Thursday, June 4, 2009

Maternal Fetal Medicine specialist

My meeting with the MFM went well for the most part.  First of all, I was able to tell him what happened to me and Lydia without crying.  I was amazed at myself since this is the first time I was able to do that.   Well after hearing it all and looking through my records he thinks that even though I could be labeled as a classic IC patient we can't be sure that it wasn't also pre-term later (PTL).  Perhaps the contractions happened really quick and caused my cervix to dilate.  Or perhaps my cervix opening up caused the contractions.  We will never know.  But for next time (if we manage to even get pregnant again) I will be getting a cerclage to keep the cervix shut once I make it to 12 weeks, and then I'll take P17 shots weekly starting at 16 weeks to stop PTL.  When describing the P17 he was all apologetic because it is a shot and "those are hard".  I actually laughed.  I reminded him that Lydia was the result of IVF and I had to have shots everyday for weeks and weeks.  So a weekly P17 is no big deal.  The doctor also suggests that I have weekly cervix checks and will do modified rest depending on how the cervix looks.  I plan on doing self imposed modified bedrest regardless.   He showed me how the cerclage would be done on this cool little model of the uterus and vagina.  Doesn't seem to complicated.  And he has been doing them for 18 years.  So that made me feel good.  When I asked about a TAC (transabominal cerclage) he said that in my case it isn't warranted because I have plenty of cervix.  Basically he only recommends TACs to women with little to no cervix left.  I'm going to do a little more research on this.  I know that he is a highly respected MFM but from what I've heard on the cerclage message boards most doctors do not recommend TACs simply because they don't know enough about them.  I do trust this doctor.  But he is just a man.  And he might not know all there is to know about cerclages.  So I'll do a little digging around and see if I can get a second opinion on this just in case.  

I did ask him about transferring 2 blasts and he didn't totally agree with my RE that I wouldn't be able to carry a twin pregnancy to term.  But he said the chances of going into pre-term labor increase with twins and that I should consider that when deciding how many we want to transfer.  I know that Busted (from Busted Babymaker) and some other women out there have had success transferring one so I'm feeling a tad better about it.  But just a tad.  I'll need to research this some more too.

The last thing we talked about was how long I should wait before TTC.  This was the only part of the consult that bugged me.  He agreed that 3 months was standard but that I may need more time mentally.  I told him that mentally I thought I was getting there and know it will take some time.  That I have an appointment with a therapist tomorrow, and I'm reading a lot about grief and pregnancy/baby loss (I have a stack of books I'm going through).  This blog, others blogs, and message boards are a good outlet for me too.  This is what works for me.  But he gave me a skeptical look and said "well it best to take some time because the next pregnancy you'll be really anxious".  O.K. I get that.  Of course I'll be anxious!  But I don't think that waiting 6 months instead of 3  is going to stop that anxiety from coming.  Whether I get pregnant tomorrow or next year I'll be anxious during the pregnancy.  I know myself.  And I know that I've waited long enough.  I waited for my husband to want to TTC.  I waited for the fibroid surgeries.  I waited to go to the RE.  I waited for IVF.  Now I have to wait again.  I'm tired of waiting.  I want to be a mother to a live baby.  I guess this is something to go over with the therapist tomorrow.   

17 comments:

Michelle said...

I think waiting is one of the hardest things in this TTC/IF process. It sucks! Definitely do what YOU feel is right and I think you are right about be anxious no matter how long you wait. Between all my mc it generally is a 9-12 months before I conceive again (not because I want it to be but because it took that long) and I am still a WRECK!!

Judith and Jason said...

not sure how I found your blog, but we are going through the same shit right now. I lost my baby boy at 37 weeks. He was full term and lovely. Cause of death unknown. I cannot wait to get back on the horse too, but like you it will be a long road of trying.

carley said...

The waiting is hard. I m/c'd end of October, had my follow up apt. Dec. 6th and was told we could start TTC again. We started TTC again right away (Dec) and it was not until the end of April that I conceived again.

I as first thought I wanted a cerclage put in, but after some more research and talking to my doctor, we've decided to do a wait and see. I see her every two weeks and if I start spotting I go to her office for her to check my cervix. Plus she checks it at every apt (every 2w) and it's been checked at my u/s visits. I'm also on progesterone that I take vaginally. Fun stuff.

I'm not on bed rest yet, again it's been a wait and see situation and so far no spotting. I feel a lot better knowing I'm seeing an specialist and getting extra care.

B MoM said...

i completely understand the desire to be a mother is much more urgent after a loss...I felt the exact same. I think you'll be ready after 3 months. The very fact that you're able to talk about your grief and blog about and are seeing a therapist already indicates that you're well on your way to recovery. You'll never not be sad about it and you'll always miss Lydia, but you'll be ready in 3 months. I know it.

Rose's Daughter said...

When you are ready, you will know. Sometimes, DOING something is what helps you to move on. Not sitting around and waiting. You will know.

Ben & Anne said...

Just wanted to let you know for comparison purposes that in the UK the independent regulatory body for fertility treatment (HEFA)has very recently recommended that all IVF regardless of circumstance transfers 1 embryo only. This is due to the risks seen with the relatively high number of twin births up until now. Our main healthcare system here is government funded and in my part of the country they are implementing this recommendation (although not sure private clinics are). I expect that cost has something to do with the decision but I don't think it could be the main driver in a decision like this and HEFA are not driven by cost as they are a regulator, not part of the National Health Service. The reports from HEFA indicate a very small decrease in the success of IVF with one embryo transferred instead of two (I think it's about 2-5% on average). So in short I don't think your chances are that hindered from transferring one if that's what you choose to do, esp as you have several great blasts frozen and got pregnant first time with your last IVF.

I had two transferred but one was pretty much non-viable (only 4 cells at day 3 and fragmented). I got pregnant and I'm betting it wasn't with that one.

Good luck in whatever you choose. I totally understand where you're coming from with the sooner rather than later approach, all us IVF ladies have certainly waited long enough for a baby!

meinsideout said...

You have been through so much - the waiting has to be agonizing. I know that it is for me. One of my IRL friends lost twins at 20 weeks after IVF and her situation sounds very similar to yours - she got pregnant again after putting one back after an FET and miscarried early. She is having another FET and they are putting two back.

Each decision is personal and up to you and your team. Even though we do not "know" each other nor have we "known" each other in blogland, I will be around to support whatever decision you make.

Andrea said...

not much to add then the other commenters, but just wanted to say that I am glad the appointment went well (other than the waiting advice) and good luck with your therapy appointment:)

Bella said...

I agree with you that you'll be anxious no matter how long you ait, so why wait? As long as it's okay medically, I say go for it whenever you're ready. Glad the MFM thinks all will be fixed with the cerclage/P17. I also chuckled at his apologies about the shot. THAT we can handle Mr. MFM!! I will be hopng and praying you get pregnant again quickly and have a healthy, full-term baby(ies).

strongblonde said...

i think that overall this sounds positive. sounds like he has a plan that is appropriate and totally workable. i'm hopeful for a quick pregnancy for you :)

xoxo

alicia said...

glad you have a plan with your Dr. So glad you are talking to a therpaist too. I am sure you will know when you are ready to try again, trust your judgment!

theworms said...

Glad appt. went well and you need to move forward in your time. GL with therapy appt.

((HUGS))

Bree said...

Hi
I came across your blog tonight when I was googling TAC. I'm so sorry for your loss. I lost me daughter, Ella on 3/15. I'm in the same boat as you, either due to IC or PTL. My doctor doesn't think I need a TAC either. She said she's been doing TVC's for 18 years and never seen one fail. However, I've come across many women online who's TVC failed. And, I'm scared. But, I'll probably listen to her and try the TVC. If, I ever get the chance. I'm desperate to conceive as well. I also struggle with fertility issues. And, we have one more thing in common- I'm a California girl, too!

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