In other good news, P4 (progesterone) bloodwork came back today under 0.2, which means that no ovulation has occurred and we're all set to move forward with our FET on Tuesday 9/3. Yay! We've decided to transfer 2 embryos this time around to increase our chances of success slightly. Given our previous failed attempts, my age (35), and my diagnosis of DOR, transferring two just makes more sense.
I met with a perinatologist yesterday as well for a pre-pregnancy consult. This might seem premature since I'm not yet pregnant, but I had some questions I figured he could answer. My OB/GYN is not exactly on top of things as far as I'm concerned, and I do not plan to stay with her once I'm expecting. Plus, perinatologists are the real pros at assessing risk factors, screening, and dealing with high risk patients.
Previously, my hematologist found the blood clotting stuff and the MTHFR, gave me a script for Lovenox and said, "Take this and baby aspirin when you get pregnant" with no other real instructions on monitoring of anything. Do I just need a preventative dose (40 mg) or a higher therapeutic dose? Is there a test I should take at any point to assess it's efficacy and when/how often? What about folate supplementation for the MTHFR, Rx strength Folgard or Metanyx, etc? How exactly does MTHFR factor into things when it's coupled with the 3 other clotting factors? No one has ever given me any real direction on this stuff. I'm basically just going off of what I've learned from other women and my own virtual research. The internet is full of opposing viewpoints, which change pretty drastically based on each person's set of test results and circumstances.
I'd like to know ahead of time if there is something I'm supposed to be doing, rather than after the fact if you know what I mean. I also asked him about his first hand experience with IVF pregnancies and IVF babies. He actually mentioned a couple things I hadn't even thought of, like the fact that he sees increased risk of pre-term delivery from things like incomplete cervix more often with IVF moms-to-be, perhaps because of all the procedures done on IVF patients before they are pregnant? (his theory) Wow, hadn't even thought of that as a result of too much speculum all up in there.
He also mentioned that IVF twins tend to be lower birth weight and earlier deliveries than even naturally conceived twins. He talked about his patients who have experienced embryo splits (transferring only two embryos and ending up with triplets) and other risk factors. It was great to get the feedback and learn some interesting new tidbits...the type of stuff RE's don't advertise too loudly.
And of course, I asked him about the whole controversial topic of increased natural killer cells, prednisone during pregnancy, and other preventative measures against miscarriage. You may know that this can stir controversy among some doctors, but prednisone has also been seen as the magic bullet for many women who've experienced multiple losses. I do not fall into the category of "multiple losses" at this point. I've only had two losses, and one of them was ectopic (they consider this an "explained loss").
Still, I don't want to have to have 3+ unexplained losses before I ask these questions and then say, "What about prednisone? Can it help prevent this from happening in the first place?" We spoke about autoimmunity, how it may/may not relate to my own situation, where to go from here once I become pregnant, and risks & benefits associated with various drugs being used. He said that he has no problem prescribing prednisone during early pregnancy as an added security blanket against miscarriage once pregnancy occurs, if it's something we want to do.
All in all, well worth the time and cost of the visit. I'm glad I went, because it answered some questions that have been floating around in my head. Hey, if you have questions and they aren't being answered by your current provider, I say go to someone who can try to answer them! It doesn't mean you're trying to create a problem that isn't there or that you're being some sort of hypochondriac. It just means you care about your body and you recognize the fact that you didn't personally go to medical school. It only makes sense to find someone who deals with whatever questions you have, right?
Outside of that, it's hubby's 37th birthday today! We celebrated by getting 2 hour massages and doing lunch afterwards. Maybe some Breaking Bad, Hell on Wheels, and Mad Men on tap for our viewing pleasure this evening. We'll by in bed by 9 PM though I'm sure. Ha!...just being good little boys and girls over here as usual. And then we wait...for a HOPEFULLY successful transfer with two beautifully blessed sparks of life 5 days from now!