Thursday, March 15, 2012

Who To Trust And Hospital Big Business

The doctor at my clinic is not only a fertility specialist, he's a Reproductive Endocrinologist (RE). An RE is trained to specifically evaluate and treat hormonal dysfunctions as it pertains to infertility. Typically a vital doctor to have on your side when dealing with PCOS.

We all know hospitals and fertility clinics are BIG business. This clinic specifically is a member of Society for Assisted Reproductive Technologies (SART). Being a SART member means the clinic reports everything, participates in specific protocols and is regulated by the FDA.  I didn't think much of it at first, but the longer I've had to process things, the more concerned I become. Why does there need to be governmental interference in this process?  What is the advantage to the patient by using a SART clinic?

If things on my end look so good and they can't guarantee that my husband's issues are causing our losses, then what's the deal?  Why the big rush to the most expensive option? At our first appointment before they had conducted any tests of their own, they handed us a 3" binder filled with IVF information. It was quite obvious where their focus was.

I have researched all of the results I had access to.  I also found many of my results were not even posted to my online portal, even though ALL test results are supposed to appear there. That's when I began to find that what they were calling "good", weren't necessarily big-picture good.  The Anti-Mullerian Hormone (AMH) test can be done at any point in your cycle and while it can't tell the quality of your eggs, it can measure quantity. Results between 5 and 15 are considered normal.  I am 34 and started my cycle early in age so I expected to have come back with a lower than typical number, but him saying my results at a 3.73 were "good" was misleading. In terms of a normal woman's fertility, those results are low.

When I found a document in the big binder giving what their acceptable range of results were, the light bulb went off.  I was at the very high end of acceptable in their book for nearly all of the results I've actually been able to see. Just because I fit in those IVF-able numbers, it means there is nothing wrong with me?  Of course it doesn't. To them, it only means I'm a candidate for IVF.  They don't actually care what my numbers look like in terms of my health or ability to have a child without intervention.  They don't care that I'm ovulating on my own. They don't care really what my body is doing naturally at all- they have meds for that.  I truly believe I'm only a statistic to them and their main concern is how I will contribute to their reporting. A cynical way to look at things? Perhaps. But, it makes complete sense to me.

I think it's a rare thing to find a doctor you truly like and trust.  You always need to have your eyes open and be sure of what they're telling you. Second opinions and research are vital. Right now, my biggest concern is staying pregnant. All of the injecting of good sperm in my eggs mean nothing if I can't stay pregnant. I would be totally monitored, which is great, but can't I just be monitored by doing this on our own? 

So, I've decided I'm going to take this all back to my OB. He originally referred us because of my husband's issues, but now I want him to take a look. And, if he won't, I'll find someone who will.

Wednesday, March 14, 2012

Changing Your Mindset

I love blogging. I don't do it often enough, but I enjoy going back to re-read my previous posts to see how I was feeling at a particular time.  After re-reading my last fertility related post, I realized I was angry and frustrated. It was valid anger and frustration, but I am that way so infrequently that reading it makes me smile a little. It shows me I'm still IN this, still fighting for it.  Sometimes it takes a while for the brain to process and emotions to follow.

My husband's second semen analysis using the more accurate protocol came back much the same as the first.  Out of 500 total sperm tested, in batches of 100 at a time, only 1 out of every 100 are considered normal. We're looking essentially at 1%, where a fertility specialist wants to see nothing under 4%.  When talking about abnormal, we found it doesn't necessarily mean his are freakish by any means. What we found was mildly encouraging. They aren't crazily misshapen, no double heads or tails, no missing tails, no coiled up or odd shapes. The nurse said "yours aren't too bad. We see some crazy sperm sometimes".  Most of what was considered his abnormal were wedge-shaped heads, or a little thickening of the area right under the head.

Unfortunately, there is not enough known about the process of what attracts sperm to an egg. "They" say the egg has almost a signaling beacon of sorts which only attracts perfect good sperm. "They" also say abnormal sperm are still able to penetrate an egg and make a perfectly healthy baby. My doctor actually said "I can't guarantee that his morphology issues are the reason you aren't staying pregnant". My confusion level skyrocketed. So, are his sperm our problem or not?

They came to my test results.  Shockingly, after a crazy number of vials of blood and testing, everything with me came back in their normal range. I'm still not sure how that is at all possible, but he literally said "there is nothing at all we would treat you for".  Even all of my testing for PCOS issues like testosterone and androgen hormones all came back normal. He said my ovarian reserve testing came back "good". I happened to see the number they had down for that AMH test, and it was a 3.73.  I didn't know what that meant at the time, but if they say it's good, it's good, right?

This doctor was quite specific with his recommendations. IVF is most highly recommended (about $15,000 for a 42.9% chance at a live birth), followed by a monitored cycle with Clomid (a ovulation inducing medication) followed by an insemination ($6,700 for a 20% chance). Last on the list, and not recommended, would be a monitored Clomid cycle without insemination, but with timed intercourse instead. The nurse said right away that it's not recommended because really it's no different than what we've been doing already.

After our appointment, we were both left feeling a bit frustrated and lost. It also led to a pretty big disagreement over what to do financially and whether or not to put a price tag on our future child(ren). After a lot of soul searching and discussion, we've come to the conclusion that barring any new information we may gain with a 2nd opinion, we'll wait out the rest of 2012, in hopes of doing this on our own. He's agreed to get healthier, diet with me, stop his caffeine and start his vitamins.  My hope is that now that we're at least established patients with the fertility clinic, they'll be really on top of monitoring me at the next positive test. Hopefully if there is some yet-undetected issue with me, they'll catch it early and we can make the next one stick. 

I'm currently on cycle day 19, and should be ovulating any day now. Bring it!

Tuesday, March 13, 2012

Make Me A Believer

Caution- long post ahead. My apologies in advance...

I'm a skeptic. A big one.  I'm always looking for the logic behind things because it keeps my world orderly. If it weren't for my questioning of things and my incessant research to find the answers to anything and everything, I'm sure I'd have a little more free time in my day. I recently had an experience which left me questioning, but also provided some insight and answers, if I choose to believe. 

During my short-lived college career, one of the things I learned was to read tarot cards (hey, I was learning something!).  It was fun for parties and people were always impressed by my skills.  But, it was just that...a skill.  I don't claim to be any sort of psychic and when learning tarot, I recognized there was a process involved. Anyone willing to get a tarot card reading is of a certain vulnerability. They want answers, they want their future told, they want to believe, all of which works to a reader's advantage. If you actually study the meaning of the cards, you'll find they're just generic enough that their meaning can be interpreted many ways. Basically, the magic comes with the reader's ability to sense and follow the direction of the person being read. Everything from facial expressions down to the jewelry they're wearing are all indicators for a reader to follow.  My sister was also involved on the back-end of production in television, so I know the stuff that goes on "behind the scenes" of the psychics you see on TV. It is the magic of television, afterall.  When you put all of that together, it can make it difficult for a skeptic to believe in these things. I do believe that sensitive people exist. I believe in spirits. I also believe that anyone who advertises themselves as such is probably a big fat fake.

When my best friend announced she was taking me to a psychic for my birthday I was a bit hesitant. I didn't want her to waste her hard-earned money for nothing.  I reluctantly agreed to go but I wanted to know the woman's name. I also wanted to make sure my friend didn't provide excessive information over the phone which would have allowed this "psychic" to research anything in advance. As it turns out, she only asked for my friend's first name, and didn't ask mine at all. Ok fine, score one for her.  

I went researching. After a quick Google search of this woman's name plus "psychic", I found no results. After searching the name of the city she was located in plus psychic, I found 10 results in the surrounding area, but no mention of her. After a Facebook search, I found her name, found her page but found NO mention of her abilities. She was a normal 40-ish woman who likes animals and Barnes and Noble. I found her address, which lined up with the address I was given. I even know how much her house is worth. It was nothing extravagant, which also served to make me a bit more comfortable that she's not out taking advantage of people while living it up in a mansion. Good. 

As the day approached, my friend was getting excited. I was encouraged by my earlier findings, but I still wasn't planning on putting much stock into what was said. I was just going to go with the flow. 

We pulled up in front of a cute little house.  When we walked in, she asked my first name. She had just a chair and couch, coffee and end tables and one tiny candle burning off to the side next to a bowl. No incense, or heavy drapery or crystal balls to be found. The room was painted a soothing light green and the furniture was big and overstuffed with lots of pillows. She was so "normal" you'd never pick her out in a crowd.  She asked us to have a seat on the couch.

We sat quietly for a moment while she started scribbling on a notebook. I saw her write 7 and boy. She looked right at me and asked if I had a 7 year old son. I shook my head no and she looked shocked. She said nephew? I said no. She looked confused. She said wow, he is definitely here. He got here before you walked in. He is very strong around you. She kept writing on her notebook.

I waited a bit, trying to figure out this 7 year old and just couldn't make a connection. I was trying to calculate what year that would have been but I didn’t want to miss anything she was going to say, so I just shook my head. She shook it off and said maybe we’d come back to it.  She asked if I was dating/married. I said yes, married.  She asked his name.  I said “Tom”.  She said “what is his full birth name?”  I told her and her eyes got big. She had circled the name Ray on her piece of paper.  Tom’s middle name is Ray, and his grandpa’s name was Ray.  She looked a little confused for a minute and shook her head again. She said she might have to come back to that.

She asked if I was in school. I said no. She said "hmm, I see you in school, do you teach? I see you surrounded by children". I just kept shaking my head but she said “young children... they love you, they are drawn to you. I don't know what you do, but teaching is very good for you”.

What she didn't know was that I originally started college with intentions of a major in elementary ed. I ended up on another path, but I think about it often. I also had been given the "assignment" of signing up for a class, any class, from my boss at my last review which I still haven't yet done.

She asked if I was self-employed.  I said no.  She said “you don’t run a business?”  I said I used to.  She said she feels I’m solitary, that I work for myself. Well, technically with the way things are set up here, since I’m a department of 1, I am solitary…a little island. And, I do freelance from time to time.  She said she sees me in business for myself.

She said I have a golden path, that I’m starting a new birth year, then she paused and said “when is your birthday?” and I said “tomorrow acutally”.  Her eyes got big again and she smiled…she said “you really are starting a new birth year right now then!”

She said she feels I have to do something this year, that whatever it is, to work for it but don’t worry about it, that the path is there for me to take.

Then she said she felt trauma around me and I needed to identify it. She asked if there was connection between kids and trauma.  I gave in at that point a little and mentioned my losses, but provided no details. She asked if I was afraid of something each time and of course I was...afraid of losing the baby. She pressed a bit. “But what are you actually afraid of? What has made you afraid?”  I said with the first one that I had just found out before getting on an airplane and that I was scared to death to get on that plane because of it.  She said “ok, but that’s where you were projecting your fear. The airplane wasn’t causing your trauma”.  I got it after that. It made sense. It wasn’t my fear of the airplane at all, but just the knowledge told to me that something was wrong with me and that any pregnancy would be difficult to attain. 

She believes the trauma was caused by my first doctor diagnosing my PCOS and telling me that if I didn’t have kids right away that I never would. She talked about the fight/flight/freeze in us and how if our energies are not being focused correctly and we hold trauma in physically, it can certainly have an effect on us physically.

She gave me the name of an author who has a book with skills for removing that stress and trauma. Peter Levine. One book specifically she mentioned has easy exercises to help, including one to identifying sensations and applying descriptions to them until they move or leave entirely. Interesting.   

She said my husband and I have a very bright path and that she sees a lot of happiness around you. She asked if I was creative. I smiled and said I was a graphic designer. She said that doesn't fulfill all your artistic needs though, does it? I said no. She said to make sure I have a lot of creative outlets for my art energy. She said there are creative people, mostly women since it’s a feminine attribute, but others are finger-printed as artists. She said creative people need an outlet, but true artists need many outlets. She described me as a glass of water or a water balloon. That if I don’t have enough places for my creative energy to go that it overflows or blows up and makes a mess.
So, after contemplating what she had to say to me, she made me a believer. Those were things no one could have known. Heck, they're things even some of the people closest to me don't know.  My friend had similar results. This woman was completely on target for her, though I had to laugh because what she told her was stuff I've been telling her for years.  So maybe I'm a little psychic after all?  ;)

Our entire session was well over 2 hours even though we were supposed to be there only 45 minutes each. This poor woman desperately needed a nap after she was done with us...she looked exhausted.
All in all, she made me a HER, anyway. If nothing else, I ordered the book she mentioned. After doing a little excerpt reading, I realized that if there was even a slight chance that she was right, some coping skills to get rid of some of the traumatic events of my life would be good for me no matter what.  Perhaps if I can eliminate some of the baggage, I'll be healthier all the way around.