and I still don't know

We had our follow-up with our doctor today. We still haven’t resolved everything. I think he is frustrated and truly disappointed; I know we are.

He sat down and basically said the cycle really couldn’t have gone better, that he was both surprised and disappointed that it didn’t work. He agreed that we should use the insurance coverage for everything it’s worth and do a fresh cycle and attempt to bank as many embryos as possible.

He listened to me about the laminaria placement, and, as he has said before, he is not a huge fan of the laminaria placement, and all of the things I described are not positive things. He emailed the doctors and the head embryologist at that famous Colorado clinic as we sat there asking them their opinion and current protocol for laminaria placements. He said he would forward me their responses when he received them.

We talked about everything from the mundane (am I too thin? – everyone else’s question) to what the hell do we do about my cervix?

There’s nothing left to test. PGD doesn’t really seem to be the answer. We either chose the wrong embryos to transfer this cycle, or my gut feeling is right about the laminaria placement. Or there are a million things the doctors don’t know about – and one of those is what is wrong.

We talked about probably 5 possibilities for my cervix. I go tomorrow for a trial transfer with a new catheter to see if the laminaria placement has any effect 3 weeks later. If it works, we seriously consider a laminaria placement sometime between the start of Lupron and the start of stims. I think there’s about a 10% possibility it will work.

My doctor would choose going back to what nearly worked a year ago: mechanical dilatation with the metal rods at retrieval and a Day 3 transfer. I’m mostly ok with that.

We talked about one study that involved placement of a catheter through the cervix for 10 days. He really doesn’t care for that approach – he thinks we’d essentially run into the same problem as with the laminaria – excessive cramping and my body working to close that cervix back up.

We talked about the study where they actually surgically modify the cervix by widening the opening. He doesn’t like this idea because of the risk of scar tissue formation actually making passage of the catheter more difficult. Or the possibility of incompetent cervix. He did, while we sat there, call the doctor (at NYU) who was the lead on the study and leave a message to ask if it was something she still does and/or long term outcomes for the patients. Maybe I’ll hear her response tomorrow. I’m not dead set on this, but the idea and her results from the study are so, so tempting.

Basically the decision about the cervix depends on the trial transfer tomorrow. Mr. Hope asked what I want; if I knew, I’d tell you and my doctor. I want it to work. And I’ll do anything and everything my doctor asks of me to make it work.

I asked when he would tell us to give up; he said, “Not yet.”

I wish I could say I know what we’ll do. I wish I could say I think we’ve got the answer. All I know is that I don’t think the laminaria placement is a good idea so close to transfer, and we won’t be doing that again. Of course, I could be wrong. We could just have really bad luck, and maybe the next time would be different. But I don’t have time for that, and I feel like I have to trust my gut on this. Add that to the fact that my doctor really doesn’t like laminaria placements – and I think abandoning it is ok.

All we can do is try again. And somehow hope again.

~ by Larisa on March 23, 2007.

7 Responses to “and I still don't know”

  1. Still holding your hope…

  2. Still holding your hope…

  3. Looking at all the considerations is truly dizzying. I hope your doctor continues to search out new truth and hope for you. I want the odds to go your way. You are truly the best expert of your own experiences; therefore, I am confident the decisions you make will be the best ones for the circumstances in front of you. I am 100% glad you are still fighting.

  4. I have been thinking of you all day yesterday and couldn’t wait to see what your RE and you had come up with. I am so glad you were able to make your feelings clear about the laminaria and at the least cross last cycle’s procedure off the list for good. I think your consult sounds extremely productive. Now you have the best of the best plus all his creme de la creme cronies scanning their databases for the best possible answer. Your resources have expanded, your RE insists it is not appropriate to give up, you are still resiliently hopeful. I think, considering everything, this is an excellent outcome for your meeting. I hope the trial placement today goes well. I’m so sorry you have to have the discomfort of the laminaria again. I hope the simplest, most painless plan evolves at the soonest possible moment. You are doing everything you can. You are doing everything right. Everything.
    I am always hoping for you.

  5. I wish it were easier.

    Today’s appointment must’ve been hugely frustrating. Hang in there.

  6. Don’t give up, Mrs. Hope. I think your doctor is right, as frustrating and saddening as this situation is.

    Good job in representing your thoughts in your meeting with your RE. I sincerely hope that your efforts will pay off soon.

  7. How your hart must sink when you see the doctor scratching his head.
    I wish you much courage.

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