I am just sitting here, floored. In shock. When I went to meet with the new RE, after our consultation he said he would email me and I could email him whatever questions I had.
I tried not to email him too much, and to combine several questions into one email, but I was a little worried I was bugging him. I think I’ve emailed him 3 times, the most recent one giving him the results I received today.
Well tonight he called and said, “Amy, you have some questions. Let’s talk.” And then we went through EVERYTHING. What the results meant. What was coming next. Different options for treatment. He told me his recommendations….and then he asked what *I* wanted to do – and said we could do that too. He listened to me. He explained everything to me. He spent 45 minutes on the phone with me, listening to every single thing I had to say, not dismissing any of it, and telling me how he could help me.
I feel like I won the RE lottery. I found a doctor who actually listens, who actually seems to care, who actually wants to help me. It makes me feel so much better. SO much better.
As for the results – he basically said that the borderline APAs, given that they were IgG antibodies and not IgM antibodies didn’t mean much. He didn’t think that was causing my m/c. If it was IgM antibodies it would be a different story. I know I won’t explain it well, but IgG antibodies don’t cross the placenta, IgM antibodies do, so IgG antibodies could not attack the embryo. Or something like that. Basically he said he wouldn’t recommend more than a baby aspirin and he’s not even sure that will do anything, but it won’t hurt. He doesn’t think I need Lovenox/Heparin, but if I really wanted to do it he would prescribe it for me. I’m not sure what to do on that one, I’m going to think about it for a bit.
He reiterated several times that given my history he would be very surprised if I didn’t have elevated NK cells and mostly wanted those results back. It will be 1.5-2 weeks most likely before we get them.
Basically he said that if we were ready we could try next cycle. If I do have the elevated NK cells, we would do the Intralipid therapy. He prefers to do that with a full IVF cycle, to ensure that the embryos are genetically sound, that the conditions in my uterus, my hormones, etc are good, and so they can know that there is an embryo in there, not leaving it up to chance with sperm meet egg, since often people have to try for awhile to successfully fertilize. I mentioned that (so far) I have gotten pregnant every time we have tried since my 1st pg and while I know that isn’t a guarantee, that is my history, and I would prefer to try naturally for a couple of cycles before thinking about IVF. He said we could do that too. We will do the lowest dose of injectible gonadotropins with an HCG trigger.
And if the NK cells don’t come back elevated we will do the same thing. So basically, its on next cycle. I need to get a list of the meds and find out what is covered by insurance. I need to decide if I want to insist on Lovenox/Heparin or let it be. I need to get my head around all of this.
I have to say, I am feeling SO MUCH BETTER about all of this. This doctor is what I had hoped for when I first consulted an RE. The first one I saw was nice and knowledgeable, but the way they handled the pregnancy I had with them did not sit well with me. (When my betas didn’t quite double after the 2nd draw on Thursday, telling me to wait until TUESDAY before I could come in again, when they had a SAturday clinic and I was basically losing my mind), and my RE NEVER called me or asked her nurse to call me to set up a follow up appointment after that loss. I don’t think they really looked at MY situation and history at all. I was just put through the machine, so to speak.
Anyway, we are still waiting for the results back, but it looks like we are on next cycle if we want to…which is exciting and completely terrifying at the same time.