First, I put off starting medication for this cycle so i could suddenly go to my friend's wedding. That moved everything by two weeks, so I would have begun shots today, Friday. Which ended up being good, i think. Otherwise, I would have been well into medication before sitting down with the doctor on Wednesday, day before yesterday.
We discussed the normal things - what else could be done to improve success, etc. She mentioned that I could take a baby aspirin each day as that wouldn't harm anything. She also mentioned a procedure that has helped implantation in some very, very small studies - an endometrial biopsy. They would take a little scraping of the lining of the uterus just before I would come off birth control pills, before my bleed. The theory is that as this is healing, it's also making the womb more receptive to implantation. There have been studies in Israel, Brazil, and China. My doctor said that the studies were so small and on women in their thirties (vs. me at 40) to warrant trying it, although she has when a patient has requested it. She did not recommend it since I would probably want anesthesia and she thinks the risks inherent in anesthesia outweigh the untested gain. If you look at the studies, you'll see that most claim to double the rates of implantation. That's worth it to me!
I sure as hell would have anesthesia. The stories I've read have varied from no big deal to screaming bloody murder and passing out on the table in pain, so I think the anesthesia is the right choice. And I think the endo biopsy is the right choice - may as well try it! Well, doc and co did not seem happy with this. oh, to book the only OR they had for this procedure, oh, to have to do it so fast since I'd need it by Tuesday (which could have been solved if I could have been seen weeks ago for follow up), and I could be bumped because the transfers had to come first, etc.
I stood up and said, yes, after second guessing myself and my instincts and my husband saying he wanted a second opinion from another doctor and my explaining that this is the
My second opinion has really been doing research online, reading abstracts of reproductive health papers (and sometimes the papers themselves), talking to women who have gone through this, reading forums, etc. I don't blindly follow my doctors as a certain Hubs seems to think at times. I know he's frustrated and scared. He wants to rail against something and there's no definite foe or magic answer to find. As I was discussing this issue with some trusted ladies in my circle, a few brought up tests. I'd been tested for autoimmune disorders and clotting, of course, right? Because that's what every doctor did before you walked down that expensive IVF path, right?
I remembered that I had asked about it before. And I had asked about autoimmune issues and clotting disorders again in my email after the second failure, but we didn't discuss it during our meeting, so I sent a follow up email after telling them that I wanted the biopsy.
I was told that because I had carried a baby to term and had never miscarried, that those issues wouldn't be applicable and would be treated with a baby aspirin. I relayed the info and the aforementioned ladies were indignant on my behalf and pushed that I advocate more strongly for myself. I trust their opinions. Some have walked to this cliff edge and more than one has jumped off of it, so they know.
I sent an email this morning saying I understood their logic, but that I now want to be checked for these issues before proceeding. Arrgghh - well, this means you'll have to change your calendar and put transfer off for a few months and we can't give you a date because you'll have to come off the birth control pills, bleed, then have the test, then have a period, and then start the pills again and go through all this and am I up for that?
And, since I mentioned I didn't want to regret not doing all I could, they'd like me to repeat another test - a two hour fasting glucose. And now see a dietitian (really??? you don't think you could have freakin' pushed this before the first IVF cycle when there was more time?? especially as seeing that I've been at the same plateau the entire time you've seen me as a patient in the last three years?) as well as see either my GP or a specialist because I've had high blood pressure the last couple of times I've been in.
Fine, doc, I will jump through your hoops. As I've mentioned, i'm locked in. I can't pull out and go elsewhere unless it's another integremed/attain clinic and then it's out of state. And I will do my research and have an adversarial relationship as I feel that I'm the only one really pushing to find answers and to try.
I've been ripped up about all of this for days, questions piling on top of other questions, trust issues, stress, timing, etc. It's probably best that this now means a transfer between Thanksgiving and Christmas. Which would suck for our schedule, so it may really be in January. And now this won't overlap with the beginning of school, kick off of treasurer duties, fundraising season, and the search for a therapist that can work with insurance craziness of denial despite my daughter needing them for her motor skill disorder. So, stress has abounded. (see: high blood pressure and specialist).
No, I don't fulfill your criteria for further tests and I want a procedure that hasn't been vetted as much as you'd like for its success . But I'm not a statistic. We beat the odds once by having a fantastic daughter - who's to say we're not an outlier again?
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