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

Holy Crap!

Today, we froze 2 additional blasts.

I attribute this outcome to the protocol change, the addition of PICSI, and just dumb luck.

Sure the embryos aren’t PGS tested yet, but this a significant win for us.

IVF #7

IVF #7 started yesterday with Lupron.

I received an actual calendar with my medications and dates on it (6 IVFs behind me, and this is the first time I’ve received a calendar) and my protocol is extremely different than anything we’ve tried before.

Different, in our case is good. Change is good here. And hey, it can’t be worse than 3 cycles where the outcome is 0 embryos.

However, we have very realistic expectations as to the outcome of this cycle. If, by chance, there are any blasts on day 5 or 6, we will be having 24 chromosome genetic screening done on them via Natera in California.

I’ve received oh so many medication boxes in the past 4 years, and was surprised to see the 14 pre-filled syringes of Ganirelix that arrived at my house for this cycle.  I guess I should be grateful this Ganirelix heavy cycle did not take place 2 years ago when there was a shortage of this particular medication.

I have kept fairly detailed accounts of my prior 6 IVFs (dosages, estrogen, follicles and the like), so I am curious how my body will respond to this new medication protocol.

For those of you who are geekily interested, here is approximate overview of my meds calendar:
Days 1-8 – Lupin
Day 9-12 – Ganirelix in the AM
Day 13-16 – Ganirelix in the AM.  225 Follistim and 1 vial of Menopur in the PM.  60mg Lovenox.
Day 17-22 – Ganirelix in the Am.  225 Follistim in the PM. 60mg Lovonox.
Day 23 – HCG Trigger
Day 24 – HCG Trigger
Day 25 – ER

Second Beta Results

My second beta was 292. Huge, fat tears are rolling down my face right now as I type this. Relief tears.

According to the interwebs and my RE’s office, my doubling time was perfect, at 36.48 hours. My nurse felt I did not need a 3rd beta, but she said I could schedule one if I wanted. I am going to have a think on that and decide tomorrow.

Up next:
Ultrasound with RE, Appt with New Hematologist, First Appointment with the MFM, Anti-Xa Bloodwork, Another Ultrasound with the RE, and my First OB Appointment.

Full speed ahead.

Edited to add: I am going to do a separate page with photographs of the embryo we transferred as well as photos of my sexy pee sticks. I think this will be helpful as after my ET and before my beta I stalked the internet looking for photos of these things. From that process, one thing I learned is that there are very few photos of hatching or fully hatched blasts out there. This worried me to the point that I asked my doctor if, based on my photo, there was something wrong with my embryo. She said “no, it’s a 5BB fully hatched blast and you need to chill the F out.” I never did get the answer if it had become a 6BB (6 because it was fully hatched). But hey, that’s moot, because the little bugger stuck.

Even if I get knocked up..

I still somehow have to get that baby home.

We’ve had a tentative plan in place since 2009, when we first saw the High Risk Doctor (MFM) to ask how we would go about managing a pregnancy and managing all my clotting factors.

I believe we are as informed as we can be at this point.

The rough plan would be weekly ultrasounds, bouncing back and forth between my OB/GYN and the MFM, with a few extra ultrasounds in the first trimester at the RE’s office. I will also be on Lovenox (of course, I’ve been on Lovenox since September 2011), baby aspirin, Neevo, and extra L-metholfolate.

I have not documented my Lovenox fight with my insurance company here, but we are banking a lot on the fact that the minute I am knocked up, they will finally approve the proper dosage. And I need to find a new hematologist, as mine does not practice anywhere near our 2 hospitals. I am hoping my MFM or the OB can recommend someone. And I want someone that will run the Anti-Xa tests to confirm if my blood levels are in the right range.

Years ago, I thought getting knocked up was the easy part. It turns out. It’s all hard.