Wednesday, June 25, 2014

The shadow of gender selection

I was talking to someone in the Billing Department at my Doctor's office regarding the cost of IVF with ICSI and PGD today.

She hesitated before she mentioned that gender selection had an additional cost. I was very quick to defend my actions, I very quickly dismissed the gender selection and pointed out I was considering the procedure due to RPL. Gender of any child I had was definitely never an issue for me.

I have been plagued with guilt ever since for oh so many reasons. I did spend my early years in India and am very much aware of what gender selection and being Indian (even in origin) means.

Background: to those unaware, India has a huge issue of gender selection and female infanticide. The government there has made it illegal to reveal gender of the baby prior to birth due to female infanticide and ppl choosing to aborting the female child. Unfortunately it is still very much prevalent today and more so among the educated then the uneducated.

I have spent countless minutes wondering, if she asked me about gender selection because my name is Indian or am I over reacting. I have spent even more time being sad that this is still an issue in India. 

Some shadows, they always lurk in the cobwebs of the human mind dont they?

Tuesday, June 24, 2014

To IVF or to Clomid

We met with the Dr today regarding the results of genetic testing after last miscarriage (also my third). 

Brief History: ttc for 4 years now, 3 miscarriages. The third one was while I was on Lovanox and Baby Aspirin for MTFHR, thyroid meds and clomid to conceive. I still have the hematoma from my myomectomy last July but hopefully its going away soon (shrinking every month).

The genetic Testing results - Inconclusive not enough tissue to test (only maternal tissue was found).

The assumption is that this m/c was a result of a genetic abnormality (DH & I were cleared). 25 % of all pregnancies have genetic abnormalities, said the Dr.

The Dr would definitely like another hysterosonogram between CD6 and CD12 and since he was on his way out of the country today (Today is CD9) I am wasting a whole month waiting. I also have to decide by then, how I would like to proceed.

Dr said there were 4 options ahead for us
1) Clomid
2) Gonadotropins
3) IVF
4) IVF with ICSI and PGD 

I really only have to decide between #1 and #4. He recommends #4. DH is all for #4, I am trying to think it through.

Financially, I have enough left on my lifetime infertility benefits to cover 1 round of ivf, but the PGD testing will be another 4 to 5k that isn't covered.

With Clomid I have a higher chance of miscarrying, with IVF (& PGD) they will take the good quality eggs, the good quality embryos (PGD) hence lower chance of miscarrying (at least due to genetic issues).

I guess at the end of the day, I am familiar with Clomid and I know it works (I got pregnant during my 2nd cycle, but we opted for iui to maximize our chances.

I am not familiar with ivf and (the unfamiliar scares me a little). 

However if I were to be honest with myself, If i miscarry on Clomid, I know there is ivf waiting for me. If I miscarry on ivf, I feel like I am out of options.

No one can make the decision for me

Background on why DH is being impatient with me: in Feb 2012 (with my previous infertility dr) I got pregnant in same cycle as a hysterosalpinogram. It was a chemical and I miscarried by week 5. Previous Dr suspected polyps and wanted to do a hysteroscopy/myomectomy in same go. I hesitated went back to my ob/gyn who did the hysteroscopy. He confirmed no polyps but said my fibroids had to go. I asked DH to give me the summer to think about it, and find a dr willing to do laprascopic myomectomy. By fall of 12 I had a mysterious illness that lasted 3 months (Daily fevers of 102-103, night sweats and no diagnosis of what caused it, despite going to 3 drs) Needless to say by the time I recovered from that and found a dr and had the surgery it was July 13. I had wasted well over a year.

Tuesday, June 17, 2014

The ripple effect

After I miscarried on May 2nd, I shoved my feelings in a hole.  I decided I was going to not make my decisions around the baby.

My appointment for the results of genetic testing was set for today, but I threw caution to the wind and postponed it a week.  I was proud of this new attitude where I could not plan life around what if.

The inevitable happened,  I m on vacation (for which I postponed appointment), and I got AF after miscarriage.

The nurse despite my pleading said the Dr won't let me start clomid till after our appointment.  I m wasting a whole month.

I keep telling myself I wanted to wait 2 months after D&C anyway. I re-iterate to myself that this just gives my hematoma time to heal.  I keep convincing myself that my uterus,  sanity,  body and marriage could use a longer break.

Nothing works though,  for once I threw caution to the wind and extended my stay by a day,  not wondering what if.  That once was a mistake and I lose a month.

I have miscarried thrice,  I don't even know if my inhospitable womb can ever give up its ways but for now I have a week to constantly worry what the results of the genetic testing hold.

Once I threw a pebble in the water,  hoping the ripples wouldn't rock my boat so hard, they did.  That is usually my luck though isn't it?