Fertility is a MTHFR.

I hope you’ve all recovered from the This is Us blog post.  That was a doozie.  So EMOSH.

This one will be pretty quick.  In between our failed IVF cycle in early September and the DNC I had to have in October, we decided to get some testing done.  We planned on doing the sperm fragmentation test for Kenny and then get some blood work for me.  My doctor said there was a huge blood panel they used to automatically do for fertility patients, but because it was so much it could sometimes cause clotting and did not often lead to results that could be treated, so they stopped doing it for every patient.  But considering we were looking for answers I could opt into it, so I did.  I wanted to do that before the fragmentation test because that was so expensive and not covered, etc.

You never want something to be wrong with you, but as they were taking vile after vile of blood I was sort of hoping something would come back abnormal that they could tell me how to treat and then move on.  So, I got a call a few days later from the nurse who said they hadn’t gotten all panels back, but I did test abnormal for MTHFR.

Is that not the best name for a mutation ever?

I had never heard of it, but it is a gene mutation that approximately 1 in 2 people have.  So, it is pretty common.  But within the 1/2 that have it, there are types of mutations that can cause other issues that affect pregnancy and fertility.  So, I had to go back to the doctor to test for these other things.

The biggest issue you automatically have is that is that your body cannot naturally process folate, so that folic acid in your prenatal vitamin you’ve been taking for 2 years is totally useless.  GREAT.  So, they put me on a prescription folate which can be processed with this mutation to add to my regimen.  Yay more drugs to pay for.

Then they sent me back in to test for Homocysteine levels.  The 1/2 of us I mentioned above who have this mutation are at a risk for elevated homocysteine levels.  While the MTHFR mutation is not necessarily related to fertility or being able to conceive, it can affect the health of the pregnancy and baby since the folic acid critical to development is compromised.  But, in my case, I never got far enough along to where the folic acid would have been an issue.  But, elevated homocysteine levels are related to recurrent pregnancy loss, infertility, down syndrome, and others.  While I was waiting to get this back, I read up on it, because it was legit the first time I ever heard of either of these things.  (That fact alone was kind of annoying.  After a year plus of fertility care, why would you never mention this?  Why wouldn’t you test me just for MTHFR even if you didn’t do the full panel, since all my other stuff was normal? Ugh).

If you want to read a little more about this try this site. It gave me a pretty decent overview.

But, I got a call and homocysteine was perfectly normal.  WTF.  I didn’t want to have an issue, but it also could finally be a reason, a guiding light in the path of what to do now.  But, nope, normal.  There isn’t much you can do if it is not.  You can add or remove certain things from your diet, which would be good anyway.

But, in the end.  We did it, glad we did, but found nothing conclusive. Same shit, different day. “You should be fine, but you’re not soooooooooo”

But, after I had the DNC, a few weeks later they scheduled a follow up appointment for me.  It was with a different doctor, because my left our practice the day of my DNC. RUDE.  So, I knew I would have a placeholder Dr for now.  *Luckily* it was the same one who was on call to send me to the ER for concerns over my ectopic, and the same one who got to call me BOTH times when my IVF cycles failed to create any viable embryos. So, you could say we were familiar.

Kenny couldn’t come to the appointment because of work, so I went solo.  And I held it together until the medical assistant from my old doctor came in to check on me.  And then…cue the water works.  But overall I was able to manage human being level status mostly.

She wanted to do another check on the good ole YUTE aka uterus to make sure I had gone back to normal after the DNC.  She also confirmed the biopsy on the DNC tissue came back positive and had what they called “early placenta cells”.  Sort of a punch in the gut to be honest.  Like, I know this, but when they say it, it sounds more real.

Besides making sure my uterus was back to normal, her biggest recommendation was for us to take a break.  We had kind of already decided that anyway, but it was good she agreed with us.  Technically we were on a freaking break when all of this happened this time anyway.  But this will be more of what we call an active prevention break. You know, an APB.  She was also pretty anti the fragmentation test we were (maybe still are?) planning on doing.  She basically wasn’t sold on whether it really tells us anything useful, there’s not a lot of research on whether it truly determines chance of success or not. But we are still debating if it makes sense.

She also said something that stuck with me, that wasn’t anything mind blowing, but she was the first person who was so blunt about it.  As much as I liked my old doctor, and wasn’t thrilled about being thrown in limbo, I was also hopeful a new doctor would look at our files and notice something that was missed and maybe we would…TA DA…have a diagnosis and perhaps a solution.  That’s not what I got, but I got this *as close to a quote as I can get*

“Look, you don’t choose your partner based on their hypothetical eggs or sperm they produce.  If either of you were with someone else, you might be able to have a baby easily, perhaps.  You don’t have as many eggs as we would like, or hope, to see for someone your age, but if Kenny’s sperm was totally normal, we would only need one. Most fertility issues are complex, they are not often just one thing or one person.”

No one had ever come out and said that I had a low egg count for my age, even though I knew that.  It was always skirting around the issue like it’s “a little lower than we’d like, but…not out of the ordinary”.  But it all just made a lot of sense.  If I had a lot more eggs then we’d have more chances to fertilize with a bunch more of Kenny’s li’l guys and make an embryo that was healthy. But, if the sperm was 100% healthy, then we would only need 1 egg to begin with.  So, it is likely a combination of both of our minor issues combining together becoming a major issue.  It for some reason made me somewhat calm.

So, for now, we chill.  Once our minds are as healed as my YUTE is, then we will revisit and devise a plan.  But, currently, Netflix and (actually) chill.

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