Monday, April 02, 2007

Apparently Normal

Well, you could have fooled me, but anyway Mr. Spouse was chuffed that his genetic analysis said that. So did mine. The consultant went through all the other results again - a couple of things are slightly quirky (apparently the mini-sacs on one ovary are not follicles, but something they can't quite explain found in 25% of healthy women, but if I had PCOS my hormone levels would be skewiff, and both ovaries would be about 3 times the size, and there is one blood test that is high and is found to be high in about 15% of RPL women as opposed to 5% of other women, but it doesn't make a difference to the outcome, and is usually linked to lupus or another immune problem, but I don't have any of the markers for those).

He reckons our chances with the next pregnancy are about 60%, which is good, as I was reckoning on 40-50%, and he says that given the signs, the next year should be fine for my fertility, and there isn't much difference between 41 and 40. Which is quite good, really, if I actually think about it, as so many other people seem to be saying "ooh, doom and gloom, pregnant past 40, forget it, it's the point of no return". He didn't think much to our suggestions of male factor and/or stress - there is an effect of both of these, but it's small compared to the effect of previous losses and of my age.

It's hard, though, to actually think about it. He did say that with no explanation for the miscarriages, I am in the best outcome group, and although we want to go along and be told a reason and that they can fix it, in fact we have a much better prognosis. But of course that's not what people (i.e. us) want. We want the magic wand and the crystal ball. Apparently about 25% of couples with RPL who come to the clinic don't try to get pregnant again. Since, by definition, you have to have got pregnant 3 times, it suggests you must have been keen to have children in the first place - so it says something that these couples don't try any more.

As for us? Well, I don't know. I don't think we'll be going for IVF. PGS is, as I suspected, a pointless exercise. He thinks it's a combination of the sample size and the willingness to get paid for treatments - not falsification of results, but the file drawer problem. If you'll get paid for doing a treatment, you don't publish the study that says there's no point in doing the treatment. He said there's a study soon to come out from Belgium or Holland saying that in a large population, prospective design there's no point in PGD for translocations, either. IVF with multiple embryos has no evidence to support it - and, given I'm relatively fertile and we would never countenance triplets, not much to recommend it for us, either.

This leaves trying again, and adoption. Try again now and put adoption on hold? Carry on trying vaguely while pursuing adoption? Have a break from trying and carry on with adoption? Just have a break? No idea. I feel like I should want to get on with something, but I'm not sure I really do - I thought I might be all gung-ho for one or the other, and maybe even wanting to ring the social worker before we go away, but I'm not sure I want to. But we are going to London on Weds and the land of Beer and Chocolate next week, so we will have a break from, well, from not doing very much work and feeling guilty about it.

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