Now with that all said, I am feeling much better today. Last night was the first night of restful sleep I've had in a week which I really needed. I didn't wake up this morning feeling weighed down. I did wake up with some pretty intense cramping and some spotting, but my guess is that my period is soon on its way. I think I am ready for it. It will be the final nail in the coffin - my body telling me it's moved on. My hCG was down to 14 on Thurs. I consider myself lucky that it dropped on its own.
On Friday we had a consultation with a new doctor. Last week we learned that our first RE just wasn't paying attention. She didn't even bother to call me herself during last week's "events." Not a, I'm sorry, here's maybe what went wrong or here's what we may do differently next time. Maybe that's not standard protocol but it's not acceptable to me. It's also not acceptable to me that, after reviewing my records from her, she sent us on our merry way after our last u/s without bothering to mention the fact that my lining of 6.1mm might be an issue. Instead she just told her nurse to send me home with a couple estrogen patches and call it a cycle. I know better now.
So we went to a new doctor and we are going to start seeing him instead. Here's what we learned from him:
- The first RE told me she didn't think I would respond to Clomid. I never asked her why. She just said we needed to do gonad. inj's right out the gate. According to the new doctor, yes, the chances of conceiving w/ inj's vs Clomid is slightly higher, but by slightly he means about 2%. Call me crazy but I don't think the $1,300/month difference between the inj's and Clomid justifies that 2%. So for the next cycle I'll be on Clomid instead. We'll see how I do. I am certainly willing to give it a try.
- He also said that had he seen my uterine lining was that thin so far into the cycle, he would have just cancelled the cycle. He said there was "no way" I could have sustained a pregnancy with a lining that thin. I told him she put me on the patch the day I triggered but he said I would've needed to have it on about 2 weeks earlier for my lining to thicken in time. I'm sure now that my lining was to blame for this miscarriage b/c as soon as I took off the patch and stopped the progesterone my hCG dropped right away. So next time I will wear the patch or do a Viagra suppository much earlier on. Interestingly, Viagra is used to address thin uterine linings b/c just in the way it works to enhance blood flow to the penis in men, apparently it does the same to the uterus in women.
- Before we start more treatments, he is going to run some tests. I'd always wondered in the back of my mind if I needed more diagnostics so I am all for it. He's going to check my AMH first and foremost. That'll test my ovarian reserve to make sure I'm not coming up short. My response to the drugs has been ok but he wants to rule it out completely before we go any further. He's going to check my insulin and blood glucose levels to rule out any insulin resistance. This is b/c I have PCOS variance, (my 1st RE gave me the same diagnosis). What's odd though is that unlike most PCOS patients, I am not very sensitive to the drugs. I have responded with at least one mature follicle each cycle, but most PCOS patients will have much more than that. And third, he's going to do a hysteroscopy to check out my uterus to see if there's anything in there that's not allowing my lining to grow like it should. He said my estrogen levels have been ok - good enough that I should have an adequate lining. But that's not the case so he wants to do some more investigating there.
- So once these tests are done, and if everything comes back normal, we'll proceed w/ the Clomid plan. I think I'm going to have the tests done in June, and then if we can, we'll start our next cycle w/ him in July.
It helps to have a plan and some answers, and it helps to feel like we have someone who is going to pay attention. It's given me a little bit of hope again. I am trying to think of this as a new beginning.
While I was in church this morning, flipping through the Bible, I just happened to open to John 16: 17-33. It's the "ask and you shall receive" message. He uses a woman in childbirth going through agony only to have it replaced by pure joy with the birth of her baby analogy. Jesus says, "Now is your time of grief, but I will see you again and you will rejoice, and no one will take away your joy." I read those verses over and over, realizing that I didn't randomly flip to that page in my Bible. All week I cried and prayed and begged to God to show me something, anything to let me know that's He's here, that He's listening.
I think He showed me.