WTF is DOR?!

To those who know me, it should come as no surprise that I started doing my research at the first hint that we may end up struggling with infertility. I'm highly anxious, an Enneagram 6, a planner, someone who needs all of the information to help me feel as safe and in control of any given situation as possible. As such, I considered myself decently aware of the possible diagnoses we might receive after consulting a fertility specialist.

Turns out, I knew next to nothing.

On my first visit to the fertility clinic, I met with the nurse practitioner, Kat, who performed an ultrasound to get a precursory overview of what exactly was going on in my reproductive organs. Kat noted that everything looked relatively normal, but that it did look like I might have slightly fewer ovarian follicles than normal. She assured me this wasn't anything to be super alarmed about and instructed me NOT TO GOOGLE IT because it would just stress me out. That same day I made an appointment for a saline infusion sonohysterography (SIS) and hysteroscopy, and I also had 25(? - I stopped counting after 20) vials of blood drawn to test for...as far as I can tell, everything under the sun.

About 2 weeks later I went in for my SIS and hysteroscopy. I've had 2 IUDs inserted and removed so I'm like...not exactly a stranger to having uncomfortable procedures performed on my uterus. During the SIS procedure a ballon is inserted into the uterus and then slowly filled with about 10ccs of saline solution, and then a transvaginal ultrasound is performed. So, it was basically the same thing as I'd had two weeks priori only Kat was able to essentially inflate my uterus to get a better idea of its shape and any abnormalities. She did not a small protrusion that looked to be either a polyp or scar tissue from my D&C surgery from my miscarriage in December. Given that they'd need to remove it either way, she decided to save the hysteroscopy (procedure where a small camera is inserted into the uterus) for later so that both that and the growth removal could be done at the same time. More on that later...

I got the results from my lab work back the next week - coincidentally, on the same day that our first baby was due. It helped to have a distraction and something positive to focus on, but given that the news wasn't exactly amazing, at the same time it made a difficult day a little harder. I'm not sure what results we were expecting or hoping for. We decided to go to the fertility clinic in the first place because we felt like we were just spinning our wheels after 9 months and 2 miscarriages, and we thought it would help to get some answers. At the same time, I think somewhere deep down I was hoping to hear that everything was fine, that I had just gotten unlucky, and that I'd have no reason to think the third time wouldn't be the charm.

But that's not exactly what happened. Kat ran through all of my lab results - which, for the most part, turned out to be completely normal - except for a potential thyroid deficiency that may not have anything to do with anything, and, the big one: diminished ovarian reserve (DOR). Kat showed us a few graphs and explained that although I'm 32, I essentially have the number of eggs that would be typical in a 40-year-old. Given that I'm on the younger side, active and relatively healthy, and have had regular periods since I was 12 with no reproductive issues to speak of, this came as quite a shock. 

It turns out that there's no reason or explanation for DOR, at least none that would apply to me. It's most likely that it's genetic, that I was just born this way. Although there are still plenty of options for fertility treatments for me to get pregnant, there is nothing that can treat DOR specifically. It is, as they say, what it is.

After my initial DOR diagnosis, I spiraled a little bit. Both Ben and I were worried that low egg count also meant low egg quality (meaning higher chances of chromosomal issues), but neither Kat nor anything we read definitively said nor even suggested that that might be the case. Still, hearing that diagnosis did give us an answer that I'm not sure either of us was prepared for: we will have trouble bringing a baby into the world. We know we can get pregnant, as we've done it twice (go us, I guess?), but our chances of having a successful pregnancy are now officially lower than the average person's. 

I should really write an entire post or several on the mental rollercoaster that hearing something like that puts a woman and a couple on, but I won't go into it in detail now. I will say that after that appointment of hearing our results (yes our - Ben also had bloodwork done and, in no surprise to anyone who knows him, it all came back perfect) and diagnosis, we went out to lunch together at one of our favorite local spots...and I cried. I cried a lot. I think I sobbed almost the entire time. Our poor waitress. It seems the theme of our pregnancy journey so far has been slow at first, then all at once. That's actually how I tend to make most of my big decisions - dwell on them for a while until suddenly making up my mind - but it's a little different when I'm not the one steering the ship. Suddenly I felt completely adrift, no better off than I was before I knew what DOR stood for, with no more options than I'd had before I stepped into a fertility clinic in the first place. I felt helpless. I felt unsure. I second-guessed myself: was this even really what I wanted? I voiced out loud to Ben my biggest fear of all: what if the reason we haven't successfully made a baby together is because we aren't supposed to? How many more times should we try and fail before surrounding to the Universe's will, before accepting that maybe this just isn't the path we're supposed to take?

Like I said, I spiraled a bit.

We talked, like we always do. Ben made me feel better, like he always does. And even though I still had those 3 letters hanging around my neck, branded to my forehead, I conceded that we still had options, just like we always had. Since I was due to ovulate only a couple days after that appointment, Kat gave us the green light to try one medicated cycle to see what happened, and prescribed me a cocktail of medications/supplements (progesterone, prednisone, baby aspirin, and CoQ10). That July cycle turned out to be unsuccessful, which led us to my next procedure: my hysteroscopy and having my scar tissue/polyp removed...