Our consult appointment/2nd opinion

Rewind, one week ago, I went with a friend of mine to one of her appointments at Oregon Reproductive Medicine (the clinic we are interested in). I got the chance to meet her doctor (Dr. Matteri) and ask a few questions. That same evening, Paul and I went to the free seminar, put on by ORM. We both felt comfortable with the clinic and liked Dr. Matteri's approach toward infertility treatment. We both felt we should meet with him one on one, so we made a consultation appointment, which took place this afternoon. My current clinic took longer than expected to fax over my records, so Dr. Matteri was not able to thoroughly look through them prior to our appointment. It worked out just fine, but when you only have an hour to discuss your case and future options, it makes a big difference if they are able to review your records beforehand.

Initially, without really knowing the nitty gritty about our embryo quality and the way things are done at NW Fertility Center, Dr. Matteri suspected that we may have a genetics problem resulting in genetically abnormal embryos. He said at ORM, if a couple transfers a total of 4 fresh (not frozen) good quality blastocyst embryos and they do not get pregnant, there is more than likely a genetic issue going on. But, the closer he looked at our embryo reports and the more info we provided him about the lab and the protocol for transfers, he said it sounds like a lab/protocol issue. That doesn't mean we are out of the dark concerning the genetics issue, but he is leaning toward the issue residing with the method/lab that NW Fertility Center uses for IVF. I appreciated that Dr. Matteri spoke very respectfully regarding our current clinic. He did not bash them or insult their practice, he just pointed out the ways that they are different and how ORM's differences are beneficial.

One of the major differences is the lab that ORM uses. They are one of the first clinics in the U.S. to put in a "clean room" lab where the embryos grow. Basically, it's a filtration system that removes any impurities from the air (dust, mold, etc.) to keep it sterile. Very important when growing embryos! Their lab is also operating 24/7, so they aren't continuously setting up and closing up shop every other month, another big advantage. Their team of embryologists are some of the best in the world, to boot.

Earlier, I mentioned that their protocol is different as well. In case you aren't familiar with this terminology, "protocol", in a nutshell is this: a clinic's medical guideline for how they make decisions regarding a patient's diagnosis, management of care, and treatment. Every clinic has their own way of doing things, you just need to find a clinic that fits your needs. I believe we have found just that--a clinic that fits our needs--and we are some needy people, so it seems!! ORM will monitor my hormone levels more frequently to ensure they are where they need to be, they suppress all their frozen embryo transfer patients with birth control pills and Lupron (just like I did for my fresh IVF cycles), they use del-estrogen and progesterone as shots intramuscularly to thicken the uterine lining so that the hormone goes directly into the bloodstream, and they advocate doing acupuncture before and after the transfer to increase blood flow to the uterus and minimize potential cramping. They also operate as a team of doctors, so they will collectively review your case if needed.

Dr. Matteri gave us some ideas of where to go from here, before transferring any of our frozen embryos. He suggested I have my blood drawn for the Anti-Mullerian Hormone (AMH) test, which is one of the very best predictors of egg quality to make sure I don't have bad eggs. The results take a couple weeks, so we will update when we know more. Once my next cycle begins, I will go in for a baseline ultrasound to make sure my ovaries and uterus look normal and they will draw blood to get my estradiol and FSH (follicle stimulating hormone) levels. If all looks good, I may start the birth control pill in preparation for my frozen embryo transfer. Their frozen transfer protocol is about 6-8 weeks long, which may interfere with our vacation planned for the end of April, so we may wait to transfer until after our vacation. Their embryologists are also going to review our embryo records next week and let us know what they think about the quality of them.

We're happy with how our appointment went. Hopefully in the next week or so, my cycle will start, and we will be one step closer in the process of becoming parents. Our journey is much like a popular roller coaster at a theme park. The journey consists of ups and downs, twists and turns, excitement and anticipation and long lines of waiting. Currently, we are moving forward in the line, but are not quite close enough to step into the seat. If you are reading this, we appreciate you taking this ride with us. Whether you strap yourselves in and ride the journey with us or simply cheer us on from the sidelines, we are grateful.

Waiting in line for our next ride...