October 23, 2010

Gold Star Uterus

Beta 3 integrin results are in: I tested positive, which is good. So between that and the other endometrial biopsy testing that also produced good results, I guess this means that my uterus isn't the issue.

Mo and Libby, in answer to your question about what the other biopsy testing was - they were checking for CD57+ cells, which they don't want to see, and FoxP3+ cells, which they do want to see.

I had none of the CD57+ and FoxP3+ cells that were "adequate in number, suggesting adequate stromal regulatory activity" according to the report.

So I guess it's looking like my immune system in general is the culprit.

We also got the results of the repeat bloodwork. While the NK cell levels in my uterus were good, they were still slightly off in my bloodstream. Not a surprise, as that was also the case during the transfers we did for IVF retrieval #1 a few years back. IVIg is still recommended, no surprise there.

My Leukocyte Antibody Detection levels (T cells and B cells) were also low, so LIT is recommended. And one of my Cytokine ratios was high, so Humira was recommended.

So, what's the plan?

I'm not doing the Humira. It has an increased risk of cancer, usually lymphoma, which is in the same family of cancer that my dad has (leukemia) and that his dad had (multiple myeloma). R and I decided pretty quickly that it's not worth the risk, and that view hasn't changed. If Humira is what's standing between me and a biological child, so be it.

I think we're going to do LIT. I'm still afraid of crossing the border, but we did go and get our passports yesterday and requested expedited processing. Two rounds are being recommended (3 weeks apart), so hopefully we can do the first trip in November and second trip in December.

We also plan to do the IVIg. And hopefully transfer in January.

At the same time, I'm ready to be done with this and move on to the next step. (Or so I say now - I realize I may sing a different tune if we wind up with one single line in January/February.)

To that end, I've contacted a local adoption agency to request a recertification application, and I've scheduled carpet cleaners to come out in mid-November. I'm not going to obsessively clean, but we have 4 dogs and 2 (indoor only) cats, and our carpet is just embarrassing.

I also need to work on getting a pool fence installed, and once we get the application completed and fence installation scheduled, I'll contact the social worker to do the home visit. If we can get that done by the end of November, we should have our certification around the time we get transfer results.

We haven't totally decided which way we would go on the adoption front. I'm still hesitant to do international for fear of being rejected. What I've decided to do with the home study is give the health forms to our family doc and mention that certain things would possibly disqualify us, but leave it up to her whether she thinks they are a possible impairment to our ability to parent and puts it on the form or not. (I haven't seen the form yet, so I don't know if it's a very specific questionnaire or if it just asks for a general statement.)

Then during the home study visit, if questions come up we'll answer them honestly, but we won't go out of our way to point out things that the social worker doesn't ask about. Once the certification is done, we'll request a copy of the home study and review what the report says and decide whether we think it would knock us out of the running internationally.

We'll see what happens.


lastchanceivf said...

Glad your uterus keeps earning gold stars! And congrats on making some big decisions...I cannot imagine trying to balance all of the immune testing information and international treatment!!

As far as the adoption stuff goes--I agree with your take on questions and how to let the social worker and doctor decide. The bottom line you need to remember in your heart and in your head: the point of an adoption--international OR domestic--is to unite a loving family with a child that needs a family. Anything that could impede that is important, but so many things that they want to know about in actuality to NOT impede your ability to be a loving mother. Just wishing there wasn't so much to always consider!

Keep us posted on everything :)

Silver said...

Well done that uterus! On the IVIG issue, have they said whether lipids might be an alternative? Less expensive and not a human blood product so fewer risks. It seems to be used more and more instead of IVIG, but I'm not sure what the criteria are for making that decision. I am completely with you on the Humira - we decided we would say no if it was offered for the same reasons as you (my dad had Non-Hodgkins Lymphoma). A good friend here in the UK is now 6 months into a pregnancy following lots of failures and losses and her main difference this time was LIT. Lots and lots of luck with it all.

Libby said...

That is a lot to take in! I'm glad things are coming to together for you though and you have been able to organize your thoughts (big task!) and decision making.

I had the same question about using intralipid instead of IVIg. I am assuming the IVIg is being recommended because of the NK levels in your blood stream? I debated about this myself, so I know it's not an easy call. The LIT is fascinating too. You have certainly researched every possibility, and it's time it paid off :)

Anonymous said...

Yay gold star uterus and good news on the NK test results! I'm sorry your have to travel to do the LIT. It sounds like you have a really good plan though.

I think that is an AWESOME approach to take on the adoption front. One I might copy in future. :)