Sunday, May 16, 2010

This gene is a MTHFR

As I sit here on bed rest at 5 weeks pregnant, I am hopeful, scared, bored and lonely. I decided to write this blog to capture my past, present and future battles with recurrent pregnancy loss.

January 2005 while living in Brazil, I became pregnant with my son. He is now 3 (he would add "and a half" here with every ounce of pride that a 3 year old can muster). Simple, easy. I give these details because only in hind sight do I think that something about living there allowed me to get pregnant and carry a healthy baby. Was it diet, caipirinhas, or the Brazilian way of life? Possibly it was it the magical pink dolphins we swam with in the Amazon that are supposed to impregnate the village women? I am still pondering these questions.

In 2008 we became pregnant for the second time. We rejoiced and told EVERYONE. (Lesson #1 learned.) Then at 8 weeks, I began spotting and spotting turned into bleeding and I went to the ER where they said there was no evidence of a pregnancy and it was deemed a blighted ovum.

A few months later we conceived baby #3. At about 6 weeks pregnant, I began having serious pain on my right ovary. Blinding pain. I thought my ovary was going to explode. Those of you with ovaries know that you KNOW when it is your ovary. It isn't indigestion or sciatica, like they tried to convince me. It is a OVARY! I went to the ER. There I met the most horrible of all OBGYNs, Dr. Golden. She ran some blood work and then did an ultrasound where she told me with absolutely no feeling in her voice and without an ounce of concern or compassion that she "highly doubted this was a viable pregnancy" and then she turned around and walked out the room. Not even addressing the searing pain in my side (which was later diagnosed as a bleeding corpus lutem cyst). Although my HCG levels were still fine, the ultrasound was showing an empty sac. The next few weeks were MISERABLE. I think I had 1-2 ultrasounds a week for the next 3 weeks. The doctors could never tell me beyond a shadow of a doubt that the pregnancy wasn't healthy. Each scan revealed a slight change with the fetus. First there was an empty sac, then a small yolk sac, then a "possible" fetal pole. In the end, at 11 weeks gestation, we had a d & c. Super fun. When we went back for our follow up appointment after the "procedure", the doctor informed me that the lab results were showing that I had a partial MOLAR pregnancy (insert the dun-dun from Law & Order).

I dare you to google molar pregancy. Go ahead do it.

The doctor began explaining the follow-up treatment. This included chest x-rays, weekly blood work and waiting a least 6 months before attempting pregnancy again. The worry here is that apparently the "molar" cells can regrow. These rouge cells can multiply and potentially cause CANCER. Yes, it is possible to get cancer from getting pregnant. Who knew? Who the %$# knew?

After getting the go ahead from the physician, we quickly became pregnant with #4. The ultrasounds at 6, 7 and 8 weeks revealed no fetal pole. The pregnancy was once again deemed "not viable". A d&c was scheduled, but the night before I was supposed to go in, I miscarried on my own. I will withhold the details or this. Let's just say 'yuck'.

After the 3rd miscarriage, we decided to seek the advice of a fertility doc. I asked my OB for my records, she copied them and sent me on my way. In the parking lot of the doctor's office, I decided to face my medical records and read about all the crap that has happened. This is when I read through my labs, ultrasound reports, surgical reports, office visit summaries. When reading through these documents, I found a lab report. On the top of this report I saw ***Patient is homozygous for methylenetetrahydrofolate reductase***. This was the first time I had ever heard these words. Needless to say I didn't understand a word of it. I figured must not be important if my doctor hadn't mentioned it. The asterisks on the page did bother me, though.
Met with the fertility doctor. I handed him over my medical records. He asked me to give him 5 minutes to review. He came back in the room after 1 minute and said "I found a problem". He said I have what is commonly called MTHFR. My husband and I laughed out loud. I have been called a lot of things in my life. MTHFR??? Couldn't they have thought of a better acronym?? He looked at me like I was a martian and didn't get the comedy. I gently tried to explain that the acronym was funny, not the diagnosis. Still lost on him. All business this one.
He then explained the implications of the MTHFR.

Go ahead, google that, I double dare you!

MTHFR has a host of super fun implications. Some of my favorites: stroke, heart disease, Alzheimer's, drug addiction, Parkinson's, diabetes, and recurrent pregnancy loss (dun dun).

His suggestion was to 1) follow up with a hematologist to make sure there are no clotting issues 2) immediately begin taking Folgard, 81 mg of aspirin and a prenatal vitamin. 3) once pregnant begin with twice daily shots of Heparin (in the stomach, fun times) and prometrium (Progesterone taken intravaginally, no less).

We found out we were pregnant again at the end of April, 2010. I immediately made an appointment with the fertility doctor to begin with the treatment plan. About a week later, I began spotting. I had an ultrasound at about 5 weeks pregnant and they said there was a "questionable sac". They want to repeat the ultrasound in a week. Now I have been spotting/bleeding for over a week, which is why I am on bed rest, and I am anxiously awaiting the ultrasound scheduled for tomorrow. Fingers crossed. Stay tuned.....

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