Introducing Dr New

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:

  1. we make a higher that normal rate of abnormal embryos; or
  2. whether they are genetically normal with some other issue; or
  3. we have have purely immune related implantation issues; or
  4. 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.

  1. Twangy’s avatar

    Andie! That sounds good, doesn’t it? Dr New sounds really smart, decent and reasonable, and, it’s good to have a plan.

    Sending you good Irish luck, my dear. Digits firmly crossed for you and D.
    xx

  2. Misfit Mrs’s avatar

    I was thinking of you and wondering where you were at. I like Dr. New. My thyroid numbers were 3.2 when I started replacement doses. I fully feel that getting that number below 2 has helped my general health. It want a magic bullet, but given how much it bounced around in miscarriages, it was a critical ingedient.

    I am very happy to see you and can’t wait to see what’s next.

  3. Justine’s avatar

    Sounds like this was a really GREAT appointment! Make sure that they check T3 levels as well as TSH … in the end, I think that helped me, though my previous endos would never listen. Cheering you on … !

  4. bunny’s avatar

    Thank you, Dr. New, for being good to our dear Andie. This sounds like a really solid plan, and I’m so happy there’s a new piece of the puzzle to work with, and someone to watch over you. SIGH. I wish a million times that you didn’t have to go through any of this, but I’m at least happy that there’s someone willing to listen to you and confirm things you’ve been suspicious of. Come on cycle, do your magic!

  5. Adele’s avatar

    It sounds like a very good appointment, Andie. And Dr. New sounds like a sensible straightforward doc. I think there is something to battering the body with stims (perhaps) not yielding the best results quality-wise. I also understand your not wanting to jump into IVF. And I think it is great news that she wants you on thyroid meds. I’ve never understood why someone wouldn’t be put on them (but I, also, had a doc who initially refused to prescribe them).

    (Hope you still got that vodka, though. If nothing else than to cheer a new beginning).

  6. Maria’s avatar

    Delurking here-I have never ever commented before on any blog so I hope I get this right! Having come across your blog a few times and seeing how similar our profiles are, I felt a need to share my story in case it may help you in your effort to have a baby. I started a blog in 2009 after ttc for over 3 years. I don’t think anyone has followed it, but its main purpose was for me to get my thoughts out of my head, so that is okay. You can check it out at http://noforkintheroad.blogspot.com to see my story. The main reason I wanted to comment is to tell you what finally worked for me in the end. I have thyroid issues like you (and RPL and MTHFR!) and my naturopathic doctor told me that anyone with thyroid issues should avoid eating gluten. I was skeptical, but figured I had nothing left to lose after so much heartache. After going gluten free (as well as avoiding other foods I was allergic to), my TSH level dropped into the normal range. Within 3 months I became pregnant naturally (after $50k+ and 6 years of infertility treatments…) and had my miracle baby. I used intralipids (due to nk cell activity and a dq alpha match of 4.1) after I found out that I was pregnant, so that may also have helped, but in the end my husband and I both feel that eliminating gluten helped regulate my hormone levels giving me a “good” egg. We had previously been told we had bad eggs and needed an egg donor… Anyway, sorry for the long comment. I just felt an incredible need to share this information with you in case you have not tried going gluten free. I haven’t read all of your posts so I apologize if you have already tried it. I know that I did not always appreciate unsolicited advice (eg, “just relax,” “have you thought of adoption?” blah, blah, blah). I wish you the best of luck on your journey!

  7. mel’s avatar

    Andie, hello again! I love the sound of Dr New and as someone else said it’s always good to have a plan… and I think you have a good plan. All crossed here as usual. London Mel xx

  8. Pundelina’s avatar

    Great news Andie! I’m so glad Dr New was so lovely, and so on the ball with everything. You must be nearing O day now – I hope all is well with you and that the tracking is going smoothly and that some more good news is on its way :)

  9. Egghunt’s avatar

    Andie, I’m not sure how I missed commenting on this post. And I dont know where you are at now with all this given that it was many weeks ago that this was posted.
    I just wanted to say that I’m so pleased you have a Dr that listened and gave sensible advice. Sounds like Dr Famous was all about pumping patients through and less about actuallly listening and making things personal.
    The plan you’ve outlined sounds totally fab. I think its great to try the ol timing method before diving into IVF cause like you say, the changes Dr New has suggested could be all you need. I really hope so.

  10. Conceptionally Challenged’s avatar

    I’m glad you went (although vodka does sound like a reasonable trade-off). And even more glad Dr. New actually listens and considers options beyond “my drugs are awesome”. Hoping that she’ll bring more good news for you.