This morning, hubby and I had a consult with the RE here in Ottawa. A 'Leader' in the field (so to speak!), his opinion was quite valued. I was glad to have the opportunity to sit down and pick the brain of someone of his calibre -- well-published and quite reknowned in Canada and North America -- about our particular case. It was wonderful to hear his point of view and get his feedback.
Some of his conclusions based on our case history:
- My E2 is not too high. As long as it is under 200, he is comfortable. That said, overweight women produce more estrogen and thus their numbers will be higher than those of an average-sized woman. If I were to lose weight, we'd see this number decrease but it's all right at this level.
- My FSH levels are good and are not being artifically suppressed, according to the numbers that he sees and the case history. Good to know that at least my FSH is naturally a good number.
- My TSH is still too high. He recommends a TSH level of 2.5 or less. I spoke to him of my research and seeing that in March 2003, the American Association of Endocrinologists reviewed its normal values for TSH and their recommendation is a TSH of between 0.3 and 3.0. In 1997, the British Medical Journal indicated that a TSH above 2.0 puts people at a greater risk for hypothyroidism. This doctor recommends 2.5. My doc in Montreal says closer to 1.0. Lemme tell you, either of those would be great!
- My insulin numbers divided by my glucose numbers (e.g., 180/5 = 36) indicates insulin resistance. If the number is greater than 23-25 (there is no consensus on the EXACT number), then insulin resistance is usually the culprit, as in my case.
- Although I tested positive for Antinuclear Antibodies, the other serum results were normal for autoimmune disorders (Lupus, Hashimoto's, Graves). In my case, he feels that the positive Antinuclear Antibodies are indicative of my having a true case of hypothyroidism.
- The odds are less than 1% for testing positive with the karotyping (for recurrent miscarriage). So I don't necessarily have to wait for those results to proceed with IVF.
What he wants:
- increase the metformin to 1500 mg per day (3 x 500 mg)
- increase the synthroid to 50 mcg per day (double the current dosage)
- follow up bloodwork in 6 weeks
- follow up appointment in 7-8 weeks
Oh, and he gave me the business card for the Infertility Psychologist at their facility. I think I'll give her a call. That certainly wouldn't go astray.
The other thing he indicated was that given my attitude now towards being open about infertility, and seeking to educate people about it and its repercussions on society as a whole, it is up to me, and people like me (thus... you, if you so desire) to put pressure on the government, by writing letters, talking to our Member of Parliament, etc., in order to reinstate insurance for infertility/adoption processes. I think I'll make a phone call or two and see whose eyes need to be opened about the pain that the infertiles of this world experience. Much of it for naught.