Deciding on TAC

I was recently asked how I came to my decision about pursuing the TAC. I’d like to share my response here. Please also follow the menu for further websites and contact information.

• We researched, researched. I read every single email on Abbyloopers all day long. And that’s a lot! I read all the files several times – there are some I still don’t comprehend yet as I haven’t gotten to use my TAC. (things like the sonos)

• I talked to my mom a lot. I have the fortunate blessing of a mom who was a NICU nurse, a childbirth instructor, and now is in medical management for ante-partum, labor & delivery, and the NICU. She had already raised me to be my own advocate, but I realised how fully she’d taught me to think about medical care and research when I was looking into the TAC. I was able to bounce ideas off her a lot. And, she did all the same research with me. So, it was nice to have somebody come to the same conclusions. Somebody I trusted and knew had my best interest in mind fully. Find somebody you can talk to. I’m most definitely available and I don’t have anything vested in you getting a TAC, but that may be hard for you to trust since I only exist on the internet.

• We met with an MFM after I lost the boys and was considering the TAC. I had not yet emailed Dr. Haney, but I had begun researching. My MFM (who is one of the best in the area and was my IVF doc’s doctor) said he simply couldn’t diagnose IC because there is no test and a line can?t be drawn with only one point. I totally understood that. That made it clear to me why so many women had to have two or more losses before getting a TAC. He didn’t even think I should put in a preventive TVC next time, rather I should have weekly checks and put one in if needed. I knew that was not a route for me to go because if I needed it, then it could be too late (learned that on Abbyloopers). He said I could convince him to put one in at 14 weeks for the ‘mental health’ of my pregnancy. ?Overall, he felt that my pPROM was a ?fluke and that ?twins do weird things to the cervix.

  I asked in what instance he WOULD recommend somebody get a TAC (because he has put in three TACs in his career). He said that if he saw ANY cervical change in my next pregnancy, then he wouldn’t hesitate to tell me TAC after that.

  So…important info for me: I knew he wasn’t anti-TAC.I also told him I felt like I was fighting for my children’s lives, and he chuckled and said I wasn’t in that camp just yet. I understood then that we were coming at it from two different perspectives. From what I’d read on Abbyloopers, if I had IC, I really was in that camp. And, being there, I realised we wanted to fight aggressively. TVC was not aggressive. TAC was aggressive.Finally, I really felt like everything I was reading pointed to the TAC being controversial – and why the heck was everybody going to just a few main doctors for this So, I asked my MFM. AND THIS WAS THE TIPPING POINT. He said that it was simply the “art” part of medicine. He said Dr. Haney was not a witch doctor selling snake oil and that his idea of a TAC was an absolute valid opinion. It also helped me to know Dr. Haney has a high reputation in the medical community (he?d spent decades at Duke University, a prestigious school in the U.S.), my IVF doctor knew of him, AND he wasn?t a young buck doing hasty medical stuff. He is much older and has been doing this for a long time.

• Finally, I did email with Dr. Haney. ?Here is his email response to me:

Dear Ms. Nguyen, I am sorry to hear of the loss of your twins and am sure it was devastating for you. I indeed have a different view than your doctor as twins do typically deliver early but that is at 34 or 35 weeks, not at 16. As far as I am aware, twins do nothing “weird” to the cervix and you simply have an incompetent cervix and had a twin gestation with IVF. I am much happier to place a TAC in someone prior to undergoing IVF as the twining rate will continue to be elevated with your next cycle and I do not want you to lower your likelihood of a an IVF cycle resulting in pregnancy to avoid twinning by transferring fewer embryos. I know this may sound surprising but twinning does just as well with a TAC as a singleton which is not the case with a transvaginal cerclage. Once you have lost a baby, in your case twins, because of an incompetent cervix, you do not have to lose another. Given the stress of IVF, you deserve the optimal treatment to avoid another loss and a TAC virtually guarantees you of a term delivery, albeit by C-section. I look forward to speaking to you on the 26th. Good luck. A.F. Haney

• We had a phone consult with Dr. Haney. ?He explained perfectly clearly how pprom is NOT normal – how there MUST be a defect in order for it to occur. While we were on the phone with him, we drew out the pictures he was explaining. It made complete sense. I also checked again with my mom, and she said, yes, absolutely, that’s how the body works.

• So, we loved Dr. Haney and it all made sense. How did we finally get there We prayed. My husband and I are Christians and we are in God’s word every day. We are constantly asking the Lord what direction we should go. There were a few things that pushed us toward the TAC in this regard:
  • Often God calls us to do what the world would say is illogical – not always and this would be a lot more explanation, but it’s a piece of it.
  • We know that in following God’s will, we continue on the path He has set before us unless He moves us to a different direction. For us, we had frozen embryos that we had committed to getting way before we did IVF. So, we knew that we still needed to get those little babes. Yes, there was the possibility of a surrogate or a TVC, etc, but that was another piece of the puzzle…that we should keep pursuing fertility and having our babes.
  • God is pretty clear all through His word that He equips us with love and wisdom IN ORDER THAT WE CAN MAKE GODLY DECISIONS. We’re not just dumb empty rocks waiting for God to drop an answer in our heads. He’s equipped us with a lot of tools for making decisions. So, when we didn’t feel a clear whisper in our hearts, and we KNEW that we had keenly been seeking God’s will, we had the freedom to make whatever decision we deemed best and ask the Lord please make it the right decision for us and to stop it dead if He didn’t want it.
  • Finally, we met with several older couples who have demonstrated a lifetime of making tough decisions and serving the Lord through it. We explained our situation and our thought/prayer process to them. We asked them if they saw any red flags or cracks in our thinking. We asked them for their wisdom. The biggest thing we got was “how will you feel towards God if you do this TAC surgery and then don’t have kids?” This question really helped highlight the intentions of our hearts: were we truly truly seeking what God had for us or were we only interested in our idea of babies. And not to say God doesn’t want us to have babies at all….just to really break down and look at where our hearts were lying. That’s why we could confidently know we had been genuinely seeking God’s heart on the matter.

• We did a cost/benefit analysis. The bottom line was that the cost of surgery for the benefit of not losing more babies and a mentally way less stressful pregnancy was worth it. And, for the benefit of not doing surgery, the potential cost of losing kids just seemed outlandish. My engineer husband also looked at it as “if we keep doing the same thing, then we’ll keep getting the same outcome.”

All those moving pieces somehow came together for us to move on to book the surgery. ?And to do it confidently.

A thought here as I look back: When I was initially researching the TAC, Hubby was very hesitant (EVERY husband is!). But after emailing with Dr. Haney and having the phone consult, he was 70/30 for it. What!! I was 99% for it! ?It took that praying and those meetings with our elders to go for it. To him, he wasn’t just making a decision about his children; he was also making one about his wife. Looking back, I think how silly it is all the scare tactics doctors use to deter people from the TAC…”it’s very invasive” (not even as invasive as a c-section, which happens all the time) and “uterine rupture” (really How about you follow TAC protocol and don?t let me go into labor before you do a c-section This has been called a ?theoretical risk by TAC doctors.)

I think a lot about Giuliana Rancic host on E! and married to the first winner of The Apprentice. ?She had breast cancer and was going to do radiation treatment. Then she came out and said she’d made the decision to go for a double mastectomy instead. May people called this “radical.” ?Really Moving towards something that definitely takes care of the problem is radical She went on Good Morning, America and shared that in the end, she felt like she was making a decision for life. ?My Dear Sisters, that’s how we felt. We were making a decision for life – for our emotional heart life and for our future children’s lives.

I know everybody will tell you this is a very personal decision and you have to do the research and talk to hubby, etc, etc. That’s very nice of them. I look back now and realise I wish somebody had just said what they were all thinking: GET THE TAC. ?It’s a good decision. Period.

Please if you have any questions, contact me! ?I have nothing personal vested in this other than caring about people and babies and wanting everybody to have the same opportunity at life that is being afforded my future little ones!