What’s next

We had our follow up appointment today. They have been discussing our case at their clinic conference. Apparently we are interesting, but one thing I have learned in medicine is you never want to be the interesting patient. We talked about the different things that could be going on. We don’t have many of the usual causes of recurrent pregnancy losses: PCOS, poor ovarian reserve, polyps. So now we look for the less common causes: blood clotting disorders (anti phospholipid antibody syndrome = APLS) or chromosomal abnormalities. For the APLS, I have to have some blood work done in about a month (if you do the tests too close after pregnancy you can get a false positive). If that comes back positive, I will take heparin if I get another +HPT. I’m also going to ask about getting thyroid antibody testing. Some studies show an association of anti-thyroid antibodies and miscarriage. If it is positive, then I will take an aspirin with the next cycle.

There are a couple of different approaches to the chromosome issues. One, is preimplantation genetic screening, which I mentioned in the last post. The other, which is what we are doing, is karyotyping of the potential parents. We are looking for a balanced translocation. This is where part of one chromosome breaks off and joins another chromosome:

In this case, every cell has all the genetic information it needs. It’s just on different chromosomes. But when the cell divides to make eggs or sperm, sometimes the chromosomes get separated and the resulting egg or sperm has too much or too little genetic information. This can make it impossible for the resulting embryo to grow and divide normally. We are getting our karyotypes done to see if one of us has a balanced translocation. If we do, we have to decide if we want to do genetic screening specifically for this abnormality.

We should have the results back in a few weeks. But in the meantime, I’m trying to get my head clear. I’m going back to acupuncture (which my doctor actually recommended–there are studies that show higher success rates for IVF when you do acupuncture). I’m going to start yoga for fertility. And assuming my doctor thinks it is ok, I’m going to start running again. There’s conflicting information on running and fertility. I really want to start exercising again, but I’m also willing to put it on hold for awhile if that’s what it takes to have our baby.

For now, we probably won’t do another cycle until April. It’s hard for me to step back and accept that in the greater scheme of things, four months isn’t that long. But when everyone you know is getting pregnant, watching their babies grow, seeing their little ones talking, learning, playing. It’s so so hard, but we will get there. One way or another. Sooner or later. This will happen.

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