doctor superman

The husband and I decided to take a cab Friday morning. A decadence we rarely indulge. The cabbie wound his way through Central Park and to the East Side. We hopped out in the 70s and found our way to a long waiting room filled with female patients and their partners. We waited. And waited. And waited. I explored the bathroom - glass vase filled with smooth rocks, the new-fangled incense in oil, floating sink and walls covered with tiny glass tiles the color of sea glass. It was, likely the best, most architecturally modern bathroom I have seen in a physician’s waiting room. Ever. Appropriate to see in the pages of Town and Country or some such magazine. This place has money. A lot.

And still, we waited.

Eventually someone came out in brightly colored scrubs. Apologies all around. She sat us down in our new doctors “office.” It was clearly not his office. It consisted of a computer, a desk and three chairs. I learned later that his office is actually upstairs. Our doctor greeted us with a warm smile and handshake. Does he know that all my hope, my last bit of hope resides in him? I met much of what he said with vigorous nodding and tried in vain not to cry. When he mentioned that we were in a good place, really, the tears began. He indicated that since we’d had a “connection”, that there had been implantation, that that was a good sign. When implantation isn’t working, there is little they can do. It is a much trickier place to be when you have failed attempt after failed attempt with no implantation. Implantation, he indicated, is very mysterious - and they still know little about it. They can place the best looking blasts into the uterus and still no connection. And they don’t know why. He said that he understood that many who have repeatedly miscarried would prefer not to get pregnant at all but that the reality is that this, biologically speaking, is a better place to be. They just have to figure out what isn’t working.

He went through a list of tests he’d like to do. Including another HSG. Something I would prefer never to do again. But, I will.

He also said that due to the MTHFR coupled with the repeated miscarriages, he’d like to see me on the folic acid combo (B6 and B12), baby aspirin and heparin.

Heparin.

Again, tears.

He then discussed doing the FSH three day test. I told him that my FSH was tested and it was 9.2. His eyes widened. He didn’t like that result, not at all. He said that at my age it shouldn’t be any higher than 7. He asked what my previous RE told me about this result and I said that he said anything under 10 was OK. I didn’t mention that I had to ask him what it was - and this was approximately 9 months after it was taken. The FSH was taken in November of last year. The new RE wants to do it again. And on Saturday. I shoved forth a study that indicates that those who test positive for the MTHFR (A1298C) gene mutation have higher FSH levels and respond poorly to ovarian stimulation (fewer follicles greater than 13 mm). It also cites a study that found that folic acid had little effect on those with the MTHFR A1298C gene mutation. I’m proof positive of that, I think. It has great effect for those with the C677T mutation. The study does not outline treatment methods however, but seemed to imply that those with that particlur gene mutation need stronger meds for ovarian stimulation. All and all it’s not exactly the greatest study in the hope department - but it does, possibly explain, my poor response to the Clomid. He initially wanted to know whether or not the study had been published - I think perhaps in a way to dismiss its validity, its relevance, or to explain why he knew nothing about it. When I told him that it had been published in the September 2007 issue of “Fertility and Sterility”, he was surprised, a bit taken aback. But he wasn’t irritated or annoyed, he seemed slightly embarrassed. Which I appreciate. I want a physician who can be humble - and is secure enough in his abilities that there isn’t a lot of unnecessary posturing and that whole god complex crap. I think my old RE would have been completely pissed off and possibly dismissive (as he was when I asked about heparin). I actually don’t expect my doctors to spend time crawling through each and every study and article about MTHFR. That’s something that I can do. And believe me, I do.

When we were done and the husband and I reached the elevator. I burst into tears. Heparin. He’s willing to do it. He’s willing to try.

I couldn’t sleep the entire night before I had to go into get another FSH done. I’m not sure I want to know. I told the doc as much and he said that that wasn’t exactly the way to do things and my husband agreed. I understand that. I’m just dreading hearing the phrase, “donor eggs.”

Afterwards I forced the husband into Pottery Barn Kids. Why the hell would I want to go there, he asked? I said, because instead of making me sad, it makes me feel like it’s really going to happen for us. I know, that doesn’t make any sense. But the way I think about it these days is this: if we really want to parent a child, we will. It just may not be through the traditional route. And I’m trying to get myself to come around to that idea.

With that in mind, after my run yesterday, I went to a bookstore (stinking up the place, yes) and read through Cross-Cultural Adoption and skimmed through The Adoption Decision. I decided to buy The Kid by Dan Savage and A Love Like No Other: Stories from Adoptive Parents.

So, here we go. I’ve dubbed him, for now, Doctor Superman. I have to believe that he has super powers. Or else I can’t get on this train again.