Chatting with Dr. K

Dr. K's assistant phoned me today to tell me that Dr. K does not do biopsies for the EFT himself. We chatted a bit with me agreeing to email him with some questions that I had. He emailed me back rather fast. I was surprised.

Back and forth we emailed over the course of the morning and by noonish he was actually on the phone with my RE. I was thrilled by his willingness to coordinate with my RE. My RE agreed to do a biopsy but it was actually suggested to me by Dr. K (via my RE) that I should be moving on with donor embryo. Yes, I know that is the party line for any woman over a certain threshold of age. I wrote back and said I'd like to try two more cycles with my own eggs - I didn't mention that I am also trying to find a surrogate. I didn't hear back from Dr. K after this last note. I felt a bit down that it seemed that my RE was pushing me towards donor through this new party.

I realized, at one point, that in doing the EFT I was still hoping I could "do it myself". It's saddening how easily I slip back into hoping. I analyzed what I was feeling and realized that doing the EFT is potentially a point of closure for me. If Dr. K finds that my endometrium is completely whacked, I'll know what is probably the #1 reason I've had failures the last 5 years. I don't think that it would dissuade me from trying to find a surrogate though. Even if we figured out what was wrong with my endometrium, we might not be able to adequately address how to fix it within two cycles and for those two cycles to contain that elusive "one good embryo" that we all seek. I sort of hope that he does find my endometrium is substandard so I can move on with full speed to finding a surrogate. What if my lining is fine and the issue really is my eggs? It still doesn't explain why out of 30 or so embryos that not a single one decided to implant. As Dr. Moustache said, "Even if every one of your embryos had Down's, we'd still expect some of them to implant." I think that him finding a perfect endometrium would raise more questions...questions that just lead to heartache in the end because there's no easy answer.

So, for you ladies that are interested in this test, there are two sorts of EFTs that Dr. K does. One is a mock IVF cycle where the woman takes small amounts of E2 in the beginning (proliferation) part of the cycle and then switches to P4 around ovulation (25mg and increasing in steps up to 200mg). The other sort of EFT test is a "natural cycle" or what one might do if you were planning on doing a FET. In this sort of cycle you only use the progesterone (P4). So, you first need to ascertain which sort of cycle you'd likely be doing. But the problem here is that who really knows what sort of cycle they're going to do at any given point? I think we all plan on doing fresh cycles, but sometimes linings are off and you wind up freezing everything. I think it would be good to do both tests so that you know if there is a major difference in your endometrium between a fresh or frozen (P4 only) cycle. Doing both costs about $1000 plus the cost of the biopsy and shipping. It's experimental so there aren't CPT codes that insurance companies can utilize...so it winds up being a cash deal after the biopsy is done. In my opinion it's well worth it for peace of mind.

Tomorrow is CD3 and I would need to start my estrogen tomorrow if I was planning on testing for the mock IVF cycle. This one actually makes the most sense as it would tell me if the stims are messing up my endometrium. I've only done one FET in the last 5 years (2006) and we all know where that led. I'll call my RE in the AM to see if he'll write the scripts. I am so curious to know what Dr. K will find.