On Monday Stephen and I had our consultation with Dr. M, the same reproductive endocrinologist who did our first IVF cycle last year.
To begin, we went over all of the test results from the clinic we got a second opinion from. Our doctor was pleased to see Stephen’s test results and confirmed that his count was double what it had been the last time she tested, as well as improved motility (forward progression/movement). While it doesn’t change our outcome or treatment requirements, hopefully it’s a sign of better reproductive potential. This is the best that could have come from the surgery he had this summer, we are thrilled.
The other results also showed that my egg reserve is still great, a good sign that time is on our side should our struggles continue for years more. The other hormones tested all came back normal - so I have the green light there.
I do need to work on my slight anemia and minimally elevated thyroid levels. They aren’t high enough a primary care doctor would treat with medication, but it’s high enough that reproductive doctors would like it to be cut in half. So back on synthroid I go!
With all of this checking out there are a few things we needed to do before we move forward:
1) Infectious disease panel (both of us) - so we saddled on over to the lab and gave blood to get this done.
I had an SHG and mock embryo transfer done last year but they’re only good for one year. During a sonohysterogram a catheter/balloon is inserted through the cervix into the uterine cavity to allow the doctors to flush the uterus with a saline solution. While doing this they use a transvaginal ultrasound to get a look inside and inspect for any fibroids or polyps that could interfere with successful embryo implantation. (In case you can’t tell, it hurts like a bitch to have done).
We were my doctor’s last consultation of the day, and she knows we live a tad bit away from the clinic. So after asking for permission she fluttered around the office gathering supplies and assistants to do this procedure right away.
YAY: No waiting a few weeks to a month to get on the schedule!
NAY: No warning so no ability to prepare with copious amounts of ibuprofen prior to the procedure.
Eventually everything was ready and we went forward with the procedure. When I had this test done last year the doctor struggled with getting clear images and my extreme discomfort discouraged her from taking extra time digging into why. We got just enough information to move forward and called it a day.
This year we had the same issues and Dr. M took the opportunity to dig around and really delve deeper into the visuals she was seeing. It didn’t take her long to realize that my uterus has a blueprint of its own and does not lay like one would expect. (The photo here explains it as she did to me).
Normally you’d expect a uterus to lay in the body like the left fist. Thin at the bottom and blooming outward, just like the diagrams in health class! As the doctor began looking around inside she discovered that my uterus doesn’t quite want to play that game. Rather, it’s nearly completely twisted around. She stressed that it’s not uncommon to see a uterus laying ways different than ‘normal’ and confirmed it should have no effect on our fertility or my ability to carry a pregnancy. It simply makes imaging processes like the SHG a little more difficult. So, not only is my cervix tilted upwards abnormally, and one of my ovaries tucked up behind my uterus instead of flowing out, the uterus is sideways too.
After this discovery she was able to do some extra maneuvering of the tools to get better images, despite the odd angles they had to be taken from.
Unfortunately, these images showed a couple areas of concern. Next month I will be going in for an endoscopy procedure - this will allow a camera into the uterine cavity and get a true image of the inside of the uterus to ensure there is nothing present that would jeopardize the success of an IVF cycle.
It’s difficult to know exactly what she saw on the images - they could be fibroids, they could be endometrial polyps, it could be that some of the lining was dislodged during the poking and prodding during the positioning of the instruments. What we do know is that our doctor is confident that whatever she may, or may not, find she can treat appropriately.
(In her professional opinion she is inclined to believe that it was dislodged lining from the procedure, they aren’t typically so rough on the body. To back up this theory, I did pass three separate blood clots of various sizes the day following the procedure).
If the endoscopy comes back clear we have everything ready to begin IVF!
The clinic’s lab closes down for the year on Dec. 19 for yearly inspections, maintenance, cleaning, etc. With the endoscopy happening in December we will be looking at IVF in early 2019. 🤞🏻
Looking at the next cycle we know this
- Our clinic has implemented new protocols and practices according to the guidelines in place by organizations whose names I can never recall and they are seeing better fertilization rates and more blastocysts for couples across the board. These improvements should help us as well!
- With my egg reserve steady at a high level, and proof that my body responds well to stimulation, we will be doing our next protocol at a lower rate. Instead of starting at 250 of Gonal-F and slashing it down to 150 a few days in, we are going to start at 150 and hopefully have a more consistent and slow egg maturity process. Theoretically, this should result in higher quality eggs.
- I have to lose 10 lbs. 😂 Which is exactly what she told me last time, I swear she just loves throwing out numbers to stress me out. Regardless, when following my bariatric meal plan that will be easily managed by 2019.
- We cannot apply for the financing we’d like any more than 30 days in advance. For now we focus on paying down any debts we currently have to make the best case for approval.
Only a few things stand between us and hopefully bringing a baby Russell earthside by the end of 2019.
For now, we are focused on preparing for the endoscopy next month. Hopefully it comes back clear like the doctor hopes and we can continue moving forward. 🤞🏻
