RE Recap

I had my appointment with the RE yesterday to discuss the results of the testing we did, my MTHFR diagnosis, and the current plan. It went great. I feel a bit like a drug-seeker might after a successful doctor’s appointment…

We talked about the compound heterozygous MTHFR thing. If I was homozygous, he would definitely recommend Lovenox. Given that I’m compound heterozygous, it’s up to me. Even if I was just heterozygous for the C677T mutation, it would still be up to me. So, I’m choosing to take Lovenox – will start taking that at the beginning of my IUI cycle, and continue, assuming I get pregnant, until 6 weeks after birth. He said a lot of patients quit taking Lovenox after 12 weeks, but there’s some risk to stopping, so I’ll plan on doing it until after delivery. He said a lot of OB’s are nervous about having their patients on blood thinners – legal issues like if I got in a car accident and didn’t get fast medical assistance, I could bleed out. But he said he’s worked with my OB before, and the OB is usually fine with patients on Lovenox. Also, I will be on Medrol for 5 days around implantation. This helps to suppress my immune system a bit so my body doesn’t reject the embryo. Add these two meds to baby aspirin and Folgard, plus the Gonal F, Ganirelix, Ovidrel trigger, and some progesterone suppositories that I had in the last cycle, and we got ourselves a whole basket of meds – all to help me have a baby. Basically we’re throwing everything we can at this, short of doing IVF.

The whole appointment went well. I felt so empowered with my research, with the knowledge I’ve obtained during this whole process. I was able to have an intelligent conversation with the doc, and there wasn’t anything he said that I didn’t understand. The hubs just sat there, listening to us, and afterwards he said he was impressed with how much I knew. The doc and I talked about different theories, different approaches to fertility. He said there are 6 doctors in his practice, he’s the head doc, and every doctor has his own theories, his own ideas. There’s one doctor in his practice that doesn’t believe at all in anything immunology related. That doc calls it “hocus pocus.” My doc was very clear that with the immunology stuff, there isn’t a lot of “scientific proof” that immunology problems are the cause, and that the solutions really work. As with everything pregnancy related, it’s very hard to have widespread clinical trials to really gain proof. We talked about Dr. Alan Beer – my doc actually studied with him while my doc was a student! So he believes in a lot that Dr. Beer did, and with the immunological approach. He doesn’t necessarily promote it, because of the lack of proof thing, but when he has patients like me that are ready and willing to “push the envelope” as he called it, he’s more than happy to oblige, and he’s not going to fight me, or encourage me to be less aggressive. He said, “You’ve gone through so much to get here, why not try everything you can?” I wanted to hug him.

This new approach gives me a lot of hope. With a diagnosis, we can fight this. I’m happy that we’re being as aggressive as possible without IVF. I really don’t think IVF will help us – I’ve gotten pregnant twice in as many IUI’s. The ectopic was a fluke, I think. And the miscarriage… I know I don’t have a lot of history to necessarily justify all this medication, but I have always felt in my gut that there was a problem. I’ve been so frustrated with the “unexplained infertility” diagnosis. Now, I feel like we’ve identified something wrong, we’re being aggressive in fixing it, we’re going to do another IUI as that seems to work, and for the first time since the miscarriage, I feel real hope that I might just get that baby. Not just get pregnant, that’s not good enough. Someday, I may have a real live healthy baby at home.