FET 3 Protocol

Let me start out by saying that I had my final, 3rd injection of the Lupron in my behind yesterday…hooray! I am so glad I have reached this milestone. I am also so thankful to God that my side effects have been very minimal, which was a huge fear of mine going into it. He has 100% answered our prayers with this.

After my injection, I sat down with our list of questions with my RE. She pulled up the scan I had last month when I was bleeding and compared it with the scan I had that showed my mass a few months prior to the Lupron treatment. Good news-the mass wasnt showing on the scan from last month. Of course we cant be sure it is completely gone until my Hysteroscopy in a few short weeks, but its a great sign so far. If its not gone, its at least shrunk! Another answered prayer. 

We discussed immune therapy with intralipids and IVIG, the differences between them, my antiphosphilid results, the studies, etc. Based on my panels and our discussions, and although they offer them at one our of their clinics, I wont be doing these treatments at this time. I feel good about this decision.

Next up was the Crinone v. PIO talk. Ive always been on Crinone for my transfers (fresh & frozen) whereas the recommended protocol for most FETs is PIO. My progesterone levels have always been great, even when we experienced losses. I pretty much refused them in fear of hitting a sciatic nerve or something, (I know not likely) but I have chronic, horrible spinal issues to begin with, and couldnt stand the thought of any additional back pain. My RE was always OK with our decision because of my reasoning. However, I am now ready to go all in and give myself those ugly intramuscular ass shots everyday for 12 weeks (I hope!!) at this point instead of using the Crinone gel. I dont want to look back and feel there was ANYTHING more I could have done. This means no more vivelle either, DEL it is. I know so many of you ladies do it, and I can do it too. I just had to be ready and I am.  I know its not that bad and Ill be just fine!

We are still undecided on the Lovenox, or blood thinner this time around. We talked about it and it could go either way. I am pretty sure this will be a last minute, go with your gut decision. I have plenty leftover from our last FET.

We moved conversation on to the Zika virus. Ugh. My RE showed me some things recently released by the CDC. Although no mosquitos with it have been found here in Florida yet, it is predicted they will be here by the spring due to our climate (right when we transfer!). There isnt much we can do, other than wear bug protectant, stay indoors at night, away from water, and wear condoms when we have intercourse. If hubby got bit, he could easily give it to me. You can get bit and be asymptomatic too. No immunizations will be available for a long time it seems, as I asked because I seriously considered waiting it out to transfer. 

I live next to two empty lots and have some water behind my house. We usually get eaten alive during the summer months.  Its horrible. Needless to say, I think Ill be investing in a HazMat suit soon to be safe. Doubt that, but I have already started reading into Essential Oil mosquito repellent blends I can apply and such. I wont be using and inhaling a chemical based product everyday when pregnant thats for sure. We arent sure about our Bahamas cruise either now with this crap. Going to play this one by ear and see how things play out over the next few months with the virus. Trying not to stress about it, just be proactive. Not like we can control nature. 

On my way out I saw my very pregnant nurse. You might recall me posting about this a few weeks back and how incredibly tough it was. This time when I saw her, I hugged her and told her congratulations. I didnt plan to do it, it just happened that way. I think I just needed time to process it all. God made it really easy for me to be happy and at peace when I saw her this time. Again, an answered prayer! 

Anyways, I called WIN fertility for a bundled FET price quote, got all my presciptions handed to me for upcoming bloodworks, and so forth. The most exciting part of the day was setting up my calendar and transfer date! It made it all feel so real again. We will be transferring almost 2 years ago to the day of our first transfer.  I am ready and praying for all good things. Really, just praying its His timing now, because if its not, I know it wont happen. 

Lovenox Help

I have had this draft post saved since summer 2015. As we finally approach our FET, I figure its time to publish it.

I would LOVE the advice of anyone who has been on the blood thinner Lovenox in a similar situation to mine. 

Let me preface this by saying that the *only* blood clotting disorder I have is Prothrombin Thrombophilia (Hetero, or just 1 copy).  I have had several RPL panels, genetic tests, etc. to confirm this. 

Here is the Lovenox history-

Pregnancy 1-miscarriage. No lovenox treatment during this pregnancy. D & C comes back “inconclusive” as to genetic anomalies in baby. 

Pregnancy 2-natural miscarriage, genetic make-ups of babies not known. No lovenox treatment during this pregnancy. 

Pregnancy 3-missed miscarriage. Treated with Lovenox from before the transfer, and through pregnancy until days before the D & C.  D & C proves baby is genetically normal.

So, as you can see, I have miscarried both on Lovenox & not on Lovenox. 

I have now talked to my OB, 2 RE’s, and a Hematologist about whether or not I need this blood thinner moving forward.  Heres the general consensus-

Hematologist-yes, I will absolutely miscarry without it.

Both RE’s-not for taking it initially since I only have 1 copy, but after 2nd loss figured we should go for it with pregnancy #3; now not sure if it could have been what got me as far along as I was, or if it could have had an adverse effect and even caused a loss. Wtf? I guess there are some studies to support this out there. 

OB-no, I dont need it unless I carry both copies of the disorder, or am homogenous for it. 

ME-so freaking confused, but leaning towards not doing it this FET cycle even though I have a bunch of shots leftover from last cycle.  Hubby is supportive, and is just as unsure really, and so is my mom too. 

Here are some of my wishy washy thoughts on the matter-

• I feel like the Lovenox didnt do its job last time, why would it this time?
• What if it did do its job last time and the mass just caused the loss? 
• Or did they both cause it? 
• If I got pregnant naturally, I wouldnt have ever been on this drug, or even known I carried a copy of this mutation…I would like to be as natural in this totally unnatural process as possible!
• What if we get rid of this mass now, dont do the lovenox, and I really did need it? 
• If there is a future genetic issue, the Lovenox doesnt matter anyways (maybe thats what happened with pregnancy 1 & 2?)

Plenty of women with my condition don’t go on it, and have completely normal pregnancies —like half the women in my family!!!  BUT, on the other hand, there are also lots of women who recurrently miscarry, do go on it & achieve success. 

I guess we would really just like to make our mind up on this so we can finalize a few other decisions such as immune treatment with the FET. 

The best case scenario is that someone out there reading this has lived through it and can help a little! Please share if thats you! 

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! 

It’s Official

Well, some more test results have drizzled in.  Thyroid panel came back normal again, along with Thyroid antibody panel. Factor V Leiden also came back negative again, along with no protein c & s deficiencies (new test).

Although my Lupus anticoagulant panel came back slightly elevated (43 and <40 is normal) the second time it was done just a few weeks ago, (first time it was 37 back in October), there is not much more we can do to treat this, other than the daily blood thinner and aspirin, as we did the last time. This repeat test basically confirms I should continue the Lovenox in any future pregnancies.

As far as the low glucose goes, I have been blessed to come across a free meter.  I plan to monitor my levels closely on my own for awhile.  If there is a true problem, I believe I can try to manage it myself.  Overall, I am a healthy person who does not mind putting in some research time on what works and doesn’t.  I refuse to just start popping more pills or shooting up more injections just yet.

We can now say that we have done every possible test proven to be linked to recurrent miscarriage here in the United States (I know I have some Canada/UK followers out there).  As of yesterday, there is now officially a big, fat check mark next to every factor on the list.  Finally.  

What does this mean? It means we can confidently say we have done all we can possibly do on our end, and thus, we will have no regrets or “maybe we should have…” if or when we choose to move forward in the future.

And the list goes on…More Results

I got some results back from my metabolic panel.  The nurse said it appears I have low blood sugar. This is all quite new and confusing to me, but I guess “normal” blood sugar is in the 70-100 range, and mine is dipping down into the 40’s.

At times, I have somewhat suspected something was up over the years.  For instance, if I don’t eat every few hours, I start to feel possessed and irate.  My stomach aches and growls, and I feel blood rushing to my head frequently.  I am super tired all the time, especially after I eat.  And when I was pregnant, it was even worse.  I literally NEVER stopped eating. I know many women say this, but it was truly out of control.  Hey, at least now we understand a little bit more why I’ve been acting this way.

The little research I have done so far tells me that high blood sugar is more common than what we have, low blood sugar. We really do not know if this could have played into our miscarriages.  However, we do know that according to the ASRM, “poorly controlled diabetes increases the risk of miscarriage.”  https://www.asrm.org/FACTSHEET_Recurrent_Pregnancy_Loss/

I also had my Antiphospholipid Syndrome panel repeated again last week, which I had done after our 2nd loss.  It came back normal after the 2nd loss, but this time my Lupus Anticoagulant PTT LA Screen came back slightly elevated (normal is less than <40 and mine was 43).  I have no clue what this means. Again, I just know we were having it tested because, “In women who have high levels of Antiphospholipid antibodies, pregnancy outcomes are improved by the use of aspirin and heparin.”  Well, I was on BOTH aspirin and Lovenox the past pregnancy and we still lost it.  So, regardless, there isn’t really much we can do with this one!

All this being said, we are meeting with the doctor later next week to discuss the plan of action for the sugar treatment, and of course the results of the biopsy too.  Heck, maybe I’ll even throw in all our questions about the Adenomyoma she plans to remove. Guess we better get our list of questions for her rolling again.