RPL Update Number I Lose Count

I started writing up a big post about the more recent developments in my journey through recurrent pregnancy loss.  I still need to finish it up, but in the meantime, he’s a quick update:

  1. In August I had a hysteroscopic myomectomy done in Denver.  The idea was to hopefully remove a fibroid that was bulging into my uterus.  Instead of a fibroid, the surgeon found an adenomyoma located directly above my cesarean scar.  I have to review my records from my 1 successful pregnancy to determine whether or not the fibroid that was present during that pregnancy changed into this adenomyoma.  Otherwise, it is likely a lovely by-product of the 2004 cesarean section that was performed on me and my daughter.
  2. I have a substantial progesterone deficiency.  Progesterone levels should not drop below 8-10 in 2nd luteal phase draw, and mine dropped to 3.  I will have to have HCG shots during the luteal phase and progesterone shots during the first trimester to support the corpus luteum and developing baby.  It makes me INSANE that the last OB I asked to test my progesterone outright refused.  I lost that baby, obviously.
  3. I have to wait until November to have an ultrasound performed to let me know if my uterus and endometrium have repaired from the surgery.  Then we can talk about ttc.

That’s my nutshell.

My Medical Insurance Sucks

My medical benefits coverage sucks for my needs.  Now if I were a drug addict or wanted to have an abortion, that would be just dandy.  But alas, I “only” keep losing babies.  The insurance solution for that is – stop procreating cuz that’d be best for us.  We certainly don’t need to help you with your fertility issues just because you want to have more children.

I’m not infertile.  I’m just a habitual loser in the whole pregnancy maintenance arena.  Who can help me there?  My path has taken many turns, most leading to dead ends with providers who can’t acknowledge their limits.  Most recently, I was diagnosed via an uterine xray with a double uterus and told to “keep trying.”  I would need a referral to see an endocrinologist, even though I doubt that a general endocrinologist in this town would have a whole lot of experience in reproductive endocrinology.  In fact, the endo that my insurance service agent recommended seems to do more with diabetes.  But I’m expected to exhaust in state possibilities before I pursue specialists out of state.  I have yet to find an obstetrics group in town that believes that imbalanced hormones contribute to pregnancy loss.

I’ll be in Denver this summer, and even though there are reproductive endocrinologists (RE) there that are considered “in network,” I’m not allowed to see them?  I can waltz into any urgent care clinic in Denver with a common cold and get treatment, no questions asked, but I’m not allowed to see a RE?

My employer has no maternity policy and no infertility benefits.  Great place for a woman in the childbearing years, eh?

Infertility Update

I have a child and yet I am experiencing recurrent pregnancy loss.  It’s a strange subset of infertility.  I’m trying to hunt down bloodwork results from 10/07 so that my current OB, who is more specialized in infertility, can fill in the gaps.

All of my bloodwork came back fine though I don’t yet know the exact numbers for anything but TSH.  The bloodwork that was done included TSH (I was normal at 1.3), prothrombin time (PT), thromboplastin time (APPT), russell viper venom (dRVVT), and flow cytometry

I saw a new OB this month.  In addition to a HSG for potential structural problems with my uterus due to age and/or the previous cesarean, he recommends testing for inherited thrombophilia.  He will also fill in any gaps that may exist with regard to bloodwork.  From what I can tell, there indeed are more tests that need to be run before I can rule anything out.  For instance, some women with lupus anticoagulant (LA)actually do have normal APTTs.  He does not think we should waste our money on genetic testing.  Also, anticardiolipin is similar but not the same as LA.

I was really disappointed to learn that the only pathology that the former OB’s office does is just confirm whether or not the tissue is normal (not infected) pregnancy tissue.  No immunologic analysis typically takes place.  In my case, I have twice wasted $116.00 on this.  Luckily my insurance provider does pay for most of this cost.  However, I have just discovered that I could still have tests run.  Evidently, slides are preserved by the pathologists in parafin blocks, and they can be sent off to labs.  Click here to read about this.  I can somewhat vouch for the information on this site since my current OB mentioned Dr. Beers several times during our consultation.

More information:
Alan E. Beer Center for Reproductive Immunology and Genetics (link to research page)
Reproductive Immunology Associates (link to miscarriage page)