Second Opinion #1

This week has been full of surprises! Right now, I am going to focus on the RE piece, and save the other stuff for later.

We had an appointment with another well-known RE for a 2nd opinion about our IVF and RPL situation this week.  Overall, it went extremely well!  He spent 3 hours (no joke) going through our records and discussing them. 

Before I get into detail, I should first start off by saying that according to ASRM, this clinics success rate for live IVF births is equivalent to the clinic we are at now (about 60% which is quite good if you research clinics across the US).

Here are some of the main points we covered at our consultation:

  • I need to be tested for Vitamin D deficiency as I have never been.  Went and got this done today.
  • I need to be tested for Celiac Disease.  Celiac disease can be linked to recurrent pregnancy loss, but is not on the usual RPL panel work-up & of course, I have not been tested for it yet either.  You would think since it is a simple blood test, why wouldn’t my current RE just order it? If I did end up having have Celiac disease, it would require a gluten-free diet. I also got this test done today.
  • Husband needs to get his testosterone, LH, FSH, Prolactin, etc. run again so we can see if Clomid would be of any use in upping his count.  It has been about 5 years since we tested these in him. They were all in normal range before, so using Clomid was not an option (it doesn’t assist with just a low count, there has to be a hormonal imbalance happening too).  Got this test done this a.m. as well.
  • This RE was very impressed with my husbands improvement from pre-varicocele surgery to now, 2 years post surgery.  He said our chances of conceiving on our own have gone from a measly 1% to about 15%.  And if we got him on Clomid, there would be an even higher chance on our own or via IUI, about 25%.  Hey, we will take what we can get here!
  • At this clinic, we can pick any day for our transfer, as we go along in our cycle.  It does not need to be done in advance.  This is HUGE to us.  Our current clinic only does transfers 1 week out of the month, and hence, they try to control everyone’s cycles with BC and Lupron, picking out the exact transfer date months in advance.  I despise this! This clinic does transfers 365 days a year if needed, depending on the woman’s individual body/cycle. Just call on day 1 of your period and off to the races you go!
  • He would only want to transfer 1 embryo in a future FET.  Great news!!!  Why do we need to transfer two if I get pregnant with twins every time we transfer two?  If we transferred just 1, we would most likely still get pregnant like we did the first time when we transferred 1! Obviously, I do not do very well with twins, and he felt that there is a chance that one twin vanishing could have affected the other making it.  Of course, there are lots of times where one vanishes and the other does perfectly fine, but not always.  There is no solid way to prove or disprove if losing one twin could have played a role in losing the other.  
  • He would do a non medicated FET like we have been pushing for.  Since my cycles are regular, & my lining looks well post surgeries, there is no reason not to.  This could involve the use of trigger or not, which we can decide down the road.
  • He wants to investigate my super high progesterone levels during each pregnancy. Our current RE said my levels are the highest she has ever seen, but also said it wasn’t an issue as far as loss goes; only low progesterone is a cause of RPL.  I know that low progesterone can cause loss, but there is something strange about how high these levels are when pregnant.  When this RE saw them, he also said they are also the highest he has ever seen.  He has been practicing for 30 years.  Hmmm…sounds fishy to me.  Our last pregnancy my progesterone level was around 300, and we are talking about with my first beta it was this high. First trimester progesterone levels are usually under 80!  They stayed consistently high like this too until every loss.  I was using Crinone for my progesterone supplementation during each cycle.  Obviously, I did not need to be doing the Crinone 2 times per day at $15 per insert for 10 weeks with a progesterone like that.  When I mentioned this concern to my current RE when pregnant, she said to keep doing them as I was regardless of how high the levels were.  Uh, OK.  The new RE said he would like to discuss the levels with his partners at the practice, which we really liked to hear.  Never once has my current doctor said she would like to consult with another person about us.  2 minds are better than 1, right??
  • He wants to perform a mock transfer if we choose to move forward at his clinic, and another Hysteroscopy to be sure my uterus is all clear.
  • Relocating our embryos will cost us $100 (dirt cheap in the IVF world), it’s a simple form to fill out, and takes about 2 weeks to get done start to finish (both clinics use the same transportation/storage facility which is good).  Also, the embryo medium is the same between clinics, they have had several patients transfer back and forth between the 2 before without issues.
  • He feels our chances of carrying to term are still quite good; I didn’t bother asking for a percentage.  He said he has had patients that have carried to term after 3 unexplained IVF losses with no prior children.  Hope!!!
  • He cannot definitively say that the submucosal fibroid caused our last loss.  Mainly because we do not even know with certainty that it was there during the pregnancy since the Hysteroscopy that identified it was not performed until 2 months after.  We figured this already.
  • We discussed anti-depressants, and post-partum depression, which due to my situation, I am at high risk for. You would think it would be the opposite, but its not. More to follow on this soon. 
  • Saving the best for last, his practice has a blood and ultrasound monitoring center literally 10 minutes from our house! Almost unreal, right? We are used to traveling about 70 miles per visit.

So, now what?  Well, we still have an appointment with another new RE set up for July 22nd.  However, we have started to ask ourselves if we should even go for another opinion??  Will it just confuse us even more?

In addition, we have an appointment back at our current RE August 6.  I feel like this appointment is almost a last-ditch effort; one last chance to tell us what we can do differently moving forward.  Each day though, I wonder if I even want to bother with it.  I guess the question is, if we like this new RE’s opinion & experience, should we just make the decision to go there and be done with it? Perhaps more information will just cloud our vision even further. 

  

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26 thoughts on “Second Opinion #1

  1. This clinic and RE sound awesome! I love that they’re willing to really listen to you and have different tests they’d like to do to try and get to the bottom of this. If it were me, I’d probably take my business to the new clinic. Good luck figuring out what’s best for you!

    Liked by 1 person

  2. Angela- this clinic has lots of positives. When I went through this, my dr was in RI, so I can’t comment on the drs in Florida. However, I can’t believe that your current office only schedules transfers one week out of the month- and you have to schedule in advance. That seems nuts to me. Most of these places should be doing this based on your schedule/cycle- not theirs. Also- the fact that they have a blood/ultrasound facility so close to your home is essential. You should not be traveling 70 miles for this. You need to make things as easy on yourself & your husband as possible! I’m so glad you are exploring other opinions!

    Liked by 1 person

    • Hi Lisa!! So great to see u on here!!
      Okay, so I wasnt sure if I was nuts or what about how they do their scheduling at my current clinic. Its absolutely absurd!! We think it should be based around our schedules too, its our money, our children, our future. Their schedule makes it hard on me and it takes so much time to do anything transfer wise if that one week doesn’t work. Ugh! Im so glad u made me feel not crazy with this! Lol. I really love the idea of being able to easily go in the mornings before work, ahhh i cant even imagine. Rather than taking a whole day off or racing to get in on time after getting up at 5 am for the drive. I guess now we just need to decide if we are brave enough to pull the trigger and move our embryos.

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  3. You are not nuts at all! I am certainly not trying to bag on your current clinic- but I have never heard of scheduling transfers in advance- and only during one week of the month. And the fact that they have to control your cycle with meds so that your transfer is done within their time frame is concerning to me. I know you are thinking that another opinion may confuse you guys even more but my thinking is that one more cannot hurt (as long as it’s not a financial hardship to you). The 3rd dr may confirm things that your current dr has told your or on the other hand may confirm those that Dr #2 said- and could even provide you with info that you have not heard of yet. As much as all of this info is overwhelming, another set of eyes on your records may actually be a good thing. And then you will have enough solid info to determine what to do with your precious embryos!

    Liked by 1 person

    • Thanks Lisa!! I have nothing bad to say about our current clinic either. There are lots of good things about them for sure. But after 3 losses, we sort of want things on our terms time wise. Also, not due to their negligence, I am having a really tough time going there. Like my husband said, I have had a traumatic experience in almost every room or spot in the clinic. I like your point about the 3rd opinion. It may help solidify things. Thanks again!!

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  4. This clinic, and more specifically this doctor sound amazing!! It really looks like they have their stuff together and really want to help you have your rainbow. In regards to current RE vs. second opinion 1 and second opinion 2, my advice would be to go with your gut. If you sought out a second opinion there is some sort of level of distrust with the current RE. It also sounds like the current RE is kind of going with the standard and not really taking into account your personal history. I’m interested in knowing more about the anti-depressants and PPD…..don’t hold out too long.

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    • You are correct! We sought out a second opinion bc of our doubts with our current RE in the first place. So far, we really love this RE who gave this second opinion too. He seems to go against the grain a little, not just following the “one size fits all” protocol. I will def update on the anti-depressants soon. I have been tossing the idea around of getting on them before our next FET. Do u have any advice or experience to offer with that?

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      • Thats what Im afraid of, in retrospect knowing I needed them and didn’t just do it to begin with. Due to our history, I just feel like I am going to be a hot mess when/if pregnant ever again. I was already pretty bad before the 3rd loss so I can only imagine now. I thought maybe starting up pre-pregnancy could get me used to some of the meds, the RE seemed to agree. If you dont mind me asking, why do u feel you should have? Hope that doesnt seem silly !

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      • Definitely not silly at all. You know my history with pregnancy loss and all of that. The kind of hidden part is how I coped with the losses and the depression that I went through behind closed doors. Throughout the whole TTC process (and to a lesser degree before then) I experienced intense mood swings and at times couldn’t stop crying. I was very sad and very angry and my mood would change in a matter of minutes. There were times I told my husband I felt bipolar because of the shift in my mood at any given time.

        I’m really worried postpartum because of how emotional this journey has been. I am afraid that I am going to sink into a massive depression and my son is going to suffer because of it.

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      • I can relate. I have these mood swings too. And the crying comes out of nowhere, some days Im just fine, others I am a mess all day. Its so unpredictable. I dont know how my husband deals with me at all sometimes! This RE warned me that due to our losses and TTC process, I am a prime candidate for PPD unfortunately. He said it wouldnt seem to be that way since you and I are the ones who have tried so desperately for so long to have a child. And that very thing is what makes us feel worse when we are tired or annoyed after baby comes than a normal mommy. Makes sense I guess. I worry like you that my future child would suffer too. You are not alone there. But of course your situation is much more real bc you are almost there! Perhaps you can monitor it or have hubby monitor it closely and get that assistance when/if needed. He did say u can breastfeed safely (i cant recall if you discussed if you plan to or not). He gave me a list of the different categories of them and which are supposed to be pregnancy/post partum safe. I can pass this along if you dont have it.

        Liked by 1 person

      • It is crazy to know that after such a struggle just to get pregnant and carry a baby to term, you could still not be “happy”. Thankfully my husband has built up a pretty big stock of paid time off and is able to take a month off after the baby is born to be at home with me and watch for signs and help me take care of the tiny tot.

        I am planning on exclusive breast feeding for the first bit of his life and pumping/stockpiling to provide breast milk for the first year of his life. I have heard that on top of the numerous beneficial reasons for breastfeeding, it also helps with PPD because it releases oxytocin which makes you feel good. I would love any information that you have though for future reference and guidance if I need it.

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      • I totally agree-its insane after what us infertility/RPL warriors go through, that we may not just be “happy” once baby comes. It goes to show how badly this all can mess with the mind. I have hope that the PPD will pass eventually if it does occur, just like all of this (i hope) miscarrying and IVF will be over too.
        It sounds like you have a great plan in place for after. And who knows, you might be just fine!! I sure hope that is the case anyway. Best wishes.

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  5. Such great happy news! So happy that there is so much hope with this new dr and clinic. He seems to have different experiences and knowledge that your current has – which isn’t bad- but maybe a good change in perspective. Each couple isn’t the same, and maybe this new one is the right path. So hard though, I imagine to deal with this new found hope. I wish you all the luck and know He will help make the decision! I just love the positive outlook, though!

    Liked by 1 person

    • Thats exactly how we were feeling- happy! I think fresh starts can do this even when we feel there is no hope. I agree with you that a change in viewpoint can be helpful. Seeing things through just one doctors lens hasn’t worked for us yet! Thanks for your support and well wishes 😊

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  6. H = Have
    O = Only
    P = Positive
    E = Expectations

    I saw this and thought it was great.. My hope, prayers, vibes and everything positive are going your way daily!!! XOXOXOXO
    .

    Liked by 1 person

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