Pre-conception Consults

On November 19, 2012, Jon and I met with one of the MFM's at the high-risk clinic where we've received all of our pregnancy care. We wanted to talk over what happened with both of our pregnancies and come up with a game plan for a future pregnancy. As is usual for us, we brought a list of questions to ask regarding what had happened and possible actions to take in a next pregnancy to try to increase our odds of a complication-free pregnancy and full-term birth.

At this appointment, we found out that I did not have pre-term labor but did have pre-term contractions. Doctors are not able to stop pre-term labor and they were able to stop mine. We found out that while Oscar's and Bella's labor/delivery and Gus' pre-term contractions appeared similar at first glance they are completely separate issues. Regarding my very fast labor with Gus, we were told that some women just have fast labors. At the end of the consult, we had the following plan in place for a future pregnancy:

• Progesterone injections beginning at 16w
• I really don't have the signs and symptoms of an incompetent cervix, but if we need to do a selective reduction again, then they will place a cerclage.
• Cervical length u/s at 16w, 18w, 20w, 22w and 24w
• Progesterone gel will only be used if my cervix begins to shorten

On February 18, 2013, Jon and I met with one of the RE's at our fertility clinic, the same clinic where we conceived all of our children. We wanted to talk about what we could do to reduce our risk of conceiving multiples and come up with a conservative plan that would get us pregnant with ONE child. During this appointment, we learned the following things and came up with the following plan:

• I still don't ovulate on my own.
• It is entirely Jon's and my choice if we give the oral meds another chance at working. RE doesn't think my body will respond.
• My follicles don't need to be as large as the "average" woman's to trigger ovulation. When we conceived Gus and Tittle my lead follicle was 16.5mm and my secondary follicle was at 14.8mm. So, we may consider triggering ovulation when my lead follicle is 14.8mm-15mm, instead of the traditional 18mm.
• For our last cycle, I was on 75u of follistim for 7 days, then 50u for 3 days. Instead of starting at 75, we will start at 50u or 25u.

I felt really confident with this plan, and as RE said, each cycle we do gives them more information about how my body responds. So, if when we are ready to start treatments again, we have a plan in place to conceive one, and only one, child.