The Department of Mysteries

It all started the day after I got our bad news.  I had a routine appointment with my rheumatologist.  She ordered routine blood work that I have done once or twice a year.  I went the very next day and had the multiple viles of blood drawn, no big deal.

The following week the rheumatologist’s office called and asked for the name and number of my fertility doctor.  On Wednesday we met for our already scheduled meeting with my fertility doctor.  My routine blood work showed that my liver enzymes were extremely elevated.

AST (normal 10-30) 102

ALT (normal 6-40) 73

Alkaline Phosphatase (normal 33-115) 140 

Not quite liver failure, the doctor assured, but still it looked pretty bad.  The main question is…why.

In 2009 I spent several days in the hospital because I had an inflamed liver and pancreas.  At the time it was considered a fluke.  In the spring, after my embryo transfer  I had routine blood work completed and my liver enzymes were high then.  I went to my GI doctor who ordered more blood work.  By the time it came back to her the enzymes had decreased.  She also sent me for a liver ultrasound which came back fine.  She said she wasn’t too concerned.  This time the enzymes were much higher than that time in the spring and again…why.

-          Do I have a yet to be diagnosed liver disorder?

-          Could it be my lupus/immune system attacking my liver and if so is it somehow being triggered by IVF or is it completely unrelated?

-          Is my liver reacting to one or more of the medications used during the IVF and if so why would my system be so sensitive?

-          Do I have endometriosis on my liver?

My doctor said something akin to…I’m puzzled. I’ve never seen anyone who is so young and not obese have a liver that reacts this way.  My husband and I started to laugh.  The doctor was aghast and told us this was extremely serious and worrisome.  We tried to explain that if he knew how many times I’ve heard doctors express their puzzlement over my body he’d find it funny too.  I don’t think he really found the humor.  I am officially grounded from any fertility anything until the mystery of the liver is figured out.  For now the plan is to

-          Talk to my GI doctor when she gets back from having off for the holidays

-          Repeat the blood work in one month to see if my enzymes have gone down

-          Stop taking birth control immediately.  My fertility doctor’s biggest theory is that the birth control pill could be damaging my liver.  They had put me back on it after the IVF failed to suppress my endometriosis while we waited for my Lupron shot to get approved by my insurance.  I’m still waiting for the shot to come in but I had to stop the pill which I had just started taking so my period hadn’t even ended before it restarted again so I have spent weeks with an inflamed intestine.  It has not been fun. 

I’m praying very hard that the enzymes go back down like they did the last time and that it is drug related and that I do not have a mysterious yet to be diagnosed liver disorder.