My Story - Part 3

Pregnancy #4
The next pregnancy was in June of 2005. Feeling very encouraged about having fixed a problem, we were on cloud nine. We were a little nervous, of course, but we felt like this would be The One. My first blood tests looked great – HCG was high and progesterone was good. It was time for what had become for us the dreaded first ultrasound. The ultrasound showed only a gestational sac but we weren’t too terribly worried just yet, especially with the good blood tests. The worst part of the visit was when we discovered that our beloved doctor had moved away since our last visit! We were very sad and to make things worse, we REALLY disliked the other doctor at that office. The new doctor totally squashed our hopes when she said she thought the numbers were too high and the sac looked too large. Even though I loathed her bedside manner, I was sure she was a skilled doctor, so we tried to keep ourselves level-headed and just hear all the facts. We had blood drawn again and a few days later heard that the numbers still looked great. We were so confused.
Now we were dealing with a new problem – finding a new doctor. Not because she gave us bad news, but because our personalities just didn’t click. At all. We had another ultrasound at that office with the hopes of seeing a yolk sac – and we did! But Dr. Doom stepped in and again said not to get our hopes up. She said to come back in two weeks and then we should know for sure. Two weeks later, it was the best ultrasound we’d ever had. The baby measured at a little over 8 weeks and we could see a heartbeat and even tiny little leg buds on the body. The doc had to admit that the baby looked great! We breathed a huge sigh of relief but were still thinking we wanted to change doctors.
After some investigating we found out that our other doctor had simply moved to another practice in the city. We gave her a call and she kindly invited us to visit her at the new office. About a week later we went to see her and she did another ultrasound. I remember it was the toughest day of our whole infertility experience at that time. The baby had grown to 9 weeks but the heart was no longer beating. No one knew why. We had no clue that something had gone wrong. We were devastated. A few days later we had one more ultrasound to be certain that there was no change. It was definitely over, so we scheduled another D&C for July 22, 2005. We felt we were back at square one.
The next few months were filled with more doctors: a high-risk pregnancy doctor, a genetic counselor, our fertility specialist, and even a urologist (to check my husband’s sperm for fragmentation – that didn’t pan out). It was really disheartening to see that our specialist was just about as stumped as we were.
I have to admit at this point that I was very, very frustrated. It made me angry that we had thus far tried everything the doctors could think of and we were continually given the advice, “Try again and see what happens.” That’s extremely hard to hear. I want to keep trying to have a full-term pregnancy, sure, but as I keep trying we keep losing one baby after another. That’s just not ok with me. We are very serious about being cautious and wise about these decisions. We refused to try unless we had made some change that hopefully would work. We’ve never had an “accidental” pregnancy. It’s always very well thought out and planned according to our treatment. When we don’t want to get pregnant, we use protection. Along the way we’ve never been told by a doctor that this just will never work out.

Pregnancy #5
After another full year of tests and doctors and with a new plan we attempted another pregnancy. It came along in July of 2006. I had previously been diagnosed with the MTHFR mutation and had been on extra folic acid along with baby aspirin for years. But the high-risk pregnancy doctor I started seeing suggested that we have tests to check for any blood clotting disorders. After reviewing the tests he thought it was possible that, although my homocysteine level was not unusual, I may have problems related to Thrombophilia, and thought that using the blood thinner Lovenox during pregnancy might help me. I immediately started using the Lovenox injections in my stomach when I found out I was pregnant. It wasn’t a pleasant thing to do every night, but I felt if it worked that it was a small price to pay.
Unfortunately it didn’t seem to help anything. I woke up the morning of August 8 feeling crampy and I had started bleeding. I had blood work just to verify that the numbers were dropping and that was miscarriage #5. It was over pretty quickly as I was just a few weeks along, and I did not have a D&C.

Pregnancy #6
This was my last pregnancy to date and it began in November, 2006. It was really more of the same with the doctors, blood work, and Lovenox injections. The HCG and progesterone levels looked good but the ultrasounds never did. We had a lot of them and although we did see some progression of the gestational sac and yolk sac, we never did see any growth of the baby. After 2 weeks had passed and we could still see no development, we knew that once again it wasn’t going to happen. I had a D&C later that January of 2007, just a few days before my 30th birthday.
That last pregnancy did bring about a few more changes. After a few visits with our trusted specialist where the three of us basically looked at each other and shrugged our shoulders, we realized that maybe it was time to move on. We have no hard feelings toward her but it was just time. I think she was truly out of ideas. We decided to seek out a different doctor. We felt like we had exhausted all of our options locally and decided to find another fertility specialist downtown. We began seeing him in July of 2007 and he has scheduled many tests and a couple of surgeries over the past year.
Here’s a quick rundown:
August 2007: Hysterosalpingogram (HSG) test – another dye test to check that my fallopian tubes are open and to look at the uterus by x-ray.

October 2007: Endometrial Function Test (EFT) – basically a biopsy of cells from the uterine lining. http://www.med.yale.edu/obgyn/kliman/resources/AIA%20vF.pdf
Those samples along with some of the tissue samples from past miscarriages were sent to a doctor at Yale University. The biopsy showed Glandular Developmental Arrest (GDA) but the overall diagnosis did not identify one problem that could be linked to all of my miscarriages. It was a little like getting punched in the stomach. Instead of one problem, we likely have several problems that contribute to recurrent miscarriage. (From what I understand, GDA is a problem where at certain stages of your cycle, the glands in the uterine lining cease to go through their normal changes or development.)

January 2008: Laparoscopy – Our new doctor wanted to do an exploratory laparoscopy. I could understand why. We had transferred hundreds of pages of our medical records to his office with tons of tests and some previous surgeries, all done by other doctors. His main areas of concern were the shape and condition of my uterus after the septum surgery, and the possibility that I may have developed any scar tissue or endometriosis. It did seem like a big deal for me to have yet another surgery just for a big “maybe,” but at the same time I knew that it could help. I was glad after it was over and we got the report. The doctor was able to use a laser to clean up the scar tissue that had formed where the septum had been (basically creating another septum although smaller) and he did in fact find and also clean up some endometriosis. That was a first for me. I had never been diagnosed with it before, but I do know that it can appear later even if it didn’t exist before. The doc definitely seemed pleased that we’d gone ahead with the surgery.