Decisions, decisions…

When i last wrote a few days ago, I explained how the RE that did my saline ultrasound was not my RE. She hinted as she was looking at it that she didn’t think what she saw on the ultrasound was surgical, but that it was “controversial” and that some doctors would. When we walked out of the office, Lance immediately said to me, “she is saying that Dr. P. is going to want to operate”. 

He was totally right. I decided that I didn’t want to wait three weeks for Dr. P’s opinion so I asked over email, and his response was that whether it was a polyp or an adhesion (scarring) it would need to be removed with a hysteroscopy. ARGH. So not what I wanted to hear!

Dr. P. scheduled me for the procedure on September 26th. A full month away, which would mean that we’d be losing yet another cycle. 

The problem is that I don’t really have a gut feeling about it. I don’t think that whatever they saw is causing all of my losses. It was so small that it couldn’t even be seen at first. But, I worry that if I have another loss I wouldn’t forgive myself for not attacking this now. 

Our initial thought, before hearing that Dr. P. wanted to operate, was that we should get my TSH in check and try to conceive. But now I’m at a loss. Clearly Dr. P. is aggressive. He wants to rule everything out before we start trying again. But to me, I hate the idea of an invasive procedure that could potentially cause more damage when no one knows for sure if it is causing our losses. I feel like the odds of something so small causing all three losses is very, very slim. Since our fetal chromosome analysis didn’t work, for all we know it was a chromosomal abnormality and neither TSH or my uterus were the cause! 

So we don’t really have a decision at this point. I believe he is scheduling the surgery but at our consultation on September 16th he is going to have to do a really good job at convincing us to do it. Because right now I think we are both leaning away from it. 

The past few days have been really hard. It is so hard to be patient when I know that a healthy pregnancy is all I need to lift this cloud from over my head. With every month I wait, and with every new pregnancy announcement I see on facebook (I should be 14 weeks tomorrow so now is the time that everyone due in February is announcing), I just sink further and further. I’m thankful that I had an awesome ladies night on Wednesday and got to play hockey last night. The distractions are much needed.

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Saline Ultrasound and More Results

At least Dr. P has kept his word about knocking out all of this testing.

Last night I found out my AMH is 4.82. AMH measures ovarian reserve. AMH is also kind of tricky. You want a high number, but not too high. My number is a little too high, which apparently can either mean ovulation issues or just a bunch of eggs. Since we know I regularly ovulate and we get pregnant easily, we’re hoping that it just means I have lots of eggs. We still need to have further discussion with Dr. P. about what this means but as of right now, I’m hoping its nothing bad.

We also got the homocysteine results back and they were normal. So with that results every single blood clotting test has come back clean – likely meaning that isn’t my issue.

So today was the saline ultrasound. I was pretty nervous going into it after mistakenly googling the procedure ahead of time. While it was pretty uncomfortable, I didn’t have the horrible reaction that some people seem to have. The fellow conducted the test with one of the attendings doing most of the reading and analyzing. They started out by inserting the speculum and then they were supposed to put in a catheter. The fellow struggled for almost 5 minutes trying to get the catheter in before the attending recommended that she dilate me to be able to get it in. I have such great luck with this stuff! Thankfully the pain from the dilation was only a few minutes and she quickly got the catheter in once she did that. Then they inserted the ultrasound wand and the show began.

They looked at my uterus and took some pictures. Then they looked at my ovaries. The fellow called out my antral follicle count numbers and I took note that they were 12 on one ovary and 22 on the other. They didn’t comment on it but I think those are good numbers?

They initially said my uterus looked good, but on the 3D look they noticed something sticking into the uterine cavity. The attending said it looked really small. She said that some doctors (ie Dr. P.) may want to do a hysteroscopy to look at it closer and possibly remove it, while she, usually errs on the side of not interfering with something so small.

So then Dr. P., who must have been double-booked during my procedure, sent me an email saying that he spoke with the fellow and reviewed the pictures and that it looks like I might have mild scarring in the uterine cavity.

I quizzed the poor fill-in attending like crazy following the procedure and she said that I should absolutely get my TSH under 2.5. We asked her about her thoughts on recurrent loss treatments and she said her big things were making sure people don’t have anti-phospholipid syndrome (I don’t) and that their TSH levels are appropriate (working on it).

Our follow-up appointment to discuss all of these different results is in 3 weeks. We’ve finally given in to sitting this cycle out and not trying. This will allow the thyroid meds to do their thing and hopefully bring my TSH levels into a more appropriate range.

I’m really not sure what to make of everything today. It stinks that they originally thought all was clear and now they think there might be some scarring going on. Now the last result we are waiting on is karotyping for Lance and I but that will still be a few more weeks. Just have to stay as busy as we have been!

 

We may have something here…

This morning, my favorite email subject line popped up in my inbox. “TEST RESULTS are now in your chart”. I quickly clicked over and saw that six of my results had come back. Five from the blood drawn yesterday plus the lupus anticoagulant from Monday.

Factor V Leiden, prolactin, and prothrombin gene mutation were all normal as was the lupus anticoagulant. The homocysteine results said “lab error” and that it had to be sent to a different lab. I also had a result that just confirmed that my chromosome analysis sample had been received.

But the other result that came in actually showed something. My TSH came back at 4.25. Even though the “normal range” goes above 5, my RE put a note on it saying that this was likely too high for pregnancy. He asked me to come in and have it re-drawn and tested again and said that he’d start me on meds if it came back high again.

So given that I haven’t actually talked to my doctor, I’ve been relying on Dr. Google and my best friend Jen for my information. Dr. Google said that TSH should be below 2.0 in the first trimester. Jen said that her doctors wanted hers as close to 1 as possible during her last pregnancy.

It looks like I may have gotten my wish and found something that just needs daily pills to cure. The only downside (besides living with hypothyroidism) would be that I would likely have to skip trying to conceive this month because it will take more than a few weeks for my TSH to come down (and Jen also prepared me that if my body doesn’t react well to the drug they give me it could take months).

I have tons of questions now but I’m just going to wait and see if this next test matches the last one before I get too worked up over this. I don’t really have symptoms of hypothyoidism, and Dr. P. had previously said that he didn’t think I had a hormonal issue, so this is pretty surprising to me.

I’ll be sure to update once I get the next set of results!

Bye bye blood

I’m happy to update that after some email discussions with my RE, he agreed to do the whole initial bloodwork panel at once. So I had three tests drawn on Monday and the rest drawn today. Next Tuesday I’ll go in and get a saline ultrasound. Hopefully between all of this we will get some sort of answer. Lance seems to think we are not going to get any answers. He is probably right, but I’m trying to remain optimistic that we will find something that we can fix. Otherwise, it sounds like we may just be playing russian roulette everytime we get pregnant.

Anyway, here are the tests that they are running. I am going to update all of the results here rather than making a separate blog post for each.

Anti-Cardiolipin (tests for blood clotting problem) – Normal
Beta-2 Glycoprotein Antibodies (tests for antiphospholipid syndrome) – Normal
Lupus Anticoagulant (tests for blood clotting problem)
AMH (tests ovarian reserve)
Factor V Leiden (tests for blood clotting problem)
Homocysteine (elevated levels can indicate a MTHFR mutation)
Prolactin (hormone test)
Prothrombin Gene Mutation aka Factor II (tests for blood clotting problem)
TSH (tests thyroid levels for hypothyroidism or hyperthyroidism)
Chromosome Analysis on me (looks for a translocation)
Chromosome Analysis on Lance (looks for a translocation)

I’m hoping to get most of the results back by early next week, although the chromosome analyses will likely take several weeks.

Let the Testing Begin

Monday is here as is CD1! Woohoo! This is definitely the fastest my body has gotten back to normal and I am very thankful for that. 

However, now I’m facing some confusion working with my RE. 

I emailed him last week and told him about the non-results from the cytogenetics and said that I thought my period would be returning in the next few days. He responded and said that he was going to order three blood tests: lupus anticoagulant, anti-cardiolipin, and anti-beta 2 glycoprotein. These all test for blood clotting disorders. He also said that I should call and schedule my saline ultrasound as soon as I get my second period.

The problem here? He previously told me to schedule my saline ultrasound after my first period!! So it is already scheduled for next Tuesday! I decided to not even respond to that part of his email and keep it scheduled as is for next week. I really don’t think he understands that we aren’t trying to have this testing drag out for months on end.

I was also really confused as to why I had to wait for my period to start to get tested for blood clotting disorders. Couldn’t he have tested for these three weeks ago? I thought the whole point of waiting until now was so that we could just test everything all at once including the typical day three labs. 

It is nice that he emails quickly and all, but I get the feeling that he has trouble keeping his patients straight and I’m already very frustrated. I decided to go in today to get those three tests drawn, and sent him a message asking if I could get the day three tests done on Wednesday. We will see what he says. I’d really hate to waste this whole cycle. After waiting four weeks to get no answers from the fetal tissue testing, it is even more frustrating to basically be told that we have to slowly do all of these tests a few at a time! 

For those of you that have been through this, is this how your doctors did things? I really just want them to take 15 vials and test everything at once! 

 

 

One Month Later – And we Get our Non-Results

I should have known. I’ve had a business trip scheduled for today since right around the time I thought I was pregnant. Shortly after the miscarriage, I looked at the calendar and was concerned about the timing of the trip.

Well today, as I was in a meeting (well, drinking a beer outside by the river with someone important), the phone rang. I ignored it as I was in the middle of this meeting. But a minute later I had a second to check my voicemail, and lo and behold it was my OB. She left a voicemail apologizing, but saying that the cytogenetics lab has been unable to grow any fetal cells. They are only getting maternal cells.

I quickly called the office back and thankfully the doctor was still there and the nurse patched me through. She explained to me that they haven’t issued their official report, but that they’ve given it several weeks and the fetal cells just aren’t growing. I couldn’t believe it. Well, in a way I could believe it, because we just seem to have rotten luck with this stuff. But I had so much hope. The initial pathology report identified chorionic villi. I know absolutely nothing about cytogenetics (and neither does Lance…they don’t even do pathology in med school apparently), but I thought if there was chorionic villi present that we’d have a good chance of getting something.

So now we are back to square one.

The good thing is that we were already planning for me to get the recurrent loss bloodwork and the saline ultrasound. So I’m guessing if those show nothing, then we just assume it was a chromosomal abnormality and then possibly request karotyping on Lance and I. But hopefully something shows up in either the bloodwork or the ultrasound. I hate the idea that at 31 I just have so many bad eggs that we are losing 75% of our pregnancies.

So it is back to waiting. Waiting for my period to show and then waiting for more test results. The saline ultrasound is scheduled for the 26th and I’ll get the bloodwork done on the 3rd day of my period (which is hopefully just around the corner as I felt some cramping this morning on the plane and this evening). Hopefully the rest of the test results don’t take a month to come back.

I had a few moments of tears but tried to get myself together to enjoy the evening. I had an awesome FaceTime session with Bella, who kept saying “mama” over and over again into the phone and blowing me kisses (and apparently physically kissing the phone as well). After that I enjoyed a lovely solo dinner at the riverfront bar at the hotel, had a nice cocktail, and came up to my hotel room to take a hot bath. On a day with crappy news, sometimes you at least have to do a few things to treat yourself.

4 Weeks….And Nothing

Today is the day. 4 weeks since the fetal tissue was sent to the lab after my D&C. So far…just crickets. I’m trying not to be too anxious but it is so hard. And of course I’m worried that the fact that it is taking this long means that they were having trouble getting the cells to grow and that we may not get any results.

Ugh. I have to go to the OB’s office for a blood draw today to see if my HCG is down below 5 (it was 22 two weeks ago) so I’m hoping that my doctor is in the office and can take a look and see if my results are in.

Meh. Waiting is the worst!