TXan

Tummy - so sorry to hear about your ectopic. So strange you felt there was a high chance of it happening. I'm sorry it ended up being true, but glad to hear the procedure went well.

Hi to everyone else! So many posts these last couple of days!

Well, I did have my second opinion this AM. What an AMAZING appointment, and a real eye-opener. I'll try to spare you some of the gorey details but we discussed my hypothalamic pituitary disfunction (I essentially don't make FSH and LH, thus why Provera or Clomid won't work on me and why I DO NEED gonadatrophic therapy, but MENAPUR is what is the best for me) and essentially my uterus is completely "shut down" due to me having hardly any amount of estrogen floating around as well as being on the pill for 15+ years. He took one look at my IVF charts, and was flored that they proceeded with my endomtrium lining at 5.2 mm and under (4.7 mm my last time). Obviously something is wrong, since I had over 2000 level of estrogen with such a thin lining. Also, because I overstimmed every time (even though side effects not bad the last time), he cited studies that show this leads to chromosonal fractures, thus my relatively poor embyro quality. He did say for my age I did resond well, so that is promising in that department.

He is pretty "old school" and wants to get to the core of my issue, which involves different protocols and monitoring - probably a 10 week process. After a couple of hours discussion and evaluation, I have decided to go with for treatment to get my uterus back in shape. It will not be an overnight process, since I will be starting a cycle brought on by a series of estrogen pills, progesterone suppositories and then vaginal estrogen cream. After this, my uterus should be more receptive to a hysteroscopy and most likely a surgical procedure called "plowing" to help bring back the lining growth. After this surgery, I will get large doses of estrogen for healing, and then go through a mock cycle to see how my body reacts, to be confident I will be ready for a stimulated cycle (with estrogen and low doses of gonadatrophins). He flat out said he wants to look me straight in the eye and tell me that my body is ready, and obviously it was not earlier. At that point down the road, he will perform an HSG to confirm my tubes are clear, so I can either try naturally/with IUI or go back to IVF. I guess I will see how I feel after the mock cycle.

I did ask about acupuncture, and he thinks that is a good idea as well. Not suprisingly, he recommended I get back on Metformin, starting at 500 mg going to 1000 mg. No more needed for my body weight, he said. Since the metabolic process within the ovaries is not well understood, especially with people with PCOS, he said it would not hurt to get back on, to help increase the chance of better egg quality.

I am really glad I went for this second opinion. He confirmed that my condition is not very common for thin women like me (or actually it is not uncommon for a low body fat athlete or someone with anorexia, neither of which I am) so the standard gonadatrophin protocols are not the way to proceed, especially with my uterus "lagging behind."

I'm not sure what my current RE would have recommended, but she obviously was not going down the path of figuring out why my uterus was not as receptive as it should be. If IVF looks like the best thing for me down the road, he said it would be fine as long as my uterus was receptive. Not sure how the referral back and forth goes, but I'll figure it out later.

Sorry for all the detail, but I really got a lot out of the appointment. Maybe with all the wait, Tummy and I will end up having similar timing down the road...

__________________
Me 36
DH 35
2 Furry babies, Wicket and Jack
TTC 11/06
D/X 6/07

TTC #1: 4/07, 1 round Clomid, no response, 1 round Provera, no response
TTC #2: 7/07, injectibles, "natural," hyperstimulation, BFN
TTC #3: 10/07, injectibles, converted to IVF, BFP. Hyperstim, M/C 12/07
TTC #4: 4/08, injectibles, IVF, triggered 4/10/08, BFN