Fertility=Eggs+Uterus+Tubes+Lining+Sperm+Overall health

Had my final verdict appointment today.

“It doesnt look good im afraid. Not good. Like, you might want to consider adoption, not good”

Thats what the doc said.

At least he is being honest. No point in raising false hopes where there shouldnt be any.

So, turns out in the fertility formula we have 5/6 (presuming we are using donor eggs and dont need my own tubes and eggs to function). But apparently that is just not good enough.

What we are missing is the lining. I just cant get it up past 0.4. Why? It could be the adenomyosis (lining that sheds outside of the uterine wall) or the fibroids. Both of these reduce the blood flow to the uterus which promotes a thick lining. The fibroids we can take care of but the adenomyosis not so much.

Even if we could get it up to 0.5. Dr. H says he tried this with another women who had a very difficult time even getting the baby to term. She experienced placental abruption (when the placenta detaches from the uterus) and lost a lot of blood (like almost died alot). Not fun.

So even if I could get my lining to 0.5. And even if we could get a zygote (fertlilized egg) to attach itself to said lining. I would be in for a very tough time getting the thing to term without harming either myself or the baby.

Dr.JH did recommend that I speak with Dr. Glei.cher in new york at CHR regarding the use of Neupogen to promote a thicker lining. Apparently Dr. G is in the midst of a studying the effects of Neupogen on lining development and will be publishing his results next year. If anyone can help thicken a lining it is this guy. So Dr. H has referred me to call him regarding this.

I mentioned to Dr. H about calling CCRM in Colorado. He had nothing but good words for the clinic itself. But said that they would likely make me go through the same rigamarole that Dr. H did to build up a lining, and may be inclined to try a transfer even if the lining isnt optimal because they get so invested in me and the whole process. I can see that happening. I may even be inclined to say lets give it a try. But the reality is we are fighting a very difficult battle here. Is it worth the time, effort and considerable expense to do something that is more likely to fail than work.

So I will call Dr. G in new york. See what he says about the use of Neupogen. I am not hopefull. It did absoloutely nothing for me. So I dont see him coming up with any sort of breakthrough that will change my life. I dont think we will call CCRM anymore. I belive Dr. H is right. They will try their best, but they wont do anything much different from what Dr. H did. So really is it worth the time and expense? At this point. I dont think so.

DH and I have decided to explore adoption in 2015. For now I will focus on work and he needs to focus on med school. Once he is into residency we can seriously consider adoption.

Overall though DH has been good about this. He has always been ready for adoption and at the moment is happy to be child free. Bless his heart. He is a god send for sure. So perfect for me in so many ways. But it still really bothers me that we can just be…normal.

Neupogen Follow-up or Why I love my clinic

Just got an email from the clinic. They will not be charging me for the Neupogen injection from my last cycle. That’s about $300.

I know amazing right?

Bascially I had consented to the experimental treatment to see how it would affect my ability to build a lining. It didnt work (at least not in a measurable sense). But nowhere along the way did anyone (not my doctor, nurses, or front desk staff) mention to me that there was a cost to doing this, or how much it would be. I know I have to pay for my drugs, but most of them I get reimbursed by my health insurance provider so I never really had to worry about it.

All my blood tests and ultrasounds have been covered by my Provincial health insurance (I love Canada). So up until now the cost of my mock cycle has been minimal (mostly my time and travel).

And as far as I know you are supposed to be told the cost of things before you buy them. Whether they are drugs or otherwise.

So I was a bit suprised to get a $300 invoice in my email a few days after the Neupogen injection appoiontment. The email stated there was a ‘clerical error’ and they forgot to bill me on the day of the appointment. Since that was the first I had heard about the cost of the injection, let alone that I had to pay it, I was a bit suprised. I told the accountant that I was not happy about this or the way it was handled, but said I would pay the next time I was at the clinic (some point in September, I was in no rush to pay $300).

I just got an email back today saying that they have deleted the charge from my account. Apparently the clinical team decided that they would not charge me for this one. Yay!

I wonder though, is it because I complained, or because it didnt really work? I guess I will find out on Thursday at my meeting with Dr. H. But really it doesnt matter. Bottom line is: the customer service at this place is awesome. I truly cant say many bad things about this place.

and yet some of us can’t have children…

It never bothered me that I couldnt procreate the normal way. That is just my lot in life. Its fine.

But every so often I read stories like this one and I cringe. It seems so unfair that, for lack of a better word, total psychos can be allowed to procreate or even take care of children while those of us that are at least a bit more normal than that cannot.

Makes me wish for some sort of Brave New World or Handmaids Tale-esque distopia where only certain people are allowed to create offspring…

Its just so unfair.

Living with POF or Entering the Big Bad World of HRT

  

Finally I have had a chance to meet with the Gynecology specialist(s) that deal with women with POF. It took about 6 months after the referral early this year (which I was told was normal). The clinic itself is bascially a group of doctors that get together on the second wednesday of every month to meet with patients with this particular issue. So I believe I am getting the best help I can for my long term health. That on its own makes me feel a whole lot better.

The particular doctor I met with, Dr.E, was a young lady who is the attending that works with Dr. W (the main gynecologist). I didnt have  a chance to meet Dr. W, since she was with another patient at the time. But i didnt feel the need to, as Dr. E seemed to get what I was saying and seemed to have a good idea of what I needed.

We spoke for a bit on my symptoms and my fertility options. I told her I had been on the pill for over 10 years before my BP start to rise and so my family doc told me to stop taking the pill. She also completed a vag exam and then prescribed me some long term treatment. This is the HRT I am supposed to take for the foreseable future (while not doing anything in terms of the fertility side of things ofcourse).

She prescibed:

  • Estring – a small flexible plastic ring (about the circumference of a golf ball) that contains 2mg of estradiol. This is inserted into the vag and left there for 90 days (!) to provice a slow release of estrogen to the vag area.
  • Estradot 100 patch – this is another estrogen replacement that I will change twice a week. This is placed anywhere on my body (but mostly around the butt area so it is more discreet).
  • Prometrium 3X100mg capsules on days 1 to 12 of the calendar month. Taken orally at night (so as not to cause too much drowsiness, apparently it makes you sleep really well)

The Prometrium is to counter all the estrogen being pumped into my system and to lower the risk of cancer that estrogen alone can cause.

The other gyno (the one that is supposed to do my hysteroscopy) had suggested estrogen cream, which I asked Dr. E about and she said that we could use that too, but she preferred the patch as it was easier to control the dosage and an easier method of delivery. I agree. So far the patch has not been too bad. I even downloaded an app on my phone to remind me when to take the meds.

The only one I am worried about is the estring. So far it is great. I cant feel it and, although I still think about it everyday, it doesnt physically bother me at all. The one thing it can cause is TSS (toxic shock syndrome). Although very rare, this is a risk. I guess it is just like using a tampon, there is a risk but it is small. I am just terrified that I will start to get TSS symptoms and forget that I have the ring in there. I guess just that fact makes me not forget that it is in there. I even told my husband to watch out if I start to complain about any TSS like symptoms. I guess at time goes on my paranoia will subside.

It has been a couple of weeks since this all started and so far so good. No hot flashes (which had started to return a couple of weeks after the last of the estrace and prometrium that I had for the mock cycles). I also dont feel as dry down there, which is great.

And sex with the ring is actually no different. Neither of us can feel it in there, so that is a good thing! (Dr. E had said that some people do feel it and have to pull it out for sex and then put it back in after but we dont)

In terms of longterm risks Dr. E said that the research has shown that the risks are so low for those of us that need HRT so early in our lives that is is worth it. Infact, the risks of not taking the hormones is much worse than it is to take them. While I have not reviewed any of this research, I do believe her. She is the expert after all. And I feel better taking the hormones than not having them.

One thing Dr. E said was that taking these drugs will not prevent pregnancy. So if there happens to be one lone follicle in there, it may just develop. But the chances in my case are extremely low given my numbers. Fair enough. Nothing I wasnt expecting there. But it nice to know that there is a small chance. Even if it is miniscule. One can always hope! I wish to be one of those one in a million women who get pregnant after being told there was no chance. I wish.

But for now we will go with the majority stats and keep planning for fertility treatments. Moment of truth appointment with Dr. H is coming up next week.