New Specialist

Thursday was my first appointment with a new specialist.  This doctor specializes in NaPro TECHNOLOGY, which I’ve discussed on here before.  If you’re in the St. Louis area, I highly recommend this OB-GYN (and yes, he is a regular OB-GYN even though he specializes in NaPro, so you can go to him even if you are not infertile).  His name is Dr. Brian Gosser; he’s at St. Anthony’s Medical Center in South County.  I loved him!  He is hands down the BEST doctor I’ve seen since we started trying to conceive a little over 2 years ago.

First of all, he is super laid back and incredibly kind.  He’s the kind of person you feel like you’ve known for a long time even though you’ve just met.  He sat with me and talked to me like he had all the time in the world, which I really appreciated.  In fact, we talked for 45 minutes!  My favorite thing about him is we share the same faith–he is also Catholic.  He and his wife have 8 children, and he seems really proud of his family.  Also, he had a diagram of the woman’s reproductive system all ready as though he always draws his patients a visual of what he’s talking about, which definitely helps make things clearer.  As a side note, I’ve been told he’s VERY natural childbirth friendly, which doesn’t really surprise me since he was so intrigued when I told him about maca root powder helping me ovulate without medication–so intrigued that at the end of the appointment, he brought it up again and asked me to spell it for him so he could research it in case it was something he may want to tell his other infertile patients about.  🙂  I love when Western doctors seek to understand and even use Eastern medicine in their practices!

Anyway, enough about this amazing doctor and on to what he told me.  As my regular readers may recall, I went to Dr. Gosser because practitioners of NaPro TECHNOLOGY work to find the underlying cause of everything rather than treat a list of symptoms as my other doctors have done.  I told him all the tests we’ve had done and what the results were.  I told him about my regiment at the Reproductive Endocrinologist office with regular ultrasounds, blood work, etc.  I told him about our failed attempts at IUI as well as the miscarriage we suffered when I was on Clomid at the beginning of this long journey.  I told him I just don’t understand why I haven’t had a healthy pregnancy yet when it seems like everything is perfect!  At least we know everything appeared perfect when I was seeing the RE.  At that time, I was on Letrozole to balance my hormones and help me ovulate, which worked REALLY well and didn’t halt my body’s mucous production like Clomid had done.  My ultrasounds showed no scar tissue anywhere, healthy ovaries and uterus, and showed lots of healthy follicles at the right time in my cycle each month.  I’ve had a normal HSG in the past, so we know my tubes are open.  Choi has had several semen analyses, all of which were above normal and super healthy.  Each cycle, when my follicles reached a certain measurement, I received an HCG injection to stimulate ovulation, which worked every time.  I did fail a post-coital test, but that’s why we tried IUI, which would have bi-passed any issues with my immune system attacking sperm.  Our rounds of IUI went well every time.  YET, I never conceived.  How could that be?

Dr. Gosser told me that it seems like everything should be functioning properly with my reproductive system, and I’ve already been tested (multiple times) for thyroid problems and similar disorders, all of which were normal.  So instead of referring me to IUI again or any other fertility “treatment” like that, he told me we were going to try to fill in the blanks, as few as there are.  He told me that 3 things came to his mind.

Number one, my progesterone levels were checked by my former OB-GYN and RE each cycle about 7 days after ovulation.  But neither of those doctors checked to see how my progesterone levels dropped as my cycle came to an end.  A common problem seen in women with recurrent miscarriages is progesterone levels dropping too fast after ovulation.  What happens is an embryo is implanting itself in the uterus, but because the progesterone is dropping too quickly, the lining of the uterus begins to shed even with the embryo attached.  This leads to miscarriages early on in the pregnancy.  The reason I was never checked for that is because I’ve only had one miscarriage (that we know of).  So, to be safe, Dr. Gosser is having my progesterone levels checked on days 7, 9, and 11 post ovulation to see how quickly my hormone level drops.  (I’m just now coming to the end of my current cycle, so it will be several weeks before I’m post ovulation again, but we will test for that in this upcoming cycle.)

Number two is a blood clotting disorder.  He said this is a new topic of interest to infertility specialists, so not many studies have been done yet; however, there is research out there that indicates women with unknown blood clotting disorders (because they don’t normally manifest themselves until we age, which is why many old people develop clots or heart disease even though they never knew they had a disorder) cannot conceive due to the disorder.  It’s still not clear exactly why these disorders prevent healthy pregnancies, but there does seem to be a relationship between the two.  He told me that in his personal experience, about 95% of the infertile women he sees whom he’s already checked for every other obvious and sometimes even not-so-obvious fertility problems with no success in finding a cause for their infertility end up having a blood clotting disorder.  He did tell me that once treated, not all of them conceive, but a big enough number do that he thinks it’s worth looking into.  Coincidentally, he didn’t even know that some people on my dad’s side of the family had blood clotting issues and/or heart disease.  So, who knows?  Maybe this test will show something we didn’t know before.  I’ll be checked for that with my first blood test for the progesterone levels next month.

Finally, if those other tests indicate nothing, then Dr. Gosser recommends I undergo the laparoscopy (surgery) to check for endometriosis.  I do have several symptoms of endometriosis, but because my HSG and ultrasounds never showed any scar tissue or warning signs for endometriosis, my previous doctors didn’t want to check me for it since it requires surgery.  Dr. Gosser said he would have done the same thing, but since we’ve tried everything else, this will be one of the last things to check for.  He said if I have it, it’s obviously a mild case; however, even women with mild endometriosis (even so mild that they have NO symptoms) can suffer infertility because of it.

Naturally, I’m hoping the rate of my progesterone dropping at the end of my cycles or the blood clotting disorders will be the cause of our long wait for a baby, but at this point, I’m willing to do whatever surgery or test necessary to get to the bottom of this and finally be able to build our family.

If you are struggling to conceive, whether it’s been a mere 6 months and you’re just starting to feel concerned or whether you’ve tried everything going as far as IVF to conceive and still haven’t had a baby, then I highly recommend you see if there are any doctors in your area that specialize in NaPro TECHNOLOGY.  It’s awesome, and I know I love my new doctor!