2nd Opinion- The 'Fetal Pole' Opposite

Survey says... (something very different from the first)!

I thought that I should update on our second opinion. It was VERY different from the first. I have to say that I liked Dr. K better, overall in mannerisms and based her opinions in a logical and empirical thought.

We all know that it's hard to summarize RE consults but I will try my best...

1st- agreed that some immune testing is legitimate. So L (hubby) and I gave blood for Leukocyte Antibodies Detection (LAD) and I just gave blood for Natural Killer Cells (NK). The IVIg treatment is not that sound as it seems that everyone gets a different result. However, those with secondary infertility see the greatest success.

2nd- egg quality is not the major issue. She said that 'bad eggs don't get fertilized... and you become pg very easily.'

3rd- she is not sure Metformin is right for me due to my consistent physical reactions. Perhaps Met could be a bigger hardship then the possible benefits.

4th- suggested that I re-do the glucose/ insulin challenge (this would be the third time).

5th- wants to get a saline u/s done to make sure there were no polyps, scar tissue, or residual tissue from the last pg. She wants to make sure that nothing is impeding implantation. Of course this is done Cycle day 7-9.

6th- a u/s while we were there. It appeared I had some more muscle on the top of my uterus (what no one has ever said that to be before?!) She showed me where it was and then showed me how my uterus is slightly heart shaped. She said that it wasn't enough to impede implantation or require surgery (whew!).

Final opinion- doing whatever it was were doing the last time since that had worked the best... (funny, that was a natural conception), then she laughed and said, 'You have had a wide variety of pregnancies'. Thinks that we will get there but we just have to get all the factors to line up.

Q: Why was my injectable cycle (3rd pg at old RE) and my Letrozole cycle (4th pg at current RE) were so very different?

A: Hard to say. The low prog. (3rd pg) could have been from the fact that I had low quality eggs and but that the number was more indicative of the pg failing from the beginning. The Letrolzole cycle (4th time) she said that while the prog. level was great, the lining was 'okay', and this was my chemical pg, but something could have gone wrong during cell/dna division.

She said that so much of this field is unknown, that it doesn't always make sense, and there are so many things that can go wrong that we just can't see.

Q: can APA's change during pg?

A: Yes, sometimes they do. However, any APA issues should have been taking care of by the Lovenox. (I think that I might get them tested the next time I am pg since I know what they are while not.)

Plan: See what the b/w looks like and do the saline u/s and go from there. She did suggest that we start Lovenox from ovulation the next time.

Saw my ob (love her and started doing testing after my 2nd loss) today for a diaphragm ( I would like to say they are slippery little suckers and they really can get stuck, Carrie Bradshaw wasn't kidding!)

Ob's thoughts on opinions (because I am kinda lost between the two and I really trust her)

Ob: I don't really understand why your 1st opinion recommended DE. If all your losses had been the same I understand but they have been a variety, especially after the last one with a heart beat. Wait for your tests to come and rest until then.

If you aren't using hormones to regulate your cycles (cause I am sick of pumping my body full of hormones) then you may want to get the OV Watch just to see if the continuing the Met is going to give you benefits (in the past it has not). It may just be good see what happens. (I will put in a call SIL as she already has one.)

Q: How can I lower my LH if I am not using hormones?

A: Diet, exercise, and using Metformin.

Q: The second opinion says that I don't have insulin levels tested and wants to re-test.

A: No we have them (flip, flip, flip)... you came up normal on the first one for fasting and insulin. On the second one... your last fasting was elevated slightly but the insulin was fine.

Q: I forgot to ask while at the RE... my breasts have been sore since the last m/c. I also getting some discharge (TMI, but isn't that what fertilty is about?) should I get my prolactin levels checked again?

A: Yes, and we will also look at your TSH again... thyroid problems can mess with your hormones. I would hate to miss something.

So, L is frustrated because he was expecting our 2nd (Dr. K) to agree with the 1st RE (Dr. P).

So there is a part of me that feels like we are back to square one in trying to decide what we want to do. Ugh... I know that once a decision is made my husband will still not want to move forward until after the new year. So I guess that's good since there is no pressure to make one, but a pain cause when we do I will be ready to move on it. So there it is... my second opinion, sorry this so long! It really is shorter than the first one I wrote (scary I know!) Feel free to give feedback if you want...