Scratch Off

I had a lining scratch/biopsy yesterday and I also requested an updated E2 blood draw. My doctor and I discussed how my body held on to the Delestrogen inordinately longer than most others. In fact, it took 50+ days to recalibrate my cycle after the medicated FET. I was happy to learn my E2 finally dropped (from 237 to 81) so a proper bleed is imminent.

They are sending the scratch biopsy out to look for any infection in my lining. We are not testing for the Beta-3 Integrin as I had that test in the past, and it indicated I was not missing the protein. If there is some sort of issue with my lining from this recent biopsy, I need to treat it with antibiotics and then decide if I want to push my next FET back to January, instead of November.

It took me 8 fresh IVF cycles to get these last 3 normal embryos, so I will need to think this through carefully. As much as I hate waiting, the logical me is saying I need to transfer under optional conditions. I have about a week to decide.

Edited to add: The results are back, and I do not have endometritis. And yes, I am surprised.

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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

The Side Effects of Prednisone

images-4There were many alternative titles for this post, including “Crisis Management,” “Zantac Candy,” and “Zombie Girl” or last but not least, “The Wheels are Coming Off.” Nonetheless, I settled with the least witty one out there. I’m tired.

I’ve been struggling with some heavy side effects from Prednisone. Right now I am dealing with significant insomnia (zombie girl), painful acid reflux/stomach issues (zantac candy), and numbness in my fingers. More infrequently, I also have had hot flashes and a rapid heart rate. Incidentally, the one side effect that I have not been blessed with is increased hunger/weight gain.

Yesterday my doctor and I spent 20 minutes (crisis management) plotting ways to combat some of these side effects so I can return to my regular, rational self (the wheels ARE coming off). I was relieved he took my worries to heart. In fact, he said “You have never once complained to me, so I can tell when you are serious.”

Look at that, I am not the girl who cried wolf.

My next FET is on hold for a few weeks. My estrogen is still significantly elevated (at 237) and therefore my body is holding on to an 8.1 lining (a transfer quality lining, not a baseline lining). My body is completely out of whack and my cycle is all off. Just another reason to say a medicated FET is not or me.

My options are to wait it out for a natural bleed or take Provera. Then I can either move into another FET or start Lupron in the luteal phase and roll directly into another egg retrieval. Edited to add: I skipped the Provera and there will be no Lupron with my next FET.

I will be the first to admit that I am currently not in the right headspace to make any important decisions. I have 3 normals on ice, but feed me a failed FET (after years of just trying to get embryos) coupled with very little sleep (zombie girl) and I keep returning to “must. hoard. more. embryos.” I promised myself and my husband that there would be no more egg retrievals come 2015. There has to be an end point to all this madness. But then again, we thought our issue was getting embryos, not implantation.

Newsflash: Life is Unfair.

I have debated posting this, but after some thought, I think there are some important lessons to learn here, so while this is now live to my readers, I am not posting for pity and the comments on this post have been turned off. Life is unfair, and one thing I am not, is a whiner.  There are worse things to suffer from than this, and I remind myself of that often.

Recently, we transferred a hatching, CCS normal embryo and the cycle resulted in no pregnancy.   There was a significant immune protocol in place and my lining was at 11 and it was triple-striped.   I did acupuncture and followed an anti-inflammatory diet too. The lesson:  even the most perfect of circumstances can result in a BFN.  Another lesson: Just because you have a chromosomally normal embryo doesn’t mean you are guaranteed a BFP.

I had a lot of symptoms leading up to my BFN, all of which can be contributed to the medications, especially the progesterone. That’s another good lesson:  those symptoms? They are from the medications.

My next FET is already scheduled and we will be following a more natural FET protocol vs. what we did recently, a more medicated FET. If this cycle results in another BFN, I will immediately start IVF#9 and do another retrieval.

An Anti-Inflammatory Diet for Infertility

10259325_10152432689699602_7098055327429859716_nAs I gear up for a fall FET, I’ve been slowly working towards following an anti-inflammatory diet. I came to this decision after talking to Dr. Braverman, researching on the internet, and discussing the inflammatory properties of food with the woman in my Reproductive Immunology Support group.

The stress of inflammation has been linked to several infertility diagnosis including PCOS, endometriosis, recurrent miscarriage, poor sperm and egg quality.

The following are things I have been limiting or eliminating from my diet:

Caffeine
Alcohol
Gluten
Dairy
Sugar and Artificial Sweeteners (Aspartame is evil)
Soy
Nitrates
GMO’s

Keep in mind a few things:
1- I am not a doctor
2- Prior to this I generally stuck to mostly organic foods and tried to limit the consumption of GMOs

As a NYC girl whose adores espresso, bourbon (generally not together) and restaurant hopping around the city, this has been quite an adjustment for me. I have no problem giving up gluten, I have done it in the past and I am comfortable creating meals and snacks that work for a gluten limited diet. Having said this, I was tested for celiacs and I do not have it, so my goal is to cook and snack as gluten free as possible, but I will not beat myself up for cross contamination or the occasional mistake.

Saying goodbye to coffee and dairy has been an absolute fight. I love coffee with cream. Not for the caffeine, I’ve learned, but I love the flavor and ritual of coffee. I’ve been working towards drinking decaffeinated coffee (Nespresso or Starbucks) with coconut milk. However, the RI group informed me that even decaffeinated coffee is bad for blood flow issues (one of my problems). Tell me I have to give up cheese for a year and I think OK that’s doable, but take away my coffee and I spiral down in panic.

So what am I eating? That will be answered in the second part of this series of posts. Stay tuned.