Friday, December 5, 2008

My head is spinning....WWYD????

My head is spinning now. Not sure what to do. When I thought for sure I had a plan I wanted to do…..I have a phone consultation with Dr. Sher founder of SIRM and now I’m so confused!

Dr. Sher started out by going over my history and what he made of my history as he took the time to go through my medical files before speaking to me.

First thing he said is the Micro-Flare Protocol you have been on is the wrong protocol and actually the worse protocol you could ever be on. He said women with Endometriosis like you have similar symptoms to women who have PCOS. He said the Micro-Flare causes too much LH which causes too much testosterone which damages the eggs. He said this is the reason they can be measuring over 20 follicles for you but then only getting 2 to fertilize. He said that the Micro Flare combined with my Endo causes abnormal eggs and the ones that do fertilize are chromosomally abnormal which causes chemical pregnancies or miscarriages. I told him I knew something wasn’t right with my protocol and I thought it was Follistim causing such a horrible response and he said no it was the protocol you were using. He said Follistim is a great drug, but the Bravelle you were on your first cycle is a horrible drug and it shouldn’t be used. He said my previous protocols have not been catered to meet me and my needs. They have been protocols used that worked for others but because I have specific areas of concern like the Stage IV Endo, I need to be on a recipe (protocol) that is catered specifically for me.

He recommends doing a down regulation protocol with me being on long lupron and coasting. He said he sees that my E2 normally skyrockets to the point of overstimming and he would like to utilize coasting with me. He said you have to be experienced with coasting in order for it to work right because if done wrong it too can damage the eggs. He said I would be watched closely and when he got me to the point he wanted me at he would coast me the rest of the way to get the eggs to the size he wanted them.

He said that PGD would NOT help us. He said it’s still a 50/50 chance that we get an abnormal embryo and right now he think our problem is an embryo issue and not so much the endometriosis effecting implantation. He said with PGD you only get 1 chromosome out to test but its 3 others left that could still have issues. He recommends that we get CGH testing done which tests ALL the chromosomes in the embryo to see if all the chromosomes are normal. He said it costs the same as PGD does but is way better because of the results it gives. He said those doing CGH leave with a baby 70% of the time. He said it takes 6-8 weeks to get the results back and the embryos would be frozen during this time. Not like regular embryo freezing but some other method that doesn’t do the damage that normal freezing does. Don’t remember the exact name he used, but he said regular freezing allows damage to the cell because ice get into the cells and degrade the embryo some. This technique they use doesn’t. So after waiting 6-8 weeks for the results I will then go back to Vegas for the transfer. I asked how many he would transfer. He said using CGH you only need to transfer 1 to get 1 baby. I said given our history I would feel better transferring more. He said well if you want twins we can transfer 2. He said but given your history we will look at the normal CGH’d embryos and decide then if its better to transfer 2 or 3.

He also said given the fact that my mom is on Thyroid medicine daily it’s a 1 in 4 chance that she passed that genetic problem to me as well. He said with Thyroid issues you normally have natural killer cells which will attack whatever is trying to implant which will cause a chemical or miscarriage. He said they have medicine that can prevent it from happening but that he would want to do an extensive immune testing to figure out what to do concerning that.

Now that brings me to…..WHAT TO DO?

My husband was like change is good, and he is coming with a lot of change which we haven’t had any of the previous cycles. He was like the only change Dr.ML is making are the changes that you suggested which is going on the Lupron and changing up the meds.

Oh yeah I told him my plans of starting on Lupron Depot and he said no, do not go on that, no that is not good, no do not do it. He said Lupron Depot stops your ovaries completely. He said it stops your body from making estrogen which interferes with having a healthy endometrium for implantation when you start your cycle.

I’m so confused….I just don’t know what would be best now. I would hate to go through another cycle with Dr. ML and face yet another chemical, but what if the lupron really does help….But what if the endo is not the problem and it really is my embryos. Dr. ML isn’t doing anything to help with my embryos and we were only doing PGD because I asked to do it and its still that 50/50 chance, and we were only changing to Gonal F because I asked to do. I feel like with Dr.ML she lets me make the calls and I’m not the doctor but with Dr. Sher he is taking the role as the doctor and telling me what will be best and not me telling him what I think would be best.

Whatever I’m going to do I need to decide quick, so I cancel my Lupron order if I’m deciding to go with Dr. Sher……..

Dr. Sher sent me an email with 28 attachments that he said he wanted me to read, so I’m about to spend my Friday night reading through this stuff and maybe it will help me make a decision.

That’s another thing I liked about Dr. Sher. He shed more light on my history in 40 minutes than Dr. ML has done the 2 years I’ve been with her. He sends me information for me to read up on things and not the other way around like I have been doing Dr. ML. uggghhh….I don’t know………..


Anonymous said...

This sounds great! SOunds like you have a doctor who knows what he's doing and is on your side. Will your local RE work w/ the other guy's plan? Or do you need to travel for the entire cycle. Good luck!

Soapchick said...

Tashida - Dr. Sher is one of the best in the country. I'd trust him over your other doctor.

Kymberli said...

Tashida, as a gestational surrogate, I know of lots of REs' reputations and the quality of care. Though I have never personally been under Dr. Sher's care, I have five surrogate friends and two intended parent friends who have worked with Dr. Sher. ALL highly recommend him. He had a wonderful reputation in the surrogacy community and in the IF community, he has a great reputation for tailoring treatment to meet the individual needs of the patient.

I HAVE worked directly with ML and RBA before, and I know that at least in the surrogacy community, their reputations aren't the greatest. RBA is a competent clinic and ML a competent doctor, but the have more of a one-size-fits-all approach and as you know, don't vary much when patients need more tweaking with their cycles. I personally didn't like Dr. ML - she had too much of a blase, non-concerned attitude for my taste. We also had some issues with her and the embryology lab. If you want the specific details, I'll be more than happy to email. In the long run, my friends ended up staying with RBA but switching to Dr. Toledo. They really wanted to change clinics, but ultimately decided to stay when RBA offered my friends free FETs (they had 9 frozens) and 2 fresh cycles (and all FETs from those) until they got a take-home baby. That should give you an indication of how much hot water they were in, especially because my friends were one step away from retaining a lawyer.

I would definitely switch, but whatever decision you make, I will be here to support you and I hope that the next attempt is THE time that it will work!

Claudia said...

My $0.02? Go with Sher. I found the Atlanta IVF doctors to be extremely stuck in their set protocols and not at all receptive to the round peg that doesn't fit into their square hole, if that makes sense. After 3.5 years of the runaround from other doctors, SIRM got me pregnant. Hope they (or wherever you end up) can do the same for you.

poodle said...

See Sher. I agree with all the previous comments. Plus I've been communicating with you on FF, so I know your journey.

Michele said...

I'm in favor of the doctor who knows what is going on. Sounds like Sher, to be honest. In this journey, the right doctor means the world...

Yolen said...

Wow, sounds like Dr. Sher is a god-send! The best of luck!

Molly said...

Hi i found your blog randomly. I dont know neither of these doctors (im in Canada) but from what I've read from your blog, I'd suggest to switch for Dr. Sher too. Our first clinic was like that too, one size fits all. When we were leaving they also offered some free meds but we had enough. They totally screw my cycle, cancelled it because they were moving to a new building that week, and just kept our money. The next clinic was absolutely great, they took in fewer patiens (unlike the first puppy mills) and Im 11 weeks pregnant now.

areyoukiddingme said...

I know it's a little late, and you've probably already decided what you're going to do (haven't read further posts yet). I used SIRM and found them to be fantastic. I knew nothing about recurrent miscarriage, other than something was wrong with me. They did a crapload of the kind of testing that satisfied me (and although I don't remember much from college, I do have a degree in biochemistry, so I'm not completely uneducated). They found my problem, which certainly wasn't sexy enough for a fertility clinic (minimal drug use (heparin and aspirin), no IUI's, IVF's, I-anythings) and still treated me like I was important to them. So, I would recommend going through their testing protocol, anyway, because they may be able to give you a better handle on what your problem may be.