Eeeny, Meeny, Miny, Mo

Confused?! No. Not me 🙂

A lot happened since my last post. Dr. Kwak-Kim has quite a plan for us but the catch is that it’s everything but easy. Her 3 page plan is super scary, risky, expensive, overwhelming, time consuming, etc., etc.

recommendations during conception cycle
1. Metanx – once daily
2. Low Carb/Low Sugar diet
3. Vitamin E – once daily
4. Vitamin D – once daily
5. Prenatal Vitamin – once daily
6. Calcium Caltrate with Vitamin D – twice daily
7. Baby Aspirin – once daily
8. Prednisone – once daily 48 hours after ovulation, twice daily after positive pregnancy test
(Fasting blood sugar monitored monthly)
9. Lovenox injections – once daily starting on cycle day 6, twice daily after positive pregnancy test
(Uterine Biophysical Profile 5-7 days after starting Lovenox)
10. Prometrium – twice daily starting 48 hours after ovulation
11. NK Assay, TH1/TH2 cytokine, Chemistry panel TFT on cycle day 2
12. Pregnancy test, Estradiol, Progesterone level 10 days after ovulation

Ok, now the plan during pregnancy
1. Chemistry Panel, APTT, CBC with platelet count every month
2. TSH, Free T4 and Free T3 weekly to monthly as needed
3. Antiphospholipid antibody, anti-DNA/histone antibody, ANA, NK assay, PAI-1 and TH1/TH2 cytokine with positive test then as needed throughout pregnancy
4. B-hCG every 2 days until heartbeat is established by ultrasound
5. Blood Pressure monitoring monthly
6. Ultrasound using grey-scale and Doppler to assess pregnancy development every week starting at 5-6 weeks
7. Triple Test (AFP, B-hCG, unconjugated estriol) at 16 weeks: screens for open neural tube defects and aids in assessing risk of fetal chromosome abnormalities
8. Non Stress Test and Biophysical profile exams weekly starting at 28-30 weeks
9. Thyroid ultrasound to follow up on cyst in 6 months

Long story short: I’d be at the doctor at least weekly starting pre-conception through the entire pregnancy.

After my regular OBGYN broke up with me (“while she respects our doctor/patient relationship she just doesn’t feel comfortable treating me”) I was sent back to Dr. John Rapisarda at Fertility Centers of Illinois. My appointment today was a surgery consult with a sidebar gestational carrier consult. I left just as confused but a bit more educated. We have a lot of research to do and important decisions to make. I don’t have to have surgery if we use a gestational carrier or do adoption but if we want to try ourselves I need to have surgery to remove the crud that’s there and soon… like next week if we want to stay on schedule.

Interesting thought: some states consider using a gestational carrier or surrogate a “Purchase or Sale of an Individual.” Under this law, the sale of a human being is against the law. Some states actually require you to legally adopt your child from the surrogate even with no genetic connection. Luckily, Illinois is surrogate friendly. Too bad insurance companies aren’t. We better start thinking of creative ways to raise $50,000 for surrogacy or $20,000+ for adoption…

I guess our next step is to educate ourselves more about using a surrogate or adoption. I may go ahead with the surgery either way if we can’t make our minds up. I don’t want to be set back another two months if I can help it. After surgery we’d wait another month to have another ultrasound and then start the pre-conception plan if everything looks ok.

We’ll update you soon

Thanks again for all your support, thoughts, prayers, kind words and love!

And the verdict is…

…hung jury…

Good news is… I got a new iPad because my husband feels bad for me 🙂
Bad news is… Things didn’t stay as positive as we were hoping.
I’m still processing everything and honestly I don’t remember all the details. Very long story short my lab results showed 3 other gene mutations on top of MTHFR – all having to do with blood clotting… All not good. There are some concerns with hormone production due to these gene mutations. I have Very poor blood flow to my unusually small uterus combined with irregular uterine structure. Labwork also reported a vitamin D deficiency and a possible thyroid issue. My TSH (Thyroid Stimulating Hormone) was normal but for pregnancy they like the number to be 2.0 or less and I have a 3.3 so the doctor ordered a thyroid ultrasound which showed that I have some pretty good sized nodules on each side (still waiting for results from the radiologist). Dr. Kwak-Kim also has a system of rating your reproductive system and out of 21 points (21 being good) I have a 7.
So on top of my uterus being small, my clotting issues, vitamin deficiency, polycystic ovary syndrome, possible thyroid issue and recurring pregnancy losses she still believes that I can carry a baby. The question is how long and how healthy will both of us be? The doc also ordered another HSG (saline ultrasound) where they make you sign scary forms about surgery and risks and then put strange objects in strange places, fill the uterus with saline and then ultrasound it to see your uterine structure and lining. During the ultrasound I hear “what is that?” and “that’s interesting” and “I’ve never seen that before”. All things that you really want to hear when your mind is already whirling with negativity, doubt and “OMG, I’m going to loose it any second now so hurry up”. Turns out my uterus is harboring some very irregular tissue and a possible calcification of some sort which formed within the last 5 months.
Now we’ve put the brakes on everything while we figure this part out which means surgery again and puts me at my 4th D&C. Once this is done we have to wait at least a month and then go back for another ultrasound before we talk next steps. She already had me start on several new medications however…

Prenatal Vitamins
Baby Aspirin (helps with clotting)
Metanx (vitamin B supplement since my gene mutation prevents activating folic acid into VitB)
Vitamin D
Vitamin E
Antibiotics
Prednisone (steroid to help with hormone production)
Calcium (supplement while on Pred as it can deplete bones of Ca)
Lovenox Injections (heparin – blood thinner)
Crinone (progesterone supplement)
Low Carb diet (helps with polycystic ovary syndrome, PCOS)

I’m not even sure I got all of this right. My mind is running laps 24/7 around what to do. I know we should try again but is all of this worth it without a guarantee? What if something happens to the baby or me? What if I get put on bed rest early on? Are we prepared to have weekly blood draws and ultrasounds every couple weeks? The meds already make me sick… Can I handle that along with possible morning sickness and fatigue? What if I can’t handle this emotionally? Are we spending thousands of dollars on this treatment when we could be saving for surrogacy or adoption? The list goes on and on…

We’ll start with surgery… see what that results in and go from there. That’s all we can do at this point. This leads me towards adoption more and more. As I try to stay positive for myself, my husband, and our families I cannot help the fact that I already feel exhausted and utterly drained. It’s hard to sound upbeat and positive in this post because this is my way of getting it all out… Therapy if you will – I’d owe you thousands of dollars! So I apologize for the frowning and sad faces that I bestow amongst you.

I am again so extremely thankful for our amazing family, supportive friends, cooperative co-workers and a wonderful team of doctors and their staff for holding my hand through it all.

Now I’m going to play with my new iPad and relax. I’ll update you all as soon as I understand more myself 🙂