Consultation

Before I talk about my appointment, I just want to mention that in addition to cooing over a newborn in the morning yesterday, when I came home I discovered a pregnancy announcement on Facebook (12 week scan!), and then, as if that wasn’t enough to convince me the whole world is having babies apart from me, my next door neighbour catches me out the front to warn me they are having an extension built, just in case they have another baby.

Right.

Just in case.

This is the neighbour who has already gotten married, pregnant and had one child in the time it’s taken us to not be pregnant with number 3. She’s going to lap me again – I bloody well know it. She’s probably pregnant already. I’ll have to spend my time furtively ducking out of the house so I don’t have to coo over her bump for months on end just like I did two years ago.

Sigh.

Well, now I’ve got that out of my system, onto my appointment.

I don’t have any experience with fertility clinics, but what’s the first thing I have to face on the way in? A corridor of massive montage photos of thousands of babies. Lovely! There really is no escaping babies at the moment. I hope it’s catching.

Dr Bird was really nice. She was also very matter of fact.

They did a very, very thorough ultrasound. Nothing was missed – that probe squished around in places that nothing else has ever reached.

In short, this is the outcome:

  • I have another cyst, this time on my left ovary. 5cm x 4cm x 3cm. She said I should be scanned again in 6-8 weeks to ensure it has resolved.
  • My uterine lining is “very thin”. Both of these are probably a result of my recent miscarriage.
  • Left ovary is normal with several follicles (yay!)
  • Uterus 100% normal (yay!)
  • They need me to dig out some immune testing details from my recurrent mc tests, to ensure I was tested for everything they would recommend, back in Aug 2013.
  • They do not test for natural killer cells. It is controversial and because it is a blood test and not a sample from the actual womb, the clinic is of the opinion it is not overly helpful.
  • Husband’s SA from two years ago shows some abnormal morphology (our GP told us it was “normal”). He’s going to get a repeat test. However, she said that since I obviously get pregnant, this is not likely to be an issue.
  • Going forward, she suggested that it might be a good idea to try on our own for a while longer because I have only been gluten free since April and the loss I just had was a chromosomal issue. These are more common given my age, and there is still a good chance that my coeliac diagnosis will now allow me to carry a pregnancy to term.
  • If I do get pregnant, their recommended treatment if they suspect immune issues is steroids. I’m not sure how I feel about that. She said there is a very low risk of defects (cleft palate). Er, okay…
  • DH and I could consider a round of IVF. She said that the theory for us would be it would allow a collection of lots of eggs in one go and that they could “flush” the good eggs to the top (by selecting the best quality ones out of those that make it to day 5). She also said that it was a possibility that we would undergo IVF only to have another miscarriage anyway.
  • She didn’t recommend genetic testing of the embryos (PGD). She said for the expense (close to £10,000) it would gain us very little advantage because it only tests for the correct number of chromosomes, and at least one of our losses was tested and was normal.

And here are the worst parts:

  • I am 40. She mentioned this several times. Apparently, just 35 days ago, my chances became significantly worse. She said that not only are my eggs of lower quality, but there are less of them. She told me that my miscarriage risk has increased regardless of my history, and that abnormalities and miscarriages are now even more likely.
  • At the end of the appointment, she folded her hands on the desk and said to me that given I already have two lovely children, I might want to think about drawing a line in the sand at this point.

That was when I finally cried.

So.

I’m still mulling over all this and working out how I feel about it. I also have a terrible headache, which I think is a combination of the emotion and the lack of sugar and (already tiny amounts) of caffeine where I’m preparing for the juice fast on Sunday.

My overall impression from the appointment is that they will do what they can, but that I should be prepared for the fact that it may never happen. I am 40, which is apparently reproductively old, and I may not ever have another child.

As far as doctors go, and aside from a round of IVF that will only do what me and DH can already do, with no guarantee of an improved outcome, I have pretty much exhausted current medical knowledge.

13 thoughts on “Consultation

  1. Rose, dear Rose! I’ve been so looking forward to hearing how this went for you. First, I’m shocked that an infertility clinic would have so many baby photos on the walls – that seems kind of insensitive. But what matter is the doctor and the clinic’s approach, which seems to me to be thorough and realistic, mostly. But I don’t like what you’re saying on them focusing so much on your age. It’s a number, and yes, we all know what happens to our fertility gradually over time. But it’s not like you wake up at 35 years old or 40 years old and suddenly everything has changed. It’s not something that happens overnight. It’s a continuum and I think the medical community does a crappy job of presenting it as such. I think the bottom line is that this is your dream, and you need to fight for it! Trust your gut on the right or best way to approach that fight…the best way for YOU. Honestly, if it were me in your shoes right now I would just take some time to let everything from the appointment sink in, and I would literally take it one month, one cycle, at a time. I think I would keep trying the natural approach for starters while the rest of it soaks in. You can always keeping BDing while you weigh other options. And what you do have now is a lot more information, and a very valuable expert opinion. I hope you are glad you’ve had the appointment. I personally think it was the right thing for you to do at this stage! (not that you asked!) Whatever the future may hold, you want to have no regrets, no “what ifs.”

    • Yes – they seem to completely miss the continuum of time. I am statistically much worse off, overnight! Have done a lot of thinking and a lot of research and reading over the last 24 hours. I think the appointment was very valuable. I particularly liked that she thought there was a chance I could carry to term given time being gluten free. All in all, we needed a realistic look at things and having got that it means we can make a more informed decision now about what we do. xxx

  2. So many thoughts in my mind right now. As you know, I’ve been through all the testings, I’ve even left my country to get better care elsewhere.
    First, a low dose steroid is a risk we were willing to take. Because a Cleft Pallet is completely fixable with surgery, we decided it was a risk we were willing to take.
    Second, I’m intrigued by the recommendation to try IVF. Our local doctor told us to only do IVF if we were going to do PGD. Our specialist literally laughed at the idea of doing IVF, as it will not help us sustain a pregnancy. In fact miscarriage is actually much more common with IVF (can be as high as 50% chance of miscarriage). So, in the end we couldn’t understand why IVF would be useful for us as our issue is not creating an embryo, it is maintaining it.
    Three, if you want to keep trying, that is your choice. I personally don’t care if you have 1, 2, 5 or 15 living children, if you want to keep trying, it is your prerogative. I’m heartbroken that your doctor would suggest otherwise.
    Fourth, RPL is hard to find figure out. It is my opinion that most RE’s are not experts in it so they recommend IVF because it’s what they are good at and it’s how they make their money. Most of the time RE’s determine that RPL is unexplained and they leave it at that.
    Fifth, you have a tonne of information to digest. Wishing you peace as you ponder everything and make your decision about your next steps.

    • Crazy how recommendations differ so much… makes me wonder if anyone really has any answers. RPL is just so poorly understood. I am slowly mulling everything over, trying to work out what to do going forward. Yes – I was a bit upset she suggested I stop BECAUSE of already having children. I always feel like people are missing the point when they point out the obvious. You wouldn’t suggest that someone never got married again just because they had already been married. Can you imagine? Remember that you’ve had a lovely wedding already, maybe you need to just move on and forget about this wedding lark. Meh.

  3. Oh Rose I am so sorry there wasn’t one magical answer that solved it all for you. I do love how she was really honest with you and not just putting you through IVF because she could. I think that says a lot about her integrity and that of the clinic. Also very interesting that being GF since April is not considered a long enough time to necessarily make the difference. You could try going back on the low dose aspirin to help the lining? It has done wonders for mine this time around. My friend did the whole immune suppressing thing with steroids to get her babies and it worked. She said it wasn’t too bad but that she did obviously blow up a bit from the steroids. As for the baby photos on the walls – well it’s weird isn’t it. A part of me is confronted by the sort of thing but the other part of me likes it. It gives me hope that the process is going to work if all the success stories are right there in front of me. I don’t know about this one as it def does make my tummy wobbly too. Look I think we all know the odds of successful pregnancy are lower as we age and it is no secret but it doesn’t mean it is impossible. A friend of mine is just having IVF baby no 2 at 42. It CAN happen. I hope you feel OK once you process this and have some ideas about how to move forward. It will be OK, Rose. Whatever happens, it will be OK. xx

    • Yes – I was impressed with that. There was no pressure or encouragement to do anything other than think about what we wanted to do with the information. She could have enthusiastically suggested IVF with pound signs in her eyes, ha ha! You know, I still keep coming back to diet and lifestyle… it’s looking like it’s really the only thing left in our survival kit that provides a chance of getting over this. Hmm. Thinking and researching. I’ll be back soon with a plan, no doubt 🙂

  4. I’m sorry you didn’t get the answers that you were so hoping for. I do like that the Dr didn’t mince words and was completely straight with you. I’m not sure about her telling you to draw the line though, I feel like her job is to give you all the info and stats and whatever else you need to help you make your own decisions on your own. I hope you’re able to have some quiet time to sift through everything and figure out what your next steps will be. You shouldn’t feel forced to give up if it isn’t want you feel is right for you!

    • Thank you. Funny enough, someone telling me I should think about giving up is guaranteed to make me dig my heels in and try even harder. She probably should have done the opposite! Yes, thinking and talking through everything with DH. It’s a big crossroad at this point.

  5. That was one hell of a doctors appointment
    I hope you are able to come to peace with whatever decision you and your family make.
    But as the doctor said keep trying naturally, and one day at a time

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