You can imagine my surprise in receiving a response letter from Dr. Hilgers today!!! SO SOON! I can't believe it! I guess it helps to know people in high places :)
I really can't do the letter justice by paraphrasing. Neither the information nor the caring, personal nature of this incredible man and Dr would be properly represented. So I will write for you the entire letter here:
Dear Mr. and Mrs. Blankblank:
Thank you very much for your recent letter of September 2, 2008 which Dr. J gave to me when we saw each other in a joint meeting in Philadelphia last week. I have had the opportunity to review your letter and also to review the various labaratory tests that you have had performed, including the laparoscopy and seminal fluid analysis. I have also reviewed your Creighton Model FertilityCare charts and I would like to give you the following input.
First of all, I think that all of the treatment you have had up to this point has been completely appropriate. (I really needed to hear this.) Of course, it does not seem all that great since you have not yet achieved a pregnancy. However, I do have a few thoughts with regard to this which might be of some help.
In your charting, you have a consistent patterm of 2 to 3 days of brown bleeding at the end of your menstrual flow and your periods go to 8, 9, and 10 days in duration. This type of bleeding pattern can be associated with a low-grade infection or inflammation present inside the uterus in its lining.** Thus, there are a couple of things that you could consider.
Since you are in New Jersey, you could consider obtaining a consultation from Dr. Blankity Blank. Dr. Blank is an ob/gyn who is also a pathologist and he has pioneered the treatment of low-grade infection inside the uterus over the last 25 years. He is located in New York City. His office laboratory is associated with the "McBlank" Laboratory and is located at: (gives address and phone #)
You could consider seeing Dr. Blank and having cultures done and then having treatment for this. He is very aggressive in getting this treated and we have had patients such as yourself be successful with it. It is a form of treatment which is consistent with NaPro Technology, although Dr. Blank himself has done and continues to refer on occasion for in vitro fertilization. In any regard, I do think visiting with him and trying this, in addition to what you are currently doing might be of some value to you.
The second thing that I would suggest has to do with something we are just beginning to investigate. This is the role of the adrenal gland in situations of infertility. There are many women who have decreased adrenal reserve (a form of mild insufficiency of the adrenal glands) and who could become candidates for treatment with low-dose hydrocortisone. I am not quite at the point where I can recommend this treatment to you, yet. However, by the 1st of November I think I will be able to do that. It does need to be monitored properly and so forth.
In the meantime, I think if you could have a serum cortisol level drawn and run on day 5 of your cycle and also on P+7 and then have those results sent to me, I can then begin to look at them and see if this would be of any potential advantage to you. Again, I will not be in a position where I can implement any treatment before the 1st of November. And then, of course, I do not know if it is going to work because it is a brand new treatment approach for us. It is, however, very consistent with the approach of NaPro Technology.
I do hope that this all may be of some help to you. If I can be of any further help to you, please let me know. I am certainly very interested in working with you. (Imagine that!!)
From this point forward, I would suggest contacting my nurses directly at (gives phone #) when you need something. I will use them as a conduit for communication.
If there is anything else we can do, please let us know.
Thomas W. Hilgers, MD
cc: Dr. J
**At the Conference in Philly, I wrote down in my notes: "TEBB (tail-end brown bleeding)- low-grade infection of uterus" because I knew I had it a lot in my charts and always wondered what it could be!! Then I forgot all about it.
So this is my letter from Dr. Hilgers :) I feel like I just got a personal letter from the Pope! This has TOTALLY given me a newfound sense of hope, and especially drive. I'm calling Dr. Blankity Blank on Monday morning!
As always, I'll continue to keep you all posted.