Wednesday, May 30, 2007

Good News? Bad News? Still Not Sure...

We went in for our follow-up for the D&E last week. Nothing big to report there. I talked with the doc a while and both of us tried to figure out what the heck happened. Actually, I think the exact phrase the doc used was "can't wrap my head around..." and I'm really not sure what he said next, but what I filled in the blank was "why I lost that baby."

The next day was our consultation with the local infertility clinic (Reproductive Endocrinologists). But before I talk about that, I have to speak of my amazement about what my regular OB did: I told him I was going for the consultation. And he made sure that instead of the regular 10 to 14 day wait to transfer the files over, they were faxed over the next day with a two page summary of my case for the infertility doc.

Wow. Really. Wow. He wants to help us get pregnant.

Cuz the news from the RE was not so uplifting. First, we're not keen on IVF what with the 9% success rate for women my age. I'm not a gambling woman with the $15k it would take for one IVF cycle. I was honestly hoping the doctor would say: oh, but YOU! YOU! You! Are the exception! We think YOU will have a greater than 50% chance of getting pregnant! Alas, he said, I'm glad you're not that keen on IVF because I don't think it will improve your chances over what you're currently doing. (Oh! One tiny glimmer of good news: my ob and the RE both agreed I get pg faster than most other old hags my age. Yippee!)

The RE then said that he thought that the last m/c was a trisomy problem, which maybe it was. (However, I really don't think so) and the RE maybe misinterpretting my attempts at humor as being carefree instead of carefully-timed-to-keep-me-from-crying went on to say he thought that maybe I was one of those women who have sticky eggs so the divisions likely lead to trisomy and that I'm like to continue having trisomy miscarriages and pretty much I will likely keep miscarrying until I can't get pg any more. (or that's what I heard at least)

Can I repeat ONCE AGAIN that we have ABSOLUTELY NO EVIDENCE at this time that there is a trisomy problem!??!?!? The nuchal translucency was BETTER THAN AVERAGE. The growth rate was BETTER THAN AVERAGE. The heart rate was FASTER THAN AVERAGE (bad, but not a sign of trisomy problem). SO EFF YOU, RE, because there is no evidence of a trisomy problem. Yet. Yes, we'll know for sure in 3-4 more weeks. And yes, if you hear hoofbeats in North Carolina then it's more likely to be a horse than a zebra (a phrase he used!), but might I point out that so far, we ain't heard no hoofbeats.

So our current options right now at the infertility clinic are....nothing. Nada. No hyperovulation stimulation because I don't have a problem with ovulating. No IVF (fine by me). No any other thing. Unless the genetic exam for the baby comes back normal. (And even then, if it's a girl, the RE suggested that it could be MY DNA and not the baby's)

Well, he did give some advice: a baby aspirin a day and 2 mg of folic acid per day. That's a boatload of folic acid, folks. Prenates contain 400 micrograms. I'm taking four (4!) additional 400 microgram pills of folic acid to get up to his suggested level. The baby aspirin helps with implantation and the folic acid is supposed to help with egg development and separation. So that, I'm doing.

However, I'm also going to go back to my regular OB and start the bloodwork to try to detect if I have a clotting disorder. I'd also like to test for some auto-immune problems. There is some possibility that women can develop clotting disorders even after having a healthy live birth. Some people think that miscarriages can even cause them. It's a bit controversial, and if you've heard anything about Dr. Alan Beer, let me know.

That's it.

I'm doing better emotionally and ready for life to get on. We're even thinking of when we're going to start trying again.

And also of seriously pursuing domestic adoption.

There could be a lot going on around here sooner rather than later.


niobe said...

I sometimes think doctors like to hypothesize that the problem is a trisomy because in many cases that's a problem that can be tested for and they'll know if they got the answer right.

I know my doctors were pushing the idea (completely wrong, as it turned out) that the issues in my pregnancy might be due to trisomies in both babies, despite the fact that I was carrying fraternal twins.

OneTiredEma said...

I think that to some REs, the fact that you can get pregnant but have trouble carrying past "x" point is much harder to solve than something obvious (blocked tubes, no sperm, endometriosis, etc).

If you have someone willing to test for autoimmunes and clotting factors, that's great. If not, glad you are planning to keep plugging ahead.

But lots of hugs for everything you've gone through in the past year and a half.

Carroll said...

Local friend here had one child, future miscarriages galore, no IVF stuff, happy domestic adoption -- two weeks after which she found out she was pregnant again and carried to term without incident...twins.

Here's to your family's future, Anita -- whatever form it takes :-)

Piratewench said...

Well, you know I've been doing the fertility drugs and guess how much folic acid they have had me on...your 2 mg, but TWICE a day, totalling 4 mg daily. Not only that, but my GP had me on 25 mg of progesterone and the RE has me on 200 mg, TWICE a day, totalling 400 mg daily. That's a huge difference!!!