I don't know what to do.. help

[achi]

I have my follow up with my OB tomorrow to discuss his plan for further testing and I'm considering asking about a referral to a local fertility clinic/RE and I'm really struggling with what to do. Here's where I'm at....

I've made a big ass list of testing to ask about, but I'm not even sure if I want to put myself through this all right now. I'm struggling big time with the idea of going through another pregnancy and potential loss. Each one has taken more and more of a mental toll on me. If I find out that it's a minor issue and easy to correct am I'm scared it's going to be the proverbial dangling carrot and I'm going to want to try again, but I honestly don't know that I can take another loss at this point.

We can't afford IVF so if we go through the testing and find out that the losses are because of some kind of genetic mismatch and that it's our only option I'm afraid I'm going to be totally heartbroken and so angry. 

I don't have my first appointment with my new therapist until the first week of September so in all likelihood I could hold off on testing until after I see her and can start to work through things. 

I guess what I'm asking is for those who have been in this place of not knowing whether to keep going down the TTC road, how did you decide one way or the other?

[joenali]

I hear you! We went through all of the tests! I just wanted to know. My RE said most diagnostic testing should be covered by insurance. But I think one test was not, because it’s a test routinely used for fertility.

Anyway, you should also do genetic testing for you and DH. That right there can rule out possible genetic disorders. That’s just a standard blood draw. It may or may not be covered by insurance. I think ours was. Or maybe mine was and Dh’s wasn’t.

The tests I had were: genetic testing, hysteroscopy, hysterosalpingogram (sp?), transvaginal ultrasounds, and I think that’s it. Basically I have unexplained infertility and in my gut I know I’m dealing with geriatric eggs. We’ll find out more about that this week.

IVF is not affordable and should absolutely be covered by insurance. You can always ask your RE if they are song any IVF studies. They were conducting one during my cycle but I didn’t qualify. And you could always finance your IVF. Which I could not do, it’s just such a crap shoot. I feel incredibly fortunate that we were able to get financial help from both of our parents. In fact, that alone makes me feel like I wasted everyone’s money since nothing went right.

ETA: I don’t know when to say when. Every day I could tell you a different answer! I saw my cousin’s 4 month old yesterday and almost melted. So squishy and smiley! Last week on our vacation I kept thinking, ok, we could go on more vacations. I can deal with this! I’m also going to be 42 next month. I’m old. But then I see friends from high school still popping out babies! Lol! But then then I also see friend from high school already becoming grandparents! 😳😳😳😳 Ughhh! I wish I had the answers!

it’s such an emotional ride.

[achi]

It IS such an emotional ride. It's god awful.

I'm not worried about the financial aspects of the testing, I'm Canadian and our provincial health care covers basically all the testing I've got on my list (sometimes one or two pieces of bloodwork aren't, but they're never super expensive. The most I've paid was $70 for AMH).

My province does cover one IVF cycle for women under 43 but the meds and things like genetic testing on the embryos aren't covered. The meds are around $5k/cycle which I KNOW is so much less than the full cost of an IVF cycle, but is still something I'm not prepared to pay for something without a guarantee of working. Also, if you go through the retrieval and don't end up with any embryos then you're out of luck and that's still considered your funded cycle.

My plan was to ask for genetic testing for H and I, a hysteroscopy, full repeat loss panel, clotting factors, lupus anti-coagulants, and sperm DNA analysis for H (he had a good SA, but that doesn't actually look at the genetic makeup of the sperm). I've also looked into natural killer cells but I don't know if that's TTC woo woo or not. I would like to know what the guidelines are for a uterine biopsy, laparoscopy to look for silent endometriosis, and an MRI to make sure I'm not dealing with a uterine septum or some other malformation.

What is a hysterosalpingogram (sp?)

[vmars]

I would probably ask for the referral and meet with the RE. Then once I got the scripts to do the testing, I would wait to do it until I felt comfortable. Here most scripts are good for 6 months. You may not need IVF so I would not worry just yet until a doctor tells you it’s your best shot.

[pinkpeony08]

I’m so sorry. Yes, it is so hard. I’ve been through 4 consecutive losses without any answers until I recently went to reproductive immunology. I have also been petrified of another pregnancy and subsequent loss, knowing that it has only gotten harder each time. Certainly gathering more information is helpful and doesn’t mean you have to try again or not try again. I found having no answers made it harder and trying to get an answer was helpful to me, though everyone is different. For us, there was quite a wait to get into re so it might make sense to get something on the calendar that you could always cancel if you didn’t want later.

I would just allow yourself to grieve and not worry about what you will do next. You don’t have to decide right now. It’s ok to just let yourself be sad.

[joenali]

achi a hysterosalpigigram tests potential blockages in your Fallopian tubes.

[achi]

Aug 19, 2019 13:11:20 GMT -5 joenali said:

achi a hysterosalpigigram tests potential blockages in your Fallopian tubes.

Ok, thank you for the info. I had a saline sono when I started seeing my OB, but it was not ordered to look at my tubes since getting pregnant is not my issue. 

[ilovecandy]

I think if you are struggling it is okay to pause until you are ready to resume testing.

My h and I did pretty much all the testing. It came up as unexplained initially. Then a new re suggested a laproscopy which showed endometriosis. Now I think I have a low ovarian reserve. But we took many many breaks some forced because of h's work and some just because I wasn't ready.

You do what you need to for your own mental health.

[shauni27]

I really do not "go here" anymore, but I wanted to chime in and offer support. I remember being in your shoes after a tough loss and then what I thought was 2 failed IVF rounds. It was so hard, we could not afford more, but I also had the same "dangling the carrot" mentality as you.

After our loss I wanted as much information as possible and did further testing that came up with a new diagnosis for me. It was really helpful and that is how we came up with the plan to do IVF. We originally said we could not afford it, but the team we met with gave us various options. It WAS expensive, and we are still, nearly 3 years later, paying it off--which is a very big financial burden for us, so I know it is not an option for a lot of people.

I mostly just wanted to offer you, internet stranger struggling with IF and multiple losses, love and support. It is such a personal and tough decision to make, and there is no right answer. I send you peace with whatever decision you make or whatever steps you go forward with.

[achi]

Thank you for all your support ladies, it really means a lot.

H and I had a long talk last night and I decided I want the testing now, and will deal with the results and what they might mean as they come in. I saw my OB this morning and he's putting H and I on a 10 day course of tetracycline antibiotic. He's ordered DNA karyotyping for both of us, anticardiolipin antibody and antiphospholipid antibody testing for me. A lot of what is done in an RPL has been done already, but he is repeating FSH since it was a little on the low side, and my A1C now that I've been on metformin for awhile. The saline sono I had was done through a fertility clinic and showed a totally normal cavity (no scarring, thickening, fibroids, septum, etc.) so he doesn't feel any further imaging is warranted at this point.

We discussed the option of going to an RE, but since the karyotyping results will take 3 months to come in (yay Canada, free healthcare is sometimes very slow) it gives me time to grieve/process and decide if I want to venture down the TTC road again. If he sends me to an RE now, I could be waiting awhile to get in and then I'd have to pay clinic fees just to have the karyotyping done so I think logistically and financially it makes more sense to go this route and then he can send results over to an RE if I decide I want the referral.

My HCG is back down to <1 now so at least everything associated with this loss is now over and I can start to work on putting it behind me.