Thursday, September 12, 2013

Another puzzle piece

I tried to describe to someone what my fertility journey has been like. It's been like trying to arrange a puzzle, realizing there are missing pieces and then finding the pieces lost all over the house and putting them back one by one.

Where to start...there are a few things on my mind.

Saddest first. Today is the 10 year anniversary of my first miscarriage. Ten years later, I cried today. Do I cry every year, no. Unfortunately, September 11th is a big reminder of what the date is. 10 years ago on September 11th, I had my 16 week prenatal appointment. It was 2 years after the attack on the twin towers and I felt like there was a curse on the day and was worried about my appointment. B and I sat in the waiting room for an hour and a half before being called back. The doctor got out the doppler and couldn't find a heartbeat, and then she tried the in room u/s machine. She told us our baby's heart had stopped and that it was a couple weeks ago - a missed miscarriage, then told us to go home to gather our things and go to the hospital. I chose to be induced and delivered Jacob on 9-12-03.

This year, on the 10 year anniversary I went to a Reproductive Endocrinologist. There were so many emotions tied to this appointment.

Anxiety - over what the treatment options would be. What if they are too invasive? Am I really willing to do them?

Anger - at the medical community who kept telling me I was too young, not trying hard enough, or not trying long enough and blowing me off for so long.

Grief - writing out my medical history brought up those feelings of grief over my losses.

Fear - that the Doctor would tell me that we are a hopeless case.

The good new is the Reproductive Endocrinologist (RE) was the nicest doctor I have ever met; kind, compassionate. He listened to my concerns, read my history (I wrote it out at home and brought in 4 pages typed), and gave me options. He told me we could be as reserved or aggressive as we want. He does not want to push us into doing anything we didn't want to do, and it was his job to educate us on the options and help us find a good fit for us.

He didn't have a magic answer that explained exactly why I was having a hard time getting pregnant. I wish it was that easy.

He calmed my fears about taking clomid. I had many; I was worried about the side effects that I would feel, and if it would cause issues with my child's fertility. He educated me on the drug, explaining that it's been around since the 1960's and that we have seen children conceived using clomid, now go on to have healthy pregnancies with and without clomid. And he did offer me a second drug option that has less side effects for me, if the clomid makes me feel terrible.

I left the office feeling comfortable with the treatment plan.

The last and most confusing thing is I discovered I have a genetic mutation which may explain my miscarriages. I am Mthfr 1298(A->C) heterozygote. How did I discover this? I requested my file from my previous OB be faxed to the RE. I mentioned specifically that I was looking for some genetic testing I had done in 2006. I remember my old OB telling me that she ran this testing, everything came back normal. But that there was one result that was slightly abnormal but it was nothing to worry about. I asked to see the test result while in the RE's office. I recognized the MTHFR mutation because a couple of girls in my support group have the same thing. I messaged them asking for translation; It causes microclots between the placenta and baby which causes the baby to die (missed m/c) due to lack of nutrients and blood supply. The MTHFR mutation causes a reaction with the folic acid cascade in your body so you're at increased risk for neural tube defects.

I asked the RE about it, and he said that he really has no concern over it. He said I could take additional folic acid to cover the deficiency caused by the mutation.

In some ways this gives me peace, knowing that there was a cause. But because it is something that isn't really researched in the medical community, there's not a lot of support in helping me treat it. Looks like I have my research cut out for me.

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