Monday, August 18, 2014

Where did I leave off?

Sorry to my 3 readers for leaving you hanging. So much has been going on, it's been difficult for me to process everything at once.

Basically, my WTF phone call consisted of me feeling so terrified and my RE offering suggestions that I thought we could have done during my previous (much cheaper and easier) FETs but had refused to say we needed.

He offered that we might not be catching my lining at the right time so perhaps we need to adjust my medication (estrogen and progesterone) during an FET.  Well, gosh, couldn't we have tried that at least once? From what I gather about adjusting these meds is the key is finding the implantation window for your embryo. There's been some studies done regarding the endometrial function test and what you can gather from testing the lining. My RE never mentioned this test, but from what I've read - he's basically offering some of the same treatment that one would offer if we weren't "catching the implantation window" at the appropriate time. Only thing is, we'd be guessing again. So he's suggesting another FET of one embryo at a time in case we need to adjust meds.

6-day transfers have slightly less pregnancy rates than 5-day - BUT I am totally discounting that theory. My reasoning? A 5 day blast means the embryo progressed at the correct rate. We only transferred at day 6 because of the PGS results, not because the embryo was behind. In fact, on day 6, my embryo was fully hatched which was exactly where it should have been.  AND knowing it was a normal embryo should have made up for some of that statistic.

He didn't think I needed a hysteroscopy.

He didn't think Metformin played any role.

Based on my stims, retrieval, embryo quality - I should be pregnant by now. His words, not mine.

We could try a blood thinner.

We could do the biopsy again and see if it helps.

No way we need donor eggs right now. No way we need to spend money on a surrogate right now either. 

Lupron Depot for a few months might help. We didn't discuss this fully. 

We could add more steroids - I've only been taking 5mg. (Though I'm positive this is not our smoking gun).

After no real answers, I felt terrible that day and the next. I was basically shocked still that we had 2 more normals.  I was getting over the sadness and anger of what could have been - my other embryos. My body is killing them.  Why was this happening again? And in fact, why is it more difficult than the first time around. I've done 5 blast transfers. With C, it only took 3! 

So, I was feeling out of control. I requested a consult over the phone with SIRM. That's scheduled for August 26th. I have a consult with Dr. Braverman scheduled for the second week of September. 

Then I spoke with E who was out of town for his first week at his new job. He suggested we need to take back control and not move forward until we're comfortable.  We discussed taking a month off. I agreed. E needs to focus on work, I need to give my body a rest. We even joked about trying naturally this month.

So to take back control, the next day I emailed my nurse and said we understand RE's reluctance to try the hysteroscopy, but we're insisting. How do we go about this?  I received an email later that day said RE would be happy to do this but he wants me to have an HSG first. OK, so I was already on CD5. I needed to be on pills to do the hysteroscopy and HSG. I could start them that day if I wanted. So that's what we did, I took the pills and scheduled the HSG. It was Friday. 

This was my third HSG so I knew what to expect. It was uneventful until the very end and the nurse explained she thought my one tube was emptying but it looked a little inflamed. So, I was given a RX for antibiotics and sent on my way.  I honestly didn't think much about it until I got a call from my RE later that afternoon.  Low and behold - inflammation detected on my left fallopian tube. He said he was surprised. The tube looked similar to the last HSG (3 yrs ago) but with maybe a little inflammation. With hydrosalpinx, they see decreased pregnancy rates and not necessarily NO pregnancies. So with C we could have gotten really really lucky and the inflammation could have been there all along or it could be new.  He thought this could definitely be affecting our cycles. My heart sank....I had requested an HSG after FET #1 failed. Then again after FET #2 failed....and again after....well you get the point. I should have trusted my instincts. My RE should have been BETTER.

You trust your doctors to know the answers, but with ART and infertility there's no such thing as a sure thing. So here we are.  He wants me to have a laparoscopy and hysteroscopy combo. He called my OB Friday and I'm just waiting to hear what the next move is. We'll see what happens next but a lap is a longer recovery - a few days vs. a few hours - than a hysteroscopy. I'm certain there's something going on in there whether it's more endo, inflammation, scar tissue - something.

This might not be our smoking gun that I've been on the hunt for but at least we'll feel better about cycling again once we've checked this box. Literally. :)

1 comment:

  1. Well I'm glad at least they've come up with something! I'm glad you advocated for yourself and insisted on it! It's awful that we can't trust the doctors to truly explore all avenues.