yet another fertility update

So where did we leave off on our fertility saga? Oh, yes: May 12 I saw my doctor, who said she had no idea what was going on and referred me/us to a specialist, a reproductive endocrinologist (RE). We had to fill out 14 pages of history before we were able to make the appointment, but then we were able to get in only two weeks later on May 27! (Apparently the economy has slowed down the rush for the fertility docs?!) It was on the back of my mind earlier in the month, but by the time the appointment day itself rolled in I was a nervous wreck! I don't know why I was so nervous, except that I was excited and wanted to be taken seriously and wanted a plan ... and I have a great ability to worry about anything and everything.

The clinic itself was a bit of a pain to get to for me, it being on the U campus and all, but Mike was very pleased with its accessibility. My doctor was only running a few minutes behind (maybe 15?) by the time of my appointment (at 3:15), which is not too bad for a specialist toward the end of the day. When he finally came into the consultation room, he just jumped right in - no chit chat, no small talk - and barely made any eye contact. But, quite frankly, I didn't care what kind of bedside manner he had because he seemed so thorough and intelligent. At this point I just want someone to figure out the problem, and so far I have confidence in him.

After about 30 minutes of excruciating detail regarding our health and reproductive histories, we finally got a plan!
1. We did some additional bloodwork that day. Apparently there were a couple secondary hormones that he wanted to get levels on, and he also wanted to rule out either of us having an STD that would interfere with conception (I'm not too worried about that being the case!).
2.  I need to go back at a certain point in my next cycle in order to have another ultrasound. He didn't like that there were still cysts after my follow-up ultrasound at the beginning of the month, and he said if the cysts are still there after another cycle that it probably means I have endometriosis.
3A. If there are NO cysts on the next ultrasound, he would schedule a saline sonohysterogram (SIS; which is supposed to be only slightly less painful than an HSG. *gulp*) to see if there is any scar tissue or other anatomical issue (since there was a slight suggestion of this on the HSG).
3B. If there ARE cysts on the next ultrasound, he would prescribe BCP for a couple cycles (I don't remember how many he said), then schedule a laparoscopy (to remove the endometriosis) and hysteroscopy (to get a better look at the uterus and its lining, which should be thinned by the BCP to make it easier to see, and then to treat any problems that are found).
There is some info about all these options both here and here.

Needless to say, I'm not too excited about the prospect of either an SIS or surgery. But, with that said, I'm also happy to have a plan and a probable diagnosis (likely endometriosis, due to my cysts and the pattern of pain I have) - and I'm excited about the prospect of having less pain if I end of needing a laparoscopy and if that procedure is successful.  And, because nothing is ever simple in my mind, I'm also stressed about all this. Even with decent insurance, these office visits and procedures all add up to be incredibly expensive. I think part of the problem is that we haven't revamped our budget in the last year or two, and with almost every penny accounted for (with bills, savings, retirement, groceries, gas, etc.) it's hard to fit in all these medical bills that we don't typically have to pay for. Furthermore, even though I work in healthcare, I guess I was pretty medically naive - I figured that we'd embark on this path, pay a couple office visit copays and be done with it. Little did I know how much each procedure would cost! We're not going in to debt or anything, but I feel like we're hemorrhaging money from our savings, which I don't like (and which could lead to debt eventually, at least in my mind, although Mike insists we'd make changes long before that ever became a true threat). And to make things even more complicated, I then second guess myself for worrying about money at all at this point - if I can't handle these medical bills, I tell myself, how in the world do I think we could ever afford a child (with daycare and diapers and stuff and all)?!? Then I have to remind myself why I even want to pursue this path in the first place (i.e., end goal = baby).

In the end, it's just all very mentally and emotionally tiring. I can't help but resent all the people who don't have to think about all this. I can't even imagine what it must be like to simply decide to have a child, to just get pregnant, and to have a healthy baby nine months later. This has already been a four-year process for us, and we're not only just beginning the path of specialty treatment. Why does it have to be so hard? Sometimes (like tonight) I'm just so tired of thinking about all this, and yet what's the alternative? Give up? That's not really an option. So it's back to doing relaxing things to end my weekend and just trying to take it one step at a time...