Tuesday, April 12, 2016

REBECCA: UPDATE

 I am really happy Rebecca upated us on her story. I am hopeful that some readers out there might be able to relate and/or share some insight on the "answers" she has been given. If you have any advice, thoughts or kind words, email me at stillnotpregnant@gmail.com and I will be happy to forward to Rebecca. 

Thank you again for opening your hearts and minds to her continued story. 

Rebecca loving on Annie

(Some) Answers
It has been hard to not feel resentful this week.  I’m trying. I’m trying hard. On one hand, I’m frustrated at all the doctors and experts I’ve seen for the past 6 years. On the other hand, I’m frustrated with myself for believing them and not pursuing other answers or methods.

I got a call from the fertility clinic Monday afternoon. They received the results of my progesterone draw:

Low.
Super Low.
1.9 Low.

I know I shouldn’t be surprised. My cycle was short this month. It’s never short. I’m usually at 29 days on one side, and 31 days on the other. This cycle was only 27 days. That makes my mind race with all kinds of questions. At the age of 41, on the top of that list are questions about impending menopause. They are probably unfounded, but they kept me awake in the middle of the night Saturday, Sunday, and Monday nights.

The clinic asked me to come in first thing Monday morning for a resting follicle count, a culture, and to review the results of all my blood work. I feel fortunate enough to have a job that enables me to do what I love, but that gives me enough autonomy to be flexible on days when I really need to be able to “flex” my time.

I hate morning traffic. So, an hour after I left my home on Monday morning, I arrived in an already-frazzled state at the clinic. Resting follicle count on cycle day 4:

Right: 8
Left: 3

More questions.  Why only 3? In some ways this is good news. 11 follicles total, without Clomid. But the uneven count between the 2 sides worried me a bit.

After the ultrasound and culture, we went over the results with the kindest nurse. After battling miscarriage, after miscarriage, after miscarriage for the past 6 years, I now have a few clues.

Clue 1: I have low progesterone (1.9) at a point in my cycle when it should be high (15 or more), making it hard for my body to build an adequate uterine lining in which an embryo can implant. Suggested treatment: Hcg shots & Clomid to begin next cycle.

Clue 2: I have an inherited gene mutation that makes it difficult for my body to metabolize folic acid. It is estimated that half the population has this particular mutation. It is known as MTHFR A1298C. It is important for the neural tube development of a fetus, as well as for blood clotting. Suggested treatment: See Clue 3.

Clue 3: I have another inherited gene mutation that has the same effects at the first gene mutation. It is the back-up gene that, if not mutated, can make up for the A1298C mutation.  It is known as MTHFR C677T. Again, many people have this mutation. However, being heterozygous for both is cause for concern.  Suggested treatment: a prescription strength prenatal that contains a higher amount, and more broken down form of, folic acid, and add foods rich in vitamin B9 to my daily intake.

Clue 4: My TSH level (3.69), while within the designated “normal” range, is not in the optimal ttc (1-2) range. Additionally, 4 years ago, when measured, it was only at 1.9. So, somewhere along the line, it has crept up. Suggested treatment: Synthroid. (And there, ladies and gentlemen, goes the tiny part of me that was proud to have escaped the thyroid issues that plague many of my family members).

Clue 5: Blood clotting is a possible factor. My anti-thrombin 3 panel came back deficient. Suggested treatment: repeat test and run a few extra tests to confirm results.

The good news is that my Vitamin D is really good (60), and well above the minimum they like to see when ttc (30). AMH levels were also good, which tells us that my ovaries are working fine. My autoimmune panels all came back normal.

Why the resentment? As many who struggle with infertility know, sometimes the emotions just don’t make sense. A part of me is screaming, “If 50% of people have these gene mutations, WHY on Earth did not one single OB, doctor, or specialist every suggest running a few simple blood tests that could have revealed this information YEARS ago?! Why did they always tell me to, ‘just go home and try again’?” Another part is screaming, “Rebecca, why did YOU not ask more questions, seek more answers, or studied more about infertility at the start of this journey?”

Predictably, I am full of mixed emotions. Truly, though, I am relieved to have some answers that go beyond a uterine anomaly that has only been detected once. I am so very grateful for the path that led me to Dr. Albrecht, and the chance it gives us to possibly be a family of more than 2 (okay, 4 if you count the dogs, and we do). I am content to know that, at least for now, we have a plan. 

I am well aware that my age, combined with the MTHFR mutations, puts us at higher risk of having a child with neuro-developmental disabilities. But we are okay with that. I am also aware that this combination may be the thing that keeps me from having kids, despite everyone’s best efforts. I’m working towards being okay with that.

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