This is the problem with googling when you get home from a doctor's appointment. It just leaves you with more questions. Therefore, I'm stepping away from the computer.
I went to the hematologist today to find out the results from my blood work. I wasn't extremely worried because I spoke to his nurse the day before and she interpreted most of my blood test results for me over the phone and told me that everything looked okay.
The only thing they found was that I tested positive for the MTHFR mutation--a clotting disorder that is treated with folic acid. Because I had been taking 800 mcg of folic acid for the last four years because we were trying to get pregnant, I had unknowingly brought down my homocystine level. The only solid advice that he had was that I should never stop taking the 800 mcg of folic acid, even after we're finished having children.
The hematologist believed he would find a clotting disorder based on the fact that my children were IUGR and my fertility history. But in the end, we are left in this foggy grey zone where there aren't clear-cut answers.
There is nothing to treat. Therefore, there is no better chance this time around of getting pregnant without treatments.
It wasn't that I wanted something to be wrong. I mean, who in their right mind would want to do injections of Lovenox throughout their pregnancy? But you know exactly what I'm thinking right now--a diagnosis in the hand feels like a cure on some level. There is a clear-cut thing you can do to increase your chances of conceiving and carrying to term. Without a diagnosis, you're still just shooting in the dark.
And the reality is that we have a diagnosis. We're female factor with high FSH and low progesterone. But that diagnosis requires treatments to circumvent the problem. And a clotting disorder meant that we could bypass all of that and at least try on our own for a bit to see if I could get pregnant and hold onto the pregnancy without help. With just the daily injections making this pregnancy anything out of the ordinary. It's a weird trade-off to wish: no treatments but daily injections vs. treatments with some prometrium for a few months. I'm not even sure anymore which one seems more desirable. But a clotting disorder would have explained so much and right now, the only thing the hematologist can say for certain is that we've certainly had a run of bad luck.
This is where he left it: the ball is in our court. He believes we probably do have a clotting disorder, but science hasn't caught up with the body and there are possibly 1000 other things in the blood that they just don't have the tests yet to find. Thirty years from now, I may have a new flurry of tests that reveal the reason for the implantation issues and IUGR. But will I even bother to get those tests? My whole reason for doing this now was to increase my chances of having a healthy baby with the greatest ease.
He told me to think about it and gave me two scenarios where I may want to do the Lovenox anyway. Either I become pregnant on my own and want to be certain that I'm going to carry to term. Or we go for IVF and we use the Lovenox injections as an insurance policy to protect a $10,000 investment. Either way, the Lovenox injections are used widely and have few drawbacks overall. It may be worth trying just for the sake of trying if it gives us peace-of-mind. Though that's a mighty painful peace-of-mind for a chickie who is scared of needles. But it's his offer since we're stuck in this grey zone with an obvious problem on our hands and no way to diagnosis it.
I had the blood work done because I wanted to be thorough and follow the advice of the OB after my children were born IUGR. And because we need to make some hard decisions that are entirely based on finances that weren't there the first time around. If you could only do IVF or adoption, which would you choose? It seems like a no-brainer: you'd choose adoption because adoption has a real baby at the end of the journey. And IVF could have a real baby or we could have no baby and a bunch of bills. But then I started thinking all sorts of selfish thoughts that led me towards the siren song of the catheter (almost as powerful as the pee stick) and the fertility clinic. We want to do IVF if there is a good chance that IVF will work on the first try--and by "work" we mean embryo implants, hangs on for 9 months, and the baby comes out at full term at an average weight. The decision gets muddled when you take into account that we've already had an IUGR baby and your chance of it occurring again increases.
And the way I'm dealing with this muddled decision beyond playing google med student for a few minutes tonight? But not making any decision. By folding up the blood work results and stuffing them into the lower drawer of my nighttable. And not thinking about it for the months we said we'd try on our own anyway. Because there doesn't seem to be a good reason to think about it now that there isn't a clear decision to make.
How is that for pulling an ostrich?