Post-Op Doctor appointment

I had my follow-up/post-op appointment on Tuesday.  I had some concerns, still bleeding and spotting some days and the irritating low pelvic burning sensation.  The appointment went as well as expected.  The doctor isn't reallly sure why the bleeding was still occurring.  When I went in for the appointment I had bleed or spotted for 12 of the 15 days post op. She said some minimal bleeding, but more spotting is normal after a D&C, but the heavy course of bleeding wasn't.  She reviewed my labs and notes from the D&C to see where I was in my cycle at the time of the surgery.  Evidently, based on the type of cells she could tell the stage of my cycle, and based on them she said I was at the beginning of the cycle not the end so I should not have had so much bleeding because the lining wasn't suppose to shed yet.  Keep in mind, none of this really makes any sense to me because with the D&C wasn't the lining scraped and thinned, so there wouldn't be much if any lining at all????

Well, the doctor said it would be an easy fix if we were not still trying to have another baby.  With us wanting to conceive she couldn't treat the bleeding like she would had we not wanted to get pregnant.  She said if we weren't trying to get pregnant, all she would do is put me on birth control to control the bleeding.  BUT, since we still would like to expand our family, she had to figure another way to control the bleeding.  As she explained it, as long as I'm bleeding, we definitely will not get pregnant because my body is shedding the most important habitat for the fertilized egg.

Her two possible resolutions were:
1.  Go on estrogen the first part of the cycle and then mid-cycle (after ovulation) put me on progesterine to support a potential pregnancy.  This approach would stop the bleeding, but wouldn't inhibit ovulation.  There would be no guarantee that I would ovulate, but the estrogen wouldn't, more like shouldn't, cease ovulation like putting me on progesterine would. 

OR

2.  Put me on progesterine for ten days to help stop the bleeding and to promote a withdrawal bleed.  She said after taking the progesterine for ten days and then stoppy this would cause the withdrawal bleed 2-9 days after the last dose.  Then on the third through seventh day of the withdrawal bleeding, the first day of actual flow would be day one, have me take Clomid to promote ovulation mid-cycle to increase our odds of conception. 

So she asked me which approach I would like to try.  Of course, I asked her what her recommendation was and her main question was, "Are you and your husband ACTIVELY trying?"  As I explained to her, "We have been TRYING for nine and a half years. We are not doing anything to prevent pregnancy and we have tried to be more active in what we have determined to be the fertile part of my crazy cycles.  Granted over the last two years we haven't used any ovulatory predicting methods."  She was quick to ask what our ultimate goal is - if it is to get pregnant and have another baby?  When I confirmed it was, her recommendation was to go with option #2.

She said it seems we have been more passive and it was time to be more aggressive in our attempts to conceive.  She recommended doing a progesterine withdrawal bleed and see if it would get me to stop bleeding and to cycle.  She also recommended not actively trying till I can get two cycle bleeds, which put us meeting with her in April and being aggressive starting in April.  Well, I explained to her that I will be gone the whole month of April and my husband will be here so we will not be trying the month of April.  So, we have scheduled an appointment for May 12, 2010 to meet, discuss in greater detail, and go from there.

I have to say, I was so hopeful that having the D&C would help with our unexplained secondary infertility and discourage early miscarriages.  I had done some reading about Simply Hyperplasia without Atypia, which is what I was diagnosed with and the ultimate reason for the D&C.  Anyway, what I had read said that this condition can actually be a cause of infertility and/or early miscarriages, and is usually not diagnosed because it isn't a common ailment.  I was SO hopeful that this would be a quick fix and we could continue to try without any assistance.  I personally would like to get pregnant on our own without the assistance of fertility meds. 

But, I am fast approaching 40, which as the doctor explained once I hit that magic number getting pregnant definitely becomes more difficult.  I inquired about my current age being over 35 I thought that was a "magic number."  She explained that the maternal age of 35 is more about the increased odds of a having a down's syndrome baby not about the odds of getting pregnant.  I guess the next couple of months I will weigh that fast approaching magic number, and decide if it is in our best interest to go back on fertility meds. The doctor also explained with my medical history of difficulty getting pregnant and the multiple miscarriages, she would only do a few months of the Clomid with us and if we don't conceive her recommendation would be then to go to a reproductive specialist.  As she explained, to be VERY AGGRESSIVE in our trying to conceive. 

I'm really not too thrilled about that, but I guess we'll see what happens the next couple of months.  First, I have to stop bleeding and then cycle - preferably on my own.