Follow up with our Doctor

Today we had an appointment with our doctor. The appointment was scheduled at the same time as the FET and I was to cancel it if we got pregnant. Given that I have made an initial appointment with another clinic, I intended to cancel it but I forgot.

When we walked in she started by saying how very disappointed she was that the FET was not successful. She explained that she had expected that this was it and was surprised by the negative. She also told us that the blasts were top grade quality and that my cycle had gone very well in terms of hormone levels. She wants us to try another FET with a natural cycle where they monitor my cycle through to ovulation and then transfer five days later without any medication (except Metformin)

When asked why she was suggesting this, she explained that despite her exhaustive testing she could find no reason why we were not getting pregnant. She thought that perhaps we were just "on the wrong side of the odds" and thought that maybe the medication was interferring with success.

This was my opportunity to ask more pointed questions about my situation. Explaining that I was doing research myself I asked her to go through the tests and results.

Surprisingly my day 3 FSH and LH numbers are normal. My freestanding testosterone is also in the normal range. My estrogen levels are ok and we know that most months I ovulate on my own (although when I am very stressed by outside factors I do not). My cholestrol is on the low end of normal and my fasting glucose and insulin levels were on the low end of normal.

My 2 hour insulin level was still very high which indicates insulin resistance but apparently only moderately so. My fasting insulin level was 42 and 2 hours post sugar test it was still 264. She explained that 264 is in the normal range but generally they like to see the insulin level come down to fasting level wihtin 2 hours. So my insulin level could have been 260 at fasting and then 260 2 hours later and that would have been fine but because it was 42 it should have gone back down.

My HSG showed no blockages in my tubes and the dye was able to pass through easily and my histosonogram showed a healthy uterus with no signs of cysts, endo or scar tissue.

I did not do a laparoscopy so it is possible that my ovaries are misplaced and my eggs never get into my tubes which would explain why we were not able to get pregnant on our own but would not explain the lack of success with the Invitro and FET.

I am just so confused. I bought this excellent book that takes you through all the new fertility treatments and tests and I thought that clearly my doctor had not done them and if we did we would be able to explain and fix our problem. But she has done every one except the lap and an endometrial biopsy.

I told her that if I decided on a natural cycle I did not want to do it until June when I was finished work, or working part time and had less stress. She agreed that stress can play a big role and agreed that we should wait.

I asked about the biopsy and she said she did not have any reason to think that there was a problem with my lining but if I wanted I could do a cycle monitor in May and have the biopsy. The cost is covered so it would be no expense to me.

Now I feel like I am right back to the beginning. Maybe it has been about the drugs. With the stims my estrogen climbed to over 14,000. Or maybe we have been on the wrong side of the odds and there is no "reason" why it couldn't work. We have 5 frozen embryo's left at this clinic. Should I switch clinics?