Thursday, May 3, 2007

My First RE Appt

I’m such a newbie that I totally spruced up my va-jay-jay AND shaved my legs for our first appointment with the RE. Just in case. Stop laughing. Damn rookie move.

I’ve named our RE, Dr. Stretch. Because he is about the tallest person I’ve seen in my life and since I am 5’1”, THAT is saying something. Also because Sticky Bun's new RE is Shorty (he IS your new RE, right Sticky Bun?), Stretch and Shorty sounded kind of fun.

Dr. Stretch starts by drawing graphs of the probability of women in their 30’s getting pregnant and bringing home a baby in the course of a year. I found it amusing that he drew these graphs with colorful Cray0la markers, like using the orange marker was going to take the sting out of his little chart.

He listed out each age 31,32, etc., all the way down to 40. I started to get insulted since I’m on the lower end of that Y axis, but then realized he’s just making a point. Showing us our odds in the most objective way possible.

Then he goes through the four things that can cause miscarriage and talks about how they will test for each one. This was all old news to me since I’ve read Jon Cohen’s “Coming to Term” twice in the past week. But it was good for Cowboy to hear. In short, we’re offered these tests:

(1) Abnormal chromosomes. Test = Karotype testing (DNA testing) on both partners.
(2) Immunulogical. Test = blood test. He put me on 81 mg of baby aspirin just in case. Baby aspirin and prenatals…the gateway drugs.
(3) Hormonal = clomid test and progesterone test.
(4) Physical Abnormalities in Ms. Planner’s girly bits = HSG.

Side note: to explain what happens during an HSG, Dr. Stretch brought out photocopied science drawing of the female reproductive system. I had to bite the insides of my cheeks to stop from cracking up because I was wondering what was running through Cowboy’s mind. We don’t even talk about AF in our house. Seriously, talking about periods (for him) and going #2 (for me) are off limits. And here he is being confronted by a full scale representation of ovaries, fallopian tubes and the uterus. Flippin’ classic. So what if I’m completely immature sometimes.

So I’m off for 2 of the 4 tests beginning CD 3 of my next cycle:

  • Clomid Challenge Test / Progesterone which happen at different days in the cycle.
  • HSG on day 12.

Cowboy apparently gets off scott free. LUH-CKY. He’s missing out though because he was going to get one fantastic care package full of porn if he had to whack off in a cup.

However, is it strange that Dr. Stretch didn’t even ask for a swimmer sample? I don’t know how I feel about this. What if Cowboy’s swimmers have poor morphology, which is contributing to a nonviable embie? Perhaps they just want to get the more obvious tests out of the way.

On the other hand, I am happy to spare any of this for Cowboy. He’s got enough stress with his job. This would only add to it.

Maybe Dr. Stretch thinks that because we’ve gotten pregnant twice before, the problem is not with Cowboy’s swimmers. Unless Cowboy’s got some freak DNA, which we’ll learn about during the karotype test.

Has anyone out there had karotype testing? It’s expensive and I’m not entirely sure it is covered by my insurance. The reason to have it is that if one of us has messed up DNA, we have a 75% chance of miscarrying every time we get pregnant. Only 7-10% of couples who miscarry have DNA issues. Wouldn’t I be just that lucky? But still, if you have DNA issues you usually go right to IVF with prenatal genetic diagnosis and voila! baby. We’ve got a couple weeks to decide on this. Any thoughts?

Other news is that Dr. Stretch suspects that progesterone is major player here. My cycles are between 23-26 days and I’ve never had a luteal phase beyond 12 days.

I had to sit on my hands to keep from snarking, “Yes, Dr. Stretch. I’ve long held the suspicion that I might have progesterone issues. In fact, I know 2 other women who had miscarriages and were put on progesterone -- no questions asked -- the minute the next time they saw 2 lines and they both went on to deliver healthy children. Instead of testing my progesterone levels after miscarriage #1, I was told to simply ‘focus on getting pregnant,’.” And we all know how that turned out.

But I couldn’t throw my OB under the bus because Dr. Stretch performed my OB’s IUI (which worked by the way). So they’re old buddies.

Anyway, Dr. Stretch wants to do the clomid test to check my FSH levels so he knows what kind of eggs he has to work with and the HSG just to check regarding possible abnormalities that would cause implantation problems.

But the most shocking take away from our meeting is that our best odds of success = IVF. Yep, we have better odds of taking home a healthy baby if we have IVF with PGD than if we conceive naturally (and, of course, once we correct whatever issue(s) I may have).

How about them apples?

I am a research geek. I am so down with the 4-1-1. I love statistics. I love facts. And when it comes to this particular fact, I am simultaneously fascinated and terrified.

So you mean I bypass all the IUI’s? No warm-up runs? We play the odds naturally? Or, we go right to IVF?

Holy…still trying to process that one. *Gulp*.


Watson said...

Phew, after some serious bloggy detective work I found you, and posted your link on my blog.

(Sorry, I know I had it, I am so totally scatter-brained these days!)

Anyhoo, I have to say 'THAT'S CRAP' about Cowboy not getting his boys tested. I am standing on a soap box now, yelling that it's not fair, and it's not right.

The man should always be tested in tandom with the woman. It just makes sense. Why go through all of the (often invasive) tests and exams when quite often it is a male-factor problem??

Especially if you're talking about an HSG or something...

I just don't get doctors sometimes. But I always yell and scream at my friends when this happens, and encourage them to demand the tests.

Okay, carefully getting off soap box now...


Sticky Bun said...

um...(she says while sheepishly looking down and dragging her foot back and forth)...Shorty is not quite yet my RE. But he will be--if we're not pregnant. (fingers and toes crossed!)

Sounds like a very eventful meeting! It does seem slightly strange that they aren't testing Cowboy's swimmers...seems like that is an easy, non-invasive test that could yield some useful info. Might be worth asking why?

As for the skipping IUI, I know docs vary on seems to me that the best reason to skip it is if egg quality is an issue...but you don't know that it is, right?

But, I should warn you that I'm the worst RE EVER, so you should probably take anything I say with an enormous grain of salt. :-)

Erin said...

I totally agree - Cowboy should definitely get his li'l ponies tested out pronto! (Ponies? Cattle? Whatevs, I don't know shit about cowboys, I guess.) Anyway, it's so easy and cheap I would definitely suggest it next time you talk with your RE. Then you can be like me and be reminded CONSTANTLY about how perfect your husband swimmers are. I know it's a good problem to have, but enough already. I get it, they squiggle with the best of 'em. Too bad my lazy ass eggs aren't as peppy. (Whatever happened to opposites attract?)

Back to you! I know this decision to leap to IVF must be weighing on you, but try not to stress out too much until you get your CCCT results back. Hopefully it will tell you that you've got scads of perfect eggs left and that you can try some low(er)-tech procedures before completely emptying your bank accounts... Good luck!

Ms. Planner said...

Ponies. Tee hee. I love it.

Bumble said...

I agree about Cowboy getting checked out too, what can it hurt? And I'm so glad they're checking all those thing for you, they sound very thorough.