After waiting patiently for the phone call and having to reschedule it, I was able to talk with Dr.Kwak-Kim regarding my results. I was hoping to get some real answers or to have a clear path to follow, but that didn’t happen.
No major breakthroughs were found as to why my pregnancies don’t last. A large part of me was hoping that something would be discovered as to why this keeps happening, but it wasn’t. A few blood panels came back with elevated levels and they could be contributing to my losses, but we really aren’t sure. It just seems that my body has a few minor things that aren’t working as they should be.
I feel more overwhelmed than ever and am starting to question if carrying a pregnancy to term is for me.
So…..after taking about 30 vials of blood, here are the things that came back abnormal or elevated.
TSH is 3.14 (Higher than it has been in a while)
ATA (Hashimoto’s) negative
MTHFR(C677T) gene heterozygous mutated
TH1/TH2 Cytokine: Increased T-helper 1, Inflammatory immune responses. Domminance of TH-1 Cells cytotoxic & pro-inflammatory.
Natural Killer Cell slightly elevated
AMH dropped to 1.72
Polycystic Ovaries – Mild PCOS
Before a conception cycle Dr. Kwak-Kim would like me to do the following:
Start Metanx once daily for MTHFR ( because I have a heterozygous mutation extra folic acid is recommended)
Start Metformin ( to help with PCOS and imbalances in my glucose levels)
Increase thyroid medication
Take one baby aspirin daily
Take prednisone 10 mg, once daily before BFP and twice daily after
Start lovenox 40 mg once daily before BPF and twice daily after BFP
Uterine Biophysical profile 5-7 days post lovenox treatment
Start Immune Globulin (IVIG), every 2-3 weeks.
Once BFP comes along:
APTT, Chemistry panel and a CBC with platelet count eery month while on lovenox.
TSH, Free T-4 and Free T-3 weekly
Antiphosopholipid antibody, anti-DNA/histone antibody, ANA, NK assay, PAI-1 and TH1/TH2 cytokine testing starting with BFP
Beta draws every 2 days until heartbeat is detected
Blood pressure monitoring weekly while on Lovenox
Ultrasound using gray-scale and Doppler techniques to assess the pregnancy development should be done every week beginning at 5-6 weeks of gestation through the first trimester then monthly.
At 28-30 weeks, weekly non stress tests and biophysical profile exams should be done
WHAT TO DO
Basically I want to cry.
The amount of tests, results, blood draws, and appointments that I have to pay attention to once I get pregnant is overwhelming. Gone are the days of getting a BFP and rejoicing. Instead when I finally get another BFP I will be put into survival mode trying to remember every injection, vitamin, and pill that has to be taken at certain times.Trying to help the baby survive and thrive in my hostile body.
The other day my hubby had told me that when we do get pregnant again he doesn’t want to do any ultrasounds or think about being pregnant until 8 weeks…poor guy obviously hasn’t looked over the report from Dr. Kwak-Kim. But, that just goes to show that we are both afraid of going through another pregnancy. Both afraid that we can’t handle another loss.
So, what am I going to do? Dr. Kwak-Kim says it is up to us if we want to undergo another round of IVF, but that she doesn’t believe we need it. According to her we can get pregnant, and if our issue was purely chromosomal then we would have had a healthy baby by now. That it is very odd to have 6 irreguarlities with chromosomes in a row. And, for once I agree with a doctor.
The hubby and I have discussed it and we are going to put IVF take 2 on hold to try naturally. Part of me is excited to not undergo another round of IVF and to see what my body can do on it’s own. But, another part is terrified to go through months of trying and then waiting for a BFP and then waiting for an ultrasound. WHy is the waiting part so killer? There really isn’t a winning situation when it comes to my decision and we just have to go with what we feel comfortable doing.
The one thing I have decided to go against is the doctors recommendation for IVIG. I’m just not there yet. I know it has worked for some women, but I can’t bring myself to make that decision. I am ok going forward with all of her recommendations, minus the IVIG. I’ve thought long and hard about it and decided its just not right for me. I am willing to follow every other recomendation and to do what she says, but I just don’t see how it would help me.
So there it is in a nutshell, the recomendations from Dr. Kwak-Kim.