Today was our appointment with Dr New.
I was not looking foward to it. Overwhelming Dread. Unspeakable Horror. Nausea. I only went through with it because D made me. And because he promised me vodka.
In actual fact, Dr New was great. She was sharp, she was savvy, she was to the point. She seemed to understand us. We are old timers. We know our stuff. We didn’t want any wishy-washy newbie nonsense and we didn’t get any. Thanks mainly to my wonderful husband, everything went smoothly. We ran through the history, she asked us a few questions. No-one cried.
First of all, she definititively answered one of our burning questions by confirming that over-stimulation could in fact compromise egg quality during IVF. When IVF#1 failed because we didn’t make it to transfer, Dr Famous wouldn’t accept this argument. He preferred to insinuate that the cycle failure was entirely the fault of me and my lousy eggs; therefore I should spend more money on his quality enhancing drugs, take more stims, and do more cycles that were doomed to failure. This incident was followed promptly by my break up with Dr Famous.
In Dr New’s opinion, we have an implantation issue and an embryo issue. That probably seems like stating the obvious, but we can’t be sure if it is one of these things in isolation or a combination of both that are causing the problem. What Dr New thinks is absolutely essential is getting a look at the embryos in the best possible environment. I actually do agree. Of course, this means doing IVF and preferably with genetic screening, because we still simply don’t know whether:
- we make a higher that normal rate of abnormal embryos; or
- whether they are genetically normal with some other issue; or
- we have have purely immune related implantation issues; or
- a combination of the above.
If we were to undertake IVF, Dr New promised me a conservative stim with a focus on quality eggs, as opposed to quantity of eggs. She would use all the new-fangled techinques to select the best swimmers, and do genetic screening. We would also have the standard immune support of prednisone, clexane, and progesterone. If we aren’t ready to do that, then she recommends simple tracking, but also with immune support. And and and and. Here comes the good part. My TSH level is 3 out of 5, and she recommends a level of 2 or less for conception. This combined with the antibody problem = thyroid medication. I’ve always wondered whether this would help, but I could never get a doctor to agree, and so am very happy about this idea. I am starting Thyroxine tomorrow. Thyroid meds will stay with either tracking or IVF.
While D and I agree that the IVF idea has merit, we simply aren’t ready for that right now. We’ve decided to make another few attempts with cycle tracking. Cycle tracking with Dr New involves blood tests starting at Day 8, plus the usual ultrasounds, trigger and HCG test at the end, with all of the above mentioned immune and thyroid support. D has to take anti-oxidants and – how to describe in polite company – keep his swimmers fresh. This, apparently, will provide us with the optimum conditions for a “natural” conception.
In a stunning co-incidence, today is Day 1. So, here we go.