At long last we had our appointment with the fertility specialist. To make a long story short, he agreed with what Dr. H has been telling us... which is essentially that the success rates for any "treatment" of unexplained recurrent miscarriages are all very similar and all very high (around 80%). In other words, no one knows for sure if the "treatment" really worked or if the patient was just destined to have a successful pregnancy that time around anyway. So no matter what any doctor does, they look like a hero.
So now for the long story. We still have options and there's a very very good chance that we can have another baby no matter what we do (as long as we try). They all vary in terms of complexity and cost (cha-ching!) and how patient we are willing to be. First of all, the clotting stuff was worthless. He said the test results were basically all normal but even the one that came back borderline indeterminate was something that only really causes problems if it is off the charts high. Ultimately he seemed pretty certain that was not part of the issue and rarely is in early miscarriages like I've had because the vascular structure hasn't even developed enough at that point for it to matter. He gave us a really long explanation of chromosomes and the different potential abnormalities which was really confusing but what I got out of it was that although the results of the chromosome testing we've done so far were "normal" there's still a chance that they weren't completely normal. He said sometimes some people are predisposed to make eggs that are more likely to develop these abnormalities, and I could be one of them. Or, more unlikely, but sometimes sperm are more susceptible to "DNA fragmentation" and cause the same sort of problems. The treatment for that is IVF which would involve getting some of my eggs out, fertilizing them to create embryos, testing the embryos to find one without any abnormalities, and then implanting just that one. That process would probably cost about twenty THOUSAND dollars but our chances of success are extremely high.
There are still a few things he wants to look at before we go down that road. He did an ultrasound today and said that my endometrium was a little thin for how far along I am in my cycle. He also said my ovaries are kind of small. I don't know yet exactly what that means, if anything, but I'll try to find out. Later today he's also going to do a hysteroscope inside my uterus to check for anything in there that might be discouraging mini me from hanging out. He's also going to check for I think fluid pockets in the fallopian tubes which can cause build up of stuff that can be toxic to the little guys. Then assuming I don't just get pregnant right away this month we're going to do some "day 3" labs to check my hormone levels and also make sure my TSH is good for the amount of Synthroid I am taking. Then when I do get pregnant they are going to keep track of me in the early days, monitor my HCG and do ultrasounds to make sure everything is going well and if it isn't they want to be proactive and get in there so they can take a good look at those chromosomes. If and when it does look like the pregnancy is a keeper then I'll just go to Dr. H like I normally would.
So the bottom line is, in the end we still probably won't find anything and I'll end up taking prenatal vitamins and baby aspirin as usual and hoping for the best. And doing just that the chances are good that eventually one will take. But it is a huge relief to know that Dr. H hasn't been completely missing the boat here. He's done everything I've asked him to do and probably would have done more if I had pushed for it but I'm glad to have the second opinion anyway. Plus now I also know that if we get really desperate and I start getting old, we could liquidate all of our assets and plunk down the cash for IVF and probably be all but guaranteed another baby. Chances are we won't need to, it's all just a matter of how patient I can be and how long I'm willing to ride the miscarriage roller coaster. I think I can hang on a little bit longer at that price.
The good news is that all this early diagnostic stuff we can probably get insurance to pay for. Which is nice because by the end of the day we will have already racked up about $2500 worth of poking and prodding.
I'll have an update later after the scope.
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