Time for a second opinion?

[Anonymous]

Hello All,

This is my first time posting. I am a patient at SG in Fair Oaks (30 years old with unexplained infertility). We tried 3 IUIs before moving to IVF. We did 3 fresh cycles (one resulting in a chemical, one with nothing and another freeze all PGD) and 3 FETs (one chemical and one 6 weeks miscarriage). Each time the doctor tells us he believes I do not have anything going on to make it impossible for me to carry a pregnancy (two HSGs, a hysteroscopy, MRI). We have been on lovenox and prednisole the past several cycles (as a catch all since I don't think they have actually tested me for any immune or clotting issues) and our PGD cycle resulted in 6 normal embryos out of 8.

The miscarriage we just had started off as an excellent looking twin pregnancy. We knew they were genetically normal and after a short bleeding scare on Saturday everything looked great in the ultrasound the following day. Unfortunately I started bleeding heavily two days later and when they went back to look the following day both sacs were gone. RE thinks it was low progesterone. Is this possible? (My research shows that usually low progesterone is from genetically abnormal embryos) We have been using endometrin suppositories instead of the PIO shots (our first FET I was in so much pain I only made it a week and since then we have just used suppositories). Aside from feeling angry that all I needed to do was get shots to protect them, I'm not sure I really believe or trust him.

So I'm looking for some advice… what would you do? I don't think my RE is thinking "outside the box" here but I also feel stuck because of shared risk (we have 4 more embryos in the freezer). I don't want to go through another loss and if we need to consider a GC I would rather just start the search now than "waste" anymore embryos. Has anyone gotten a second opinion within the same practice? How do you go about doing it? Has anyone left SG for a second opinion but returned for treatment? I know there isn't much they can do differently with an FET but I feel dumb for how long we have stuck it out without success.

Any advice or help would be great.

[Anonymous]

OP, I am very sorry for your loss.
I think it's high time to seek a second or third opinion who is willing to look at you from a different perspective. Your RE may be ultimately right but it gives comfort when a different RE studies your case and gives you a similar opinion.
SG doesn't believe in immune issues. I'd suggest look for someone who is willing to consider immune issues also. Since you are young, egg quality might not be that much of an issue.
I am someone who is struggling as much as you. Good luck to us.

[Anonymous]

Definitely get a second opinion from someone who will test for immune issues. To me, miscarrying genetically normal embryos screams a bigger issue and it might take an expert (reproductive immunologist) to figure out the problem and treat it.

I just had my 2nd successful pregnancy after 8 first trimester losses. Although we didn't have trouble getting pregnant implantation issues were found and treated. The belief might be somewhat controversial but for those of us who have been through it we know there is an immune component related to trophoblast invasion. Had the treatment not worked we would have gone with a GC.

If finances are not too much of a worry go see Dr. Braverman, otherwise make an appointment with Dr. Abbasi and get the testing she offers along with consulting with her and the Beer Center.

[Anonymous]

If you are asking whether you should get a second opinion then that generally means you should get a second opinion. I was afraid of wasting time starting over with a new doctor and new clinic, but in the end I got pregnant with the first cycle at the new clinic.