Summary of Dr. Appt.

Tony and I met with Dr. B yesterday and it went very well. Dr. B explained to us the 5 general categories of why people can't get pregnant - problems with: eggs, sperm, tubes, uterus, endometriosis.

He went through our entire history of all of our tests - sperm is good, tubes are clear, uterus is shaped normally, eggs can be fertilized in a petri dish even though there is a diminished quantity of them appropriate to my age, hormones are not terrible, so the last thing that has never been tested for is endometriosis. He said that even though my CA 125 test came in low, he still thinks there is a 60% chance or better that I have the disease. He's had patients with a low CA 125 have the worst cases of endo he's ever seen, and he's had women with high CA 125 levels having no endo. The only way to know for sure is with surgery. If he were a betting man he would lean towards some endo in my case, but he cannot guarantee it. He thinks there is a strong possibility that it is creating inflammation that is preventing the sperm from fertilizing my eggs. He even talked about the example of how a lot of women get pregnant after the HSG tube test when they run the dye through the tubes. He said it isn't necessarily because the dye opened the tubes, but because the dye running through the uterus changes the PH of the uterine environment and it may flush out some inflammation. Very interesting.

He went over our options again:
1) have surgery to rule in or out the endo
2) IUIs
3) IVF with my own eggs
4) FET with one embryo
5) DE cycle with same donor
6) DE cycle with new donor

We went over all of the pros and cons of each one. He said that the endo may or may not be affecting the implantation of our embryos. He said that it is just assumed that our DE cycle didn't work because of egg quality, but that it may not have been the case. There could be endo causing a problem. He explained again that he thinks RMA triggered our donor too soon and that if we were to use her again he'd use different drugs and cook her more slowly. He says we can go ahead and do another donor cycle without having the endo surgery, but it's up to us. He does wonder why Dr. W didn't go ahead and do the lap and look for endo when I underwent the hysteroscopy for the polyp removal. He would've done so since he was already in there. He again expressed that it's a philosophical difference between the 2 clinics. They are in the business of IVF, and he is more interested in finding the root cause of infertility. He didn't put RMA down at all, he said that both Dr. M and Dr. W are great doctors, they just do things differently.

Tony hasn't yet absorbed all of the information yet, nor mulled it over completely (as Erin knows very well it takes him much longer to process), however we have agreed to go ahead and schedule the surgery. It can always be canceled. I'll call on Monday to schedule it for mid May. I know that I want to do everything I can to ensure that if we do another DE cycle we've crossed all our t's and dotted all our i's. I can't do it before May because I've got to pass my PMP exam. Although my exam is scheduled for 4/19, I have a feeling I may be pushing it out a couple of weeks as I just do not feel ready yet.

We've ruled out IVF with my own eggs, but I'm thinking that we will do the surgery, then do a few IUIs, and then a new DE cycle. I am going to contact our donor and see if she would consider donating for us again. I haven't heard from her in a couple of months and for all I know she is pregnant again. I know she wanted to try for another baby soon so that her kids would be less than 3 years apart. We aren't in a hurry for the DE cycle. That's the cool thing about that, I can be 50 years old! Although I don't really want to be, haha.

So next step is surgery - mid-May - I think.