2nd and 3rd opinions

I had consultations scheduled this week with RE’s at both Yale and SIRM. I am trying to get as many opinions and insights as possible before moving forward with another transfer.

Yesterday I met with an RE at Yale who I was told was a recurrent pregnancy loss specialist of sorts. Up until late last week, I had no intention of going there, but I ended up speaking with one of women on the board at Resolve (long story), and she highly recommended seeking an opinion at Yale. It just so happened they had a last minute cancellation for yesterday, so I was able to get in.

The meeting started off well, she asked a lot of questions about my history and I appreciated that she paid attention to every detail. But as the appointment progressed, I became less impressed. She is clearly not a proponent of any sort of empiric treatment and even pooh-pooh’d my use of Lovenox, baby aspirin and Metformin. She tried to tell me that my FET could have ended in a chemical pregnancy due to poor quality of the embryo after the thaw (Yeah, I don’t think so). And, she seemed to put a lot of stock in an endometrial scratch being the magic answer. All in all she just didn’t have a lot to offer, and because at this point I’m looking for a doctor to think outside the box, I knew when I walked out of there that there is no chance I’ll cycle there.

So today I had my long-awaited consultation at SIRM. The RE I met with has a great reputation, and he did not disappoint. He had some great suggestions and helped me start to formulate a plan to move forward. The best part is that he will not require me to do my transfer at SIRM, and is willing to let me cycle at UConn while he would just manage the immune portion of the protocol.

He already wrote up a requisition to test my Vitamin D, thyroid antibodies, natural killer cells, and T helper cells. He also suggested I work with my current RE to do a mock cycle leading up to my hysteroscopy, that way when he does the endometrial biopsy, the timing will be right to send a portion of the sample off to Yale for their endometrial function test. (Which ironically, the RE I met with at Yale also shot down). Depending on how the results for these tests come back, the possible treatments we are looking at are: Prednisone, intralipids, neupogen, and a long course of Lupron.

I have a meeting with my current RE on Monday to fill him in. It’s supposed to be my pre-op appointment for my hysteroscopy, but I am hoping he’ll agree to the mock cycle plan and push the surgery back. I know none of these things are going to be a silver bullet. But at the very least, if our next transfer fails I will know I did my best to introduce new treatments

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Opening my mind to other options

One of the worst parts of this past cycle ending in another loss was the realization that I may never stop miscarrying and may never be able to carry and birth my own child. My current RE cemented these fears when he broached the topic of using a gestational carrier during our last meeting.

If you had asked me a year ago if I’d consider a GC, I would say no way, never. But now that it is becoming a very real possibility that I may not be able to carry our child, I have tried to open my mind and heart at least a little bit to the possibility. I’ve done some light research on the costs (Over $100,000!) and what is involved. I desperately hope I don’t have to utilize that option, but I am trying to remain appreciative that we can probably make it work if we really need it.

I have a friend who has children now after her own battle with infertility.She confided in me today that she used an egg donor to conceive her children, and encouraged me to keep my mind open to alternative options. It was comforting that someone understood where I was coming from, not just about the general pain of infertility, but also about the hard decisions we have to make and accepting the loss of building your family the conventional way.

As much as a nightmare as this process has been, the way in which some people have showed their care, support, and kindness has made a huge difference.

Trying to enjoy life

You would think the pain of each miscarriage would compound, but it’s almost gotten easier to cope. Every time it happens it’s a little less shocking. I feel almost numb to it now. When I found out 10 days ago that our FET was a chemical pregnancy I cried for an hour or two and I haven’t cried since then. I feel like I don’t have any tears left to cry. I’ve even started opening my mind, just a little, to the possibilities I refused to accept before, like using a gestational carrier, or living child-free.

It’s not that I want to go down those paths. I desperately hope that I don’t have to. It’s just that I realize now I realistically may not have a choice. I always believed having a child was a matter of when, not if. But it has finally sunk in that there are definitely no guarantees, and my odds of carrying and birthing my own child are not looking great.

In the meantime, I feel like I just can’t waste any more time mourning the loss of all my dreams. Not only has infertility robbed me of the family I wanted, but it’s robbed me of the enjoyment of my newlywed years. Too much time has been spent crying and refusing to pick myself up to do the things we should do together as a married couple. Don’t get me wrong, I do still need to avoid triggering places and people (Children in our family, places and events geared towards children, etc.) I think that’s necessary in order to maintain my mental health. But I do need to get back to doing the more carefree stuff we used to do together.

Today, for example, we went to the beach. It was a gorgeous hot day and the sun always makes me feel better. We picked up some food to grill for dinner and more flowers for our deck on the way home. My brothers will be joining us for dinner later. It’s been a lazy carefree summer day, and its this type of stuff I should be doing more of.

A New Chapter

Today began a new chapter in our journey. We attended a seminar for SIRM (Sher Institute of Reproductive Medicine), hoping to learn more about their practice and help us decide for certain whether we want to let them manage our care from here out. We already have a consultation scheduled with their medical director for later this month, but have not made any final decisions regarding where we will cycle next.

As soon as I learned my 4th pregnancy was not viable (Another chemical pregnancy, to be exact), I knew I wanted to explore a second opinion. While I like and respect my current RE greatly, he is a little “old school” in that he refuses to dabble in the reproductive immunology field. Being that we’ve already established that there are no chromosomal issues, blood clotting issues, or embryo abnormalities causing our losses at this point, I know that I need to explore something else.

So, that brought us to the SIRM seminar today. We were intrigued by the portion of the presentation about reproductive immunology, and the doctor who would be my RE gave an impressive talk. So far, I have a good feeling about him. We still need to figure out whether we want to bring our embryos to a brand new lab. My current RE warned me against being one of the first people to cycle with a new lab, and advised we wait until they have been up and running for a while first. So I want to proceed with caution in making this decision, considering we have just two embryos left and really want to avoid another fresh cycle.

I think my path will become a lot clearer over the next month as I have the consultation at SIRM, and a hysteroscopy which my current RE will perform next month.