DH and I both went, because we needed to "re-group" and get a plan going from here, in collaboration with the treatment protocol from Dr. Kwak-Kim.
The one thing I love most about my NaPro Dr is that she is sooo open-minded, and definitely willing to learn more about areas she's not an expert in (like immunology, clotting factors, etc.). When I told her about the Doppler u/s and no blood flow in the endometrium, she was astounded! She thought (just like I did) that this was a SUBSTANTIAL finding, and admitted that when I was first diagnosed with the MTHFR, she really didn't think it had any bearing on my fertility.
She does think I should go out to Chicago for another ultrasound on 80 mgs of Lovenox, the cycle after next (if next cycle is unsuccessful).
The only "bad" part of the appointment was that I was denied injectables :( Just as I suspected, NaPro, and my Dr, are not fans of over-stimulating the female system and manipulating it to our "needs." She also reiterated that I've always responded really well to both Clomid and Femara, and that with the progesterone support in the post-Peak phase, this may be all I need to conceive and then implant with the Lovenox. She said she's noticed that Dr. S is using post-Peak progesterone support more and more with women who are on ovulation inducers, even when their P+7s are already high... and that she is starting to pick up on this, too. Especially since my estradiol is always through the roof in the post-Peak (last cycle was 454), she thinks making the progesterone level nice and high may be "just what I need."
So, while I was a bit bummed about the injectables, I do see her point. She even voiced my true underlying desire, by saying, "You know, a lot of women who have been through this for as long as you feel like they want twins or triplets..." but she basically said that the injectable mind-frame is founded in the ART world, and even though Dr. Kwak is respectful of my wishes to do things naturally, she is probably just thinking, "well, why not hyperstimulate her?" This does make sense to me. I think I'll give Femara one more shot, and then I'm literally going to beg for a low-dose injectable.
As for the thyroid stuff, she told me that she's not concerned about it, because since I'm ON T3, it's bound to be elevated in the labs. In NaPro, the end result of the T3 therapy is normalized body temperature, not clinical labs, so we're going to do my temp-taking again next pre-Peak and check the levels of the thyroid hormones at P+7.
I also feel TONS better about my decision to come off Hydrocort after talking to her about it. I decided to wean off of it since I wasn't fond of the idea of being on it to begin with, especially since it didn't help ONE of my symptoms!! (I still had brown bleeding, still had fatigue, actually the fatigue got worse after a few weeks on it.) But I had read on the internet that people can have hypo-thyroid symptoms if their adrenals are not functioning properly, so I was starting to second-guess my decision.
My Dr. said she is actually glad I'm coming off, and that she's personally leary of the long-term effects of cortisone therapy, herself.
So, we're going to continue on all the same meds/vitamins except for Hydrocort, and Dr. Kwak's letter to my NaPro Dr. also recommended I add Vit. E (Dr. Kwak never mentioned this to me!), so I'll be adding that. I won't be taking the Dr. Toth antibiotics, BUT I will take Amoxicillin again as a mucus enhancer during my mucus cycle.
A good game plan, I think.