The Imperfect Science of Medicine

Currently I'm reading Complications by Atul Gawande. If you haven't read it, I highly recommend it. Gawande is a surgeon and uses case studies to discuss the imperfect science of medicine. He discusses the fallibility of doctors, the mysteries and unknowns of medicine, and uncertainty itself. As I'm reading the book I can't help but think about my experience with infertility and the doctors who have treated me. I understand and accept that my RE is human, yet I often expect him to have all of the answers. It's a strange inner struggle that comes from my need to be in control, but as I've learned over the last four years I am far from in control.

Last night and this morning I've been reflecting on our appointment. I have to admit that I'm not really all that satisfied with the notion that we just need to keep trying and hope that one of the good ones is transferred, but at this point the only other viable option is to move on to CCRM or SIRM and neither of us is emotionally ready for that at the moment (not to mention the expense and logistical issues involved). I guess I'd be more comfortable with our plan if the future transfers were going to be to me. I know that I can handle a potential miscarriage because I've handled 4 of them, but to ask someone else to risk going through that is tough. As Dr. S reminded me miscarriage is a risk of pregnancy and anyone who attempts to achieve a pregnancy must assume that risk. I get that and I know every surrogate also gets that, but until you go through it you don't know how you will feel or how it will affect you and your family.

The fact that I've had 4 miscarriages myself and 1 with a carrier weighs heavily on my mind. I realize that some of m/c with my uterus were likely due to my uterine problems, but the fact remains that we still don't know anything about those embryos that we lost. As a scientist I feel like I don't have enough data to analyze to arrive at a sound conclusion. At this point we are hypothesizing at best and we are hoping that future cycles will support our hypotheses. I have to remember that medicine is an imperfect science. Gawande reminds me that often medicine doesn't have all of the data because there are so many uncertainties and unknowns, yet they sometimes have to take a "stab in the dark". I know that there is science in reproductive endocrinology and as Gawande says there's also "intuition and plain old guessing". So, for now the best we can do is go with our intuition, hope that Dr. S's hypothesis that there are a few more good eggs will be supported, and ultimately just take a "stab in the dark".