What I like most about Dr. Chang is that she doesn’t waste any time. The day we arrived for our consultation she was counting egg follicles and taking blood.
Of the tests she ran I was most curious about the CA-125. I hoped the blood test would confirm whether or not my years of suffering from painful menstruation were due to endometriosis. The scary thing about this test is that “CA” stands for Cancer Antigen. Putting me and Cancer in the same sentence is an unsettling and uncomfortable combination, but a necessary evil all the same. This test is primarily used to determine the likelihood that a woman might have any of the following cancers: ovarian, endometrial, peritoneal and fallopian tube. But it’s also used to pre-diagnose uterine fibroids, endometriosis, pelvic inflammatory disease and cirrhosis.
Is the CA-125 test accurate?
There are confusing aspects of the CA-125, according to the Mayo Clinic.
“A CA 125 test isn’t accurate enough to use for cancer screening in all women — especially premenopausal women — because many benign conditions can increase the CA 125 level. What’s more, CA 125 levels are normal in many women with early-stage ovarian cancer.”
Furthermore, when used to diagnose endometriosis some studies claim that the test seems to be most accurate in identifying women with severe endometriosis rather than those with less advanced forms. CA level ranges vary as well. Some medical professionals set the limit at 20ml, some 30, and some 35. This is interesting because my level was 34.
“We can almost assume,” Dr. Chang said when reading me the results, “That you have endometriosis because a 34, combined with your history of severely painful periods, can lead us to that conclusion.”
There was more. Not only did Dr. Chang nearly corroborate my hunch that years of suffering and elevated Cancer Antigens almost guaranteed that I had endometeriosis, a condition that can contribute to, if not cause infertility, but she also found something growing inside me. I had landed on planet subfertility with a thud and it appeared that I wouldn’t be visiting baby country any time soon, at least not until these issues were addressed and resolved.
Sonohysterography & That thing growing inside me
After reviewing the slides from my HSG, Dr. Chang noticed what might be a polyp or fibroid in my uterus. To be sure she decided that a Sonohysterography could help her get a better view. This would also help her determine whether or not we could proceed with egg stimulation and IVF. Additionally, she planned to conduct an endometrial biopsy for two reasons, 1. to determine whether or not my endometrial lining was developed enough to support embryo implantation and 2. To stimulate new cell growth in the uterus which improves IVF success rates.
While I was interested in the sono results, I was, and still am, terrified of the endometrial biopsy. I waited for Dr. Chang and poked around the office for clues of what to expect. I saw a bevy of torture tools laid out (pictured here). As a result, I began praying that I indeed had a polyp. If so I’d need surgery instead and would be sparred the biopsy. Surgery meant I’d be asleep in dreamland when any slicing and dicing of my uterus occurred.
Not only is my tube blocked and it’s likely that I have endometriosis, but we did indeed confirm the presence of a rather large polyp, or my very own alien baby, growing inside me right where a fetus should be.
During the ultrasound I remarked, “It looks huge!”
At first Dr. Chang disagreed. “It’s not THAT big” she said, until capturing more angles of the weird looking growth, “Oh wait. Maybe you’re right. It is pretty big.”
She proceeded to ask if she could use the aforementioned images at an upcoming medical conference. The bad news is that my alien is acting as an Inter Uterine Device (IUD), another obstacle on the road of our fertility journey. The good news is that my uterus is a perfectly shaped specimen as if drawn by an artist. Dr. Chang was pretty impressed. There is nothing like a female anatomy compliment when you’re stirrup-ed in and half-naked with a wand up your cooch. I might start telling people that I’m a uterus model.
I was then instructed to schedule a surgery with Dr. Collins to remove the pesky polyp. Dr. Chang also prescribed birth control pills. This seemed weird. Wasn’t I trying to HAVE a baby, not stop one before it started? I learned that birth control pills are used to prevent hyperstimulation of the ovaries during an IVF cycle. Also, according to Science Daily, birth control can help time egg retrieval.
Additionally, Dr. Chang said that I might be a good candidate for a two month cycle of Lupron which increases IVF success rates for women with endometriosis. She gave me a run down of the side affects and they didn’t sound good. Lupron would shut down my reproductive system sending me into a temporary menopausal state. A glimpse into menopause at 32 didn’t sound like an exciting way to spend the beginning of 2013.
I went home that night and read the numerous Lupron horror stories out there. Weight gain, acne, and anxiety to the point of needing a sedative, were listed by people who had used it for just a short amount of time. I could hardly imagine what longer term use could do. There had to be another way.
Endometriosis & Laparoscopy
I’ve been told by many doctors over the years that the only positive way to diagnose endometriosis is though laparoscopic surgery. So, after speaking with Dr. Chang about my polyp and the possibility of Lupron, a light went on. What if Dr. Collins could perform a laparoscopy while she was removing the polyp? I’d already be under anyway I surmised. And after years of suffering I wanted to know for sure.
Dr. Collins agreed she could use the surgery to further explore my abdomen and remove any adhesions. She cautioned, however, that Dr. Chang might still recommend Lupron depending on the severity and prevalence of the adhesions or endometriomas.
I then discussed my Dr. Collins conversation with Dr. Chang. She too liked the idea. In fact, she asked to assist Dr. Collins so that she could get a first hand look at the inner workings of my reproductive system. I would have two gorgeous and brilliant female doctors working together to help heal me. I felt and feel lucky, especially because my husband and I have insurance that will cover most of the costs of all of these procedures. I can’t imagine what we’d do otherwise. Save up for a laparoscopy? IVF? Pray for a miracle?
As my surgery countdown begins (7 days!), my heart goes out to the women all over the world who suffer from painful periods every month, the kind that leave them vomiting and moaning in pain. Endometriosis can be a debilitating and life altering condition and I wish more funds were allocated to researching its causes and cures. My heart also goes out to the women who can’t afford fertility treatments, but desperately want children. When treatable medical conditions prevent one from realizing the dream of motherhood, insurance companies should do their part and pony up the funds.
Luckily my heart is gigantic (because of all the cardio) and so I have one more very large piece to give away… for my husband, family, and friends who have been amazing through all of this. I’d tear out the rest of my heart and let you eat it if you really wanted to, because without you I’d be a manic mess (without my heart I’d be even worse off, but you get my point). Thank you for being there with encouragement and kind words, for listening and loving me. Baby or no baby, pain or no pain, you make life worth living and then some :).