Protocol for FET #3

My next FET will vary from my last one in a number of ways. To prep, I am going to do an endometrial scratch and a long course of antibiotics (to treat any possible infection). My last cycle, I had a combo saline sonogram/mini scratch. While my doctor doesn’t put much stock in the scratch, he is willing to do it as it cannot hurt our outcome.     We are also going to follow my natural cycle, with supplementation of estrace and progesterone, only as needed.  There will be 0 medicated suppression.  The immune protocol will remain the same.

Let’s be honest, things aren’t very positive here right now.   We’ve been actively pursing infertility treatments since March 2011 and we have 0 living children.   Short of using a gestational carrier, there isn’t much more we can do to make this work.

Supplements (daily):
Vitamin E (400-600iu), Vitamin D (2000iu), Calcium (500mg twice a day), and Fish Oil (1000mg)

FET Medications
Prenatals
Estrace Pills (Oral)
Progesterone in Ethyl Oleate (100ml / 2m l)
Doxycycline (for 2 weeks)

Immune Medications
Metanx
Baby aspirin
Prednisone 20mg
Lovenox (30mg 2x a day until first ANTI-Xa)
Intralipids

Drug Interactions and Supplement Absorption Crazy

Someone in my Facebook Reproductive Immunology Support group pointed out that I was taking my calcium at the completely wrong time.   In fact, she said,  I should not be taking it with iron (i.e. my multi-vitamin), but should be taking it with my vitamin D.

This sent my crazy brain into overdrive.  Shouldn’t I be taking my medications in a way that maximizes each and minimizes the less than ideal interactions?    OF COURSE I SHOULD.  I am still trying to decide if the subsequent hours of googling/reserach are the mark of intelligence or excessivism, but maybe I will just settle on a little bit of both?  Here’s a peek into the sticky note from my desktop:

no vitamin E with fish oil
no vitamin E with aspirin
no vitamin E with prenatal
no vitamin E with metanx
no vitamin E with Lovenox
no doxy with prenatal
no doxy with calcium
no doxy with aspirin
no doxy with any vitamins
no doxy with fish oil
no metanx with aspirin
no metanx with d
no metanx with fish oil
no metanx with vitamin E
etc…

I am a night owl by nature, so that is a bit of a roadblock for me in terms of spacing medications properly/psychotically.   Also, I will be relieved when the Doxycycline is out of the lineup, so I can move things around a bit.     Either way, I now have a medicine schedule that has me injecting or swallowing a pill nonstop.  Fan-tastic.   Behold my crazy:

10AM – Lovenox, Doxycycline
12PM – Prednisone
2PM – Estrace, Vitamin D, Calcium
4PM – Vitamin E
6PM – Metanx
8PM – Calcium
9PM – EV2, Progesterone, Prenatal
10PM – Lovenox
11PM – Doxycycline
12AM – Probiotic, Baby Asprin, Fish Oil

Off with my head

I’ve been fighting a significant headache since 11am, and the 5 Tylonol I took (spaced out over 12 hours) didn’t even touch it.  I napped for about 1.5 hours at 4:30 and thought I got rid of it, but it returned with a vengence 2 hours later. Hell, they have me on Medrol, Lovenox, Endometrin, and Doxcycline now.   I wonder if Endometrin is the culprit?  Or perhaps its my body coming down from the hormones and the decrease in estrogen?

If there is one thing I learned about the IVF process is that my body is very sensitive to medications. 

We’ve received no updates about our 9 embryos.   They told us if things were going OK, we would not get a report till day 5.  I am hoping no news is good news.  However, I am stressing about their possible dwindling numbers.   If there are enough healthy day 5 embryos, (and I think to us that number is 5 or over), we will PGD them.  Anything less, and we enter the banking program and do a freeze all, and possibly another fresh cycle prior to 2012.   Aieee!

At this point, there is a very slim chance we will choose a day 6 fresh transfer.  In fact, we are discussing a late November, early December FET.  Of course the decision could be out of our hands, especially if my estrogen is too high, or my lining is too thin, or if the embryos need another day or two to develop.

Either way, we will have all these answers on Thursday.

On with the show

Well my period arrived yesterday.  And tomorrow I go in for my baseline ultrasound and bloodwork.   With my doctor.  That is quite a lucky coincidence for me.  My doctor only does monitoring 2 days a week, and my baseline just happend to fall on one of those days.  I am so relieved.  

My second day of monitoring will be Saturday, and there is a great (female) doctor scheduled for weekend monitoring.    So far, so good.

If all looks ok, I will start stims, 375 Gonal-F and 75 Menopur, tomorrow or Thursday at 8pm.  It’s also back to Lovenox tomorrow.  It was a nice 4 day vacation from blood thinners.

Oh and my nurse told me to eat somthing small with my Doxycycline.  Thank god.  Doxycycline is a stomach destroyer.  Because really?  Any drug that is also used to prevent malaria means business.

IVF Antagonist Protocol

I want to post my IVF Protocol, because during my research phase, I scoured the web looking for these.

This is what I would refer to as a modfied Antagonist Protocol, as it has been tailored to my specifc issues.  The difference?  It includes Lovenox, and does not include birth control or estrace.

Lovenox (blood thinner)
Gonal F (follicle stimulating hormone)
Menopur (follicle stimulating hormone)
Ganirellix (to suppress the LH surge and ovulation until the follicles are mature)
Ovidrel (final maturing of eggs and trigger the release of mature eggs)

I am also taking:

Medrol (steroid used to increase the chance of implantation by altering the immune system slightly for a short period of time so that embryos are not rejected)
Doxycycline (antibiotic to reduce the risk of infection related to the egg retrieval)
Endometrin (progesterone suppsitory crucial for the development of a uterine lining that will support the early pregnancy)
Metrogel (for the treatment of inflammatory lesions of rosacea)