I had my appointment with the fertility specialists yesterday. And I believe that I have the best doctors in the world, being as I go to the U of Michigan Hospital and they are 13th top ranked in the world. Anyway, it was a great appointment and I am glad to share it with you here.
Dr. Marsh, the younger female doctor who performed my surgery, came in to speak with me first of all and shared that the initial pathology from the tissue sent from the surgery suggested that there was enough tissue to culture and it would take a few additional weeks to get a final analysis from that on if there were any genetic cause to the miscarriage. She said, unless that comes back positive we do not need to test Shaun and my genetic karyotypes as it has a very low yield to show anything that would be helpful for us. She said that the most likely relationship between the 3 losses (full term abruption, chemical, and 8 week miscarriage) would be random selection. Or possibly a clotting disorder for me. She asked if I had any clotting testing done and I told her that I had. When she searched my file to find it, it was not in my records. I told her that Dr. Gardner sent me to Dr. Mowat, the hemotologist, and he would have the labs, but he had told us 5 years ago that I did not have anything unusual. She told me that they would request the labs and if there were anything that he had not done or that could be retested that they would let me know. But, since I probably don't have any clotting issues, then most likely all of these losses are completely rare and bad luck.
She answered all 36+ of my listed questions. Most noteworthy are:
1. Do these miscarriages teach you anything about my condition? Yes, they say to us that it is not terribly difficult to get you pregnant, except that you have to be here, but we need to identify if there is anything else we can do to help you sustain it, such as adding a baby aspirin or blood thinner when you get a positive test.
2. What would be the next plan of treatment? Do hybrid cycles until you get pregnant. It is very likely that you will get pregnant within the next 3 cycles.
3. Should I consider surrogacy? and is it legal in Michigan? No, it is not legal in Michigan, but if that were the only option, we do have ways to get around the law, and no, we don't think that it is necessary for you to hire anyone to carry your child as we believe it will happen for you shortly.
4. What if I don't get pregnant on the hybrid, what's next? Then we would offer IVF. But, if you were responding well to the hybrid, we would continue to use hybrid since you have said you do not want to do IVF.
5. Do you think with my history I should see a high risk OB or would a regular OB be fine? (she laughed and said emphatically, touching her third trimester pregnant belly) YES, see the high risk, if I were you I wouldn't mess around with the regular OB.
6. How many years of fertility do you think I have left? I want to be able to have more children and wonder if I should try to get pregnant immediately after delivering a live birth? I think you have many years left as you are still young and are responding well to treatment. So, if you wanted to wait a little while to space your kids, you may.
7. How many miscarriages would I need to have before you all tell me to quit trying? We don't have a magic number and it will not be bothersome to your physical health to keep trying, but it would depend on you and your hubby's emotional wellbeing. You two decide what is right for you.
So, then Dr. Randolph, who has worked in the practice for 25 years came in to solidify all that Dr. Marsh had said. He was so patient, kind and came in compassionately, asking both of us how we were doing emotionally. I told him that I was handling it all very well and Shaun agreed he was doing fine too. He asked how Thanksgiving was and what we were going to do to get through the holidays because he knows how rough it is for those of us who have lost. He then said, as long as we were ready emotionally, this would be the next plan:
1. Wait for beta to drop to 0.
2. Get a hysteroscopy (a camera looking inside of my uterus for structural abnormalities) done in the office before period. And take a 2 hour glucose tolerance test to check for diabetes.
3. Start Prometrim 2 weeks after beta is 0, and take for 2 weeks until I start a cycle.
4. If all tests come back, including the pathology from the fetal tissue, then we can start a hybrid cycle, if Shaun and I are ready. If not then we will wait 2 weeks and restart prometrium to induce another cycle.
5. Take Femara on days 3-7 and give shots 7-10, on day 10 ultrasound to see if follicles are ready and then give ovidrel.
6. If I give ovidrel, then 8 days later take a progesterone test.
7. Depending on results of the multitude of tests, then I may begin progesterone or aspirin or heparin blood thinners once a positive pregnancy test is seen.
Shaun and I left the office feeling a sense of confidence. I told the doctors that if they told me that it was unlikely to carry a baby to term that I was willing to admit defeat and move on to the other options, like surrogacy or adoption. They were very passionate about how they believed that I would be pregnant within the next few months and the outcome looks good. All these testings were just to prove that there is nothing wrong and it was all just bad luck.
So, I feel ready to start again. Ready to move on to being parents. Hopefully, next Christmas, we will have a little one to share it with. We believe that God allowed us to be in this place for a purpose and are praising Him for letting us share this journey with you.
Father, I thank you again for modern medicine and allowing doctors the gift of learning and discerning to use medicine and research to help people. I praise you because you are the Great Physician and you have given your knowledge to man. I ask that you continue to provide peace and comfort to all who mourn and to us who are currently on this journey. Give my friends peace who are still trying, who are deciding to stop trying, and to those who are pregnant and worrying. I pray that you allow your will and you give each of us a sense of your will so that the pain only lasts a moment. I pray that you will bless Shaun and me with a child and that you will allow us to be the parents that you have destined and designed us to be. I pray all of this in Jesus' name, AMEN!