The road to IVF

As we waited for miscarriage #5 to complete and for my cycle to resume (a process which usually takes around 2 months), Chad and I reflected on what we'd gone through so far with our RE. Overall, we liked her, but her clinic's sister surgical practice had done some shady billing for a hysteroscopy procedure I'd had. Also, she was always running 30 - 45 minutes behind for every appointment and she had an irritating habit of glossing over information too quickly. Still, we decided to go forward. We signed the consents, went over the treatment plan, and set aside the $12 - 14,000.00 it would cost.

Being forced to wait for two months for my cycle to resume gave me *alot* of restless time to think... and to read everything I could find about IVF and infertility on the internet. I admit I obsess a little over this stuff. I read message boards, personal blogs, doctors' blogs, scientific papers... basically anything and everything.

For example, I stumbled across www.SART.org, which compiles the success rates of fertility clinics across the country. There, I learned that curiously, the success rate document she had given us did not match what was reported to the CDC. Next, I found Dr. Sher's blog, which contained a wealth of knowledge. For one, his research showed that women with DOR didn't have a great response to the Micro-dose Lupron protocol (exactly the one which our RE suggested). Second, he recommended that women with recurrent pregnancy loss (RPL) undergo a full RPL workup, including a thrombophilia panel, thyroid testing, and chromosome testing.

I met with my RE to discuss my findings.

She blew my concerns off and said we could spend thousands on testing and probably wouldn't find anything. All of my losses could be explained by my DOR and we should just go ahead and do IVF (and pay her $9000). Oh, and if we really were concerned, we should just do PGD (Pre-implantation Genetic Diagnosis) for another $4500. Nevermind that it doesn't actually increase pregnancy rates, is risky to the embryos, and isn't very accurate.

I went back to the internet, this time to find a second opinion.

I located PRC through SART.org and made an appointment. While they didn't have the top success rates in the country or even in california, theirs were much better than our current RE's. Also, the soonest I could get an appointment at the top clinics was months away, and if we had sticker shock before, well, their price tags were even more ridiculous.

We met with Dr. Abdalluh in early October, a few days before payment was due to our RE. He advised us to hold off on IVF and do the RPL testing first. Also, my first RE had never done a repeat hysteroscopy after removing a big fibroid from my uterus in May, and he advised us that that should be checked again as well.

We scheduled an operative hysteroscopy for the following week, and I had about 13 vials of blood drawn for the RPL testing.

When the results came in, we finally had a clearer picture of why we were having so much trouble: I tested positive for anticardiolipid antibodies. I had a clotting disorder. Maybe those first two babies, the ones who had heartbeats, would have had a chance had we known I needed to be on blood thinners? We'll never know for sure.

Anyway, I had another fibroid as well as a polyp in my uterus, so Dr. Abdalluh removed those.

Chad and I made the obvious decision to break up with our old RE. When I told her we were leaving, she really made an effort to keep us. Suddenly, we could qualify for the "discounted" 2-cycle option program which she'd previously refused to offer us due to my high FSH level. Also, she offered to donate all of the medication we'd need... which actually was a very generous offer, considering meds would cost $5 - 6k... However, we just didn't feel comfortable with her anymore. The fact that she didn't want to do RPL testing (that my insurance fully covered) despite 5 losses really didn't sit well with us. It seemed like we would have to go through yet another miscarriage to convince her to do more thorough testing...