In mid-December I finally had my long-awaited consultation with my new Reproductive Endocrinologist. It went really well, and I felt like I got a lot of good information. I waited over three months to speak with my new doctor because he is really in demand and booked out far on his schedule. The extra time I waited also allowed my body to heal and I am happy to report I currently have no scarring remaining from my last surgery. But with Asherman’s Syndrome the scarring could return at a later time, so it’s a kind of wait and see thing.

 

 

 

 

When I spoke with my new RE for our initial consultation, he let me know he had not received my medical records from either my local OBGYN or my previous fertility clinic. Dang it! I was worried this was going to happen. I don’t think I allowed enough time for my records to arrive to new doctor, since I filled out my ROI only one week before my consultation. I really should have completed those ROI’s sooner. Oh well, live and learn.

I created a last minute backup plan for this exact scenario of him saying, “We didn’t receive any of your records.” I created a master document of all of my fertility records. Yes, that’s right, I create one entire document of over four years of fertility records. It took a lot of time, but I really needed to do something like this sooner. I compiled all the records I had on hand. The whole point to doing this was to have a single go-to record so that I could easily search for information. After the document was done, all I had to do was type “ctrl+f” to search the document for specific keywords related to what I needed to find out, rather than wasting time flipping through hundreds of medical documents. 

This method worked wonders during my consultation. Every question he had that I didn’t know off the top of my head, I was able to quickly find, therefore making my consultation much more productive. I was able to come up with the answer for everything he asked. It would have otherwise been really difficult to remember every single minute detail like “what dose of Leuprolide were you on in August 2018?” Because who the hell remembers that stuff?

So what did we actually discuss in our consultation? After I told him about my recent surgery to correct the scar tissue, as well as the discovery of my septate uterus, he was shocked to hear that I never had an HSG much earlier. He told me it should have been one of the first things they did in the beginning, not four years later. This is the second doctor who said the same thing. Clearly, there was a huge gap in my treatment early on that was missed with my previous RE. I was born with a septate uterus (increases risk of recurrent miscarriages), and the fact that no doctor out of a handful that I’ve seen tested me for this at all was honestly nothing short of negligent. But thankfully, the discovery of the septate uterus and the subsequent corrective surgery has put me on a much better path to hopefully have a successful pregnancy in the future.

After we talked about my septate uterus and scar tissue surgery that happened in October 2020, we started discussing my MTHFR gene mutation, which can cause issues with processing folate (needed during pregnancy). He had a very interesting take on my MTHFR gene mutation and whether they were related to the babies I lost due to trisomy disorders. He believes that the MTHFR gene mutation is related to inflammation in the body. I wish I could remember all the details of what he talked about, but it essentially boiled down to reducing the “expression” of the gene mutation by focusing on reducing inflammation. 

The diet he recommended to help improve my egg quality and overall health is actually quite a strict diet. It is similar to Carnivore Keto, focusing on beef, bacon, butter, and Keto ice cream. He told me to avoid vegetables and not to do most exercises (except for yoga or gentle walking). He explained that vegetables have pesticides and toxins on them that can cause inflammation in our body. He said exercise that is moderate or high intensity “cooks the reproductive organs” and causes inflammation. He recommended in addition to the mostly meat diet he recommended that I also do intermittent fasting, eating one meal per day plus one snack. “No problemo” I thought to myself, because I have already been doing intermittent fasting fairly consistently these past few months. Can you see where this is heading? If not, I’ll talk about how my first week of this diet went in a minute.

But before I get into how this diet actually worked for me, let me talk about the fact that you can probably already tell that most of what he recommended to me is completely unorthodox compared to what most doctors tell you. Other doctors say, “Eat lots of fruits and vegetables, reduce meats, especially red meats. Get enough exercise.” So essentially everything my new RE was telling me was the polar opposite of everything I had ever known about being healthy in general, and opposite of what I had learned about improving fertility. 

But during the consultation I kept a completely open mind, I listened to him emphasizing the importance of reducing inflammation and how his style of Keto could do this. It actually sounded good in theory. I mean, everything else I have tried hasn’t worked, so why not try what he is saying. Why not try the opposite of what all my other doctors have said? I really had nothing to lose. Also, it was really fascinating to listen to a completely different take on a fertility diet.

 

 

He looked at my previous medication protocol, which included very high doses of stimulation medication during my IVF cycles. We are talking “maxed out” dosages here, yet I was still a low and slow responder, with few eggs being produced. He also had a different take on how I should do my next IVF round. So after two rounds of high-dose IVF medication, he suggested I instead do something called Mini IVF. This is one thing I have not tried yet. I’ve recently learned about this alternative medication protocol which focuses on a lower dosage of medication over a longer period of time. It’s meant to help women such as myself who are “poor responders” to high doses. The logic is it allows women who have poor egg quality or too few eggs, to have plenty of time to produce quality eggs at a slower rate. Granted, you generally produce less eggs, but the idea is that you will have better quality eggs. I mean, why not try it? It’s a totally new approach that is actually recommended for someone like me with low AMH and low egg counts during IVF. I heard about Mini IVF before, and I have heard good things, as well as some who also say it’s a waste of time, but I’ve mostly heard good things. I’m willing to try it, especially since the high doses did not work for me twice.

The last thing he asked me was “When are you thinking of doing IVF again?” Great question Doc. I thought about this question a lot before my consultation, which happened to be during the time I purposely chose to take a break from fertility treatment. I needed the break for my physical and emotional health. I was tired of dealing with the ups and downs of the hormonal medication as well as the constant stream of baby-on-the-brain thoughts. I needed a friggin’ break! But here I am in my consultation and I needed to answer his question. How do I answer this? 

Well I discussed this question with my husband as well as with my mom, especially in regard to the current COVID pandemic. After much careful thought and consideration, I decided to postpone fertility treatment until after I get the COVID vaccine. So many factors went into this decision, and I feel it is the best choice for us. I am currently in the process of trying to sign up for the COVID vaccination (because my work offers it) but I am dealing with technical issues on their website. So as of right now I am “eligible” for the vaccine, but I am waiting to hear back about how to fix the scheduling issue. I’m hoping I will be able to get this vaccine soon.

So to answer my RE’s question of “When are you thinking of doing IVF again?” I let my him know I am waiting for the vaccine, then I will most likely be ready to start a round of Mini IVF. As far as my physical and emotional health have been going, I feel like I am in a much better space lately. I’ve lost some weight and emotionally I feel so much better being off of fertility medication. I feel re-centered and a lot happier. It’s a great feeling, and I don’t regret taking this break from fertility treatment. I feel “normal” and more content than I was before. Even when I attended my infertility group online, I can tell I feel a lot better because my updates I share with them are not based around “When am I going to have a baby?” or “Why is this happening to me?” or “Everyone else is having a baby, why not me?” All of those thoughts have been reduced significantly. They occasionally come up from time to time, but it’s a lot less. 

Oh, and how was this new, radical diet that my doctor recommended to me? Well, it’s just not for me. I gave it the old college try, and did it for a week. But I found myself feeling ravenous which led me to be concerned I was going to start a binging cycle. I’ve heard that extreme forms of keto can lead some people to develop eating disorders like binging. I decided to take a step back and reevaluate what is reasonable for me. I think a more moderate approach is needed in my case. I decided a more doable option is to incorporate standard keto in my life for part of the week, and not carnivore keto every single day. 

I’m still testing the keto waters, and trying to see how often I can realistically do this in a given week. Currently I am going to try 3-4 times per week on standard keto. I’m already doing intermittent fasting which is now really doable for me and I’m not having any issues with this. So I am going to keep doing intermittent fasting and add in Keto for part of the week. Hopefully this moderate approach will help reduce inflammation, like my doctor wants for me. I’m also adding in more exercise, just not super strenuous. I believe moderate exercise will probably be okay in my case because I do have some weight I need to lose. I will continue to focus on my overall health and hopefully the next time I write I will have had the COVID vaccine.