Update! Our Journey to Baby #2: You Matter
A week ago I had my appointment with my new fertility specialist at Repromed who had been recommended to me by a couple of friends. I have blogged in the past about my previous experience with Repromed being quite clinical and how I felt like a ‘number’, so going back there made me feel a little anxious. But to my surprise, I walked in there and felt somewhat comfortable. I nearly wrote ‘at home’, but that’s a bit of a stretch! In hindsight, I think my feelings associated with Repromed were more to do with my own anxieties rather than the care I received. Anyway, Dr Y called me through and the first thing he said was ‘sorry for keeping you waiting, I was reading your history and really wanted to understand your story before we talked’. Immediate ‘tick’, I liked this guy! And then he said ‘Wow you are so lucky to have James’. Two ticks, what a bloody legend! We went over my history one more time, and I was impressed that he already knew so much – he sure had done his research! The next thing he asked actually took me by surprise. He said ‘So what do you want to get out of this?’ I instantly knew I had 100% made the right decision, not only in my choice of getting a second opinion, but also in which doctor I chose (thanks to those who pointed me in his direction!) My answer was of course that I wanted to get pregnant, but I also wanted to get to the root of our problems & treat it appropriately (not just throw random hormones my way & hope for the best).
Dr Y said there are 3 things we need to address:
The uterus septum. He wants to confirm that the second surgery was a success. Dr S was confident after my 2nd resection surgery that she had removed the septum…so confident in fact that she didn’t feel the need to do any further imaging. But Dr Y has booked me for a 3D Ultrasound to check the shape of my uterus, just in case!
The thin uterine lining. Dr Y believes this is going to be tricky to manage as it isn’t as simple as the hormone treatment I was given the past few cycles to ‘fix’ it. My body is obviously releasing the right hormones in order to ovulate, so he doesn’t believe it’s purely a hormone issue. In fact, treating with hormones can sometimes do more harm than good e.g. cause more of an imbalance. I swear this made sense at the time, but I’m doing a shit job at describing it! At the end of the day, if we do treat with hormones, we need to do so at the beginning of the cycle, not wait until after ovulation. Hallelujah, that’s what I’ve been saying all along….
? Endometriosis. This one came as a bit of a shock. Dr Y explained that most women with uterine abnormalities also have some form of endometriosis. The fact that I miraculously conceived James naturally after having a D&C (to clear out the uterine lining and products of conception after our first miscarriage) also pointed him to this. Although I have very mild symptoms and it hasn’t been reported on any of my history despite previous hysteroscopies and imaging, he doesn’t want to rule it out.
So what do we do about all of this? Firstly, we pause fertility treatment for a month (or two). Yes, this was bloody hard to hear, but in all honesty, I had prepared myself for this going into the appointment. I want answers and a proper plan, and this takes time. Dr Y said ‘I always tell my patients that we need to start slow – it’s not a race, and there’s no point rushing into treating something we don’t yet understand’. I think mostly, we are upset that we have wasted months and hundreds of dollars with treatment that was sub-optimal, not to mention the time we have wasted if I still have a septum despite two surgeries (gosh I can already feel my blood boiling!) Which brings us to the next step…a 3D ultrasound. If they find that I do still have a septum, Dr Y will perform another resection and look for endo at the same time (after I scream into my pillow and eat a tub of ice-cream) – this is seriously my worst-case scenario. If my uterus looks nice and empty like it should, we will have a discussion as to whether I have surgery to determine if I have endometriosis +/- remove it at the same time.
And then we start fertility treatment again. This will either consist of 1) clomid (to induce ovulation) and neupogen (a fancy medication that’s inserted through the cervix into the uterus to initiate an immune response, thicken the lining & promote implantation) – this is the cheapest option. Or 2) IVF – obviously the more expensive option but it gives us greater control and subsequently a greater chance. IVF. Those three little letters, so damn frightening; something I honestly never thought we would need. These options are something we will need to discuss further when the time comes, but something that will be playing on the back of our minds in the meantime. Dr Y explained that we were extremely fortunate to fall pregnant and maintain a pregnancy to 30 weeks with James (even though it wasn’t easy), and I must admit that this probably gave us a false sense of security leading into baby #2. We knew the next pregnancy wasn’t going to be easy, but we honestly thought that falling pregnant wouldn’t be as hard this time around. How wrong we were.
Although this is a lot to take in, I feel like a weight has lifted from my shoulders. I walked out of that appointment with tears rolling down my face – I finally felt heard. We had a plan, and we had found someone who was willing to give us the best shot at making our dream a reality. If you ever feel as though you don’t matter, please get a second opinion until you feel as though you do, because YOU DO MATTER. What works for some, doesn’t work for others. Sometimes you can only do so much and get so much out of a situation before you need to move on. Nothing is permanent, as long as you’re learning something along the way.