Thursday, October 1, 2009

Follow-up to the Follow-up

I had my WTF appointment with Dr. B today.  M and I took the day off of work.  Our plan was to go to the appointment at 11:30, have lunch, then see a movie.  We arrived for our appointment and were told that it wasn't on his schedule and had been canceled.  I freaked out.  However, the receptionist told us that it was ok as he did have time to see us.

We waited about 15 minutes, then Dr. B came to take us back to the consultation room.  I like him.  He is kind and compassionate but also straight-forward.  He isn't going to cheer you on by saying he "has a good feeling" but he will say, honestly, that you shouldn't give up hope.  He will also say, if appropriate, that he doesn't think this will work. I think that M. would like it if he did more cheer leading, but I appreciate the candor and honesty.  Here's the rundown on the WTF meeting:

  • There was no tissue from the D&C, therefore he is only speculating that my miscarriage, and all the freaking bleeding, was a symptom of poor embryo quality.
  • We talked about future risk.  He said that he doesn't really know.  That in a "normal" pregnancy, risk of recurrence is about 15%.  However, in my situation, since I've had such crappy egg quality and fertilization, it could be as high as 50%.  That sucks, thank you very much.
  • Prior HSGs have show evidence of a uterine polyp.  Apparently, some of my ultrasounds have shown that as well (who knew).  Therefore, he wanted to schedule me for a hysteroscopy to check it out and remove anything that is there.  I'll do that after I start my period.
  • He recommended antiphospholipid antibody testing, and another blood test as well.  I appreciated that I didn't have to push for these tests.
  • I asked Dr. B if there was anything I could do to improve my chances of success.  He said that there is some evidence that losing weight could help with both IVF success rates as well as incidence of miscarriage.  He recommended trying to lose 10% of my current weight.  I have been reading this as well, and I do think he was sugar coating a bit on this one.  We agreed that I would take some time off before my next cycle to try and focus on losing weight.  I think this is also good as it will give me an opportunity to get my head together a bit more.
  • We talked about what we could do differently from a medication perspective to increase my chance in my next cycle.  He wants to try an Antagonist protocol with the hope that that will increase my eggs retrieved and # of mature eggs.  I've read mixed reviews so far on Ganirelix protocols, but some of the literature does seem to suggest that it might be helpful, and will certainly be easier to manage.  If anyone has experience with this, I'd love to know.

M is feeling a bit down after this appointment, but I'm feeling a bit more positive.  I have a plan now.  I don't need to second guess things.  I have some things that I can do to proactively move forward, as well as a new protocol lined up for when we start.

I've done my homework, and I know that the chance of miscarriage is still pretty high for us.  That are odds aren't great that we'll get a "take home baby".  I never want to go through a miscarriage again.  Ever.  But, I'm not willing to not try for a baby just to prevent miscarriage.

In other news, I'm still bleeding.  It stopped for a few days, then started up again.  I've been bleeding for almost 3 weeks since the m/c.  And, really, off and on for 9 weeks since the pregnancy.  I'm ready for it to stop.

We didn't end up going to the movie.  Our heads were exploding, so we came home.  M. is sleeping on the couch with the big puppy as we speak.  They're spooning, so it's pretty cute.


  1. I had only a little bleeding after my D&C and then it started up for real four days later. It's been almost a week and seems to be slowing down though definitely still pretty constant.

    I don't have my WTF for 3 weeks... my dr is going on vacation AGAIN.

    Thinking of you.

  2. It sounds like you have a positive outlook on this and I think that is great. You had a good appointment with your doctor and that's a step in the right direction. I'm glad that you are able to put a plan in place for yourself while moving forward with your testing. I hope you get some answers soon.

  3. I think my head would have exploded when they told me the appointment had been canceled.

    I've only ever done Antagonist protocol (BCP, Follistim, Ganirelix)so I can't compare to Lupron. I've had 6-7 good eggs both times.

    The only thing is that Ganirelix stings like a bitch. As in it causes a welt that lasts a couple of hours. Gah.

    I hope you stop bleeding soon and can keep moving forward at whatever pace is best for you.

  4. We did the Antagonist protocol, too (BCPs, generic Repronex from Europe, and Ganirelix). And Mrs. Higrens is right. It does burn like crazy. I didn't get lots of eggs (5), but the quality was good. I also had a hysteroscopy to have a bunch of polyps removed about a month before our cycle. I'm sure if we hadn't done that, we would have had problems with implantation.

    I'm glad it sounds like you got some good info at your appointment and you have a plan.

    Thinking of you.

  5. Glad to hear you are feeling pretty good about how the appointment went and have a "game plan". Good luck!

  6. I agree that a gentle but direct doctor is much better than a blunt "you'll be fine" doctor. I'm glad you feel a bit more positive, it's still very early days and it'll get better bit by bit. Will you get your HCG tested to make sure they are falling? I've had such a bad experience of course I'm always worried now others may go through the same! Much love, Fran

  7. I'm so sorry for all you've been through. I'm so glad the doc was able to see you. I'm on a weight loss break, too. I hope it makes that difference we're hoping for.

  8. I just did the estrogen priming protocol with antagonist (gani.relix). No BCP, no aspirin, no steroid. Personally, it was the best of the 3 cycles for me. I felt good the whole time, did not gain weight, and I barely noticed a sting from the Gani.relix. Thought the Meno.pur stings way worse. I got my first rising beta/bfp with this cycle! Good luck.