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Follow-up to the Follow-up

Posted Oct 01 2009 12:00am
I had my WTF appointment with Dr. B today.  M and I took the day off of work.  Our plan was to go to the appointment at 11:30, have lunch, then see a movie.  We arrived for our appointment and were told that it wasn't on his schedule and had been canceled.  I freaked out.  However, the receptionist told us that it was ok as he did have time to see us.

We waited about 15 minutes, then Dr. B came to take us back to the consultation room.  I like him.  He is kind and compassionate but also straight-forward.  He isn't going to cheer you on by saying he "has a good feeling" but he will say, honestly, that you shouldn't give up hope.  He will also say, if appropriate, that he doesn't think this will work. I think that M. would like it if he did more cheer leading, but I appreciate the candor and honesty.  Here's the rundown on the WTF meeting:

  • There was no tissue from the D&C, therefore he is only speculating that my miscarriage, and all the freaking bleeding, was a symptom of poor embryo quality.
  • We talked about future risk.  He said that he doesn't really know.  That in a "normal" pregnancy, risk of recurrence is about 15%.  However, in my situation, since I've had such crappy egg quality and fertilization, it could be as high as 50%.  That sucks, thank you very much.
  • Prior HSGs have show evidence of a uterine polyp.  Apparently, some of my ultrasounds have shown that as well (who knew).  Therefore, he wanted to schedule me for a hysteroscopy to check it out and remove anything that is there.  I'll do that after I start my period.
  • He recommended antiphospholipid antibody testing, and another blood test as well.  I appreciated that I didn't have to push for these tests.
  • I asked Dr. B if there was anything I could do to improve my chances of success.  He said that there is some evidence that losing weight could help with both IVF success rates as well as incidence of miscarriage.  He recommended trying to lose 10% of my current weight.  I have been reading this as well, and I do think he was sugar coating a bit on this one.  We agreed that I would take some time off before my next cycle to try and focus on losing weight.  I think this is also good as it will give me an opportunity to get my head together a bit more.
  • We talked about what we could do differently from a medication perspective to increase my chance in my next cycle.  He wants to try an Antagonist protocol with the hope that that will increase my eggs retrieved and # of mature eggs.  I've read mixed reviews so far on Ganirelix protocols, but some of the literature does seem to suggest that it might be helpful, and will certainly be easier to manage.  If anyone has experience with this, I'd love to know.

M is feeling a bit down after this appointment, but I'm feeling a bit more positive.  I have a plan now.  I don't need to second guess things.  I have some things that I can do to proactively move forward, as well as a new protocol lined up for when we start.

I've done my homework, and I know that the chance of miscarriage is still pretty high for us.  That are odds aren't great that we'll get a "take home baby".  I never want to go through a miscarriage again.  Ever.  But, I'm not willing to not try for a baby just to prevent miscarriage.

In other news, I'm still bleeding.  It stopped for a few days, then started up again.  I've been bleeding for almost 3 weeks since the m/c.  And, really, off and on for 9 weeks since the pregnancy.  I'm ready for it to stop.

We didn't end up going to the movie.  Our heads were exploding, so we came home.  M. is sleeping on the couch with the big puppy as we speak.  They're spooning, so it's pretty cute.

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