RE Appointment: “Are you going to try again?”

I had an appointment with my Reproductive Endocrinologist yesterday. It was mostly just a yearly check-up as he manages my hormones and monitors a few blood levels. Because I travel two hours away to my RE and my in-laws who live nearby were meeting me to help with and visit with Leland, the appointment sparked questions throughout our families of "are you going to try again?"

I’m not sure if I have made the right decision to be so forthcoming, but I have been honestly answering this question lately. The truth is....we are going to try again next year. This decision comes with a lot of emotion, both excitement and stress. And there is a lot of planning and preparation to be done. We plan to adopt embryo again through the NEDC and because we thawed all five embryos we adopted we will have to be matched again.

Robert’s mother got almost giddy when I admitted this to her. I then reminded her that even best case scenario, we are two years out from actually having another child. But I guess it’s nice to have someone who is just purely excited, not blinded by the cost and the possible risk.

Leland is front of the fertility clinic sign. He really is a miracle!

So, back to the visit with my RE:

1. He took a look at the blood work my primary care doctor had run at my physical and the only other test he wanted to run is my cortisol levels. Does anyone else’s RE / doctor monitor this?

2. He did an ultrasound. My lining is 9.4mm - having used 2mg / day of unopposed (no progesterone) estrogen for four months straight. This is a good thing for uterine health while I stay on this hormone regiment to promote breast feeding. This did not feel very encouraging in that I had trouble thickening my lining for our mock transfer and for our FET. My RE reassured me that on the FET protocol my lining will respond better next time having carried a pregnancy and having taken so much estrogen in the interim. Here’s hoping he is right!

3. My RE confirmed that I don’t have to have a gynecologist. My amazing perinatologist had agreed to keep me on for routine gynecological care. But then last Fall he accepted a faculty position teaching at Stanford Medical School. I had hoped to continue my gynecological care with the doctor who took over his practice, but when I called a few weeks ago to schedule the appointment I was told she did not do that. Considering my history with OB/GYNs, this induced an emotional melt down that I am still not fully recovered from. After much though I decided that I could avoid the trauma of a bad OB/GYN by avoiding the OB/GYN altogether. And my RE agrees that this is fine so long as my primary care doctor is willing to perform my Pap Smears (and she is!). Problem averted.

4. I asked my RE about testing my Vitamin D levels. He agreed that this is something that MUST be tested ....by someone else (my primary doctor or endocrinologist). I love my RE, but he frequently plays the "not it" game, limiting the scope of his care for me to the essentials.

5. I asked my RE about the new perinatologist who took over. What he thought of her, would I need to meet with her before I was pregnant again, etc? And I discovered that she is not in private practice on her own like my old perinatologist, she is actually part of a larger practice group associated with the local medical college. Basically, my RE is her boss. And he would be happy to have me as a patient in the high-risk pregnancy (perinatology) practice. I still think I want to meet with her at least once to be sure I am comfortable with her.

I think that sums it up. Some questions answered and some new things to look into, but a good visit overall. And you get a gold star if you are actually still reading at this point!