Tuesday, June 30, 2015

Getting our FET ducks in a row

We are in preparations for an FET at the end of August to transfer our three remaining embryos. Full steam ahead, trying to get everything lined up.

My plan is to do everything we did that brought us Magpie. We don't know which pieces of our previous plan were causal, and these are our last three embryos, so we want to do all we can. Likely a lot of it is unnecessary but this way we can know we did all there was to do if the FET fails.

So what are the pieces so far?

Consults and more consults. We went in to see our old local RE, who will be monitoring me here before I travel to Denver. We have an appointment to see the miscarriage wizard again mid-July for all of his reproductive immunology advice and plans.

What are our ingredients for hopeful success?

Depot lupron to decrease endometriosis/improve implantation potential: I took the first of two depot lupron shots on 6/12 and feel nothing yet, although I have begun bleeding the past several days. But no hot flashes, night sweats, no depressive mood. Hopefully that will remain the case. I truly HATE depot lupron, but stage 3 endo is a real thing. And so....I can do this shot x 2 one last time.

Endometrial biopsy: Our old RE has agreed to do an endometrial scratching/biopsy about one month prior to the transfer. There is some data that the growth factors released in the healing process increase implantation rates, with some studies saying success improves by up to 50%. We did it last time, before Magpie's transfer...

Prednisone: I was on prednisone starting about two weeks prior to Magpie's transfer and through most of first trimester (I think it was that long). I'll do whatever the reproductive immunologist says on that count.

Lovenox: I was on this after transfer and throughout my pregnancy. Will see again what is recommended, but I'm sure I'll be on it. The reason was just in case of coagulation issues, since i've had so many losses. Probably unnecessary. but not harmful. and we did it last time...

Diet changes: Last time with Magpie's transfer, I cut out gluten and dairy and eggs and tomatoes. OMG. In a bid to reduce inflammation, and because some testing I had a while ago showed that I supposedly have some sensitivity to these things. So, sigh, I guess I'll do that again, at least for a while... with her I stayed on track with the restrictions through most of the first trimester. Can't imagine doing it again that long, but we'll see.

IVIG: This is the one that causes the most marital conflict (Will doesn't want to do it again). So expensive! And makes me so sick! But then again Magpie is here...so I will be doing this again, at least until (if we are lucky) we can get a solid implantation and heart beat going.

Folic Acid: I took a lot of this last time. Something like 3000 micrograms a day. I'll do whatever the reproductive immunologist says. For now am just on my regular multi, which has 800 mcg.

Multi + Vitamin D + Fish Oil: Yes, I'm taking taking them all, just like last time.

Caffeine: Will be cutting this out. Decaf products too. Sigh. Until later in first trimester. This one's a bit tough, but will do it.

Acupuncture: I did this last time because of uterine blood flow issues, but was going to skip it this time because I passed the uterine doppler test the Denver clinic does. Also because I don't know how I could possibly fit it in to my schedule. Will likely do it immediately before and after transfer though, just not the 6 weeks 2x/week insanity I did last time.

Baby Aspirin: I'll be adding this in but can't remember when.

Alcohol: Will be cutting this out too. Sigh. Last time I did so about 6 weeks in advance. Will find out if that is truly necessary or if I can wait until closer to the transfer.

I think that's about it (Thank God).

Anything else anyone's aware of that can help with implantation? Let me know!


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Sunday, June 14, 2015

Back on the depot lupron....headed toward FET

We opted to go with our remaining three frozen embryos and not do another fresh IVF cycle. Procedurally, for me this means two months of depot lupron (to reduce my endometriosis) prior to then starting estrogen, etc., to build up the lining again and going for the transfer itself. Hopefully the transfer can occur in August, but they haven't given me a calendar yet (finding the bureaucracy much more difficult to navigate than in transfers past), so I'm not certain I can arrange the time off, given my colleagues also likely taking time that month.

I talked to Schoolie on Friday about our Day 3 results. I'd already come to the conclusion that it didn't take a world class reproductive endocrinologist to tell me I'm pretty darn infertile, and that more IVF at 43 and change is not the surest pathway to more kids if we felt we needed to have them. We only did the day 3 testing in the first place at Will's request. In my mind, if we'd strongly wanted to cycle fresh again, we should have done it as soon as I weaned Magpie or, possible weaned her early to try to maximize our chances.

I also remind myself that we'd gotten to a place where we were comfortable with third party reproduction, and actually, now that Magpie is here, I'm more open to adoption than I was previously as well, although that's not an easy path either. Any of those alternative paths, however, seem a surer bet than my own eggs at 43.5, especially with a history like mine.

Schoolie confirmed. He said the numbers suggest I may still have good eggs left, but I certainly don't have many of them (only 4-5 follicles). So...well...yeah... no more fresh cycles.

Instead, I injected myself with depot lupron Friday night. How far we've come that Will can now be in another room, and I can self-inject intramuscularly in the bathroom. Sub-Q injections have never fazed me, but the IMs? Yikes. But well... doesn't faze me now. I worry about the emotional effects of the depot lupron. I've found it historically to be the hardest part of the medical infertility stuff, with me tending to crash headlong into hot flashes and dark, black mood states. Really hoping this time is somehow different, but we shall see.

So... heading forward. We shall see what happens...


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