Consult with Dr. D

Today we had our consultation with Dr. D, our fertility specialist.  The first thing we noticed today in the office was a bulletin board covered in birth announcements and Christmas cards. We both noticed right away there were as many twins as singles...even a few triplets! Scary, but also exciting!

The appointment went well and while we still have lots of questions, we were able to come up with a plan for the next few months.

We began our appointment by reviewing our fertility history.  A few things from our history jumped out at Dr. D as being important.  First, he was encouraged that we have been able to get pregnant.  Even though we lost the baby early on, he thinks it was a good sign that we conceived and were able to see a heartbeat on the ultrasound. Second, he determined that I may have a Luteal Phase Defect.  Your luteal phase refers to the 2 weeks of your cycle after you ovulate.  When you have a Luteal Phase Defect, your hormone levels are below normal and can inhibit implantation of an embryo. Whether or not that turns out to be the case, it was nice to hear a potential diagnosis for the first time.  It's also very frustrating that this wasn't determined earlier by my gynecologist.

Based on our working diagnosis, Dr. D offered us two options.

Option 1: IVF
Pros: 

• most effective option (50-60% chance per cycle)
• more control over potential multiples (we can choose how many embryos are transfered

Cons:

• expense ($15,000-$20,000)
• start date of January 2012

Option 2: Gonadotropins (Injectable Fertility Medication)
Pros:

• less expensive than IVF ($1500; possibly some expense covered by insurance)
• can start immediately

Cons:

• less control/higher potential for multiples (if we have many large follicles, we will have to determine whether or not to proceed so we don't end up like Octo-Mom)
• if this cycle fails, it would be an added expense on top of IVF
• moderate success rate (30%)

We have opted to try one cycle using injectable fertility medications (option 2).  Since we have missed the deadline to begin IVF in December, we would be forced to wait until January to start that process. At Dr. D's office, he starts groups of couples at the same time each month to help with scheduling and provide community support. Leading up to IVF you take birth control pills to regulate your cycle and he uses that to get all the couples on the same cycle.  Some couples take the pills for 2 weeks, others maybe 5 weeks, but they all stop on the same day. Since I will be starting a new cycle any day now I have missed the chance start in December. We are going to take advantage of an extra attempt using injectables before moving on to IVF in January.

The injectable medications (gonadotropins) are different from the Clomid and Femara that I previously took.  Clomid and Femara block your estrogen receptors in your brain and basically trick your brain into telling your body to produce more hormones. Gonadotropins are made up of two hormones (LH and FSH) and they act directly on your ovaries to stimulate egg development.  We have an appointment on Wednesday morning to go back and learn how to give me the injections. We will also find out which of the gonadotropins (there are 4 types) we will be trying based on results of blood work that was done today.

When I asked Jeff recently what he wanted for Christmas, he replied, "My wish list has 10 fingers and toes (hopefully) and smells like spoiled milk." If all goes well this month we could get a Christmas baby! Keep your fingers crossed and say a prayer that this month will be our month!