The Greatest Single Choice of My Life: What’s Next? Part 2

Going forward with my plan of doing IVF to freeze embryos, I left my clinic with a long to-do list before we could continue. This list included more lab tests, a visit to the gyno for a yearly exam, genetic testing, financial planning, sperm donor selection, as well as deciding exactly when I could fit this into my schedule. I set my sights on February 2020 for several reasons.

First, I could take some time to get started on my to-do list without stressing too much, especially during the holiday season. Not to mention the time spent with family during the holidays could be spent mostly distraction free, and allowing time to prepare myself physically and mentally.

Another reason, is that after the egg retrieval I could take a month-long break in March and then start trying to have a baby via IUI in April, that is, if I wanted to. At the time, I still wasn’t sure when exactly I would start trying to conceive but planned for sometime in the next year or two.

I quickly made my gyno appointment for December 13th, got my yearly exam, and asked my doctor to order the additional labs that I would need. A month later on January 13th I went to the lab early in the morning before work to get my Vitamin D level, B12 level, thyroid labs, and infectious disease tests done. The fact that it was early in the morning would prove to be a slightly unfortunate decision.

The thyroid lab known as TSH (thyroid stimulating hormone) was required but not the accompanying T3, T4, and thyroxine that you usually see with basic thyroid labs. Again, knowing too much, I knew how important thyroid health is to egg quality so I added those to the list myself. Within the week I had my results and I was not expecting what I got.

My vitamin D was low, within normal limits but on the low side, despite having been supplementing with 5000IU almost daily for the last nine months. My B12 was high, which could be a sign of over-supplementation or inadequate absorption. These two could be easily fixed with adjustments to my supplement regimen but could also be related to the other result I got that threw me for a loop the most, which could therefore be a big red flag that something was very wrong was going on with my body and I didn’t even know it.

My TSH was too high at 3.482 uIU/mL. Normal range is 0.358-3.740uIU/mL for normal folks (although this is currently being debated in the medical world), but for those of us trying for a science baby, most clinics prefer it to be less than 2.0-2.50, which I was clearly higher than. Additionally, my T3 was slightly too low, but my T4 was good.

I couldn’t even focus at work for two days straight while I tried to work out everything in my head. What does this mean? Do I have hypothyroidism? Do I have Hashimoto’s Thyroiditis? This definitely means my egg retrieval could be pushed back if I don’t figure it out in time, of which I don’t have much. Do I need to add more supplements? Do I need medication?

I spent days researching all I could about these conditions and what it meant for my health. Following doctors and dietitians that specialize in thyroid health, signing up for email lists, considering books to order, reading blog article after article, anything I could do to learn more and figure out my next steps.

It didn’t take me long to decide it was impossible to learn everything I needed to know and that I needed to give up control by speaking to an integrative doctor that could help me get to the root cause of the problem and could order more specialized labs for me. Gratefully, because I’m a dietitian I actually have the ability to order some integrative lab tests myself and pay the provider cost instead of the high client cost that is almost never covered by insurance. Even with my discount, these tests can easily cost a few hundred dollars.

FYI: An integrative practitioner is one that specializes in integrative and functional medicine (and/or nutrition), which is a more holistic practice, merging eastern and western medicine, and takes into account the whole person, including all aspects of life (stress, sleep, nutrition, environment, and more), to get to the root cause of disease.

I found a doctor in Ventura County, but then had to wait another two weeks for a free 15-minute initial consult via telehealth. On that consult, I explained my situation, and we agreed to get more extensive thyroid tests, which she would order, as well as a GI Map test and a micronutrient test, which I would order. GI health as well as micronutrient status can tell a lot about health in general and are also heavily related to thyroid health.

At the end of this 15-minute consult I scheduled my first actual appointment to follow up with the lab results, and paid the $179 appointment fee right there on the video screen with the doctor, which I wasn’t able to get until early March! More waiting, plus hopes for a February retrieval down the drain.

In the meantime, I continued to research thyroid health, and a few things not only started to bother me, but also got me thinking that my TSH result may have not been fully accurate.

First, I had no symptoms of hypothyroidism. I was getting plenty of sleep, a goal that I had been working on for months, going to bed early and trying for at least 8 hours every night. And it was good quality sleep, I have always been a good sleeper, I swear if sleeping was a profession I would be stinking rich. I was not overly tired during the day, I definitely was not finding myself worn down, unable to focus at work, or unable to exercise. My skin was great and not overly dry, with no eczema flare-ups. My hair is thick and continues to grow very fast. And my stress level, despite just having gone through a divorce and being at a new job, was honestly little to none.

I mean, just about every symptom of hypothyroidism was not something I could check off the list. Even if the hypothyroidism was caused by an autoimmune condition, which I may be prone to, I still should’ve seen at least a couple symptoms.

I also learned that thyroid tests are sensitive to the time of day that you take them. And guess what, TSH is highest early in the morning, especially if you are fasting, and may be affected by stress. So maybe, just maybe, taking the lab at 7am, after waking up earlier than usual, stressing about getting to the lab early so I can make it to work on time, before eating, was not the best idea. TSH is lowest later in the afternoon and after eating, so you best believe that I made my next lab appointment in the afternoon, on a Saturday, so that I could sleep in, not stress, and eat a good breakfast.

I was finally able to get all of these labs tests done on February 29th and March 2nd, a full month after meeting with the doctor, and three months after my first appointment with my clinic. I had also already done the GI Map test on myself the week before this and was waiting on the results of that as well. I decided not to do the micronutrient test, mostly because the kit took a while to ship to me and the turnaround for the results is currently 6+ weeks.

Exactly a week ago, on March 6th I got the result I had been hoping for and my world instantly changed for the better. My TSH was 2.39, I had no antibodies (so no Hashimoto’s), and my GI Map showed the same, no autoimmune pathogens and overall not bad gut health! My T3 and T4 are a little low and I could make some dietary improvements for better gut health, but overall I think with some focus on eating well and maybe some additional supplements, I’m confident that I will have a decent outcome with my egg retrieval and IVF.

I was able to cancel my appointment with the integrative doctor and get my money back, thank god. I also made plans for a late April egg retrieval, as it was already too late for the March cycle. Now, it became a waiting game for my period to start (due tomorrow March 14th, according to my cycle), so I could call the clinic and receive my prescriptions for all the meds I would need to start taking very soon, as in by Monday or Tuesday of next week.

And then….the shit hit the fan and the state of the world is in an uproar, changing on a seemingly hourly basis. Suddenly, everything is in question. Will my clinic stay open? Will I get sick, which may affect egg quality or put my egg retrieval in jeopardy somehow? What if I pay for and start the (very expensive) meds and then the cycle gets cancelled? What if we get overwhelmed at work and I can’t get to my appointments that are four hours away? So much is up in the air now.

I know it’s par for the course with infertility but it doesn’t make it any less frustrating. You just never know what is lurking around the corner, waiting to rear its ugly head and get in the way of reaching your dreams.

I called the clinic yesterday and got an email back from one of the nurses, but I currently don’t have an answer about the possibility of the clinic closing or my retrieval being cancelled…

And so we wait.