Cheating on your specialist
I was talking to a freind a few weeks ago, who had recently had her fourth unsuccessful cycle of IVF.
According to her clinic, she and her parter had no discernable reason for their inability conceive - the dreaded "unexplained" infertility which affects around 20% of infertile couples - and, said her doctors, it was just a matter of keeping going and transferring embryos until they got the right one.
I asked her about all the testing they had, and assumed it would be similar to what my partner and I had been through. But I was shocked when she said that apart from some tests to check ovulation, a laparoscopy, (with a bit of endometriosis that had been rectified), and a standard semen analysis on her partner, their clinic hadn't ordered anything further. No tests for auto immune issues, no natural killer cell testing, nothing to check the DNA of her partner's sperm, no karyotyping. And not only that, for all IVF cycles, the clinic had followed the same protocol, with the only adjustments being the amount of follicle stimulating hormone administered to maximise egg collection. Frozen embryo transfers (FET), of which she had only had a couple, followed a basic unmedicated protocol. All of this over a period of three years with not even a hint of a positive pregnancy test.
I suggested getting a second opinion - she is in her late 30s and time is of the essence, but she confessed she felt so guilty even entertaining the thought of visiting another specialist. I know how she felt, because I have been there. I call it "cheating" because - not that I have ever cheated on a boyfriend - the secretive behaviour, the phone calls, the cancelling of appointments, all of this clandestine behaviour sneaking around someone who knows your most private parts - well it's kind of like seeing another man.
I have cheated twice, but I don't regret it at all.
The first time, we had been seeing each other for almost two years. Convinced I was the one with the problem, and buoyed by several good results from (what we later discovered were very basic) semen tests, I persevered with specialist #1 until he actually suggested I go see someone else. Back then, in the newbie days, I knew nothing at all about assisted conception. I happily popped Clomid pills for several months in the belief that it would get me pregnant - despite all tests indicating I ovulated normally and had no need for it.
I break out in goose bumps now when I think of the possible multiple birth bullets we dodged on that one. I had no monitoring or testing at all during those four cycles. Clomid, in case you didn't know, is one of those fertility "wonder drugs" that end up as cover stories on weekly women's magazines. "Our miracle quins" or "I'm pregnant with twins - For the third time!!!" but those mistakes happen when no ultrasounds are performed to see how many egg follicles are being produced. I could have been pumping out six or seven per cycle. It's almost a relief that my partner's sperm is so warped it couldn't penetrate the eggs.
It was during a cycle of Intra Uterine Insemination (IUI, or artificial insemination for the old school readers) with my next specialist that I bumped into the ex. A brief hello was followed by me telling him in what I like to think was very subtle language, that he had made several bad decisions regarding my treatment, and that specialist #2 discovered a few more problems which could have saved us a lot of time and money had the very basic tests been carried out sooner. I like to think he learned something from the experience.
I saw specialist #2 for a good 18 months, three IUIs, three IVFs and four FETs before getting the magic third opinion, but by that time, I had become much more educated on assisted reproductive technologies. Thanks to the magic of Dr Google and the combined learnings, wisdom and experience of the women on Essential Baby, I knew exactly what questions to ask, what testing to insist on, and when to suggest to my doctor that it was time to try something new.
#2, thank the gods, started out with a pro active approach, ordering a barrage of tests on both me and my partner. He started treatment conservatively, with IUI to get things moving, but when I suggested we move on to IVF, he was more than happy. For FETs he was willing to take my suggestions on board, and when I suggested we switch IVF protocols - try some different drugs and the length of the cycle - he was very accommodating.
But there were a few niggling things a doctor friend had discovered on my test results that he didn't seem to think were important, so I sought out another opinion. First, I made a booking to see another specialist when I knew #2 would be away. This doctor agreed that some of my test results were "interesting" and suggested an additional drug regime to counteract my homozygous MTHFR (just click, ok!). Then after continually pestering #2 for natural killer cell testing, it was time to make a booking with #3.
I knew something more was wrong, and it made me feel like a dirty strumpet to go behind #2's back, but #3 confirmed my suspicions. I did have a high percentage of natural killer cells. He concurred with everything else #2 had done, but gave me a new drug regime to counteract the NK cells, et voila, four weeks later, the magic second pink line appeared on my home pregnancy test.
I urge everyone who is going through AC who isn't satisfied with their care, who "has a feeling" or who has come up against conservative doctors unwilling to try anything new, to PLEASE consider getting a second or third opinion if it's possible. Doctors aren't infallible - they dont know everything, and sometimes, they are set in their ways. I also urge you to read as much as you can about your condition. People may sneer at Dr Google but there are some very good resources online, and always other people whose experiences you can learn from. You never know, it might work.
I cheated twice, how about you? Comment on Prue's blog.