Wednesday, January 4, 2012

The plan

It's 15 minutes 'til bedtime, here at Casa Lagerquist, so I'll make this quick. Tonight's 5:00 follicle scan, scheduled yesterday at Dr. M's suggestion (smart man!), revealed (sigh) two more residual ovarian cysts on the right side. It turns out that stimulation via drugs has a tendency to cause residual cysts, because as they burst to release egg cells, their large size - mostly fluid - causes them to seal up again, leaving a fluid-filled sac where there shouldn't be one.

The good news is two-fold: first, my "sleepy" left ovary has reawakened, and I have three pre-antral follicles (as he called them) gearing up to "go." He thinks I'll ovulate from the left side this month, despite the cysts on the right. Secondly, Paul and I want to wait until March to do another superovulation IUI cycle, and the timing is working out great. I need a break from the drugs, and it would take until February to get our drugs here from Europe, anyway. Also, since February is the anniversary of our first failed attempt - the one that resulted in the Little Embryo That Could but Couldn't - I'd rather not jinx ourselves by doing another stim cycle during that same month.

Oddly, even though there was a couple "in line" ahead of us at the clinic tonight, Dr. M. still did my ultrasound first, leaving them sequestered in his office by themselves, and then took LOADS of time to complete my charting, review everything, and discuss next steps. It seems that once your chart hits the more-than-one-inch-thick mark, you get VIP status and are moved to the front of the line. We left feeling very happy with our visit.

Dr. M. ordered a blood test for anti-mullerian hormone (AMH), which will check my ovarian reserve. This one scares me a little bit. I really, really hope it comes out normal, because if it doesn't, that means that I'm runnin' outta eggs. It's a little early for that...I'll only be 38 in March. Still, my peak estradiol levels - estrogen - were disappointing during all three stim cycles, so he wants to know what we're up against. (He did say the Metformin I've been on since July 2010 can suppress stimulation drugs, so he may have me go off them next time. I wish he would have told us that sooner!)

We also spent more time discussing our loss of Aliya and Bennett. He's quite displeased by the second trimester miscarriage. It shouldn't have happened, but it did. Chances are that the polyp is solely to blame. However, he also noted "chronic abruption," given Aliya had two placental abruptions (the first at 7w3d and the second at 14w). Therefore, he's ordering three more tests, all of which check for blood clotting disorders:
  • Anti-cardrolipin IgG and IgM
  • Lupus anticoagulant
  • Activated Protein C resistance test (also called Factor V Leiden)

Paul and I both think these three will turn out normal, mostly because Aliya is the only one who had the abruptions (not Bennett)...and she also had the contributing factor of a slight placenta previa (which is more prone to abruption, being too close to the cervix), and Dr. A. from the HMO said both placentas looked free of clots or other deformities. On the other hand, if I do have a clotting disorder, usually they can be treated with baby aspirin and Heparin (or Lovenox) shots during pregnancy. I'd certainly rather NOT have a clotting disorder, but I'd also rather know for sure. (Most women who miscarry have to lose three pregnancies before doctors will order these tests. I'm "lucky", I guess.)

In the next week or so, I'll be calling around to price these tests and will get them drawn. Meanwhile, since Paul's and my contributing infertility factors (his male factor and my presumed endometriosis) mean that we're highly unlikely to conceive on our own, so we'll be doing a timed (single) IUI this month. The cost is pretty minimal, research shows slightly increased fertility after a stimulated cycle, and getting the best possible sperm sample a head start in my uterus could increase our chances of getting pregnant. In all, I'm pretty satisfied with the plan...medically.

Emotionally/mentally, I've had serious internal conflicts about whether I'll ever conceive again for awhile. Even immediately after our loss, as much as I wanted to be pregnant again, I had this nagging feeling that I'd never get to experience a healthy pregnancy. To help combat these beliefs and try to work through them, I'll be continuing my acupuncture but will add four sessions with a hypnotherapist who specializes in fertility (and also teaches HypnoBirthing), and who happens to be a retired certified nurse midwife. I had an hour-long phone consultation with her on Monday and really, really liked her. I start on the 16th, another day off for me, and I'm very excited to dig in. I'm certainly no stranger to therapy - having gone through 7 years of counseling and Prozac in my 20s - and while the traditional therapy scheme doesn't feel right to me today for *this* (at least not yet), talking with a skilled therapist who also fully understands both infertility issues and birth trauma totally does.

Here's hoping, between the two plans, we're starting off 2012 in the right direction...toward the point in the not-too-distant future when we bring home a living child or children.

1 comment:

  1. I have anticardiolipin antibodies... Didn't have anything to do w my loss but so glad to know if have it do it can be treated. Although with the placenta previa, I am the last person that needs the have a clotting disorder and be on heparin, hence the hospital stay. I hope u get the all clear, but super glad u r getting tested.


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