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Our WTF Appointment

Posted Jun 19 2009 12:00am
*Side note: I am sitting here in the public library mootching their wifi. When we moved into our new house last year, DH said we weren't going to get internet access. Turns out, our neighbor had wifi that wasn't password protected. So we've been using that until recently, our neighbor either grew wise to our scheme or upgraded his internet and we haven't been able to log on. Luckily, there is a public library within walking distance to our house, so I am now using that. Damn my cheap husband for making us go sans-internet. We should be up and accessible by next week, once we figure out which company plan to decide on.

Thank God for the cool "quiet room" at the library which is accessible only to grown ups. I'm sitting here on the plush recliner typing to you instead of out in the main lobby where kids on sugar-highs and on summer break are running amok in the library.

Today was our WTF appointment with our RE. I explained to DH that WTF means, "What the fuck happened? Why the fuck didn't it work? and What the fuck is wrong with us?" I prepared questions to bring along beforehand (see last blog post) but since our internet was unavailable *cough cough I couldn't bring them along with me. So I flew by my pant's seat and sat down to get some answers about the Rubix Cube of my reproductive system.

(LOL, love the LOLCATZ. I had to throw that in.)

First, the Thumbs Up:

RE said that our embryos looked perfect with no fragmentation. He was glad to see them growing nicely and he was happy to put them both back with no problems. We had a great retrieval (minus the empty follicles) and a great transfer. The embryos were picture perfect. My FSH level at the beginning of my cycle was a 7. All of my estrogen and progesterone checks and LH checks were perfect. Right on target.

Next, the Thumbs Down:

He said that he believes that we must have had a problem with implantation. He is looking at us the same way he would look at someone who has had a pregnancy loss. A recurrent pregnancy loss.

I was all like, back the fuck up! We've never been pregnant at all! Apparently, our RE looks at our two healthy embroys that did not attach and says there was no reason for them not to turn into babies......therefore we had a pregnancy loss. Huh.

Therefore, as someone who apparently has recurrent pregnancy loss, we are now advised to have every blood test under the sun. He wrote out 3 slips full of blood tests. I asked him how many vials that would be, and he said "a bunch." As someone who faints when getting her blood drawn, I was advised to lay down for this one. I'm having trouble reading his "doctor handwriting" on the slips, but I will list what I believe to be the tests below. Our blood testing will be the following

  • Testing for chromosomal translocation (both DH and I will get drawn for this) "Karyotype Blood Chromosome Testing"
  • Lipid profile testing
  • Lupus anticoqualant testing
  • Antiphospholipid Antibody testing
  • MTHF gene testing
  • Factor V Reductose gene testing (sp?)
  • Plasminogen A....... Inhibitor 1 activity testing (sp?)
  • Protein C
  • Protein S
  • Anti.......III (sp?)
  • Homogystem folate (sp?)

So yeah, a SHITLOAD of blood testing. He wants to know if I have blood clotting disorder or anything else that might be getting in the way of IVF working. On top of that, he wants to know if we have chromosomal translocation issues which is why we are having karyotype testing for the both of us. On top of all of that, I am also getting the blood glucose screening to check for insulen problems or PCOS issues (although he is fairly certain that I don't have PCOS).

Holy shit.

So I asked him, what happens if I have a blood clotting disorder? He told me that I might need to go on heparin injections. From the blogs I've read before, I have a slight knowledge of this.

I asked him, what happens if we have chromosomal problems? He told me that we might need to look into donor sperm or eggs but he didn't really go into this, I think, for fear of scaring us too much. He showed us a diagram of chromosomes splitting and I walked away from the meeting with a vague elementary idea of what he was talking about. This sounds like something pretty major.

He told me that he'd like me to do DHEA next time. I was glad for this, because I wanted to take it anyways. I read a blog by Jason and Amber and she just got pregnant from her IVF that included this. DH laughed at me taking DHEA because Mark McQuire took that. I asked the RE about side effects and he said I might get oily skin. I was afraid I'd look like Mark McQuire from taking it. I'm trying to lose weight, not gain it.

He told me that with the DHEA, usually poor responders will do better. If I produce more eggs, he wants to transfer more embryos back. DH was glad about this because he wants to transfer at least 3 embryos back for the next IVF. The RE recommended that we transfer at least 3. I was really surprised by that, because usually RE's don't like transferring more than 2. I told the RE that I would be OKAY with triplets, because this is our last insurance covered IVF. The RE told me that triplets usually occur with women that have had more than one IVF already. Good. Thumbs up.

The RE thinks that I responded poorly, had empty follicles, whatever, because of my body's response to the protocol. He DOES NOT THINK I have PCOS, endometriosis, or poor ovarian reserve. (Which is a relief, but also scary because we still don't know what's wrong with me.) He does not recommend that I go on Menopur again (THANK GOD). He says I will more than likely be on Antagonist Protocol and be taking Follistim again. I was glad to hear that because I think being on pure Menopur fucked me up. It seems like when I was on Follistim before, I had a pretty good response.

I asked about the possibility of my thyroid being the root cause of all of this. He seems to think we are ok on thyroid because I got a blood test a few months back, so we have current info. I will more than likely PUSH for more testing while I am stimming next time to make sure my thyroid is staying in check.

I asked about the need for a laparoscopy. He told met that he does not think I have endometriosis but isn't sure until he can get a look inside (obviously). He told me to check with my insurance to see if laparoscopy is covered, and if it is covered under my infertility coverage. If we can get a laparoscopy without it taking money out of my lifetime infertility coverage, then we should go ahead and do it. If it takes money out of our coverage, we probably shouldn't because (like I said before) we have enough for one more IVF but not if we spend it all beforehand. So, I will be calling Anthem to see what's up and possibly scheduling one for summer break. We will see.

And so it is. DH and I have been sitting and processing it all. It sounds like, to me, that my RE is being proactive about getting down to the root of the problem instead of jumping in head first into an empty pool. It seems to me like he wants to check for everything before we begin again. I didn't even tell him we wanted to try again in October before he started running off the list of tests he wants to do. That shows me he wants this to work for us. (My old RE would have let us run out of money before he changed his protocol.) Our RE said he felt sure we would have ended up pregnant after our first IVF, but since we didn't, he wants to make sure that I am on the right meds for me. The meds I was on obviously weren't the right ones for my body, blah blah blah.j

I have another appointment scheduled with another RE, but I am thinking I will cancel it. I feel confident that our RE we have now is doing everything in his power to help us. I trust him and I like it that he is open to any ideas we want to throw at him. I like it that if I have a question, I can email him and get a quick response. I don't know many doctors that are that open and caring. I think we will stick with this one. He didn't charge us for our WTF appointment, which was also nice I thought.

So in the next couple of weeks, I will go in for my giant blood draw and glucose testing. Half the blood will be drained from my body and we will check for every factor under the sun. I am sure that these tests will run a nice fat pricetag. I want to be confident that we are going into our next and possibly last IVF with our heads on straight.

***********Now, I know nothing about blood clotting disorders, DHEA, chromosomal translocation, or Antagonist protocols. If you can, please leave me a comment in the comments section and let me know if you have any any experience with any of these. Is there hope for me yet? I'd like to know ahead of time what I'm getting into.

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