The roller coaster continues…
Up…
Before we went through IVF, Dean and I discussed getting a second opinion because a diagnosis of “unexplained infertility” just isn’t very satisfying to wannabe parents getting ready to drop a whole lotta cash on fertility treatments. (Treatments to treat what, exactly? Exactly.) But the combination of inertia, excitement, and I guess comfort with our clinic and doctor sort of got in the way. Before we knew it, we were handing over our savings, doing injection training, and scheduling things like a trial transfer and baseline ultrasound.
and down…
After we found out that our fresh cycle didn’t work, all we cared about was how soon we could try again with one of our little frozen embies. (Oh yeah, that’s just a cute little nickname I have for our literally frozen as well as frozen-in-time embryos). Quick aside, we have two frozen embryos. If we use one now and one later, and they both result in babies, we’ll have two kids who were conceived at the same time but born a year or more apart. They’d be like twins except that one of them was basically put on pause for a while. Science is amazing, right?
and back up…
Okay, getting this blog post back on those rickety wooden tracks… All we wanted to do was try again ASAP, but we were instructed to take a full month off to make sure all my lady parts had time to recover from the stimulation and retrieval. In the meantime, my sister gave me the latest update on one of her friends who was also struggling to get pregnant. After over two years of trying on her own, she had one of her tubes removed and got pregnant on her own the very. next. month. She had something called a hydrosalpinx, which is a blocked tube that fills with fluid, which can leak into the uterus and for a variety of reasons, prevent the successful implantation of a fertilized embryo. How’s that for incredible? Removing one of her tubes improved her fertility!
After speaking to my sister’s friend directly, I got a little obsessive about the possibility that I might have the same issue. It was unlikely, since I had had an HSG a year ago (the test where they push fluid through your tubes while looking at them using an x-ray to see if they’re blocked and/or filled with fluid) and my doctor had said that both of my tubes were open. She mentioned that there might be a little blockage on my left side, but since the tubes were both open, there was nothing to worry about. I called the friend’s clinic and made an appointment with her doctor right away. They squeezed me in quickly since I said I was getting ready to start a frozen transfer at my other clinic.
and back down…
From here on out, my original doctor (an older, very sweet, very nurturing, very well educated woman) will be known as Doctor A. My friend’s doctor (a younger, arrogant man with a tendency to over-explain everything, citing medical studies and cultural trends for added credibility) will be known as Doctor B. Dean and I met with Doctor B, and being on a geeky side ourselves, liked him instantly. He recommended a repeat HSG (trying sooo hard right now not to get off track again by going into the terror I felt hearing I would have to undergo this incredibly painful procedure again… Ah, another day, another post…). We scheduled it right away.
and up again…
The HSG was performed by a highly experienced nurse practitioner, and at the end of the procedure, she told me that the x-ray dye spilled out both sides, which meant that both of my tubes were open. I thought, okay, we’ve done our due diligence; now we can move forward with the frozen embryo transfer with confidence. Bummer we didn’t learn anything new, but at least there’s no reason to think we won’t be successful with our next transfer. And then I got a call from Doctor B’s nurse.
aaand down again…
She said that Doctor B reviewed the video from the HSG and my tubes were blocked after all. She said the doctor was recommending a more invasive, surgical procedure to get a closer look and likely remove my tubes. “Both of them?” I asked. “Yes,” she answered. She actually wanted to send my charts over to the surgery scheduling department right away, and when I hesitated, she offered to schedule a consult with the doctor first instead. UM, YES, I WOULD VERY MUCH LIKE TO DISCUSS THIS WITH THE DOCTOR, PLEASE, BEFORE I SCHEDULE SURGERY TO HAVE BOTH OF MY TUBES REMOVED! Smh…
way, way down…
I had a whole weekend to consider this before meeting with Doctor B, and I realized I was really sad about this tube-removal business. Going into the HSG, I had ranked the potential outcomes. The best case scenario was that they would find one blocked tube with a hydrosalpinx (I could have the one tube removed and fulfill my own get-pregnant-the-very-next-month fantasy). The second best outcome was probably that they found nothing wrong (I keep my tubes, move forward with a frozen embryo transfer, and maybe a successful pregnancy cures my infertility forever–it happens! If not, we could always do more IVF). The worst-case scenario was having to have both tubes removed.
Removing both tubes meant that I would never, ever have a surprise pregnancy. In all likelihood, that’s probably not going to happen for me anyway, and really, who wants a surprise pregnancy? Only embattled infertility patients, probably. What a dream it would be to just wake up and find myself pregnant without all the pricks and pinches and wands and catheters and anxiety that go along with getting pregnant the new-fashioned way! This weekend was a pretty low point for me on the infertility roller coaster.
back on the way up…
Monday morning came, and Doctor B said that just one of my tubes was blocked! The left one. The same one as my sister’s friend. He said there was a 0% chance that he would take out both tubes. He showed me the video that convinced him that I had a mild hydrosalpinx despite that fact that my tube is technically open. The roller coaster was back on it’s way up! This was music to my ears, exactly what I had hoped to hear! What the eff is wrong with his nurse, I asked!
and down, cue the nausea…
I left that appointment with a CD containing all the HSG images and the video to show Doctor A, for what I termed a “reverse second opinion.” I saw her the next day and showed her the images, which unfortunately, since the video wouldn’t play, didn’t quite do my mild hydrosalpinx justice. Doctor A, who had been skeptical since I first mentioned Doctor B’s name, was not convinced. She said a mild blockage did not warrant removing a tube, and that this was a gross over-reaction to one failed IVF transfer. I had really hoped she would back Doctor B’s recommendation, and thought she would after she saw the video and images.
She told me that she would not advise me to get my tube removed. Exhausted and out of patience, I asked her, “What am I supposed to do now, get a third opinion?” She answered, “No, that would be ridiculous. You obviously want to do this, so go for it. At least it’ll reduce your chances of an ectopic pregnancy.” Sweet, a silver lining to a possibly completely unnecessary operation!
Leveling off, at least temporarily…
It’s amazing how far a week without any doctor appointments can go toward restoring my equilibrium and reducing my anxiety level. I scheduled the laparoscopy (the exploratory surgery that will likely result in my losing one of my tubes) for a week from tomorrow. Here’s the way I have rationalized my decision: If I don’t remove the tube and we do both frozen embryo transfers, and neither one works, I’m going to kick myself for wasting these chances and a considerable chunk of time. Averaging the cost of the fresh IVF cycle and two frozen embryo transfers, each of our three embryos is worth about $10K. We’ve already lost one. We want to do everything we can not to flush the other two down my possibly toxic reproductive tract. If we do the surgery and then I get pregnant, we may never know whether the surgery helped or not, but it won’t matter because we’ll have what we want so badly. Sure, there will be some scars and the surgery will cost some money, but it seems to me that the worst case scenario is significantly worse if I don’t do the surgery.
Wish me luck!