We had a phone consult with Dr. Surrey at CCRM last week. It went really well. Dr. S was very personable which was nice. Being that we’ve been through lots of treatment we could really focus the conversation on some new diagnostic test work and strategy. His recommendation was that we proceed with some recurrent pregnancy loss (RPL) testing. Technically RPL testing would more likely come after a person has experienced 3 early term losses. While we have had 3 losses with the missed miscarriage, ectopic and chemical, the ectopic doesn’t really count because it’s not that the pregnancy wouldn’t have worked it just wasn’t in the right spot. However, 2 losses with potentially diminished ovarian reserve deems this a good time to check the potential for RPL characteristics off the list. He said that there are 3 tests he’d like to do:
1. A blood test to determine if I may have a propensity for blood clots which can cause some issues during early term pregnancy. They treat this with a blood thinner. I am sure there is waaaaay more to the story if this is an issue.
2. A chromosome test (karotype) for both me and my husband. They will be looking for any translocation issues. If they are present in us, then when our DNA meets, there can be complications in forming a complete package that works right. Apparently this is correctable in an embryo if the lab people know where to look for the translocation. This sounds very complicated. Not to mention expensive.
3. An x-ray of my tubes. My doctor here never re-checked my tubes after the surgery for my ectopic. It’s possible that in healing, the tube could have closed at the top which is where the incision was made. Studies are showing that the success rates for IVF in women who have closed tubes is lower than in women who have open tubes. So strange. I assumed that because the tubes aren’t used in IVF that they were an non-issue. Apparently not.
If any of you have done these tests (2 seems to be the one more foreign in concept to me) please let me know!
I am sure that we can do these tests here in Oregon. However, we feel very strongly that going to CCRM for these tests along with the whole battery of other tests that they do during the one-day workup will be beneficial. It gets everything done in one fell swoop by people that CCRM trusts.
CCRM will do the following tests: baseline ultrasound/dopplers, hysteroscopy, communicable disease screening, semen analysis and antisperm antibodies culture, sperm chromatin assay, Beta-3 integrin and PCOS labs.
After that we will likely do a full IVF cycle with CCRM. This is in part due to the desire to have more than 1 child. We have frozen embryos here but finding out if there are any RPL warning signs coupled with the chromosomal screening of our embryos will give us some insight as to how these snow babies will do down the road. Good news/bad news… our embryos here were not created using ICSI (this is where they inject the sperm into the egg) so they cannot test the chromosomal make up of the embryo because all the spermies that didn’t make it in, are hanging out on the outside so it’s hard to tell what’s what when it comes down to that testing.
Overall, we feel good about the consult. Now I wait for my period to start, have a full natural cycle and then call them on CD1 to get in for the workup sometime between CD4 and 12. The problem is that my cycle is unpredictable so we will be doing the last-minute thing to Denver. This isn’t that big of a deal, it’s just not as cost effective as I’d like.
So… now we wait.
Hope you all are doing well!