Tuesday, October 13, 2009

Find the Cause!

One of my major frustrations with doctors while being treated for infertility was the very common practice of just treating the symptoms and not the cause(s). If you go to your GYN one year after trying, you will most likely get a 21 day progesterone bloodwork (maybe a thyroid and prolactin) and a semen analysis for your hubby along with a prescription for clomid. Go have fun! No monitoring with ultrasounds, no real concern for what is causing the ovulation problems...just here is your clomid candy. When that doesn't work (it does work for some people...yay for them), it is time to see a RE. Depending on your RE, you might get more of a thorough workup with different hormone levels, but from what I've witnessed from my own experience and read from other IF bloggers...it is more of the same just a more aggressive version. Hey here is this clomid or femara...come back around day 10 for an ultrasound...okay time to trigger with a hcg shot...two days later come back for an IUI. When that doesn't work, the next step for most REs is injectables. Other REs jump straight from the clomid/femara protocol to IVF (my dr is one of these- but I twisted his arm to do injectables...something not right about going from a $7 medication to a 10,000 cycle). So there you sit with two choices, go home with no baby and no treatment or take the 10,000 dollar plunge for IVF. Half of the couples (if you go to a good clinic) exit the scene at this point with their little miracles...with the other half having to go back to the RE for a WTH Appt (what the heck is a nicer term than what most IF bloggers use). Sometimes REs are able to give answers on why the cycle didn't work but for the most part it is just a better luck next time appointment. Now the couple feels like they can't step back to a more affordable treatment from IVF, they must slap down another 10 grand if they want to try again. Does anyone else see a problem with this??!! Now before I go any further...please do not get me wrong! I am all for REs--in fact I love them. They are the ONLY ones in my opinion who should prescribe fertility meds because of proper monitoring and nurse accessibility with a few exceptions. I love infertility treatments--clomid, injectables, IVF. All of these are important medications and treatments, but they should be used once everything (and I mean everything!) is looked at for possible causes of the infertility. Do you know I had to ask for my surgery? There is no way to know now if I would have gotten pregnant without the surgery but at least I know now the cause of my infertility (or at least part of the cause).

This vent now brings me to why I'm writing this post. My IRL friend also is completely frustrated with this process, and she has decided to take charge of her treatment plan and her overall wellness. She went back to her GYN to ask her to run every possible test/bloodwork that she could. If you saw this friend's medical file, you would think that every test would have already been run...unfortunately that is not the case. Everything so far has come back normal (still pending some results) except for a major vitamin D deficiency. After finding this out, my friend googled vitamin d deficiency and infertility and was floored by what she found. I had not heard about this study, and I couldn't wait to get home to google after hearing about it from her. I started taking Vitamin D3 1,000iu daily probably around August of last year along with my prenatal, baby aspirin, and dha/omega 3 oils because my mom bought some for me. We are all super sensitive about MS because my Aunt has MS, and there is a strong genetic link in our family. My Aunt's doctor told her that her younger female relatives should be taking vitamin d3 so that is why my mom purchased the vitamins for me. What if my deficiency was part of the cause for my ovulation problems??!!

Here is the current research on Vitamin D and Infertility: (hopefully more will come soon)

A team from Yale studied infertile women and their Vitamin D levels. Not a single woman with ovulatory disturbance or PCOS had normal Vitamin D levels. They even found that those undergoing infertility treatments that had a higher level of Vitamin D were more likely to achieve pregnancy. These studies were small so more in-depth studies are needed, but in the meantime...why not add a little Vitamin D supplement? (of course talk to your dr first). You might need a prescription for a major dose of Vitamin D if you are severely deficient. This was the case for my friend.

I encourage all of you who are still waiting for your precious little one to research and to become an advocate for your own health. Remember that you know your body more than anyone else. Ask questions. Demand bloodwork. Pray for wisdom. It is absolutely no skin off a doctor's nose (no idea where this saying came from?) to run a few tests. Checking your vitamin levels and ALL of your hormone levels is a great place to start. And once the levels come back...don't just accept that they are "okay"...know what the levels or results are and what they mean. Give hugs and read Eileen's story for just one example of why we have to be our own advocate (which includes finding the right doctor!).

If you do this or plan to...please let me know what you found!

15 comments:

Heather said...

Wow-I am a non infertile person and this still makes me mad. Why not look for the cause and just treat the symptoms? This is part of the reason why insurance companies are the way they are. It is an interesting connection between the vitamins and the subsequent pregnancy.

Robin said...

Wow. Great post. You are right, the many causes of IF could be right there and they are just not looking for them.

Jaime said...

You couldn't be more right! The doc that your friend talks about in her blog is one of the ones open to the testing of the immune system but there are others if you do your research! I was TTC for 5 years and went through 2 failed IVF cycles. After the second one failed my RE suggested donor eggs. No reason for it other than nothing else was working. I did my own research, shipped my blood to California from Florida and received some possible reasons for the failures. I found a new RE who was open to the treatments recommended to me by the RI in California. I followed those treatments and just found out I am pregnant for the very first time via IUI with my own eggs and DH's sperm!! Never give up and BE YOUR OWN ADVOCATE!! I tell everyone that will listen!
Thank you for your post!

Courtney said...

Congrats Jaime! Looks like your blog is private so I'm hoping you will come back and see this. I've heard about the immune system testing...would love to hear more about that and also what you did differently.

shauna said...

*Long time lurker*
You are so right about taking control of your health. My OB never even tested my husband before putting me on a year of clomid(!!!) I kept getting cysts on the clomid (later I found out i needed a trigger shot) My OB had no idea how to deal with IF, and I knew nothing about it either.Once I went to my RE we found out it was a sperm problem and that IVF was our only choice. How I wish we could have avoided the stress and meds, that were unneccessary. Sometimes you need to listen to your intuition that is saying maybe the doctor doesn't have a clue. (looking back I saw signs that my OB was seriously lacking in IF experience) thankfully though I had a wonderful RE. I'm glad your friend is finding answers. I will definitely suggest to people struggling with IF that they have their vitamin D checked.!

Searching for Serenity said...

This is SO true. Sometimes we feel like we are at the mercy of our doctors, when really we should be taking control of our own health. Two ob's tried to prescribe clomid candy for me before running any tests. I refused both times for personal reasons. It wasn't until my husband was tested and put on Clomid (yes, for low counts), that we started to see progress in our journey. My doctors were not able to diagnose me, but that's because they only looked at bloodwork and HSG results. It took months of research for me to figure out that my cycle was off and I eventually started acupuncture treatments. Ok, so the Clomid probably could have straightened out my cycles much quicker, but like I mentioned I refused to go that route. I have a heart condition and I wanted to avoid multiples. Sorry. I'm totally rambling now. Bravo! Well said.

nancy said...

VERY good post. And I agree. It drives me nuts when doctors just prescribe meds and never look for the cause. Thankfully my doc is not one of them. I got TONS of monitoring and found early on I was suffering from LUF syndrome. Everything shows that my body ovulates, +opk, follies, everything, but low end of progesterone. Instead of just figuring I needed progesterone supps, my doc did the next test to try to confirm ovulation and saw that I make the eggs, I just didn't let them go, instead my body held onto them until the next cycle where they'd be reabsorbed. Thank goodness for my doctor who went the extra step, when it shouldn't be the extra step, it should be the baseline. But yes, I am a huge advocate for monitoring and this post was just another one for me to shake my head "yes" to.

I also wanted to thank you for taking the time to respond to my blog in how you "met" me. And I laughed when you said you had to bleep the "f-word" when reading me. Sorry about that!

KBird said...

I agree. Good OBGyns and fertility doctors are incredibly thorough, and after going through a couple of not-so-thorough ones, I finally know what kinds of questions to ask--I just wish I had known these kind of things earlier. Thanks for your thoughts for those who are just starting the process or feel "stuck" with a doctor who doesn't research everything.

Melanie said...

I totally agree with you! Why don't they do more testing instead of just giving us more pills? It would be nice to have some testing or something for ovarian reserve. I would have known what was wrong with me. We spent the tons of money on drugs.. then IVF. I wouldn't change it for the world but they should have some testing so that we don't have to spend this kind of money if it isn't going to work. They need to do the simple tests right along side the extensive tests. Little things matter too! Thanks for sharing.

Jaime said...

Thanks Courtney! Yes, I still have my blog private because my family doesn't know I am pregnant yet! LOL! I used the blog to keep track of this cycle. I am 6 weeks today and have my 1st ultrasound Wednesday...so we may tell after that. Anyway, this cycle I did 3 infusions of IVIg, am on Dexamethasone (steriods) and Lovenox injections. I also started Metformin a couple months ago for borderline insulin levels. It was a hard road to get a doc that would listen to what I wanted and especially one who was ok with IVIg infusions!! It's hard to argue the success though...TTC for 5 years with two unsuccessful IVF cycles and then I get pregnant on my first IUI with this treatment! The book I read that pointed me in this direction was..."Is Your Body Baby Friendly" by Dr. Alan E. Beer. I have mailed my copy on to someone I met online, hoping it will help her too BUT I do recommend that people who just don't feel right about their infertility/treatments read it!

Robin said...

Terrific post and I could not agree more. We started off with MFI so that pretty much sent us straight to IVF. But along the road, we found out I had diminished ovarian reserve. After our first IVF failed and they said "donor eggs" to us, I knew I had to do something. Thanks to another blogger friend, I learned about an organic diet, all natural cleaning products, non-toxic hygiene products and vitamin supplements. I did all of that along with a low sugar diet (sugar can reduce your uterine lining) and acupuncture for 4 solid months. My antral follicle count went from 5 to 10. We are now 14 weeks pregnant with our miracle. It takes time to do the research and it certainly takes more than a little determination to make such drastic changes to your lifestyle, but it's worth it. And wouldn't we all do pretty much anything to have our own child?

Lauren said...

Thanks for that great advice! It's important to trust our doctors, but to also remember that nobody will look out for us the way we do for ourselves!

Anonymous said...
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Anonymous said...

Hi Courtney - Im the "anonymous" commenter from your other blog. I left a comment on your letter to the "purple shirt girl". I have been seriously loving this blog. I started from the beginning and read all of your posts. Your story is truly a testament to the "awesomeness" of the Lord. Thank you so much for sharing.

I have a question... open to anyone who may read this.

My husband and I have been trying the "natural" way for 2 years. I HATE taking medicine, so I have just been praying each month. I have used the OPK but with no luck - obviously. So... I started reading a book called the Infertilty Cure by Randine Lewis. That got me going to an accupuncturist and on herbs. I have been doing that for a short while. I love it. It is all about treating the cause, not the symptoms. However, I have an appointment with a fertility doctor in Feb. (on my birthday, actually...fun way to spend my 27th birthday, right). After reading this, it sounds like I need to do research before I even get to the appointment. Are there certian things that I need to ask him, or look for. I feel overwhelmed!!!!!!

Much Love to you all,
Megan

Anonymous said...

PS - who ever has some helpful advice, feel free to email me... sorry Courtney, not meaning to use your blog as a forum. Which, I have been to those and for some reason they seem so cold. I love your blog because I feel like I kind of know you even though I dont... and I bet the people who read this blog feel the same way too.. anyway, my email address is meganmckenzie83@gmail.com

XO
Megan