I just had my WTF appointment with my RE (if you don't know, a WTF appointment is exactly what you think it is--What The Fuck...as in, what went wrong) and she gave me a lot to think about.
First, she said that even though it doesn't seem like it, this pregnancy is a very positive sign. It shows us that my eggs and The Coach's sperm can meet and fertilize. Obviously the result wasn't what we wanted but she said they have statistical data that shows once someone (in my age bracket) achieves any type of pregnancy once, they have a higher chance of achieving pregnancy again in the future. It gives us a better prognosis for the future. She also said that in my age bracket, each pregnancy has a 20-25% chance or resulting in a chemical pregnancy, if there are no known problems (chromosome abnormalities, clotting disorders, ect.). So, essentially she said what I was expecting...we likely [hopefully] just fell on the wrong side of a bad statistic.
She also mentioned that, of course, they don't know for sure where the pregnancy occurred and started to implant (uterus versus fallopian tubes) because there was no ultrasound performed. She said that research shows that 98% of chemical pregnancies do form in the uterus, which is a good thing.
She finds it "interesting" that I did get pregnant my first month on my new protocol (adding in the Menopur) and that the Menopur must have done the trick.
We discussed my "low progesterone" during the pregnancy and she confirmed what many wonderful ladies on the message board I frequent had told me...that progesterone suppositories get the progesterone where it is needed (the uterus) and therefore isn't accurately reflected in blood work. She said they have found that typically, while on supps, the progesterone is actually 6x higher than the blood work shows. She did say, however, that in the future they would start me on 3 suppositories per day immediately instead of one. That's when I asked her about PIO shots instead of suppositories and she said "Knowing you and your personality, I'm sure hearing the actual progesterone level number is what you want so if you'd like to do PIO instead of supps, that's fine with me". Ha! She knows I'm psycho...
She said they really don't recommend doing any testing (karyotyping or RPL testing) until 2 loses. But, again, knowing me and my personality, she said she would go ahead and approve a thrombosis profile right now so I'll be scheduling that next week.
Her recommendation is to take this month off, go in with my next period for a baseline and if all is well, cycle again using the 150iu Follistim+150iu Menopur+1cc PIO. Then if that cycle is unsuccessful, she wants to go ahead with the lap/hysteroscopy in January to check for scar tissue, uterus issues and endo. If this next cycle were to result in another chemical, she'd also add in the karyotyping and RPL.
I'm still pretty uninterested in doing another cycle but The Coach really wants to and our RE said she is hopeful. When I was telling The Coach about the WTF appointment he said he heard optimism in my voice...hmmmm...
I will definitely do the thrombosis profile and go in for a baseline to check for cysts with my next period. Beyond that, I can't promise anything right now.
At the end of the conversation my RE told me "Hang in there sweetie...stay with her and we will get through this..."
I guess I need to try to believe her....