A woman knows by intuition, or instinct, what is best for herself.
I gave my doctors the benefit of the doubt. All my blood work came back normal. Except my TSH (thyroid-stimulating hormone) was on the high side of normal and my progesterone was on the low side of normal-both things we can correct with some Synthroid and Progesterone supplements. There really was not other explanation-it was the translocated chromosome that continued to cause our babies to have genetic problems and subsequently die before ever being given the opportunity to be born. So we tried to do something about that..we were tired of getting pregnant with babies that were just going to die and cause us continued emotional pain. We followed our doctors recommendations, against all moral values, and attempted IVF with pre-implantation genetic testing. And that failed to even get us pregnant.
What options are we left with? My eggs suck, apparently. They carry genetic disorders. Some that are absolutely deadly-monosomy 13, monosomy 21, and trisomy 13, and some that are "usually" deadly-Trisomy 21 (Down Syndrome). Not only do they carry these genetic disorders, but we found out during my IVF that I create many immature eggs that aren't suitable for fertilization. We don't want to waste any more time or money on my eggs-so the solution? Let's use my sisters. She's young and fertile and doesn't carry the translocation and has a healthy child-all great signs that this could be our ticket to having a family.
Yet my inner voice says, that's just a start. That's not my only issue. That could get me pregnant with a beautifully healthy baby, but is my body going to nourish and be able to carry that baby to live birth? Every doctor that I've spoken to tells me yes. But something tells me no. Something tells me this storm is never going to end unless I seek the answers to this voice inside me.
So I did just that. I learned about Dr. Braverman in New York from a fellow recurrent loss mom in one of my online support groups. I did my research on him-he specializes in recurrent pregnancy loss and recurrent failed infertility treatments. He finds answers for women that other doctors don't. We had our testing done in May and we finally got our results yesterday. Every review I read about him was correct-our appointment started an hour and a half late. And he was dressed like a bum with holes in his jeans and a regular Joe off the street shirt. But I am so very glad to have had his testing completed and to have gotten a second opinion from him because now I know my intuition was absolutely correct.
Here are Dr. Braverman's opinions:
#1-My fasting insulin level is too high. Interesting. Kettering Reproductive and Ohio Reproductive had no problem with my level being 17.3 in January before we began our IVF cycle. Yet I found out from a friend who was also going to Kettering Reproductive for IUI treatments that they told her they wanted her insulin level to be below 10. So why wouldn't they want mine before 10 too? That doesn't make any sense. I asked my new doctor about this just 2 weeks ago and he didn't seem concerned either. He did retest me though and my level came back this time at 20. 7. While this is within normal range...this is the very high end of normal, and just like my TSH was at the very high end of normal-this needs to be treated and needs to come down before we attempt another pregnancy. According to Dr. Braverman-he believes I have polycystic ovarian syndrome(PCOS) due to my high Insulin level and the large amount of follicles in my ovaries. He explained that the high insulin levels would cause my ovaries to produce lots of eggs, but lots of very bad quality eggs. He said women with high insulin levels are at risk of hyperstimulation during IVF cycles. Having high Insulin levels and PCOS causes miscarriages too.
The interesting part is two-fold. I've had concerns that maybe, just maybe I have PCOS. It's been a fleeting thought though. One that crossed my mind for a quick second and then I said nah...I can get pregnant too easily and no doctor ever mentioned any cysts on my ovaries or have ever mentioned this as a possibility. But I have a few symptoms-30 lb weight gain in 2 years...but that's just depression and stress and not working out I tell myself. My cycle has been weird the past 2 years...it was ALWAYS every 28 days but since July 2012 it's varied anywhere between 25-38 days and I didn't really have an explanation for this other than-but it's not affecting me from ovulating or getting pregnant. Then my insulin level coming back high normal-and doctors being concerned about this for other women but not me was just strange.
The good news is-we can treat this issue very easily. Dr. Braverman wants me on Metformin to lower my insulin level before and during pregnancy. Easy peasy-just a pill every day. I can do that. He is checking my Anti-mullerian hormone again to see if I do have PCOS or just the metabolism of someone who would have PCOS. I should hear something soon on that.
#2-I have resistant blood flow to my uterus. Wow. I have NEVER had a color flow doppler ultrasound completed before Dr. Braverman did one. He said the blood flow in my ovaries is great...uterus, not so great. Since it is not so great, when I'm pregnant, the babies are not getting an adequate supply of blood from me. This will kill them. Without blood, they cannot survive. Why is my blood not flowing well to my uterus? We don't know. Dr. Braverman suspects endometriosis. He recommends that I have a laproscopy to confirm or deny this suspicion. He also found scaring in my pelvic muscle and he is not sure why that is there because I've never had abdominal surgeries and my D&C's should not have caused scaring into my muscles.
So how do we increase this blood flow? I've already been taking Asprin and that isn't helping. I will be on Lovenox since I have a risk of blood clotting with having Homocystinuria and that will thin my blood out. But this isn't enough. I've done both those medications during my previous two pregnancies too. There are other injections Dr. Braverman would put me on-he just isn't sure which one yet. I will be talking to my OBGYN about getting a laproscopy scheduled now. I brought it up to her back in May and she didn't think it was necessary and didn't think I had any signs of Endometriosis. But I'm going to push the issue now. Why not? We've already met our deductible and everything I do now within the Kettering Health Network is paid at 100% so now is the time to get it done. If I have it, and we clean it out, it could help my blood flow and improve my progesterone level so its a win-win. Yea, it's surgery and I will be off work a day or two-but I'm not messing around this time. If Dr. Braverman thinks its necessary-then I'm doing it.
#3-I have too many T-regulatory cells. Essentially, this means my body naturally feels like it has to constantly fight off infections and invaders. This is only heightened when I am pregnant. These cells believe babies are an outside invader that needs to be rid of. Basically, as I suspected-my body is attacking and killing our babies. With every pregnancy, the t-regulatory cells become more activated and increase in number. According to Dr. Braverman-this will cause earlier losses with each pregnancy. This makes complete sense. Especially within the past year 2 years. With Logan, I miscarried at between 9 & 11 weeks. With Audrey, I miscarried between 4 & 6 weeks. With our IVF embie, it never had a chance to implant.
If we don't treat this issue-there is a VERY high chance I will miscarry again. The treatment is not cheap and requires a couple different injections-some that have to be given by home care nurses. I will do whatever it takes to get my body to the point of accepting a baby as a blessing and allowing me to grow our baby to birth.
#4-I have genes that predispose me to several autoimmune diseases. The most likely disease that I could have is Celiac Disease. The treatment is simple. Or so it seems. I will be attempting a gluten free diet. Hopefully by decreasing or eliminating gluten, I will feel better overall and will not have as many joint pains or abdominal bloating. Hopefully it will also allow my body to stop attacking itself. Recently I started suspecting that maybe I had Celiac Disease-I don't really know why but it's been on my mind. We don't know that I HAVE it-we just know I have a gene that can cause it. And I know if I have a gene that can cause it-somehow I will get it. It never fails.
The biggest thing that really sucks is that I already can't eat much protein. I eat a lot of carbs and a lot of food that has gluten. Which, by the way, I think is what has caused the high insulin level and possible PCOS. The diet for PCOS is low carb, high protein. So I feel like I'm screwed all around. What can I eat? When my diet gets restricted like this I end up giving up and eating whatever I feel like honestly. I haven't been complying very well with my low protein diet or my medication for my Homocystinuria lately because I just get so sick of eating the same things and drinking nasty tasting food supplements. Ugh...I have GOT TO get back on track with all this. I have to do it for our rainbow baby. I will start kicking it in gear on Monday, after my friend's wedding. After all, I can't give up drinking beer before her wedding, right?!?
Whats next? I need to email Dr. Braverman with the contact info for my fertility doctor here in Ohio. They need to talk about my test results and my doctor here in Ohio needs to agree with the treatment plan Dr. Braverman puts together. My doctor in Ohio has to be the one who orders all the medication for me. I need to call my OBGYN and get a laproscopy scheduled. Dr. Braverman has ordered a DNA fragmentation test on my husbands semen which he's going to complete next week. Although our fertility clinic thinks 3% normal sperm morphology is okay, Dr. Braverman is not in agreement with that. He wants to make sure there isn't a lot of fragmentation in the sperm because fragmentation can lead to genetic problems and poor embryo development. My husband may be getting prescribed Clomid to increase his morphology depending on the results of this test. And he is actually willing to take it if he needs to. He finally understands he has a very important part in creating a child for us and we need to do everything we can to make sure we get healthy babies.
Alright-enough of my results. Want to know how our trip to New York went? Here's the down low-China Town is crazy with street vendors EVERYWHERE. It was a little scary the first time we walked down the street. We figured out quickly the other side of the street had way fewer street vendors so we walked on that side the rest of the time. Little Italy has a very cool feel. The streets are blocked off so you can walk in the middle of the streets and there is restaurant after restaurant. Not impressed with the food from De Gennerro though. However, the gelato-A-M-A-Z-I-N-G! I got the salt and carmel flavor and it was to die for:) The Statue of Liberty is pretty neat to see in person, but it looks the same as it does on television. Ellis Island had way too much history that it got boring after awhile. It is very interesting though how our ancestors came to America. The 9-11 memorial is pretty. We only saw the fountain at ground zero and didn't go into the memorial museum. Central Park is huge but you really don't need to rent bikes to see it all. We spent more time walking our bikes then riding them because you can't ride them on the walk-ways to see the monuments or features throughout the park. The Metropolitan Art Museum was a snoozer for me, except the African art section with all the Mayan costumes and totem poles. Times Square is crazy. The amount of people walking around on a Monday evening was unreal. It was packed like sardines. The stores are the same as the ones in the malls around here-H&M, American Eagle, Aeropostale. Except the prices were surprisingly cheap. Alcohol is overpriced everywhere you go throughout New York. A 6 pk of beer at the convenience store next to our hotel was $17. The food was okay-not great. The best thing we had was crab and spinach dip at Langen's Irish Pub in the Times Square area. We got dessert at Cake Boss Cafe which was the longest wait ever but totally worth the delicious carrot cake and strawberry shortcake we got. The subway system is confusing at first, but as long as you carry that subway map with you at all times and aren't afraid to ask people for help-you'll figure it out pretty quickly. The train station was byfar the most challenging. They have dozens of tracks your train could be on and don't post your track number until 5-10 minutes before departure so its a mad rush to get to the train before it leaves. There is construction on every street it seems throughout the city. My absolute favorite thing about New York was the street performers. Those people know how to hustle to get some money, but they are entertaining. OH, and The Stand in Gramercy Park was a cool place to spend and evening between their delicious Moscoto and funny comedians. Would I go back to New York? Honestly, probably not. It was a neat experience but we prefer the mountains or the beach.
Overall moral of today's post: