And So It Goes

I have had a lot of conversations with the RE over the past week.  In fact, I think today is the first day I haven't spoken to him since last Thursday (the weekend not included).  It feels odd.  I'm kind of hoping to hear from him regarding the various blood tests that were being run.

As for those tests, one result has come in.  Apparently I have an anomaly in my PIA-1 level.  Most people have an 4G/4G or 4G/5G allele.  I have a 5G/5G level.  My doctor spoke to a hematologist who said that, pending my seeing him or another hematologist, that most likely it would be recommended that I begin a course of injectable blood thinners post egg retrieval.  From the little bit I understand, this anomaly can cause a person to develop blood clots which, in the case of pregnancy, can prevent implantation and could also cause complications further along in pregnancy.

None of the other panels have come back yet.  Hopefully there won't be anything else unusual in those results, so only this one will need to be investigated further.

Of course, my RE wants me to see his friend who is at one of the most prominent practices in the city.  And, of course, they do not accept my insurance.  Even if they did, I would need to get a referral from my primary care physician.

So, in the hopes of seeing someone in-network (of which there are surprisingly few based on a preliminary search on-line), I have an appointment on Monday to secure a referral.  It's not with my primary care (he's booked through the end of October), but another doctor at the practice.  Hopefully his doctor will understand the urgency and will expedite the referral (my the potential egg retrieval date is in three weeks).

Failing a quick referral, I have spoken to the office manager at this specialist's office.  She was lovely.  While an initial consultation is only $325, if the doctor wants to order any tests, those can start anywhere from $200 - $300.  She gave me her direct number and said that, if I can't get an in-network referral quickly enough, I would be able to get an appointment with this doctor within a day or two of calling.

My RE also said that if I'm comfortable with adding the injectable blood thinner to my protocol this cycle, he will prescribe it without my first consulting with a hematologist.  And from what I've read on various fertility sites/forums, most women who have this same anomaly have been put on this med, so it appears to be the most likely course of action.

Tuesday I'm set to begin Lupron again.  While the initial protocol in my calendar dictated no changes from our first (failed) attempt with this med, after speaking with my RE, he opted to increase the dosage to prevent my body from "break through."  I'll know on October 4th if the suppression was successful.  My fingers are crossed.