In this rant-like blog post, I vent about a recent frustration with my fertility clinic. This post isn’t eloquently written or poetically articulated. I am angry. And I vent. Like a 14-year-old girl after not getting chosen for Varsity basketball…but more significant than that. (PS: Cory is the cover photo because he makes me happy and calm…and I need a little bit of that in my life right now.)
Hey Unicorn Community.
I have 20 minutes to write this blog post before I head to acupuncture. I need to write. I need to vent. I am so totally completely frustrated right now, and I need to be heard.
This might get a little fertility-technical, so I apologize in advance.
And I don’t have a ton of time to edit, so hold on tight…I’m just gonna let it spew out of me.
After my recent uterine exams and chat with my doctor, it was decided that we were going to more forward with a frozen embryo transfer (FET) - this is where they take one of our frozen embryos, put it in my half-sized uterus, and hope to the Universe that it sticks. This transfer was going to take place early February, right around my 33rd birthday. I was excited!
Then yesterday, I spoke with another IVF nurse about the more realistic timeframe for the transfer. She told me I would have to take birth control for 16-25 days starting 1/2/19, then I would need to prep my uterus for 16 days (with Lupron, estrogen, and progesterone in oil intramuscular shots on the daily). My FET would be closer to mid-to-late February when all was said and done. No big deal. This was just a couple weeks later than I expected.
BUT THEN TODAY.
Today I got a call from Conceptions in regard to my recent bloodwork checking my Vitamin D and thyroid levels. My Vitamin D was fine, no surprise, but my thyroid levels were too high for the happy fertility range even though I have been on .25 mg of Synthroid since May 2018. My thyroid is currently at 3.6, and it needs to be 2.5 or lower to move forward with a transfer. The woman from the clinic told me they would increase my Synthroid to .50 mg, and we would re-check my levels in 4-6 week. IF and only IF then they were below 2.5, then I could be transferred to the “Transfer Team” and start the 4-6 week transfer prep cycle(s). If my levels are still too high then, they’ll have to increase the dosage yet again, and we’ll have to wait another 4-6 weeks to see if they drop to 2.5 or lower.
I was infuriated. Frustrated. Disappointed.
But why all the negative feels, Kristen?, you might be asking me through the screen of your cell phone / computer right now.
Because Conceptions should have been monitoring my thyroid levels all along, rather than waiting until the final countdown to check in on where they’re at. When Conceptions first looked at my thyroid levels on 6/28/18, I was at 3.71 (remember less than 2.5 is needed for a transfer). I had already been on Synthroid for one month when they assessed me back in June, and I was STILL much higher than the target level of 2.5. Then why weren’t my thyroid levels re-checked in August or September, I asked the woman on the phone. The woman explained that thyroid levels are only checked every 6 months because I have been taking Synthroid. (Wait, what? That makes no sense.) I pressed on.
Why wasn’t my IVF nurse better managing my thyroid levels through the late summer and fall in preparation for this transfer? Why wasn’t my Synthroid dosage changed MONTHS ago when they would have inevitably found that my levels were still too high?
“I don’t know. That’s a good question, and I don’t know,” the poor, unsuspecting IVF assistant said to me softly on the phone.
And then I unleashed. Well, the Kristen version of unleashed which looks like a stern voice and empowered, self-advocating language like:
“I feel like my thyroid levels have been mismanaged by Conceptions.”
“I feel like Conceptions dropped the ball in managing my thyroid levels in preparation for this transfer cycle.”
“This 4-6 week delay is unacceptable given my low ovarian reserve. I feel like a ticking-time-bomb based on my conversations with Dr. Bush and my nurse. My ovarian reserve is dropping by the month and moving forward efficiently, in a timely manner is imperative.”
“If my upcoming transfer does not work, the plan is to do another egg retrieval to try to get more embryos. Dr. Bush recommended this plan. If we have to wait 4-6 more weeks for my thyroid levels, then 4-6 more weeks for the transfer cycle, then a 2-week-wait after the transfer to see if I’m pregnant, and then 4-6 weeks after the transfer if it fails, it’ll be 5-6 MONTHS until I can do another egg retrieval. My ovarian reserve does not have the time to delay this.”
The woman validated my feelings and told me I could speak with the lead IVF nurse tomorrow. I told her that I would very much like to speak with her tomorrow…sign me up.
I totally, 110% get that my thyroid levels need to be in a good range prior to transferring an embryo. I totally get that taking care of this now is better than transferring with too-high thyroid levels. I totally get that it is worth getting my ducks in a row prior to transferring one of my precious three embryos. I totally get that.
What I don’t get is that the clinic knew my levels were high at 3.71 already on Synthroid (June 2018), and they knew my levels had to (magically?) decrease to below 2.5 by the time of a transfer (NOW). As a layperson, non-doctor, I didn’t know that my thyroid levels had to be below 2.5. Back in June, I was barely digesting the fact that I was experiencing infertility issues…that I had a unicornuate uterus with endometriosis…that I had low ovarian reserve…that I most likely was not going to get pregnant on my own…that I needed to use my savings to pay thousands of dollars for fertility treatments. Back in June, I was barely aware that of my thyroid stimulating hormone (TSH) levels. I vaguely remember my OBGYN saying that they were “slightly elevated but subclinical but that the Synthroid should bring me down to levels suited for fertility.
As the patient, it is not my responsibility to know everything that’s out there about TSH levels…I have no idea. (But you better believe that now that I’m educated I will be monitoring these levels like a hawk.) This is why I pay a “top-notch” reproductive endocrinologist and his medical team the big bucks. To be aware of these levels and let me know what I need to do about them (wow I sound snarky!). I follow instructions. I do not identify plans of care or diagnose or prescribe. What the heck have they been doing all this time knowing my TSH was 3.71 SIX months ago?!
Okay - that’s all I have. 20 minutes passed. I need to jet to get to acupuncture on time.
Please tell me that everything is going to be alright. Please tell me that I’ll eventually have a baby in my arms. Please tell me that everything isn’t ruined because of this.
I’m going to pause, breathe, and read this beautiful poem to anchor me to this moment. This now. The only thing that is real.
-A very frazzled Kristen trying to will herself to say “Thank you.”