Sam and I decided to go to the Utah Fertility Clinic and meet with Dr. Shawn Gurtcheff to discuss more options for our case. We filled out a novel sized packet of new patient information and brought our medical records with us to be reviewed. When we sat down to speak with Dr. Gurtcheff she informed me almost right off the bat that she did not think I had perimenopause or that my problem was just that I had a small reserve of eggs left. She said that it was more likely that I had Primary Ovarian Insufficiency or Failure (POF). She said it is very rare and only effects about 1% of women within reproductive age. The most common cause of POF is chemotherapy, it can also be caused by an autoimmune disorder or a genetic disorder. Since I've not had chemo the last two are the options we are looking into but often women with POF do not ever find out why they have it. She said that she thought the IUI would not be effective in our case and that we needed to do something more aggressive. She said that what we would try to do is bump up my medication to 4x the amount that I did for the IUI. If I produce at least 4 to 6 eggs then we could discuss if we felt the next step would be to trigger ovulation and try to conceive on our own or to do a round of IVF. She then did an ultrasound and said that things looked better then she was expecting as my body was already working on growing 6 eggs on its own.
She ordered a boat load of tests! Tests we thought seemed pretty vital to our treatment so it just made us feel more confident with our decision to find a different doctor. They took blood until I had nothing left to give in order to do the genetic makeup to see if I have any recessive genes that might be harmful or Fragile X which is one of the genetic causes of POF. I was pretty nervous having had good and bad experiences with giving blood over the past few years. But she was really good and as long as I didn't look the 10 or 15 minutes it took to fill the vials went by pretty quickly. I told her I wasn't going to look at her but was going to Facebook instead. She didn't seem to mind. The other test she ordered was an HSG test. Anyone had one before? It stands for Hysterosalpingogram, it's where they inject dye into your uterus to see if your Fallopian tubes are open. I had read about this on a forum and people had mixed reactions to the test. Some people didn't handle it well and others said it was uncomfortable but they were okay.... I was not comfortable with the mixed bag of reactions... I went into the clinic a few days after our consultation and did the HSG test. Lucky for me I was fine. I didn't have a bad reaction and nothing but mild cramping for the next few days but I did find out that my uterus and cervix are off to the left and shaped like a curving drain pipe. Want to see a picture?? Well I tried to edit one to make sense and it just ended up looking more like a picture of a creepy alien so I decided to hold back. Best news of all was that the tubes are open!! One less hurdle. This means we can discuss the option of not doing a round of IVF because the eggs should release on their own.
Our next hurdle will be our genetic testing. We get the results next week. I think the worst case scenario would be that I have Fragile X. This is where my X chromosome has a really long tail. If it gets too long in women it can manifest as POF, but in boys it can cause retardation. If I have fragile X then it would take my eggs out of the running completely. If I don't have fragile X and there are not any major repercussions to our children then we can discuss starting the meds. She also mentioned that the lab was closed for part of December due to the holidays so we might have to wait until the new year to get started.
Dr. Gurtcheff mentioned that with this course of treatment, if all the variables work out, we stand a 20% chance of conceiving with my eggs. We stand a 70% chance of conceiving using a donor. I've done more research now and have looked into other stories of people that did use a donor egg and I am starting to feel more comfortable. These people seemed happy and I didn't sense any of them had a disconnect from their children because they were created with someone else's DNA. We are more seriously considering this as an option but not until after we feel we have exhausted our own chances. If we can't use my eggs the sense of urgency will be removed from the equation all together.
Even though the diagnosis wasn't great and we might have to resort to the same suggestion that the first doctor gave us, it was so relieving to know we had a doctor that understood us and what was happening and to have a game plan that made sense for us. I wont have any more updates until our appointment next week and trust me the wait is driving me crazy!!! But until then I'll try not to think about it because if I've learned anything it's that things can change. Wish us luck in practicing patience and flexibility.
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