FET #3: Stims Day 1-4

I have tried to set a daily (home) routine for this cycle. So far stims days 1-4 have gone like this:

Before work:

  • Wake up & make a vanilla flavored protein shake containing acai, maca, pomegranate, bananas, avocado, & almond milk. Sounds like a lot of random stuff mixed together, but its actually really tasty and filling! 
  • Take all oral meds (Estrace, baby aspirin, prenatal)
  • Do Lupron stomach injection 
  • Today was the first day I cut out coffee! 

After work:

  • Cook a healthy dinner
  • Take a candlelight bubble bath while drinking my raspberry leaf tea (2 cups per night)
  • Read our couples devotional together 
  • Listen to my Circle + Bloom meditation CD as I put my legs up the wall (fell asleep like this the other night)

 

  • Do ass injection (only every 3 days for now). Have 2 down so far. Bled during 2nd one. Ugh. 
  • Early bedtime!

Tonight I went to acupuncture for the first time during this FET cycle. Ive done it during all our prior cycles. Its a must for me! Ill be going weekly for now. I go to the same lady each time. She goes the extra mile for me, massages my neck and feet, helps me with visualization, and so on. Tonight she asked me if it will be a girl or a boy, and I told her GIRL for sure! She smiled. 

Overall, I feel pretty good. Headaches here and there since the estrogen started this week, and some emotional bits too. Hopefully I can keep that under wraps and not fly off the handle completely. I went from being in a menopausal state for months, to the polar opposite. I dont think it helps either that our state testing is in about a week. Kids are stressed to the max and so I am.  

Ready for April to be here already! 

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To Do List

Okay, so what can I say? I am in transfer prep mode and its still about 68 days away. Crazy, I know, but what feels like not too long ago, I posted it was 100 something days away and that flew by.  Im assuming these will too, especially with it being such a busy time of the year at my job.  

Ive already made my 2WW list, I figured I might as well also make my before -transfer-non-negotiable to do list. Hopefully making it will hold me somewhat accountable! 

  • Start back up on acupuncture by the end of this month at the latest. Ive done it religiously with every transfer.
  • Renew my yoga membership ASAP. Hitting yoga at the right time has helped my lining significantly increase during an FET cycle. 
  • Get my blood drawn at Quest for my updated Vitamin D level, Prolactin level, thyroid level, etc. to make sure all are still in normal range 
  • Call WIN fertility for an FET bundle price quote 
  • Email my nurse to refill my Folgard prescription
  • Make a decision on whether or not I will be on the blood thinner, Lovenox again post transfer/pregnancy (post to follow soon on this)
  • Dig out my Circle + Bloom FET audio CD 
  • Start weaning myself off the caffeine (bye, bye coffee)…this is always one of the worst parts of cycling in my opinion
  • Spring clean! Thinking back, our house got quite messy from all the light duty I was on during 2 week waits, pregnancies, and miscarriages in the past. 
  • Stock up on all the healthy “stuff” I need. Save this for a later post too. 

I think that about sums it up for now. Notice I didnt put anything about purchasing HPT’s this time around. Im actually leaning towards not testing before my beta for once, but I cant say with all honesty that I wont.  But for now, its not on my list and Im good with that! 

Do the Benefits Outweigh the Risks?

This might sound somewhat insane, but recently after our 3rd IVF loss, I asked my RE if there are any safe anti-anxiety medications I can go on should I become pregnant in the future.  I guess this conversation has been crossing my mind again as we are approaching the month of July.  The truth of the matter is, should we plan to do a FET in the fall, it will be here before we know it.

Being a recurrent miscarrier, my anxiety is through the roof once I see those 2 pink lines.  Because for us, those 2 lines mean that the battle has only just begun.  Sometimes I feel odd because most of the women I meet in the infertility world are most stressed about going through the treatment cycle itself and whether or not it will even work.  Rightfully so, because calendars, stims, retrievals, transfers, and 2WW’s, are all extremely stressful things to endure.  But unlike most, when it comes to stressing, we spend the majority of our time thinking about miscarrying rather than the other things, even before the treatment actually begins.

Of course, my RE informed me that there are no “safe” medications for anti-anxiety when pregnant, which is what I figured. She gave me the option of going on a “safe” anti-depressant before I become pregnant, and continuing it through my pregnancy.  I really do not want to do this, considering I am not on any antidepressants now.  And isn’t this situation usually the other way around anyways? Like, a non-pregnant woman may be on antidepressants, but once she is pregnant, she weans herself off the meds. Here I am, a non-pregnant woman who is not on antidepressants, but wants them should I become pregnant! Totally backwards.

At times it pisses me off that what is supposed to be a time of joy and bliss, is now a time of anxiety and fear for us.  I feel like something primal has been stolen from within me.  Probably because it has. Could these feelings mean I am not ready to move forward again in a few months?  Does it mean I need more time to heal mentally?  I don’t believe so. No matter how you look at it, those losses will never go away.  It doesn’t matter how much time passes by.  It still happened to us and we will never get over losing our children.  I believe our fears are justified, and they are a part of us now.  Sure, I’d really just like to go back to being my old, normal self before the RPL days, but I don’t think that is humanly possible.

Regardless of the fears, neither my husband or my mom want me to go on an anti-depressant solely for pregnancy purposes either.  And even though they say some antidepressants are “safe” for pregnant women, there are still risks involved and I don’t believe the benefits will outweigh them.  Ladies, please feel free to share your experiences with this.  For now, the short of it is, I need to find additional relaxation techniques to do in conjunction with the prayer, support groups, coloring, yoga, and acupuncture to get me through a future pregnancy without losing my mind. I never thought I would need to think this far ahead in terms of pregnancy anxiety, but I do.

This being said, one additional resource we plan to use is visualization through Circle + Bloom.  If you missed my prior post about the Circle + Bloom CD programs, they are designed to reduce stress and provide a therapeutic mind-body connection through visualization techniques.  If you research it, you will find that the techniques have shown effective in cancer treatment and education.  I actually received my Circle + Bloom FET 3 disc audio CD in the mail today and  I wanted to share a coupon with you in case you have any interest in purchasing a CD yourself….Circle + Bloom coupon


  

They have audio CD’s for natural cycles, egg donation, pregnancy/delivery, PCOS, energy improvement, sleep, IUI, IVF, etc. Obviously, I have not listened to the FET CD yet, but I have listened to the free Healing & Recovery CD for pregnancy loss and it is really amazing.  To me, the CD is just as, if not more, relaxing than yoga or acupuncture.  Down the road, we plan to purchase the Pregnancy CD as we go through another FET cycle.  I am hoping that I can listen to it frequently and calm myself down when I need it.  Of course, that is if we ever see those 2 pink lines again.

Always Room for Improvement

Right off the bat, I should say that I know no person is perfect, and no IF clinic is perfect either. Perfection should never be the expectation. However, in any profession, if you aren’t reflecting and trying to improve or do better, that could be a problem. Experience only makes you wiser if you learn from it and apply it to future situations. I know this from being a teacher the past 5 years.

This being said, we have made a list of things we think could be improved upon at our current clinic, or any clinic for that matter.  Here is what we have so far:

  1. The most advanced uterine tests should be performed on all patients before IVF. This means a Hysteroscopy should be done on every patient prior to IVF.  You heard me right.  That is our opinion after the hell we have gone through. We are proof in the pudding that an SIS and HSG aren’t always enough.  If we had done this procedure from the start, there would be no questions in our minds or our RE’s if that fibroid had truly been around for all 3 losses or not.  
  2. PGD should be offered to all patients before they begin IVF.  Looking back, we were never informed of this option & I wish we had been. We cannot do PGD testing now with our remaining frozen embryos, as it can only be done in the days following the retrieval.  We never knew about this option until we miscarried and started searching the web. Suddenly, we started seeing all of these women who did PGD before transferring.  I mentioned it to my doctor at that point, and found out it was too late to genetically test our embryos.  Since we looked good on paper (under 35, appropriate weight, etc), perhaps it was assumed we would succeed & not need this expensive option added on. If we were to miscarry again, I do not know if I could go through another transfer. Instead we have discussed a surrogate. How much more confident we would feel knowing we were transferring a genetically normal embryo into a surrogate than not! While I get that PGD is not 100% accurate, it should be offered to the patients if it is a service the clinic provides.
  3. RE’s should discuss the worst case scenarios upfront with their patients before they begin IVF.  When we began IVF, we were so set on it actually “working” that we didn’t think of anything before that point or after that point. We didn’t discuss that only embryos making it to day 5 or 6 would be kept.  We never talked about the chances of chemical pregnancies, miscarriage, or RPL.  We had no idea we would go through the torture of beta testing and what would need to happen with all that if we ended up pregnant.
  4. The RN’s should not do all of the ultrasound monitoring during an IVF cycle.  This is probably common at most clinics simply due to the amount of patients undergoing treatment.  It was never an issue to us before we miscarried either as we do trust our RN.  However, our nurse ended up missing something early on in one of our cycles that our RE probably wouldn’t have if she had been the one doing the ultrasounds to begin with. Moving forward, we have told our RE we will not be monitored by anyone other than her and she has agreed this is best.  If our RE would like to have the nurse with her for another set of eyes, great! Bottom line…I want the person who will be transferring those embryos into my uterus monitoring it before hand. No exceptions.
  5. All viable embryos should be considered for transfer.  At our clinic, only embryos that make it to day 5 or 6 are transferred.  On the day of the retrieval you are handed a piece of paper that says “be here on day 6 at _____ am for embryo transfer.”  I know several women who have had successful day 3 or 4 transfers, so I do not think it is fair to limit to just a day 5 or 6 transfer. Thankfully, our 8 embryos made it to day 6, but what if they hadn’t?
  6. After retrieval, the embryologist should provide daily updates on how the embryos are doing.  I never once talked to the embryologist for an update. I received a voicemail the day after retrieval with a brief summary, but that was it. Those days after the retrieval are sooo stressful as it is, and remember we had to wait until day 6 not knowing anything. In my opinion, not knowing anything until you show up for the transfer is adding a lot of unnecessary stress to the situation.
  7. Get input from the patient about their IVF treatment plan.  Sit down and show patients all of the different “protocols” available for an IVF cycle. Short, mini-stim, antagonist, un-medicated, etc. Tell them the success rates with each. Explain what type of patients you have seen do well on each type of protocol.  Understand that this should not be a “one-size-fits-all” approach.  Ask them questions about their bodies, and act like they are educated. Through this process, I have learned that I know my body better than anyone. Just because Susie did well off all of the drugs you gave her, doesn’t mean I will. Show me what is available, whether it is your preferred method of treatment or not.
  8. Clinics should disclose what will happen if you do get a positive beta post IVF.  We never talked about the cost to continue a pregnancy if we achieved one.  We had no clue we would be spending thousands more on medications after the actual IVF cycle itself ended.  Medications are only paid for up until the beta test in case you get a negative.  If you get a positive, you will need meds for 6 more weeks, at least.  That adds up to thousands more.
  9. Designate clear roles within the practice.  Since it is so easy to communicate with everyone at the practice (listed as a perk yesterday!), you never know exactly who to talk to about things. For example, we have had prescriptions not called in, called in twice by different staff members, etc. It would be great if each person had a clearly designated role or each patient had a clearly designated go to person.
  10. Wellness services should be provided at clinics. Everyone goes into treatment hoping it will work the first time.  But, that is not always the case.  Actually, majority of the time it is not the case.  After all of the emotional and physical trauma, we wished that our clinic offered things like acupuncture, counseling, etc.  Don’t get me wrong, when asked, they provide recommendations, but we have ended up finding our own specialists in these areas.  It would be great if clinics started including these in their treatment packages.

Hind sight is always 20/20. But we hope this list is helpful to those searching for a clinic to call home!

The Weeks Leading Up to FET #2

My favorite time of the year was here. Winter in Florida had finally arrived. 60’s at night, 70’s during the day, ideal weather for a hoodie and some comfy leggings (maybe even a pair of boots).  Who wouldn’t love this weather?  Just like northerners look forward to the summer every year, likewise, we Floridians, look forward to the winter.

During what felt like the longest November ever, I taught during the days, and at night, I practiced yoga or received acupuncture. In fact, I was going to acupuncture 2 times a week (not cheap!!!), and yoga 3x a week for a solid month.  My goal was not only to reduce my stress levels, but to get the blood flowing to my uterus, which in turn would help thicken my lining.  At home I was also practicing yoga. Every night I had my “legs up the wall.”  All you yogis out there know exactly what I am talking about!  I would sit, butt up against the wall with my legs up for at least 30 minutes, all the while praying my lining was growing.

yoga-leg-up-the-wall-pose

After that, I would pour a glass of red wine (something I never did with other cycles–you get risky after you are a pro!), and take a candle light, lavender bubble bath.  I remember feeling incredibly tired day after day, especially come mid-November, when I starting taking all of the hormones again. There were many days when all I wanted to do was just take a hot shower, eat dinner, and curl into bed after work.  But I pushed, and kept going. I kept thinking about December 19th, our “big” day; for this was the day we would start our family.

All of the therapeutic practice paid off. By the first week of my ultrasound monitoring, after only 1 week of estrogen pills and patches, my lining was already at an 8.  Yep, that’s right, an 8! The thickest it had ever been.  And the best part was I still had 2 more weeks for it to continue thickening.  FYI: Lining doesn’t get thinner, or shed, until a menstrual cycle.  This being said, we knew my lining, at minimal, would be an 8 for the transfer.  As it ended up, I never even needed to take the vaginal Viagra, which I couldn’t complain about (even though we already paid for it).

The week following my first ultrasound, on what just so happened to be Black Friday, my lining was up to a 10.  We walked out of that appointment just staring at each other in awe.  We couldn’t believe it!  The doctor and nurses couldn’t either.  They were actually clapping and cheering.  We thanked God over and over again.  When they asked me what I was doing differently this time, I said, “praying harder.”  We tried our best to give God the glory any chance we could.

December was here. At our 3rd ultrasound, my lining measured a whopping 12.  Anyone in the world of assisted reproduction knows how awesome this is! I had finally made a thick, cozy bed for those embryos to burrow into. I was actually proud of my body, which I hadn’t felt in quite some time.  At this point, I stopped taking the Estrace vaginally and switched to a lower dose orally since my lining didn’t need to grow anymore.  I scheduled 1 more ultrasound for the next week, just to make sure everything was perfect before I started taking the progesterone.

The morning of the final ultrasound did not start out well.  First, let me tell you that every one of our ultrasounds were scheduled for Friday mornings at 7:30 a.m. so I could be on time for work. Even though it meant getting up at 5:30 a.m., and leaving the house by 6:30 a.m. to get to the appointment on time, it was better than missing work.  Bright and early that Friday morning, I stopped to get gas before I got on the turnpike and headed to my appointment.  After I pumped the gas, my car wouldn’t start.  I called my hubs since he was still at home.  Of course, I was crying hysterically!  A woman, on tons of hormones, the week before her 3rd IVF transfer, stranded at a gas station, in a skirt, and it’s barely 50 degrees.  Not good.

out_of_chocolate

He was there within 15 minutes.  He tried to jump the car, no luck.  It was obvious that not only was I going to be late to work, I was going to be late to the ultrasound too.  And the kicker was I couldn’t even call the doctor’s office to tell them I’d be late because they don’t answer the phone until 9 a.m. (don’t ask me why!!).  We had two options: A.) He takes me to the appointment, then takes me to work, and finally, one day, gets to his job (God only knows by that time it would be noon-everything literally takes hours in Florida), or B.) He drops me off on his way to work to get a rental car, I go to the appointment, and then, eventually, to work.  We chose B.

I got the rental car and arrived at my appointment, needless to say, an hour late.  I stormed in completely flustered, waiting for someone to even try to tell me they couldn’t see me because I was late! Thankfully, everyone was understanding and the nurse saw me right away. I figured once she took me back, I would be in & out within 20 minutes. Quickness is the norm with these blood and ultra appointments during a cycle. But today, that was not the case. Today, I had what appeared to be fluid in my uterus. Fluid in my uterus meant our cycle could possibly be cancelled.

I burst into tears in the office. The nurse told me she wanted me to stay until the doctor arrived to get a second opinion. Well, the doctor did a scan & thought it was fluid as well.  She said we would have to cancel the cycle if it was.  She suggested inserting a catheter into my uterus where the fluid appeared to be, in hopes that it suction the fluid right out.  We tried 3 times that day.  We tried with an abdominal ultrasound view once, and then a vaginal view twice.  Yes, I had an ultrasound probe and a catheter in my you know what at the same time.  I could see the catheter right at that fluid sac, but nothing would come out.  We tried again the following day (thank God I rented that car, mine was still out-of-order).  Still couldn’t get it out. More tears.

The doctor came to the conclusion that the fluid had to be right outside my uterine cavity.  She said she would not cancel the cycle at this point.  Can I tell you how mixed my emotions were?  I completely despised the thought of cancelling the cycle because that meant the past 2 months were pointless.  However, what I hated even more was the idea of something being wrong and going through with the transfer.  If there was fluid, and we did the transfer, it could be deadly to the embryos.

Right then, I begged her not to do it if she thought there was any fluid in my uterus. I told her I could handle it being cancelled, when in all reality I didn’t know if I could.  She must have thought I was crazy; I didn’t care.  I didn’t want anyone to feel bad for me, and thus sway their decision.  She assured me that she would not perform the transfer if she thought there was fluid in the uterus, or if the fluid increased in size or changed location at all in the next week. This being said, we set up another ultrasound to check the day before the transfer.  This was now the new “big” day.

For the next 6 days we didn’t know if we were going to be doing the transfer or not.  I started my progesterone as if we were, as I was told, and waited.  I was a nervous wreck.  Unfortunately, there is nothing else you can do to get the fluid out of your uterus, it simply dissipates on its own. Sometimes quickly, sometimes not.

We were so frustrated! In a matter of minutes, we went from being over the top about the lining to not even knowing if we were moving forward.  I know I’ve said it before, but I will say it again, with IVF there are no guarantees, and something major can go wrong at any given time.  In all actuality, just when you think you are free & clear, you realize you may not be. And so, our prayers began to change. We prayed for God to close the door if he didn’t want us to move forward.  If this was his way of telling us no, then so be it.  Over and over again, I whispered, “anything God, but PLEASE, PLEASE just don’t let us lose another pregnancy.”

The day before the transfer finally rolled around.  Another week that felt like a year.  My blood pressure was through the roof when I got there, and I was shaking like a leaf.  As soon as the doctor came in, I was crying.  The things hormones will do to you. The things you will do to have a child.  The things you will do for your dream of a family.  She inserted the probe and we stared at the screen. Then we got the news: ALL THE FLUID HAD DISAPPEARED.

IMG_2789

The Journey of a Thousand Miles Begins with a Single Step…or Shot

We decided to pour our hearts and souls (and pocketbooks) into a process that has no guarantees. That’s right, no guarantees.  As you may have guessed, we decided to do it;  IVF that is.  We redid every test under the sun before we began just like we were told, with a few new ones added in for good measure.

I remember the excitement before the start of the first cycle.  Excitement because we thought for sure it would work.  Excitement because we would finally have a family after 6 years of trying for one.  Excitement because finally, we were here and it was our time.  I also remember the fear.  Overwhelming fear.  Fear that I would get terribly sick and hyper-stimulate from all of the drugs.  Fear that we wouldn’t administer the drugs properly.  Fear that our cycle would get cancelled because my body didn’t react right.  Fear I wouldn’t have any eggs retrieved.  Fear my husband wouldn’t be able to produce a sperm sample the day of the egg retrieval.  Fear that I would fail to get pregnant.  Fear of losing our money. Fear that it could tear us apart if it didn’t work.  The thoughts were endless.

Ironically, I never feared that I would miscarry.  I think at the time, you only focus on whether or not you will get pregnant (if you have never miscarried before). You can’t see that far out, especially on your first IVF.  One worry at a time.

us

Getting Started, “Pre-IVF”

We met with the surgical coordinator, and she gave us a calendar of the dates for our cycle, with the details of what medications to take each day.  The calendar dated from February 9th, 2014 to April 19th, 2014.  That’s a long time.  That’s a lot of blood, sweat, and tears! And drugs.

Next, we met with the financial coordinator and chose our package.  Sounds like a vacation but it’s not.  We decided we would only pay for 1 fresh cycle.  We couldn’t imagine paying for more.  Plus, we thought it would work the first time, even though the statistics say that most couples need at least 3 IVF’s to achieve a live birth. Key word, live. 

Once we chalked up the cash, we got our meds shipped to us.  That was a scary day.  It was now so real. The surgical coordinator gave us an injection training and made sure all the correct meds were there (another day we had to miss or go into work late; there are lots of these days with IVF).  I was so confused at the injection training…thank God for my husband who is always so calm.  What would I do without him?  She also gave us our own “special” voice mail box that we would call after 5pm on the days we had blood work and ultrasounds done to get our results.  The voice mail was very important because it told you the dosages to inject each night based on the blood work and ultrasounds from that morning.

#IVFmeds
All of my meds for IVF #1

And then it began. I was on birth control for a month to suppress my ovaries, and when I got my period in February, I had the infamous day 3 ultrasound done to make sure I had no cysts (a must before starting an IVF cycle), which I didn’t, so we were good to go. I started following the calendar like a science and taking the medications, or “stimming” as they call it in the world of IVF.  I triple checked everything.  We watched You Tube Videos numerous times before we would do an injection to make sure we were doing it correctly.

calendar

Note: I would recommend keeping a journal if you do IVF because sometimes you simply forget things (the drugs can make you forgetful at times!).  I kept a journal and wrote in it everyday.  I wrote about what I ate, what injections I did and their times/amounts, along with any oral pills and their times/amounts, what my estradiol levels were, the size and amount of follicles, what type of exercise I did, my mood, if I had acupuncture done that day (I bought a package and did this once a week for a month leading up to the transfer date).

baby_dust_fairy_journal

As you can see, there is sooo much involved in the IVF process. We have decided to put further information into our following post titled, “IVF #1-Stim, Retrieval, Transfer, & 2WW (all you ever needed, or wanted to know)”