We had our appointment with the fertility specialist yesterday, and it went much the way I expected. The doctor is testing for a few more things, and we meet again in three weeks to go over the test results. The doctor was pretty great; he spent over half an hour just going over my charts from the other doctors and talking with us. I have every confidence we are in the best medical hands we could be in, so I trust that we’re in the right place. If there is anything to find and fix, this man will find it.
Based on our history and previously healthy test results, the doctor more or less said there wouldn’t really be anything else to look for if these blood tests are normal. This round of tests will look for more antibodies and clotting factors than have previously been tested for. If anything does show up, then we should be able to treat it in future pregnancies. If nothing shows up on the blood tests, then we are faced with trying again and having the new doctor follow us through the pregnancy from the beginning. He would monitor everything more closely than is really possible in a regular OB office. Then, if things go south, he would do a d&c so they could do chromosome testing on the embryo. My interpretation is bleak at best, I know, but we are faced with the same circle of gloom and despair with every test: I am always hoping to find something wrong with me so we have something proactive to do next time; finding nothing but healthy normal ranges means that all we can do is try again and hope for the best, which hasn’t really worked for us yet.
More than a few times, when reporting a good test result, I have been faced with holding back the rant I’d like to let loose on the unsuspecting commenter. Usually the person says something along the lines of, “Well, that’s good – you’re healthy, and now you know that’s not the problem.” There is nothing wrong with that line of reasoning, except it frustrates the hell out of me: if that’s not the problem, then what is? I know how messed up it is to hope for some bizarre disease or structural malformation to treat; it is not sane to wish for a health problem (although I think we may all do it at some point in an effort to avoid something else we see as far worse). I’m not sure how much more sane trying again is at this point. I keep hearing the quote, “The definition of insanity is trying the same thing over and over again expecting a different result.” Am I not the walking definition of insanity, then? The ugly truth is that, in this situation, I would rather find a problem because then I would have a circumstance I could control. There, I said it: I want to have some control over the process and outcome. I want to know going in that I have bettered my odds at a successful pregnancy. I want to know that this time, statistics are on my side. Bizarre medical condition = discernible and treatable condition. Thus changing the current equation, healthy parents + pregnancy = miscarriage.
But the flip side to my desire for control is the effect it would have on my faith. If I could control any part of the equation, would I still be trusting God? I think so, but usually my desire for control reflects a lack of faith and trust in some part of the system. Finding nothing on the blood tests would mean continuing in faith through another pregnancy, which I would do, but I would not be happy about it. I know the pain and devastation another loss would wreak on our lives, and I’m a little exhausted and more than a little depressed about the prospect of yet another miscarriage. Before you feel tempted to reply with some affirmation of God’s power, I know that God could provide us with a successful pregnancy. I know it could happen because God can do anything, but those of you who are still tempted to encourage me on this point have to realize that blind hope in a possible success means it hurts that much more to fail. Statistically (and I know that statistics are meaningless to God), I have less than a 50% chance of a successful pregnancy, even if no cause is found (this link shows the average of the stats I’ve read online, and they actually cite their source material: http://miscarriage.about.com/od/riskfactors/a/miscrates.htm). Based on that, I’m doing really well right now to have more than 50% hope of success when we try again; that rate will improve with time and distance, and I recognize that rating my hope possibly indicates that my faith is woefully lacking.
A side bar on the statistics, or all the things you never wanted to know but are reading right now anyway (I can’t recall all of the sources, but a general overview of well-vetted stats can be found on most sites like American Pregnancy Association or What to Expect, etc.): only about 1% of the population experiences recurrent miscarriage, defined as 3 or more pregnancy losses. Of those 1%, less than half ever find a diagnosis. On the positive side, women with two or fewer miscarriages are really no more likely to miscarry in their next pregnancy, and some sources even say that women with recurrent miscarriage who have no medical explanation for it have a 75% success rate in their next pregnancy, making them only slightly more likely to miscarry. Of course, there are some sources who put my success rate at 5% or less after more than four miscarriages. The bottom line is, often the doctors are as clueless as we mere mortals are, and if you try anything enough times, you might succeed. Or go completely insane. I’m still waiting to figure out which direction I’m headed.
Lest my statistical rant or my morbid desire to find an actual problem in the blood work have left you terrified that I require constant adult supervision, here’s my bottom line. We will wait for three weeks before seriously thinking any more about tests or trying again or anything related to it. There is no point in discussing options without all of the facts. I will try my hardest not to think about it until we have actual results and the good doctor’s opinion. If our only option is trying again with close observation, I’m sure we will, but it will likely be at least five months before I want to think about that. I pray everyday that God will “help my unbelief,” and I still believe we might have our own children. And I’m sure we will pursue other options when we’re ready for that step. In the meantime, we wait some more.