November 5th, 2009

On November 5th, Tim and I had our first consultation with Dr. Odem.  Dr. Odem has been seeing infertility patients longer than I've been alive and everyone at WashU recommended him.  I had already faxed in my 36 page medical report and brought in another 14 pages his office required.  Here's what he told us...

Tim's numbers all look good, his motility is a little slower than normal, so we should keep trying with IUI's.  My MTHFR and PAI-1 are indicators that I'm more prone to these blood disorders.  But since my family has no history of stroke or deep vein thrombosis, he thought that its unlikely I actually have the disorders.  He said I shouldn't continue on the aspirin or Lovenox shots due to an OB's recommendation.  I shouldn't have an OB treat a blood disorder and should go to a Hematologist if I'm concerned.  Besides, the MTHFR increases miscarriages, not prevent pregnancy.  The blood disorder also goes with the extra folic acid pills, and he said I should just stick with a basic prenatal vitamin.  That's what he had to say about my blood results.

As for the process of IUI's at my previous OB's office, he thought it was overkill and to basically pad "their bottom line".  Dr. Odem saw that all my previous cycles didn't show enough thinning of my lining, so the estrogen shots and patches weren't doing anything.  I also have always ovulated on each cycle on my own before, he didn't understand why they forced me to ovulate by taking more hormones.  He showed research that says follicle size varies per person, sometimes as much as 1.2cm - 3.0 cm.  So my follicles may not have been done before they got triggered.  My progesterone levels were always normal also, so that test and extra hormones are out now too.  He showed that research doesn't support back-to-back IUI's being more effective than just one.  He said he could do it if I preferred but he said it would only help his bottom line.  Dr. Odem showed more research that clomid levels below 100mg are rarely effective, so even that was off.  Tim loved that he showed research to support his treatment plans, which does make more sense.  I guess I just followed the previous OB's wacky science experiment because my coworker went through the same thing and got pregnant. 

After our appointment, it was a lot to take in.  I'm glad we had driven all the way down to Forest Park Parkway together so we could talk it out on the way back home.  I was stunned to hear all that I had been doing my not have helped, maybe even hurted.  I was taking 4-5 pills and shooting injections into my stomach daily.  I averaged 7 drs appointments each month.  One at the beginning of my cycle to see my starting point (ultrasound), another to check follicle growth and get extra estrogen and HCG shots, two more visits for IUI's and another to check progesterone levels.  Now Dr. Odem, says to take clomid and come in when my ovulation monitor shows ovulation.  At that one dr's appointment, he can still check my lining, see my follicle size and do the IUI all together.  Which will be easier to schedule with work and the holidays coming up but also nice since its a 45 minute drive to the office.

So we'll see how this method of treatment goes.  I definitely have more free time without all the drs appointments.  The increase in clomid definitely made things a little more sporty around the house lately....sorry Tim.  Those chemically induced mood swings are doozies!  I still can't get over my worry about finally getting pregnant and then miscarrying due to a genetic condition I was aware of ahead of time.  I understand that the majority of miscarriages are unexplained, its hard to pinpoint what caused them.  But if I have repeated miscarriages, that is the hallmark of MTHFR and I couldn't mentally bear it.  The mental stress of this whole process will do me in way before the physical stress and pain.  So I did schedule an appointment with a Hematologist, that is later today.  Hopefully they can put my fears at ease.  It's not like I enjoyed my daily shots or the beautiful bruises they left behind, but you never know what you're willing to go through till you're there.