So, the official diagnosis is "Um.... we're not really sure." Obviously, the effect was pre-term labor, however the actual cause is up for debate and could have been one of several things. I'll outline them:
1. Incompetent cervix - this is what I heard in the hosptial, but I was told today that it is actually probably NOT the cause. Typically, an IC happens over time, as the baby(ies) grow. So, it's likely that somebody would have noted something in a previous appt. The other thing that makes them suspect otherwise is the speed at which the situation progressed. At 11 am, my cervix was only 50% effaced (or so) and the cramping was mild, highly irregular and very spaced out (by hours), by 4 pm, it was pretty much 100% effaced and was having actual contractions about 30 minutes apart (that's an estimate, they were never actually timed). By 5pm I was also 3cm dialated and in the span of roughly an hour I went from 3cm to 10 cm. This is not, apparently, a typical pattern for an IC. However, my cervix will be closely watched in all subsequent pregnancies and if there's any sign of effacing, then we'll go to a cerclage. It's also possible that we could go to a cerclage at my request, especially if I have another set of twins.
2. The number of eggs implanted was 4. It's possible that this set me up for an early labor, since my body may not have realized that two of them stopped growing, or just the hormone levels were off. How that could have gone unnoticed is beyond me, since they took lots of blood, but they hadn't taken blood in quite some time, so that could be it.
3. On that note, it could be a progesterone issue. Even if it's not, progesterone shots have been known to help reduce preterm labor, so we could try that as well.
4. There could be some defect or anomaly within my uterus. To rule out this possibility, I'm having a hysterosonogram on September 5th. The goal here is to look for any polyps or fibroids in the uterus or any abnormalities of the uterus itself. Essentially, it's an ultrasound, and they fill the uterus with fluid to get a look at the inside.
Yeah, quite a list, huh? We can also throw in that I'm Rh negative, so will need rhogam for future pregnancies (cause there's no way Chris is going near a doctor to find out what his blood type is, so we're assuming he's positive).
So the current treatment is kind of complicated now. First and foremost, we want to minimize the chance of my conceiving multiples (since obviously that's a problem). I am clearly sensitive to clomid, and while that doesn't mean we won't use it, it does mean we'll go about this a different way. Step one is waiting to see what my body does. It's possible that my body may "fix" itself to some extent. I'm also going back on the metformin (850mg 2x per day). Apparently, the longer you're on it, the better your body reacts to it. She wants me to be on it for about six months to see exactly what my body is going to do. If after six months, my body is still having irregular cycles, then we can try Letrozole. This drug is similar to clomid but less potent. There's also only one dose of it, so unlike the clomid we wouldn't have to mess around with figuring out which dose works. It would either work, or it wouldn't. If the Letrozole doesn't work then we could go back to the clomid.
In the meantime, we can try if we want to (there's no physical reason to not try). Obviously, we don't know if we'd have any luck and I need to wait to have a period first (although it's possible to ovulate before the first period returns, it's also just as likely that I won't) and then... then we wait. So, unless lightning strikes or divine intervention occurs (and when in my life have I EVER been that lucky?) we're stuck waiting for awhile. That sucks. And that's all I have to say about that.