My 2 Doctors

Friday S and I met with my RE and TCM doctor to discuss my recent miscarriage and develop a plan.

In May we switched to my RE, Dr. L, for a 2nd IVF, which was to be done in August. We unexpectedly became pregnant on the Clomid Challenge Test, with an IUI, which just recently ended in miscarriage at about 7 weeks. We are not ready to hop back into IVF and want to try Clomid IUIs for a while – after all it worked 2 out of 4 times (1 chemical and this one).

Dr. L was very compassionate about my miscarriage, which S and I really appreciated. He thinks my FSH (12.2 and 13.0) is the cause of both my infertility and the miscarriage – an indication of poor egg quality. He feels IVF would be the best option for us still, as they could presumably choose embies made from better quality eggs (how true this is without PGD I don’t know – last time all my embies appeared to be in excellent condition, but none of them implanted). With IUIs it would basically be a crapshoot.

So, his clinical recommendation would be IVF. But he sees that we are not ready to go there yet and agrees to go along with our desire to do IUIs. “But don’t make a career out of it.” He is recommending Letrazole/Femera instead of Clomid, as it does not have the anti-estrogenic effects that Clomid has. We would start after 2 periods – in late September or October.

So, Dr. L is basically saying, "you may get pg this way, but you are more likely to miscarry," whereas Dr. J says "this pregnancy that ended in a miscarriage is an improvement and building towards having a baby." Two different perspective, 2 different world views. No wonder I feel schizophrenic in my thoughts at times.

We have been seeing Dr. J for 4 months, getting acupuncture twice a month and taking Chinese Herbs every day. She had identified my TCM diagnosis as Blood Stagnation (endo, scanty periods, not implanting any of the 6 perfect embies, holding heat in my body which is frying my eggs), as well as Kidney Deficiency (infertility and reproduction in general). Her plan for me is to tonify my Kidney and smooth my Liver Qi, while continuing to work on Blood Stagnation. The Kidney will address my low progesterone, poor EWCF, and egg quality. The Liver will address egg quality. She says egg quality is 70% a Kidney issue, 30% a Liver issue.

TCM claims to be able to improve egg quality, which Western medicine says just goes on a natural decline. I hope the East has it right.

My TCM directions are to do acupuncture twice a month, acupressure every day, and 32 oz of my Chinese herbs everyday. Eating wise, I get to continue to eat “everything” (really those are her orders!), my recent sweet-tooth is ok for now, reframe from coffee and decaf, and I can even have occasional red wine for my Blood Stagnation since we are not TTC right now. (Wow! THIS is the advantage of seeing a doc of my own, rather than just following the restrictions in The Infertility Cure.) Most important, reduce my stress.

Reduce my stress. That’s a big one for me. She says that stress and unhappiness affect egg quality, and I know it does physical things like reduce blood flow to uterus. I am looking forward to using this blog to hold myself accountable for all the ways I am helping myself not stress out. Stay tuned…change is on the horizon!