Keep trying.
None of them think it is just bad luck, but they also say there is no indication that the endeavour is completely hopeless either. Although none can actually pinpoint where my body is going wrong, we have come out of this week with a couple more ideas to try.
The lovely Jennie Slee, geneticist at KEMH, says there is nothing to indicate I/we should throw in the towel. Both DH and I have normal Karyotypes, and though many of our embryos have been ‘chaotic’, we did have two ‘normal’ ones, which indicates some hope. She recommends continuing with PGD if we do IVF again, and was not sure if there was a clinic in Australia using CGH testing for embryos. I will have to do further research on this. The CGH method is a bit more reliable than FISH, plus has the bonus of testing ALL the chromosomes, not just 8 of them. Jennie also mentioned another test, the microarray based CGH, which she thinks is still in experimental stage in Australia. This test is apparently a lot more reliable than the other two, but I need to do some more research to see who may be offering it, and when.
The hardworking Dr Barry Walters, physician and recurrent miscarriage specialist gave me and my paperwork a thorough going over. Although he found nothing conclusive he did suggest that trying Clexane 40mg daily as soon as pregnancy was confirmed, may be helpful. According to him, studies have shown that in cases of recurrent miscarriage where clotting disorders have NOT been found, administering Clexane still increased live birth rates. So I shall be giving that a go should I be lucky enough to fall pregnant again. Dr Walters did not seem to think low dose asprin alone would be of any benefit, however the third specialist we saw (below), said he thought it might be.
Dr Mark McKenna is a lovely chap with a good sense of humour and an interest in his patient’s problems-a rare bird in this industry! He has also closed his books so we were very grateful he even agreed to see us. I think my GP had done some hard grovelling on our behalf. And perhaps he likes the real challenges. Anyway we spent about 45 mins shooting the recurrent pregnancy loss breeze with a person who knew EXACTLY what we were talking about. How refreshing to have one’s questions sensibly and concisely answered by someone who had actually spent time thinking about what those questions might be BEFORE YOU EVEN GOT THERE.
Dr McKenna’s take: the rate limiting factor for us will probably not be menopause, it will be emotional burnout. (Amen, sista!) So the question was really, given that there is still a chance of success, how long are we prepared to go on trying? And then if we do intend to go on trying, in what capacity shall we try?
The first answer is yes, we will continue to try to create a child. And we will do that slowly at our own pace with as many breaks as we need to, in order to stay sane and married.
The second answer is more complicated. What form will the trying take?
Well Dr Mc Kenna’s suggestions for improving our chances include trying clomid. He seemed to take my luteal phase defect seriously, thought it could be interfering with the egg maturity and why not give it a whirl. [He didn’t have a preference over femara or clomid, so please write in folks, and let me know your own experiences/suggestions/advice/opinions on which I should choose.]
None of the specialists seemed to think we ought to rush out and use another woman’s eggs. In fact, no one brought up the egg issue until I mentioned it, and consensus was that no proof existed to suggest mine were so faulty we needed to abandon them. I raised the idea of surrogacy and no one jumped all over that either. They all seem to think I have plenty more time to give things a go with my own eggs and body, but ‘isn’t it nice that I have other options up my sleeve for later’ sort of response. So there you are. 38 and I seem to have all the time in the world. Much more reassuring than having everybody freak out and wave their arms in the air telling me to get on with it, and quickly!
So, plan A:
- Begin low dose asprin now – what can it hurt? [if you have an actual answer to this rhetorical question, please do leave a comment!]
- Start clomid/femara next cycle
- If pregnancy occurs begin clexane injections
- If pregnancy doesn’t occur by the end of the year, think about an IVF cycle. Decision as to where will be made on availability of best PGD process vs inconvenience of perhaps having to go out of state to have that done.
Plan B: At some point [we will know when the time has come] we decide plan A hasn’t worked, then:
- donor egg IVF in Perth
- think about surrogate
HOWEVER: HSG results have thrown a small spanner in the works by showing that the left tube is being compromised by remaining ectopic tissue/and/or scarring. The dye made it through (painfully) but you can see it isn’t properly clear. Given that the technician tried very hard to flush it out with saline but due to me being in quite a lot of agony gave up, there seems to be not much hope it will go away of its own accord. It may reduce slightly, but some of it will be permanent scar tissue. What this means is, if my left tube ever decides to escort a future embryo, then: (very probably but can’t say DEFINITELY) hello ectopic, hello surgery, goodbye left tube. So this makes trying again ‘naturally’ rather nerve wracking. Having said THAT, IVF presents a 25% risk of ectopic anyway, so what the heck. I’m pretty much spinning the wheel either way.
Of course I COULD have pre-emptive surgery to remove the tube now, or even remove both of them. Then I would be guaranteed no more ectopics. But I hesitate at such a radical step. At the moment I prefer to take my chances. The tubes will go only when they HAVE to.
Oh yes, one last thing. They found that my uterus was slightly retroverted. Which probably explains why the procedure was so painful.
And there you have it. My week in a nutshell. Carry on.
*I reserve the right to remember other details later and add them in without admitting I have edited this document.
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