with a certain number of eggs. What they're born with is all they'll have in their entire life.  This hormone is an indicator of a woman's remaining egg supply otherwise known as ovarian reserve.  Typically, the younger the woman, the higher the hormone count. According to this chart a women of my age should have a count of 2.1 or higher. Mine was .85 or equivalent to someone 40+.  Insert shocked face.

This information would have been awfully helpful 10 months ago when I first started seeing the RE started taking medications that could diminish my ovarian reserve even more. I remember on my first appointment, on 20 Sep 10, asking for more blood work and them assuring me that it was unnecessary. At nearly every appointment I have questioned the doctor and asked for more testing. I was told that because of my age it was unnecessary. Repeatedly, I was assured that my fertility should not be questioned because of my age and my regular cycles.  I should have never listened to them. I should have been more persistent.  Maybe the test results are wrong but I do know that they had better do further testing on me. CD3, antral follicle count, etc.

So what does this mean for us? Honestly, I have no idea. Is IVF our only option? If it is, it would have been nice to know that a year ago since the waiting list is so long.  Does the age and quality of my eggs are bad? Can I even conceive at all? These are all questions that I will have to talk to my doctor about at my follie check on Friday which, by the way, I had to fight for.  They tried to tell me they were completely booked but I insisted that I had to be seen since I'm starting a new drug. Can you believe that? A RE who will prescribe fertility drugs to a patient and not do any monitoring? They ended up double booking me and told me that I could be waiting awhile but I assured them that I'd rather wait than not be seen at all.  I think I need to take a few hours, read through my old blogs and take a trip to patient advocacy.  I think I have a good case for being referred off post.  The care I have been receiving has been greatly lacking, it's a fight almost every month to get an appointment and the potential DOR thing should have been diagnosed much, much sooner instead of brushing me off because of my age. They also could have had the courtesy to call me with my lab results instead of me finding out by going to patient records.  At this point I am just so baffled.  I'm  frustrated, hurt, angry, stressed and scared.

I honestly have no idea what and of this means for us or if I'm totally overreacting. So.....advice? Insight? Have any of you been diagnosed with low AMH? Any of my military readers have any experience dealing with patient advocacy?