Flip a Coin?

Went back to the Dr again Thursday for my post-op and to discuss what we're going to do. Here's the recap:

- TPO (thyroid antibodies)- still significantly elevated in latest blood work, so we will treat with synthroid starting now so I can get used to the medication
- anticardiolipids- borderline elevated. Will definitely treat with at least baby aspirin, and he will make a call about using the other meds once I get pregnant

So here's our choice:

- do IVF, where we could also do genetic screening and get as close as possible to "ensuring" that things will go ok, considering that we can never make anything absolutely 100%

- do a less invasive version of controlled egg release, where we would essentially try to play a numbers game and have 2 or 3 embryos develop in one cycle, assuming that if 1-2 of them have genetic issues that we would get 1 that comes out ok

We are seriously leaning towards the IVF for this round. We are very fortunate that my employer will pay a large portion of the costs for it for a round so figure we don't have too much to lose in trying.

We do have a debate underway though and I asked Jacob what he thought about just flipping a coin to decide :)

Coexistence

I've been thinking a lot lately about how I can have different emotions about a particular subject coexist, even if they are seemingly in complete conflict with each other. For instance, I recently learned that a good friend is newly pregnant. One part of me wants to feel so happy for her, while another part is jealous and wishes that I could just get pregnant and have things be easy. But this morning I thought, why not just be both? I feel like I put pressure on myself to feel just one way or consistent, when in reality, who says I can't be both? In an ideal world, sure, I'd just be happy for her and that would be it. But it's not how things are, so why not just accept that and go on. I feel like mentally I have a hard time thinking that that is "ok" but hopefully it will get easier over time.

On the update front, my repeat blood work came back with essentially the same thing as before, elevated TPO and borderline elevated anticardiolipids, so we'll discuss treating both with the doc next week when we go in. I'm feeling a bit more settled in our decision about IVF but am still hoping that once we really start it I will feel more at peace with deciding to do it.

Procedure updates

Went in yesterday for my hysteroscopy, which was a relatively short procedure. But I hope I don't have to sit around a hospital again for a while!! For someone who was never seriously ill before, 4 surgeries in just over a year feels like a lot. And maybe I'm a wuss, but getting the IV is about the worst part. This time it took 5 tries for them to get mine started....ouch.

Anyways, yesterday the doc found that there was some tissue left from my last pregnancy, which he then cleaned up so hopefully I have a clean slate going forward.

We will go back in 2 weeks for a post-op and also to plan moving forward- I think we are mostly decided on doing IVF. Unlike people who use it because they have trouble getting pregnant we would do it primarily for the genetic embryo screening. I have struggled a lot with whether or not to do it; do we go the very invasive route, or just try again naturally and see what happens?

The only thing I keep coming back to is that going into the third pregnancy I decided that the third time was going to be it- after that I wanted to do anything we possibly could to test, fix, and take every chance to have a healthy pregnancy and baby.

More tests and more tests- Update 9.5.14

So I am starting to feel a bit like a human pincushion. We went back to our specialist yesterday and have a few new results to report:

- genetics- Jacob and I both have normal karyotypes (which does not mean that we act normal!) but is good news. Means that we *should* be able to combine our genes to form a good embryo
- saline sonogram- had this done in office yesterday, looked mostly normal but did have a polyp which is going to require a hysteroscopy to remove. Oh good, another surgery! Kidding. It is relatively minor but certainly kind of annoying that we have to do yet another procedure. I am scheduled to go next week and at least this time we can go to Jacob's hospital to have it done.

We also got blood drawn for a prep screen testing for other rare diseases we might be carriers for. That one will take a few weeks to come back.

In the meantime, I'll go Monday to have blood drawn to re-test my antibody levels from the testing in August. Talk about maxing out the insurance this year.....

Also, before we left we did talk a bit with him about next steps, where Jacob and I always like to ask for the doc's real opinion, what they would do, as long as it seems like we trust them. So when asked, he said that if it was his wife in this situation, and if they had the money, they would do IVF. The only real thing that it does for us is eliminate the question of the genetics of the embryo being ok, but given that there really doesn't seem to be too much else we can do and that I REALLY don't want to have another miscarriage, it may be the route we end up going.

In short- we're lucky that all the tests have come back fairly normal and have not revealed any additional serious problems. On the downside, it hasn't pointed to any definite reason for all the miscarriages. So....wish us luck with the next round of tests!

Sweet Kiddos

I got to spend the last 2 nights with one of my coworkers, and since we've been friends for a while she invited me to stay at her family's house outside of Boston.

She has 2 sons, ages 3 and 6, who are just adorable bundles of energy. I always think it's so cute to see how kids can be shy at first, because you're a stranger, but after a few hours of hanging out with them will be snuggled up with you by the end of the night. The boys seemed to have endless energy- jumping in the pool over and over, racing each other back and forth around the house to fetch toys, and bouncing up and down on the sofa. To me, it was adorable, but I'm sure for them dealing with it every day is a handful!!

I am grateful I got to spend time with them and it makes me very much look forward to the day when Jacob and I will hopefully have our own rascals running around.

Guest Blog- Rachel

My college roommate, Rachel, is a brilliant doctor, wife, and mother of two beautiful boys and graciously agreed to let me post what she sent to me in response to the blog:

I know I have told you about the miscarriage that we had between Liam and Rowan and I know that having one is nothing like having three, but over the course of that year (of trying, miscarrying, and trying again), I could definitely relate to some of the sentiments that you shared.  

We started trying for #2 in June 2011....After four months I was pregnant.  We went to Florida on a trip at 7 weeks, just before the first doctors appt.  I FELT so pregnant and was very cavalier about telling ALL my family and friends down there that we were expecting again....Only to be so deeply disappointed and devastated when there as no heartbeat at our appt a few weeks later.  Christmas that year was tough so say the least.

We started trying again as soon as we could.  In my residency program of 15, it seemed everyone else was trying to get pregnant too.  Tracy (due June 2012....a few weeks before I *would* have been due....a constant, painful reminder), Siri (due Oct 2012), Emily( due Jan 2013), Lixia (due Feb 2013), Julie (May 2013).  It took until July 2012 to conceive again and I swear those months of trying, wondering, stressing were among the longest of my life.  These women were all my friends but I was too bitter and jealous to listen to them talk about their pregnancies.  Unlike Facebook, I couldn't avoid them and seeing them all pregnant and happy everyday at work was like a slap in the face ;( 

During those months of trying I did all I could to help increase my odds of conceiving....I read WAY too many blogs/websites.  Sex was no longer fun but was a chore.  I went for weekly acupuncture (which was an expensive form of torture, BTW, and didn't help) and took weird herbal supplements given to me by a sketchy Chinese herbalist.  I also had a hystersosalpingogram (which was normal) and was prepared to go on fertility meds (if nothing happened by Sept 2012).  

During this time it was very helpful to me to hear stories of others who had gone through something similar and to know that I was not alone.  

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Thank you for sharing Rachel!

Specialist Update

So right off the bat, I have to admit that I had a bit of a meltdown (as Jacob can confirm) leaving the Dr's office yesterday. It wasn't that there was any bad news per se, just more that there are still a lot of questions out there and I think I wanted there to be some "aha!" moment with a big answer.

The summary is that we are going to do several more tests to explore what to do next:

- genetic screening of Jaocb and myself, to hopefully rule out that we have translocations occuring

- repeat blood work for me- I had some questionable results in anticardiolipids, which could have just been that the levels were still elevated from being pregnant. If not normal next time, would mean blood thinner treatment

- TPO antibodies- will also be repeated since they were very elevated, but thyroid function is normal, so no clear path of treatment there. He thinks that this would affect implantation if anything, so if it was causing issues I likely wouldn't have had pregnancies get to 9 and 11 weeks previously

- saline ultrasound- will have this in a week or 2 to make sure my uterine cavity looks normal

- elevated AMH levels- this is an indicator of egg reserves- my number came back high, which is good and bad- the good is that it means I generally will get pregnant easily, the bad is that I have so many eggs that it may be throwing off the ratio of good:bad eggs and make it harder for us to get a "normal" embryo

So- it will be about a month until we have all the testing done and results back, and then, barring any really new info, will be up to us to decide if we want to go the more invasive route, which would mean doing IVF to do preimplantation genetic screening of the embryos, or if we want to "roll the dice" one more time, probably with some low level drugs in there too, and see what happens.

As of now, I'm fairly inclined to go with more intervention at this point. I feel like my tolerance for another miscarriage right now is low.

Stay tuned.......