Repro. Immunologist appt

megs3084

I'm sorry I've been absent this week.  I feel like I missed so much!  HUGE hugs to everyone that needs them. My update might be kinda long-Sorry! 

  I've been absent because I had my appt with dr. Kwak-kim on Wednesday.  Overall it went well, it was just a lot to soak in-hence the absence.  I am fortunate enough to live about an hour away from her office, so I drove up Weds. morning.  After getting checked in, we went straight into the u/s.  That alone was worth the drive.  They even have a 2nd monitor hanging near the ceiling so I could watch.   We did a quick external u/s then moved to internal.  As soon as we looked at my ovaries, all I saw was BAM cyst city!  (I've never been called PCOS, but I think I meet a lot of the characteristics.  My androgen levels are normal, and I only have a slightly elevated FSH per my RE)  Due to the cysts, we also scanned my thyroid, since problems with it can be seen with cystic ovaries.  We also did the doppler to check blood flow.

  Next was labs and the physical.  They are lab magicians there!  22 vials of blood on one stick!  I am beyond impressed!  The physical was with the NP, and it was a more in depth review of family history (lots of stroke/clot issues).

  Finally I met Dr. KK.  She was amazing!  I've never had a Dr. with such a great bedside manner and she was looking at the whole picture.  She told me that she was considering my a multiple implantation failure (MIF) and that can be tracked back to 4 main causes.  Genetic, Endocrine, Immune, and Hematological.  Right away she's ruling out genetic, stating it's only a 15% chance our problem is genetic after transfering 4 enbryos.  She is focusing on the other 3.  She's concerned about endocrine because I'm now seeing polycystic changes in my ovaries.  She also said it is possible to be PCOS without having abnormal hormone levels.  She is also looking into the immune and heme, because of my family history.  

  Her Recommendation was to delay IVF #3 till June instead of May.  Her reasoning is that she wants time to fix anything she might find.  Her concern was that if I cycled without fixing any problems, then with the polycystic changes paired with my lower AMH, I will over stress my ovaries and put myself at risk for POF.  Her other concern was the doppler study.  Apparently I have insufficient flow to my left ovary and uterus, which makes sense cause I think I always get more eggs from the right.  When they look at the uterus, they also look at the different layers and the flow in them.  She said that in addition to my low overall flow, I have no flow to zone 3, which is responsible for implantation.  

  She feels all of this is a fixable problem and we will meet again 4/19 to make a plan.  By then my labwork should all be back as well as the official reading from the radiologist on my u/s.  The flow issue is generally a blood thinner, but itll depend on the labwork (if I have an acquired clotting disorder etc)  I forgot to ask her if I am a candidate for metformin, but I can email her about that.  She told me reducing my BMI and weight will also help and suggested a low carb diet in the meantime.  

  Now that I've had time to think about everything, I'm happy I went.  Yes its sad to be delayed yet again, but it's also a little overwhelming to think that maybe I'm not unexplained.  Maybe there is something wrong and something to fix.  I'm feeling pretty hopeful.  She also told me not to worry about my REs lack of belief in reproductive immunology.  She will sync her calender with his when we make our plan and work in parallel with him.  She will manage whatever problem she finds and he will manage my IVF cycle.  

 If you've made it this far, you deserve a cookie!  Thanks to everyone for their good thoughts and the encouragement to keep the appt.  I'm glad I went.   

DoublePortion

Wow, that is a lot to take in but it sounds like a really good appt! I'm sorry you'll have to delay the cycle but if helps bring success it will be worth it. Also, I'm impressed with 22 vials on 1 stick! They'd have to turn me upside down and shake me to

liz4paws

Wow sounds like a lot got done!! And you have some good things to take from your appointment. I'm glad you're hopeful and that you have a plan in the making.

megs3084

Dp I thought for sure I'd pass out but didn't. Usually I get woozy around 10 vials. They are magic!

Liz thanks so much. I've been thinking about you!

violetmarie61516

Wow Megs, that is a lot to take in at once and I understand.  It sounds like the appointment went really well and I'm sure you are glad that you went.  If nothing else, you will have more things that are ruled out.  I'm sure she will be abl

megs3084

Love4Labs326:

Wow Megs, that is a lot to take in at once and I understand.  It sounds like the appointment went really we

BrideJackie11

Sounds like a very productive appointment.  I am glad your RE is on top of everything.  I may be cycling with you in June depending on when my beta gets below 5.

luvboston

Glad you liked her I have only heard great things!! I was delayed as well to cycle but it was worth it because we just made it to the 2nd trimester after 6 losses. ri might be on the edge but it works. I heard Kwak has a new patient portal that you email

PurpleIris30

Sounds like an overwhelming but productive appointment. I hope she's on the right track to success for you.

megs3084

luvboston:

Glad you liked her I have only heard great things!! I was delayed as well to cycle but it was worth it because we just m

rockpaperlove

Thanks for the cookie!  nom nom

I was unexplained until recently and I had the same sense of renewed hope that you are experiencing!  I also got del

brooklynesque

I'm glad to hear the RI has ideas for you!  She does sound very thorough.  Can't hurt, can only help.