Egg Nog, Christmas Cookies and Injectible Anticoagulants!

As the time nears when we may start trying again (and if this is confusing to you : Adoption? Yes. Trying again? Yes. Just think of my husband), I’ve been obsessively searching for data on those who have the MTHFR A1298C gene mutation, used heparin and had a successful pregnancy. What I found, mostly, were people who will be using it the next time. Of special note, however, were several people who began heparin therapy at cycle day 6 or at ovulation. Last time I met with Doctor Superman, he checked the incision sites and we discussed IUI versus naturally trying to get pregnant. He mentioned using progesterone the minute I get a positive pregnancy test but didn't specifically mention heparin. So, I said, "And heparin? Right, you’ll be using heparin?" He said yes, I could start heparin at the time of a positive pregnancy test. It seemed as though he was advocating for us to try naturally at first - and the husband and I discussed this and it seemed like a fine plan.

However, as I continued to read the message boards where most if not all were starting heparin before a positive pregnancy test I began to panic. I told the husband about the whole "cycle day 6" business and he suggested that I call Doctor Superman. But I just couldn’t. There were so many times during discussions with Doctor Wonderful (previous RE) where he seemed to dismiss everything that I said, that I just couldn’t muster the energy to go there again. I feel like I’ve been screaming since day one, "Something is wrong with me! This is just going to keep happening until someone figures it out!" And it has always fallen on deaf ears. All I heard, time and time again, from my OB/GYN, RE and everyone else, were the statistics regarding miscarriage were in my favor, that it’s a common occurrence and most women go on to have a healthy, normal pregnancy the next time around. I was still, unbelievably, told this after the fourth miscarriage. Doctor Wonderful’s (that name was always used with a touch of irony, by the way) mantra seemed to be, "Keep trying, eventually it will work out." It’s difficult, as a four time loser to sit back and think "everything will work out." I don’t necessarily believe that heparin is the magic bullet either - but I’d like to try everything. I mean, what the hell do I have to lose?

In the end, my lovely husband took it upon himself to call Doctor Superman and Doctor Superman discussed the three different "points of entry" for the use of heparin during pregnancy: 1) from the beginning of your cycle, 2) at ovulation and 3) at a positive pregnancy test. Doctor Superman doesn’t really see the point of starting heparin at the first day of your cycle and he wasn’t really sure why anyone would do "cycle day 6" but he was willing to start heparin at ovulation. It’s incredible, in a way, to me, oh, girl-with-the-needle-phobia that I am pushing for the use of heparin - but again, doing the same thing over and over again and expecting a different result seems akin to insanity. I suppose, however, if there were chromosomal problems in several of the pregnancies, and I was told there was only say, a 20% chance or even a 50% chance of the chromosomal problem occurring again, I may continue trying (that is, of course, until it continued to not work out (how many times? who knows) and then I would insist on IVF with PGD). But when virtually nothing has been found - it’s hard to just blindly fall of the cliff again and again. Heparin is my last ditch effort. So, I will be going on the lovely Clomid again (which I hated), and moving towards an IUI (do IUIs ever work?). One study, which I’ve mentioned previously, predicts that those with the A1298C gene mutation will respond poorly to the use of stimulating drugs, such as Clomid. And I didn’t exactly prove that theory wrong last time. I think the husband is somewhat dreading the whole escapade (who wants to do your business under the watchful eye of several dozen medical personnel - even if the bathrooms, and I’d imagine, "the Depositories" are beautiful and ready for a photo essay in a chi chi interior design magazine).

IUIs do make me nervous. It seems like a lot of effort when there's still a very real possibility that I won't even GET pregnant in the first place. Then I'll have given myself heparin shots for two weeks for nothing. I'm sure that this may be the doctor's thinking when they prescribe heparin at a positive pregnancy test versus earlier.

On a semi-related note, the husband and I put ourselves on a strict budget for Christmas shopping this year - we are trying to save as much as we can for Ze Adoption. Let me tell you, $100 sure doesn't go very far in this town.

'Tis the Season!