What the Dr.said

Our blood test results came back early! My R.E. was nice enough to call me Friday during my planning time to tell me all about the results. I have to say, the fact that she made a point to call me at a specific time so that I could get to the phone was really great. And, she spent thirty minutes explaining everything to me. If you ever know someone who needs a fertility specialist, tell them about Dr. Detti at Fertility Associates of Memphis. I've heard all three of the doctors are great, but I know from experience how caring and thorough she is.

Here's what we learned:

1. Our karyotypes are good, which means that we do not have any chromosomal defects that would make it impossible or extremely difficult for a baby to grow to full term gestation. That's a big blessing and relief.

2. My metabolism has only one defect. I do not metabolize folic acid. Crazy! I will have to look up the odds of having that issue. I am a numbers kind of person. And, because it's best to find the humor in situations, I'd like to know just how unique I am. :) To solve this issue, I now take "fabb tabs" (that's really their name) in addition to regular prenatal vitamins. These are a special supplement of B vitamins and folic acid that will make me metabolize them.

Here's the most important news we learned...

3. I have one mutation in my chromosomes. It doesn't affect getting pregnant, but it seriously affects staying pregnant. I am a carrier for Factor V Leiden. I am Factor V Leiden Heterozygous, which means that I have one copy of the Factor V blood clotting gene and a normal copy of a regular blood clotting gene. That means that one of my parents has it and one does not. They have never been aware of this until I mentioned it yesterday. So, since I am a carrier, I am not at risk for the lifelong bad symptoms of the disease (thrombosis and other clotting problems due to this blood protein problem). However, because I am a carrier, the clotting disorder only affects me in specific situations, such as pregnancy or if I've had a broken bone or surgery and can't move for months.

Dr. Detti even specifically said that she believes this is the exact cause of the two miscarriages I've had. Basically, the one Factor V gene I have overtook my regular clotting gene because my body was in an irregular state: pregnancy. So, she believes that I clotted the blood in the placenta and the baby(ies) couldn't receive blood in order to grow.

I hate that we didn't know this earlier, but doctors generally don't run these tests until there have been more than one miscarriage. That makes sense to me, and I'm glad that we know this about me in terms of future pregnancies and general health.

So, we have another new plan.

See a hematologist on a regular basis. The hematologist and Dr. Detti will work together from now on. Sam also is going to be tested to see if he is a carrier for Factor V. That way we can know if our baby will have it. If he has it, which means they would definitely have it, we would know that they have the disorder and we can be educated about it.

Every day...

Take the thyroid med to keep my thyroid in the range that research says is most likely to lead to pregnancy. Take my prenatal vitamin. Take my "fabb tab" to give me some folic acid.

Days 3-7....

Take 100 mg Clomid to try to ovulate and combat the effects of PCOS. Keep taking my "every day" meds.

Day 8...

Begin taking baby aspirin every day to fight the affects of Factor V, in case I do pregnant. Keep taking my "every day" meds.

Day 13...

I will have an ultrasound to see if it looks like the Clomid worked. If it has, I'll have my Ovidrel hcg trigger shot to force ovulation. If it looks like I need more time, I'll have the shot a couple days later. I will also keep taking my aspirin and "every day" meds.

If I do get pregnant, then I'll keep taking my "every day" meds and aspirin. We will also add in progesterone (since I don't produce enough to keep a pregnancy going on my own) and two shots each day of Heparin to fight the clotting. I'll also weekly ultrasounds through the first trimester (or so) to make sure all the meds are doing what they need to do).

So, that's the news. We are thankful that our karyotypes are fine and that we do not have any major factors that would further inhibit getting pregnant. It's also nice to know that there seems to be a specific cause of the miscarriages. I think that God definitely has a plan for the timing and that maybe part of his timing involves us learning all this stuff. I am glad to know that the issue is one that will only affect my health in specific situations and that it's not a risky situation for my life. I think it's also good to know that, because I am a carrier, my parents can be tested to find out what can be done to treat/handle it.