Well I went to see Dr Tubes yesterday evening in the private clinic. I must say we got our moneys worth as he packed more in and listened more carefully in 35 minutes than anyone else has done in our first clinic in 18 months.
I had sent copies of test results along with a summary of my ishoos before our appointment - he said this was helpful and smiled when I put forward my own theories and he entered in to conversation about them. That was very odd - I am used to being slapped down the minute I try to hold a discussion.
Dr Tubes thinks that my tubes ARE the main ishooo. Ok that is not new but he was far more specific about my tubes. He said that even though my right tube was never actually 'blocked' and was instead tethered down with adhesions according to the lap, this partial blockage was still likely to be causing some fluid to be sent the wrong way in to the womb and flushing out embryos. Basically my IVF and natural attempts were never going to work. I was under the impression from my last clinic that only a true hydrosalpinx (blocked tube) could cause this issue but apparantly not.
Dr Tubes thinks that if my tubes as still open after the lap then I absolutly have a chance of natural conception. And the stretched and dodgy right tube has much chance as the normal left one. He is not prepared to assume they are still open and functioning however even though he has a copy of the lap report from January. He reckons post surgical adhesions could have affected the tube(s) again and he wants to check for this before starting on a management plan. I was a little bit worried to hear this - I thought I was in the all clear post lap. So I have to have another HSG. I can get this done very quickly and have the results and treatment plan discussed on the same day - impressed. I have been advised it might hurt me less this time as some of the problems have apparantly been removed (I certainly hope so).
So if there is a blockage - he will want me to move straight to IVF again and I may need surgery before this. If they are open he is placing me on an 'intergrated treatment plan'. This means every natural month is given a boost and the aim is to focus on natural conception. But with the option to siwtch to IVF in a few months and then back to natural again. He says this will increase my stats a great deal. The natural cycles will involve clomid. Dr Tubes says he get great results with this as he uses it with women like me to increase chances where there are some other small bariers. We will also have ovulation monitoring and he said he will be able to time ovulation to the hour and tell us when to dtd.
This was all very refreshing. He didn't make any promises but seemed keen to try lots of different things. He has a very hollistic approach and seemed to be nurturing our pyshological well being too. He suggested a pub we should go out for out tea when we are inbetween the HSG and the follow up consultation next month. He also said he felt we had been unlucky.
Dr Tubes is also an endo expert and knowing I have some he thinks the adhesions at the end of the right tube could have been endo all along. If so, he thinks I miscarried due to toxic fluid running down the tube when it was partially blocked. Again - this is a new spin.
So now I am hoping like never before that my tubes will be open at the HSG. It will determine so much of what the future will hold. I am a bit scared that surgery beckons again.
We also discussed NK cells. His view is that women with repeated miscarrige and failed IVF cycles do have raised NK cells - in that there is no doubt. But what he doesn't push for is always having the treatment. He is happy for people to do it and some people may get real success but for some there is not. He thinks my NK cells may show to be raised but that my tubes are the more obvious cause of my problems and that is what we should focus on. I also liked the way he accepted straight away when I said I had never had PID, STD etc. At the other clinic it felt like they didn't believe me or Chumba and were trying to catch us out.
I really like Dr Tubes and would recommend him to anyoone looking for a second opinion or new ideas. He was happy for me to go back to my NHS clinic if I wanted rather than continue with him onced I had the benefit of his advice (however we are paying wherever we go now). Maybe all fertility Dr's are like this and I just managed to be in the catchment of some awful ones. But I am very impressed. I feel lighter. I know there are still no guarentees but at least we are dealing with my ishoos specifically rather than the "hydo but not a hydo tube girl" sitaution.
Hope the above wasn't too boring.
Pout - how have you been feeling just recently?
Big hello to Rabbit, Lemons, et al.