Thursday, December 2, 2010

Grand plans

I met with this RE in India who came up with an interesting potential cause for my losses: PCOS that was affecting egg quality.  My regular RE had thought my ovaries looked slightly polycystic (~17 antral follicles in each ovary), and he had checked DHEAS and testosterone. DHEAS was in PCOS range (over 200) but testosterone was low, so the PCOS diagnosis had fallen by the wayside. This new guy now wants to recheck antral follicles and also LH and AMH (both of which are elevated in PCOS, and have never been examined in my case).  This offers a possible answer and the fix would be metformin both before and during pregnancy.

I know that there is still a higher than normal risk for miscarriage with the next pregnancy. This is, after all, only an emperical treatment. On suggesting gestational surrogacy, he flatly refused. He told me by all accounts, that I had a healthy uterus, and using surrogates just because I could would be premature and wrong at this point. In all fairness, I have to agree with him. But, I'm not ready to face the prospect of another short lived pregnancy and loss, while back in the States and alone.  I need a good support system and I can get this only if I  a) magically find Mr. Right and get hitched or b) come back to India and try here while being with family. All in all, I've reached the end of my tether as far as going-it-alone is concerned.

Setting the stage for short term return to India will take one year.  I'm willing to put off babymaking for that long. I''ll be only 32 at that point, and by all indicators, would have plenty of eggs left. The only real hurry has always been in my own head. To stay sane, I need plans with contingencies upon contingencies, so here goes.

The Plan 

1)Check genetics (mine and babies) and run every RPL test under the sun. If all is normal, then do nothing for 1 year. Enjoy life and return to the the person I used to be before pregnancy loss.

2) Return to India, start TTCing with unmedicated IUIs after 3 months on metformin.

3) If a loss occurs, then do IVF using 2 different donors ( including my original, who I just don't want to give up on yet) and THEN (with  this RE's blessing),  go to gestational surrogates. This is the part which can be repeated again and again, if need be. 3 losses would be when I'd stop using myself a s a guinea pig, its just too much. With surrogates and a shitload of dough though, its a different thing. I'm really lucky to have these options,.

4) If multiple tries here fail too, then that implies the issue is genetic and with my eggs.  At this point, go to donor embryos and use my body to carry them (hoping that all parts are still functional at the end of this and the issue was never with my uterus in the first place)

5) if this fails too-adoption in India. 

I can deal with the prospect of short-lived pregnancies and more losses, but I need to choose my battleground wisely. Having lived through the last few days mostly easily, I know being at home will do it.  But importantly, finding real peace requires preparing myself  for the final 2 options which involve letting go of a biological child. Once I become ok with this concept (its going to take work) then who cares how long it takes to get there? Life is making me work for a child, I have faith that it has something good (even if its not what I originally envisaged) waiting for me.


  1. I don't know about pearls of wisdom but some of this sounds like what I was told after my miscarriage. My RE said he felt I may be slightly polycystic & that may have affected my egg quality. He put me on Metformin right antral follicle count went way down...I was worried but my RE said he was more confident about the quality...and, well, you know the rest...

    It's good you have a plan & back up always, I am awed by your strength.

  2. I certainly think it was so wise of you to get a second opinion as another RE can provide a fresh perspective based on his/her individual experience with patients.

    You have formulated great contingency plans. I personally think that having fall back plans really helps me find balance and move away from the "all or nothing" mentality which can be really emotionally draining. I think it lends itself to a rigidity of a redwood tree which breaks in a harsh wind storm.

    "The willow submits to the wind and prospers until one day it is many willows - a wall against the wind." - Frank Herbert

    I think trying to be flexible in one's plans helps position one to be a place that allows one to overcome any potential challenges.

  3. Hi Jay, I'm glad that this RE wants to rule out PCOS.. the AMH will be important. Did the RE in SD explain why your DHEA value was high?

    I hope you are doing well.

  4. @ Tiara, that is useful to know. What was your metformin dose and did you continue during pregnancy? Did you ever get blood sugar levels checked? I just did mine and my fasting is 85- I have no diabetes, apparently.

    @ Babychase, everybody forgot about PCOS because testosterone was so low, I wish my RE there had checked AMH and LH, but hindsight is always 20/20.

  5. Thanks for the lovely comment on my blog!

    I have to say I really love your last paragraph: "I have faith that it has something good...(is)waiting for me." Such a wonderful thought, and a very difficult perspective to keep - so, well done.

    I don't have any advice a this point, but I certainly do wish you the best.

  6. I have no pearls of wisdom, but I am glad to hear that this RE is looking into other possibilities. Sometimes having someone willing to really look for more helps so much...