I've not said much because honestly, there isn't much to say... we're at a dead end it seems and are not sure what our next move is.
Apparently my current RE (Dr. Kutteh in Memphis) "doesn't believe in" NK cells as an issue in getting or staying pregnant. He doesn't test for it or treat it. His nurse called after we faxed in our results and said they had been reviewed and Dr. Kutteh wanted to continue with our cycle as planned. I was a bit shocked since to me, that was not an option! Proceed as planned when my NK levels are elevated and we've been told that means it attacks/kills embryos!!? She said she would talk to the doctor again and call me back. Less than 5 minutes later he called me personally but was very hateful, as if it was a waste of his time to even be talking to me about such nonsense and then proceeded to make my last cycle and all of my other ones sound like complete shit. He said THAT is why we are not pregnant, it has nothing to do with NK cells. He also mentioned my BMI still being above 30 and that more weight loss could help.... When at my LAST sit down appointment he bragged super HARD on my weight loss and wanted to try the 7.5mg femara instead of injections BECAUSE it was such a good loss!! My last cycle wasn't good?! We had 3 follicles on oral meds and in my voice-mail about my P4 the nurse said "your progesterone is 15.7 which is fantastic!!" I have it saved!! He even made it sound as though my injection cycle was not ideal response wise... if it was so shitty... why didnt they say "hey your response is shit! and cancel my IUI?!?! I was told we had 2 Good follicles around 18-21 and a possible around 15/16 at trigger! (i forgot the exact measurement) I think that was a very good response!
We are very confused at this point in time and not sure what our plans are. Except that we will not be back to our current RE. Ive always liked them, so this actually kind of hurt! We will see Dr. Dayal for my Fluid ultrasound on the 13th. And we will talk to her more about the results and what we can do outside of IVF. But my understanding is that SIRM only does IVF cycles.
Update: 2-10-2014
This morning Dr. Kutteh called me singing a very different tune. He still does not believe in NK cells as an issue in pregnancy and miscarriage/implantation failure. But he wanted to review my results again and was very polite and friendly. He said that another patient had gotten some sketchy NK test results for free and now the lab was wanting $1800 for further tests. I told him that wasn't the case for us, but I do appreciate that he thought of us and wanted to be sure we were not in the same boat. He talked to me in a much friendlier tone about why he feels the way he does about NK cells and honestly, he has some valid points. He says that the research is all very new and controversial at this point. There are studies supporting both sides, but he is not convinced. He says in tests on women who have had a miscarriage it is true that results often show elevated NK cells, but that it can not be proven what came first. Are the levels elevated because of the lost pregnancy and the body responding. Or did the body attack and cause the miscarriage because of the elevated numbers. He also says that you can not differentiate between overall NK blood cells in the blood and those within the uterus. He feels that we have made a lot of progress and are on the right track, he doesn't want us to waste time chasing after this. He also said that if we wanted a second opinion he would be glad to refer us to someone for one.
Im not sure who or what we believe. We feel like Dr. Kutteh has made some valid points and I do appreciate that he took the time to call me this morning and was much more clear and polite. Im not sure If that is enough to make me want to continue cycles with him after the conversation on Thursday.
We do plan to talk with Dr. Dayal and get her thoughts, treatment options, information etc from someone who DOES believe in NK cells. We want her side of the story and what research supports this. I know our own personal research showed a lot of women with recurrent losses in the past having a successful pregnancy after treating the NK cells with intralipd infusions or steroids.
We have made the decision to go ahead and start femara this month, better late than never? It is CD7... not sure how this will work out, but it can't hurt! And we will see Dr Dayal for her side of things prior to ovulation. If we are convinced this is an issue for us, we can skip BD and just let the cycle work itself out with no chance of pregnancy. If we are not convinced, we will do TI at home.
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