Yesterday, Mr.A and I went to meet with our new RE. I always get so nervous before appointments like this, where I feel as though the outcome of the appointment could determine the rest of our lives. First we met with a young medical student who went through my records from Dr.K, my bloodwork, loss, diagnosis of MTHFR etc. She was pretty knowledgeable and very personable. If she becomes a RE, she will do well. She left, then returned with Dr.S, a nationally recognized infertility specialist.
Dr.S went through Mr.A's medical history, and ordered him to get a S/A before we begin treatment in two short weeks.
Dr.S was patient with me as I asked my one million and one questions. She was very knowledgeable on MTHFR and stated that my particular gene mutation is the one where having extra folate was critical. She also wanted to run some bloodwork to check my homocysteine levels which can rise if your folic acid intake is not enough. A pregnant mother with MTHFR and increased homocystein levels is much more likely to have a child with neural/tubal defects; which we are trying to avoid. In addition, Dr.S said that recent research has shown a correlation between a mother taking asprin prior to ovulation and infertility. After I was diagnosed with MTHFR, I was told to take one baby asprin daily to aid with conception. Dr.S asked that I only take it now after I have confirmed ovulation.
Next, we discussed my low progesterone levels when I was pregnant before. She told me that as soon as I get a +HPT, to begin progesterone immediately. Since I was on CD20, she ordered a blood draw to check progesterone. I had a voicemail this afternoon, she didn't leave results but asked me to return their call. By the time I listened to their voicemail they had already closed for the day.
Finally, we discussed our path forward and costs. Beginning next cycle, we will begin monitoring and introduce an HCG trigger shot to force ovulation. The trigger will only be around $75, but if the ultrasounds are not covered by my insurance (may or may not depending on how they are billed), they will be nearly $300 each. After trying this route for a few months, we will move onto IUIs will will be a little more expensive each cycle.
Overall, the appointment went really well and we are excited to move forward. We just hope that with our insane travel schedules, everything works out and I am able to get pregnant.
Amberley,
ReplyDeleteYou mention that your doctor would like you to take more folate. You might want to ask her about L-methylfolate which is found in the prenatal, NeevoDHA. Because you have the MTHFR polymorphism you have a limited ability to break down folic acid (the folate found in most prenatal vitamins). NeevoDHA contains L-methylfolate which is 7 times more bioavailable than folic acid. L-methylfolate increases folate levels and decreases homocysteine levels more effectively than folic acid. I wish you the best of luck with trying to conceive.