LESS Questions, MORE Trust

Letting go of control and learning to trust doctors is one of the hardest things to master along this infertility journey. Maybe it's because I got off on the wrong foot in this journey to begin with.

I started out in July 2011 with my OB/GYN, taking Clomid, only to be told "Your case is too complicated, so I'm referring you to a specialist." This is the same OB/GYN that I later had a 10 minute debate with on why doing a CD21 progesterone test would not show ovulation in my case, because sometimes I do not ovulate until CD21 or later. Clearly this would not be accurate, but she didn't get it.

I moved on to an RE, Dr. Burger, who seemed to be taking me in the right direction, only to keep finding mistakes and snafoos in her protocol. My final cycle with her was spent arguing whether or not I ovulated or should begin Prometrium supplementation during the luteal phase. Even though I'd had a huge BBT temperature spike and I was having post-ovulation symptoms, she refused to agree that I ovulated.  I insisted on a P4 test which proved I did ovulate. Only then did she write me the Rx for the Prometrium, and I was able to start the medication as she had outlined in her own protocol originally. This is only one instance among others, but it just always felt like pulling teeth. Totally exhausting working with her.

Fast forward to the RE I see currently see. My first cycle with him was like a dream come true. I did not have to remind him where I was at in my cycle. We clicked. He predicted exactly how I would respond, and I did. I became pregnant my second cycle with him using Femara and IUI...unfortunately it was an ectopic pregnancy and a long drawn out process to finally move on from it. It was then that IVF was recommended.

Then, despite not becoming pregnant, my first cycle of IVF went really well! Despite having low AMH/DOR, we got 17 eggs, 14 mature, 12 fertilized naturally, 2 were transferred and 5 blastocysts of 150-200 cells each were frozen. Again, I responded just as predicted and then some. Unfortunately our first attempt did not work, but at least we have frozen embryos to try again.

When I think about it, even though we've been seeing Dr. Vaughn now for 10 months, which seems like forever because of the never-ending ectopic pregnancy, long IVF process and break period in between, we've only actually done 3 rounds of treatment with him total.  In that time, he has given us every reason in the world to prove his expertise and he has actually never done anything to give me any real reason to doubt him, even if his protocols aren't the most aggressive in nature (in regards to reproductive immunology at least) and even if we haven't had ultimate success YET.

Lately, I find myself questioning more; Questioning him more, questioning the process, questioning whether or not this will work. Why? For one, the months and years are passing by and we've yet to achieve a successful pregnancy. Plus, there is so much information out there about what "other doctors are doing." This field is not cut and dry like cardiology for instance. There are many different schools of thought and protocols, and it's maddening comparing oneself to others and others' treatment processes. Hubby and I are both becoming drained emotionally from the whole roller coaster of it all. Time passing is a scary thing, and when coupled with my already impatient and inquisitive nature, it makes for an extremely restless situation.

I didn't even realize this until hubby pointed it out today, but even though it's already mid-June, we've actually only had one full cycle of treatment in 2013. Furthermore, when you think about it, considering I've only done 3 cycles total with my new RE, we have made good progress during those cycle. I've been pregnant once and have gotten a nice haul of good quality eggs and embryos in those few tries. When I think of it that way, it's much easier to contend with.

There is definitely a good time and place for questions, but I can also see that some of my endless questioning becomes detrimental sometimes. Today's appointment for my lining check was a perfect example. Condensed version of our apt..

Dr. V:  "Everything looks great for your transfer one week from today."

Me: "8.1 mm? Is that it?"

Dr. V:  "What did you expect it to be?" 

Me: "Above 9. Double digits would have been nice. "

Dr. V: "Well in our clinic anything above 7 is considered good for an FET."

Me: "I am just having a hard time grasping why some doctors want above 9, some say 8-9 is "iffy" but you are happy with a 7. I feel like I'm at the bottom of the range. "

(que me covering my head in my hand and trying to hold back tears unsuccessfully)

Me: "We just really need this to work!" wahhhhh


A 5 minute discussion ensued as to why my lining is fine, but we were given the choice to wait another week to see if it will thicken more. BUT there is a small risk of ovulation and thus a cancelled cycle if we did decide to wait. Just what neither of us wanted in today's appointment...more decisions. If I could just trust what the doctor is telling me I know I'd save my husband and I both a great deal of stress and anxiety, but I'm always questioning EVERY little thing. Then when I get frustrated with the prospect of yet another decision and scared of making the wrong one, it turns into more frustration and tears.

Yes, I am a mess. Could it be the 3 doses of estrogen I'm taking daily? Could it be previous experiences with other doctors that have scarred my ability to trust them fully? Could it be that I cannot endure another failure and I want to make sure all conditions are as perfect as possible so that we don't have to endure another negative result? Could it be that I just learned of another friend's pregnancy only moments before my appointment?

It could be all of those things, but I need to take a step back and realize that HE IS THE EXPERT in this relationship and I have got to be more trusting. If he says my lining is good, I have to trust that it is and just shut the fuck up!  The live birth rate at my clinic is actually equal to what it was for my fresh cycle and according to my nurse their FET rates were closer to 70% last month. Here is the most recent SART data for 2011...

Worth mentioning that they had 918 IVF cycles that year, so it's not their first rodeo. My doctor has helped people like Lance Armstrong conceive all 3 of his children via IVF at his clinic.  I mean, if my RE is good enough for Lance, he should be good enough for me right?

I've said all along that I will fully trust Dr. Vaughn until he, God forbid, strikes out 3 times with IVF/FET.  If at that point, I am still not pregnant we will have other considerations to make, but for now I've got to give him the benefit of the doubt and just follow doctor's orders like a good patient.

Yes, I am still happy I am taking the Lovenox on my own accord, because in my case I think it can only help. However, I also respect my RE's perspective that there just aren't enough peer reviewed double blind studies on the efficacy of Lovenox during IVF to start prescribing it to all of his patients.  It is more of an experimental approach in all honestly, rather than something with extremely solid proof. When it comes down to it, all of this is one big ole crapshoot really.

Still, I know I'm in good hands. I have to believe that God put Dr. Vaughn in our lives for a reason and that he'll be the one who helps us have our baby. For my husband's and my own mental sanity, I've got to let go of the control a little more and just go with the flow. I am of course, trusting in God first and foremost,  but I've also got to trust the person He's given the tools to help us here on the physical earth. So, from here on out LESS QUESTIONS and MORE TRUST.