I am in love

I stopped taking my post-surgical darvocet yesterday so that I could make the 80 mile drive to Marlton, New Jersey. There was a horrible downpour on the way there that made me thankful that I didn't take my meds. I wound up there an hour early anyways which was good as they had a bunch of paperwork for me to fill out despite the stack of forms that I'd already faxed over.

The office facilities themselves aren't impressive. Rather mundane and low tech. That always scares me a bit but these guys have some of the best stats in the world for older women and women with higher FSH. I just have to trust that these guys are world class even if their office isn't.

Dr. Check was late due to the storm. I sat in his huge office, A/C on a bit too high, Loreena McKennitt blaring over the intercom. Interesting choice of music. His office was filled with medieval furniture - I sensed that this person was a romantic at heart. I figured he was a curious person, too. I waited for him for a while and a nurse finally came in to apologize again for his lateness. I explained to her that I was thinking of going the GS route so she brought in the Donor person to chat with me while I waited.

I got lots of great information on their donor program. They will indeed transfer into a compensated GS, no issues there. They gave me suggestions as to what to look out for (red flags) and what I should be looking for in a surrogate, who the good attorneys are in the state. No one too old as it can cause complications. No one on public support. No one who REALLY needs the money. BMI up to 31 or 32 is generally fine. A psych evaluation needs to be done even on a seasoned GS if she's had any major life changes in the last year (ie, divorce). All good information. One of my two surrogates was eliminated due to age (45) and that she'd recently become divorced and seems to be in financial need.

Eventually Dr. Check showed up with a 3rd year medical student in tow. We went right to the meat of why I was there. And after seeing that I had gone through EIGHT IVFs, 1 FET, 2 IUIs, a lap, and two laparascopies since 2005...he didn't even breath the "donor" word. No. He didn't. I was shocked.

Instead, he spent the next two hours telling me why he felt that he could in fact get me pregnant. That I'd transferred 27 embryos into my supposedly defective uterus didn't give him the slightest fear. He sees me as a challenge. Not an insurmountable one either. He honestly thinks he knows what to do for me. And the adenomyosis? He's not convinced that it would cause a problem with implantation. He even felt that my recent surgery might have been completely unnecessary (and he is friends with my surgeon, Dr. Persian from Stanford, too. That's saying something). That, I didn't need to hear as I'm still in pain from the healing. Especially when I am worrying that the surgery on my ovaries to remove the endometriomas may have totally fucked my ovaries and FSH levels.

But as he talked, he walked over to a sideboard filled with stacks of studies. He'd pause between his stories and, every so often, would pull out a relevant study for me to read. Apparently he had an Israeli woman as a patient. I believe she was 38. She'd transferred 92 (not a typo) embryos without a single pregnancy. Then she went to see Dr. Check. And yes, she has a baby today due to his work. FSH? He sees no correlation between FSH and his ability to get women pregnant. He showed me his data on this. He actually has pregnancy rates of at or above 50% at the age of 44 and 45, but the live birth rate is about 8% (loads of aneuplodies at this age seem to be the reason for why he can't KEEP these women pregnant). His data is nothing short of mind boggling and he was more than happy to share anything he had with me.

He explained that he has a PhD in Reproductive Immunology and is board certified in Reproductive Endocrinology. A perfect combination, in my opinion. He knew Dr. Beer in Los Gatos (my RI doc) and did a lot of research in the same areas. He said that he found that IVIG and intralipids DO NOT WORK at all. They do nothing. They're a waste of money. The one thing that DOES work? LIT. Thank god for that. We chatted about the Ober study that made LIT illegal here in the states. I didn't tell him that I do my own. I didn't want to freak him out that much. But something tells me that he wouldn't have been freaked out.

Another interesting thing he told me about LIT. It doesn't work for the reasons that Dr. Beer, Dr. Coulam, and the other famous RI's have written about. It has nothing to do with DQ-alphas, LADs, etc. You can do LIT with ANYONE'S WBC's - again, DQ-alphas don't matter. Dr. Beer's office finally caught onto this but they are going down the T-Reg Cell path. What it actually does, according to Dr. Check, is to provoke an allogenic immune response that forces a certain type of cell (delta gamma something) to produce progesterone receptors. When he discovered this, he figured that if the cell made receptors, it must be for a reason. He then added in progesterone to see what would happen. At a certain threshold level of progesterone the cell kicked out a protein. (mRNA codes for proteins). He wondered what this protein was for. So he stuck it into a dish with a square segment of natural killer cells and found that this protein deactivated the NK cells. So, LIT reduces NK cell levels because of this protein that is formed by mRNA. That's why LIT works. It's all so fascinating. I actually do remember Dr. Beer saying something about LIT helping to reduce NKs but I am not sure if he ever figured out "why" while he was alive. Another brilliant doctor he was.

For over two hours he told me story after story like this, diving into incredibly technical lab research he'd done. I had a stack of studies at least one inch thick when we were done. It will take me a few weeks to read everything he gave me. Fodder for most posts I suspect. :-)

He did an u/s, they didn't see any fibroids or endometriomas...so it was good to see that Dr. Persian's work was indeed done at my surgery just over two weeks ago. The did a pap, tested for mycoplasma, ureaplasma, and then put a swabbing from my cervix under the microscope. He put the images on a screen....and showed me that my cells were "clumping". What this means, he explained, is that if I were to become pregnant that they wouldn't be able to use my cervical secretions to tell if I was getting enough progesterone. Apparently 85% women will "clump when pregnant IF they are getting enough progesterone". No clumping? Then you need progesterone. The other 15% of women clump for no apparent reason at all and cervical secretions can't be used on them as an indicator of progesterone saturation. Well, I fit into this peculiar category of "non specific clumper". 8 IVF cycles later and there's a test I haven't heard of before. Utterly fascinating.

He thinks that the high stim protocols that I've been on were a huge mistake. He feels that I'm one of the few women that the gonadotropins really screw up our linings. (Why am I always in the minority category?) My endo is probably also playing a part in it. There's a medication that he wants to put me on for endo pain that I believe he said will also help my body to produce the same protein that is coded for when someone does LIT. I have to go to his office in Pennsylvania to get it...so I'm hoping to fetch this on Friday. It's worth a try at least. I do believe that it works though. He brought in one of his nurses who had had repeated IVF failures. She's 42. He put her on the medicine and she got pregnant the first try. Lost it. She had a second loss. The third try? She's now in her third trimester. So he was able to get a 42 year old woman pregnant three times in a row with this drug. Her losses might be attributed to aneuploidy or just not a high enough level of the drug in her system. No matter, what he is doing works.

There's so much I could say about this meeting. It was just amazing. I left with the hugest sense of hope I've had in a long time. If anyone can get me pregnant (or my GS), it's him. It's as if I've been to the Mecca of IVF at long last.

He has a memory that is amazing. He remembers every patient. Every detail. He's willing to go WAY out on a limb to try to get a patient like me knocked up. He doesn't see a woman with a high FSH or repeated failure as a problem, but rather as a puzzle that needs to be cracked. He truly sees it as a positive challenge. He is one of those people that you look at and say, "Someone needs to clone this man or retrieve every piece of information that this man has in his head before his life is over". When he one day passes, I cannot even imagine the knowledge that will pass with him. He's that frighteningly brilliant and amazing.

He is willing to transfer embryos into me or into a GS. Either way, he is willing to treat me. He's not turning me away or pushing me at donor. I wish I'd flew out to meet this man 4 or 5 years ago when I first read about Cooper. He's the most amazing physician I think I have ever met. He's inspirational, admirable, enthusiastic, sensitive. Everything you want in a physician.

I am in love.