I got Good News and Bad News... which do you want first?
First the Good News..
All tests came back normal...
For those of you with medical degrees from the University of Google... Here are the highlights...
Metabolic Profile: normal
Lipid Panel: normal
cholesterol: 187
FSH: 3.3
Prolactin: 9.1
TSH: 0.7
Testosterone: 3.23
Here is the wierdest...
ANTICARDIOLIPIDS: >7... That is normal... normal.. nothing wrong... We are chalking up the whole past 3 months (Lupus scare... being told I need hepirin & blood thinners...) to:
A - Bad lab work
B - Some "transient thing" my body was going through at the time of the first test... probably the miscarriage.
OK.. NOW... the Bad News...
(I TOTALLY need opinions on this one... I know what my gut says... but I need your advice.)
I think I have to fire this new doctor...
After telling me that everything so far looks normal and good he told me I need to schedule a laperoscopy to check for endometriosis... I have no reason at all to think that I have endometriosis... including being "infertile" because I have been pregnant twice in the last year.
I am starting to suspect that my new doctor just wants to test for everything... whetcher I need it or not...
After I told him I was not really up for this surgery... He said then I needed to start IUI's or IVF... That is when I got really freaked out... WHY? Why do I need help... I have done OK with the getting pregnant part... and IUI or IVF don't keep you from miscarrying... The doctor said that it could help make sure I had "better quality" eggs... Well how do we know I have "bad" eggs??? When I asked that this is the info he gave me...
At my last appt. my follicle measure 14mm on cd 11... A healthy mature follicle would grow to 18mm and then spit out the egg... well today there was no follicle... that means that I ovulated sometime between Friday and today. So... either my follicle matured normally and popped right on schedule and my eggs are ripe.. or it didn't grow anymore and released a puny egg... BUT... my point is... we don't know... because cd12&13 were on the weekend and today is cd15 and I already "o'ed". So it seems a little drastic to suggest surgery, IUI, and IVF without the total picture... especially when we know I can conceive on my own.
I guess I wish he would have been more positive about my "normalness" and suggest that we try on our own for a few months and see what happens. And then... if we are not pregnant or think we need help conceiving that these things would be the next step. Instead, he was ready to book my laperoscopy for next week and then was ready to talk about the IUI and IVF packages.. since my insurance doesn't cover either. I immediately was put off... I just felt that this was "not good". I just feel it in my gut. I feel suspicious. I feel like he just might want my money and order test after test or procedure after procedure. My original goal was to find out why I have had 2 miscarriages... and not we are looking at infertility treatments... Am I being silly or does this sound weird to you? I just don't know...
I hate to think of starting all over with a THIRD doctor... But I don't want to ignore and "red flags" and regret it later. My pregnant neighbor H. LOVES her RE and suggested that I see him. My other friend M. had a great OB/GYN that she LOVES and says I should go to her. Do you think I am being neurotic??? Am I acting like a crazy women changing doctors every three months???
I don't think I have endometriosis... but I don't know enough about it to know if it can cause miscarriages... I really don't understand why he would suspect it...
I don't want to have an exploratory surgery... especially when I have no symptoms of endometriosis that I know of... it is risky... something could go wrong... and what if it is one more test that "rules something out"... and I am stuck with the costly bills for a surgery I didn't need?
I don't think I am ready for IUI... I want to try to conceive on my own for a few months first... again... Conceiving hasn't been the issue since we figured out I "O" on day 13 and not day 16 or 17 like my previous doctor thought.
I think I am FAR away from IVF... I am 33... I have conceived twice... why could I start on this EXPENSIVE road unless it was a last resort?
Uggghhh... please... I am calling out to all ladies who have been or who are in my shoes... Does all this should reasonable to you? Should I search for a new doctor? Or am I in denial about a possible condition that I should be tested for?
Please help me figure this one out...
I really don't know what to do...
posted by Mrs. D. @ 12/07/2004 05:51:00 PM
15 Comments:
Hey Jaime,
I don't think you are being crazy at all. Your RE should be someone that you really trust. This guy seems kind of crazy. Already mentioning IUI and IVF that is really crazy. It isn't a bad thing to change doctors alot right now. It isn't like you are doing it for fun if you could just find a good doc you would never let them go. Besides I am still weirded out that he shares an office with the hair place. I hope this helps. I am so happy that everything is normal.
Jenna
I think your gut is correct. He doesn't seem to be basing it on anything, other than wanting to rule something out. He better have a damned good reason before doing any invasive procedure, and make it perfectly clear to you.
It almost sounds like he wants to hurry up and do these procedures before you "accidentally" get pregnant on your own.
If I were you, I'd just tell him you want to try a few more months on your own, or get a second opinion. Chart your cycles so you know if your having sex on the right days. This saved me several months of anguish, because all I had to do was look at my chart to see that I didn't have sex on the right days, and there wasn't some underlying health-related reason that I wasn't conceiving. Sometimes it just takes a long time to get it right.
I say I tried to conceive for 10 months, but if you don't count Feb. and March when I was pregnant, or June when we took a break, or October when we missed the egg, I actually got pregnant on the sixth month of "real" trying. Which is average. Which was pure torture.
I see women on the boards all the time who "fib" about how long they've been trying or who doctor their charts to make their intercourse look like it was timed better, so that they can get treatment. Who the hell would want these procedures unless they absolutely had to have it done?
I just hope you get preg this month and it's all irrelevant. And I hope some women with more experience than me can give you their educated opinions.
-Erin
Jaime,
Go with your gut here. With those tests results and not even a hint of endo (you'd feel it, believe me) and your age, I don't think he's barking up the right tree. Since you're getting pregnant and miscarrying, I think he needs to examine things from the luteal phase aspect, such as your progesterone isn't strong enough to support a pregnancy -- common and easy to fix. I would be barking up that tree instead of a whole bunch of tests that he knows is going to come back normal. Just my opinion.
xxoo,
Emily
scrambledeggs
I would trust my gut instinct as well. But..the beauty of a lap is to rule out any other complications (fibroids etc). We had to go the IVF road and after so many negatives it was nice to know there was nothing other than sever MF wrong with us.
There's nothing wrong with getting a 2nd opinion. Pick one of the people that was reccomended to you, and take all of the info to them, and tell them what this doc reccomended. See what they think. We're talking thousands of dollars here and, not least of all, invasive medical proceedures. Many people don't make an expensive purchase in the 1st store they walk into, they shop around. Thus endeth my analogy!
-Abby (abfausto@hotmail.com)
Hi,
In my experiences with treatment (7 yrs to get pg), IUI and IVF, I have come to believe a few things about RE's. They don't feel the stress about money because they deal with people every day who have to worry about it. Just like my dental hygenist never seems to feel bad when she hurts me, she does it all day long to everyone, how could she worry me. I think they just focus on getting you pregnant, and ruling out the different causes of trouble, not thinking about costs or pain involved.
I realized somewhere along the way I was the one who gets make the major decisions, not them. They may know how to handle the treatment but you know yourself and your body and I think you should be able to tell them you don't want to waste your time, energy and money on something that seems to be going in the wrong direction.
I don't get how doing an IUI or IVF is going to help with egg quality, you are going to produce the egg you produce and putting the sperm near doesnt change that, that sounds strange. I would totally trust your instincts on this one.
Deana
In April, I started seeing my new RE after moving back home from out of state. At that point, we'd been under the care of other REs out of state, trying to get pg for over 3 years with no luck on our own and with 4 IUIs. My RE here was aggressive (I'm 35) and immediately began a barrage of tests (17 vials of blood at the lab) and explained that he'd also like to do a lap to rule out endo. I felt a little weird about his wanting to move forward so fast but was confident in his abilities so I agreed.
So we did the lap a couple of weeks later and, lo and behold, stage 2 endo that was completely asymptomatic. Had anyone ever told me I had endo, I'd have told them they were nuts. But I did and he lasered it off. Next cycle, first IUI with him, bingo, we're pg. Now I'm not saying the lap was the trick, but I don't think it hurt. And I'm not saying you should have it done, I just think he's being an aggressive doc. I've read conflicting reports about treating early stage endo (stages 1 and 2) surgically--some think it doesn't help, others think it does; some cite that endo could interfere with implantation while others do not.
It's all an inexact science as we know but you've got to do what feels right for you. And if this doesn't feel right, or he's not the "right" doc, then find someone else who is willing to be your partner in treating you, not someone who's trying to steer you in directions you're not ready to go in. Only you know what's best for you...good luck whatever you decide!
Hey, maybe you are neurotic -- and there's NOTHING wrong with that, I'm as neurotic as you can get. I don't see anything wrong with getting a second (or even third) opinion before committing to surgery and spending a ton of money on something you aren't even sure you need. In fact, it seems the sensible thing to do would be to get another opinion.
Go with your gut! Don't let this dr. talk you into something that you are not comfortable with. I would definitely get another opinion.
You are not crazy or out of your mind. I would be thinking the same thing as you if that is what my dr. said. Try on your own. You are right IUI/IVF should be your last resort. Wait a little longer before you even consider it.
I am really happy to hear that all of your labs came back normal and that you found the right "O" date.
I am thinking about you. We lourve you and we are all here for you!
Chasity
Always get a second opinion for surgery.
Good luck!
Just delurking to say--his rationale sounds crazy to me and I think you should trust your gut. He lost me when he equated improved egg quality with IUI and IVF. If anything, ovulation drugs decrease egg quality or release eggs that your body would've "rejected" on its own in the race to ovulation. I don't know your whole story or the details of your losses, but a conservative, "give it some time on your own" approach is a better idea given your test results.
Julie
jmarkoski@nc.rr.com
I think if you don't trust your RE's opinion, then you should move on. Personally, I think money is the bottom line at a lot of places. I don't think REs can actually imagine women getting pregnant without their help. But I wouldn't entirely rule out looking for endo, simply because a friend of mine had it and didn't know it until after she gave birth. This was after 5 years of fertility treatments and 2 failed IVFs (#3 she had twins). Her doctor refused do a lab because he thought she didn't need it. On the other hand, who wants to do a lap? Sounds painful.
As someone who has dealt with recurrent pregnancy loss, I would find someone to run the entire miscarriage workup, not just do the limited tests you had done. You're very young. At 33, you wouldn't expect two miscarriages in a row in such a short amount of time. If you were older, maybe. But since you aren't, you might want to see if there's an underlying problem. Lots of doctors will do the advanced testing (look at the Sher Institute's website under recurrent pregnancy loss to get a list of the tests available). While your situation could just be bad luck or, as your RE would probably like to think bad eggs, it's worth looking into before you spend a ton of money. I don't understand why these tests aren't run before women do IVF anyway, considering that they are not that expensive; there are plenty of women out there who had them run too late, after a handful of failed IVFs, only to run out of money and time.
Good luck.
I went to a 2nd doctor. My 1st was a wondeful lady who kept me believing that all was fine. Never suggested a lapscope despite three years of ttc. The 2nd doctor suggested it at the 1st appointment - I was totally against the idea. We did 2 IUI with no success and decided to do the lapscope. We found stage 4(!!!!) endo everywhere in my uterus, my left ovary was fused to my uterus wall with endo adhesions. I was completely asyptomatic. I am glad I had the Lapscope. I think you should do it - hopefully to rule out a few problems. Serena
I'm 34 (nearly 35) and have also had two miscarriages - both this year. I'm due to see a miscarriage specialist here in London in November (long wait for treatment in UK...) but decided to also see a fertility/IVF specialist in the meantime, just to see if i would benefit from IUI or IVF. I saw a fertility/IVF doctor this morning and he categorically told me that any form of fertility treatment was unnecesary at the moment because i am capable of getting pregnant naturally, albeit not remaining pregnant for long. He said IVF/IUI wouldnt get me any further than where i can get naturally on my own. I suspected this was the case but it was comforting to hear it confirmed from someone who knows what their talking about. This clinic is one of the top 5 for IVF in England and im confident of his advice. Don't know if it helps you at all but thought i'd share it. Also, my FSH is much higher than yours (9.1) and i therefore have much more reason to suspect 'bad eggs' are at work in my miscarriages. Your FSH is so 'normal' i really dont see how any pre-IVF screening of your eggs would benefit you. The IVF doctor felt any screening of my embryos would not reduce the risk of miscarriage at all. He said my problem is miscarriage not conception. By all means have the test for endometreosis if you think it will help, or make you feel you're doing something constructive, but im not sure i would go ahead with invasive procedures unless i saw some clinical need. I'd say get a 2nd opinion on the need for it. As for IVF/IUI i think i'd leave those well alone and get further tests into your miscarriages done. Tests such as chromosome testing, auto-immune disorder testing and thyroid function test may shed some light on it all (although apparently you'd know if your thyroid was so out of whack it was causing you to miscarry). Remember (as im having to) two miscarriages isnt actually all that uncommon, especially if they're early (mine were both under 6 weeks)Sometimes you just have to keep at it i guess. Im saying that to myself as much as you! Good luck...to all of us.
I just wanted to add to my previous post and say that i know how hard it is not to panic after two miscarriages. I re-read my previous message and realised it sounded like i was saying "just relax"!!! I'm not in the slightest bit realxed about all this....I've turned into a complete lunatic and am petrified i'll have a 3rd miscarriage...hence the trip to the IVF doctor today. I know its impossible to stay calm when you're so afraid it will all happen again. Anyway...Good luck again! x
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