Tuesday, March 18, 2014

Our WTHeck Appointment

Yesterday was my follow up appointment with my RE regarding this last FET. Of course I went into this appointment with a laundry list of questions that I wanted to ask him. I knew from the get-go that I wouldn’t get all my answers, but I was hoping to come away with something…I just didn’t know exactly what that “something” was.

Unfortunately Ken wasn’t able to go with me. One of the many problems we have with him working for the jerk he works for who happens to be the owner of the company. (I could call him many things but I must be careful what I say). I could tell that my doctor was surprised that my husband wasn’t there for an appointment like this, and honestly I didn’t want him to dig too deep into wondering why he was absent. After all, I was kind of upset that Ken wasn’t there myself.

I walked into his office with my pad of paper and pen in hand, ready to make my notes. I wanted to utilize his time wisely and I didn’t want to miss anything. All I can say about that…it was a good plan and I had good intentions but I didn’t write down a single thing. Sad, I know.

Anyway, my first question of course… “What do you think happened?” This was the big question that I hoped to get an answer for…sadly, he couldn’t answer this. He reiterated that the fibroid surgery was a necessity due to the size and location of the fibroid. I of course agreed completely. His next statement was that he highly suggested that I have PGS (pre-genetic screening) done on any embryos we have should we elect to do another round of IVF. I have more to say about this a little later!

I asked about having a RPL (repeat pregnancy loss) panel done along with any and all other testing that could possibly shed some light. This includes auto immune testing, leukocyte testing, genetic testing on both Ken and me, etc. I knew that my old clinic did an RPL panel of testing on me after our first FET because of my age and the way that whole thing played. That testing was done back in early 2011 and although nothing showed up in those labs, I am not 100% confident that testing was done properly or that they even did ALL the necessary testing. After all, we are talking about the clinic that killed six of our eggs right off the bat with inseminating them TWICE! If you couldn’t tell, I am still pretty upset over that situation!

Doctor M agreed that we should have a bunch of labs done and he listing several of the tests, but honestly I just couldn’t keep up with everything he mentioned. I plan on getting in touch with my nurse to see if she can email me this list so that I can do some further checking on what he plans to test for and to make additional requests if I feel something is missing from that list.

My next question started the discussion of where we go from here and what would be different should we do another attempt at a full IVF cycle. I asked him if he thought that the high dosage of stimulant drugs I was given from the other clinic in preparation for my egg retrieval could have caused the quality of my eggs to be diminished. After all, I was on such a high dose that they retrieved 33 eggs from me. I remember everyone at the clinic that day “bragging” about how many eggs I had because they hadn’t ever gotten that many before. Of course at the time, I thought… “yay, we have a lot to work with!” But now, all I can think of in my simple un-medically educated mind is that it was all about quantity and not quality with them. The more eggs the lower the quality. I wasn’t sure how my doctor would answer this question, but he agreed with me that being on the high dosage of stimulants has been shown to lower the quality of the eggs. He then went on to say that I would be on a much lower dose and that I would trigger with Lupron instead of Ovidrel because it lowers the chances of OHSS. Thankfully I didn’t get OHSS when I did my egg retrieval back in 2010, but that was always a fear because of being a woman with PCOS. He also said that ideally he would like to see me have somewhere around 6-10 eggs at retrieval, and of course mentioned the PGS testing again. Still more to be said about this!

After discussing what kind of protocol and what would be different in our next attempt, I felt that we were at a place in our discussion for me to ask my next question… “Would it be silly for us to take a step back and try 2-3 rounds of IUI before trying another IVF?” Yes, you read that right. I asked that question because I felt like this was an opportunity for us to be “trying” to conceive while deciding if we wanted to go through the full blown IVF thing again. I was actually surprised when he said that he thought it was a good idea and he would happily do whatever it takes to get us our baby. He then joked about how awesome it would be if we got pregnant through IUI after all we had gone through. He mentioned that even though I had 3 prior IUI’s at the other clinic, every protocol is different, that it was over 3 years ago and that we had the fibroid removed since then as well.

During the entire discussion about the IUI option and different protocols I asked him if he could recommend any type of supplements for me for egg quality, etc as well as anything that Ken could take to help with count and motility. Seriously, anything we can do to boost our chances I am definitely willing to look into or do. After talking about this with Ken, I feel he is on the same page with that. Anyway, I specifically mentioned something like FertilAid for Men. Anyone who has been on the TTC train for any amount of time has read about this supplement. I have always been curious after reading a ton of reviews on this stuff, but never really asked a specialist about it. He really didn’t have an opinion one way or the other and really didn’t think Ken needed any supplement help. I was kind of surprised by this actually. So, I have decided that I am going to invest in a bottle of the FertilAid for Men and have Ken take those for a few months. It certainly can’t hurt and it might even help our odds if it does what it says it does.

So, here we are. We have had 3 FET’s using 7 high quality embryos. We have gotten pregnant all three times, but we have never had a successful end to these pregnancies. How do we fix this? Is it going to take donor eggs or embryos or even donor sperm? I had this question on my list, but I was afraid to bring it up. I didn’t really want to think about that right now. Not that I am opposed to it, I just am not ready to go that route right now. I actually expected my doctor to mention this option to us, but when it wasn’t brought up by him, I just skipped over that question on my sheet. After all, if he didn’t feel the need to discuss it then I didn’t feel the need.

As you can probably tell, this appointment was more about “what direction we take” as opposed to “what the hell happened”. And as I mentioned, the topic of PGS (Pre-Genetic Screening also the same as PGD) came up a few times during our appointment. I’m not quite sure how I feel about this and I will tell you a few reasons why. First and foremost I feel that this is taking the science of IVF a little too far and almost playing the role of God. I mean to take an embryo and test a few cells to check some of the chromosome make up to determine if it is “normal” or abnormal kind of freaks me out a little. I feel that God doesn’t make mistakes and it’s not my job to choose between one embryo or the other and let’s face it, sometimes those tests aren’t 100% conclusive. Secondly, I know of several instances where women have had “genetically normal, PGS/PGD tested embryos put back and either NOT get pregnant or have an early loss as well. So, you spend the money and you do this test and yet it still fails. Which brings me to my third point regarding this pre-genetic screening… let’s say that we do this testing on our embryos and we transfer what they consider to be “perfectly normal” embryos that should result in a pregnancy and be right where we are now. It’s bad enough to know that your body isn’t letting you carry your baby to term (trust me, I’ve been there 3 times already), but I think that if I knew that the embryos themselves were perfect and yet it didn’t result in a take home baby it would be 100 times harder for me to deal with the emotions of that.

So, I of course mentioned these thoughts and feelings to Dr. M and explained to him exactly how I felt. His response kind of triggered something that made me want to research this a little more. He kind of flipped the coin on me and said, “ok, let’s just say that all the labs and testing we do on you and your husband come back clear and tell us absolutely nothing as to why this keeps happening to you. Then we do another IVF and FET and transfer two embryos that “look” perfect but we didn’t screen them, so we don’t know anything about them. And then you get that call you have gotten over and over again that you are pregnant, only to know in 4 weeks or so that you are losing the pregnancy. We would be right where we are now. Don’t you want answers? Wouldn’t you like to have some assurance that the embryos you are getting transferred have the best chance at a full term pregnancy?” Ugh…he just had to go there. But honestly, I’m glad that he laid it out like that. I told him that I would be thinking more about this option and Ken and I would discuss it closer to when time comes. But, I also told him that I really wanted to wait until all our labs were done and see if those showed anything that we were not aware of.

So, in conclusion I guess our first step will be to have the RPL panel done along with all the other tests that he believes we should get done. We do have to wait until my beta is down to 0 or below 5 before this can be done. Yesterday my level was still at 17 which seemed higher than I expected. The week before it was at 25, so it is dropping very slow. Dr. M mentioned that when the levels are falling they can kind of take their sweet time to get to 0.

In the meantime we are just going to take some time to ourselves and enjoy each other again. I will continue to do acupuncture and I started a new diet this past Saturday. As of today I have already lost 4 pounds! YAY. I want to focus on myself and not baby things for a little while. I will be ordering Ken some of the supplements and we can try for a natural miracle over the next few months. I might be attempting an IUI in June or July, but I don’t really want to rush into that decision now.

1 comment:

  1. I'm glad you got some questions answered and got some more things to think about. The ONLY thing I will add is that women with pcos A LOT of times do get a ton of eggs but will have lesser quality so actually having more to work with is better than less. Not saying you should strive for 40 but I don't necessarily agree with striving for 6-10 either, especially if you end up doing PGD/PGS..

    A fellow blogger and IRL friend of mine has pcos as well. Take a gander at her blog:


    I will be following along waiting to see what you guys do next! Wishing you both all the best!! <3 <3