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

Sweet Relief

Oh sweet relief.  We saw and heard our little guys heartbeat yesterday.  He is right on track for his gestational age and the MFM said the sac looked “textbook perfect.”

It’s about fucking time that something was textbook perfect.

Since this is my first rodeo, I found this chart helpful in understanding the proper heartbeat ranges based on gestational age:

Age Normal Fetal Heart Rate
5 Weeks (Beginning) 80-85 bpm
5 Weeks starts at 80 and ends at 103 bpm
6 Weeks starts at 103 and ends at 126 bpm
7 Weeks starts at 126 and ends at 149 bpm
8 Weeks starts at 149 and ends at 172 bpm
9 Weeks 155-195 bpm (average 175 bpm)
12 Weeks 120-180 bpm (average 150 bpm)

Prior to my MFM appointment, I had Anti-Xa bloodwork done at the hospital.  This is a timed test that is used to determine if the blood is thin enough while on Lovenox.  The results were back within the hour and we learned my blood is a tad too thick.  My hematologist is increasing my dosage of Lovenox from 40mg to 60mg.  I must admit,  this conversation brought me to tears, tears of relief that I (finally) have the right doctors who will monitor my issues.   It gives me some hope for this pregnancy.

Also, as much as I bemoan the issues that make my pregnancy high-risk, we were really impressed by the ultrasound machine at the MFM’s office.  Dare I say they were sex-ay? They really blew my RE’s ultrasound machines away (and those are nothing to sneeze at either.)   We also straightened out my monitoring and ultrasound schedule for the next 15 weeks or so and now we can can schedule some things we’ve been holding off on.  So while being a clotting nightmare is no prize winner, there will be many appointments, and the constant reassurance during this pregnancy is welcome.

Worry.

I am worrying nonstop that this pregnancy will end because there will be no heartbeat next week, or that somewhere along the line, I will have a missed miscarriage. While I know this worry isn’t healthy in my current state, it is all I can think about.

In other news, we met with the new hematologist yesterday and he was perfect for me. This is such a relief. He explained everything and is on the same page as we are about my care for the next 10 months. In fact, he scheduled my Anti-Xa blood work next week, immediately before my first MFM appointment. Both appointments are conveniently at the same hospital, and close to my office too.

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.

A baby or a house?

A little background.

In 2009, I (today, age 36) was diagnosed with multiple clotting disorders:  MTHFR, the Prothrombin Gene Mutation, and the Lupus Anticoagulant.  I also have a few other #’s that aren’t fantastic, such as a high count of CardioLipin IGM Autoantibodies and a slight Protein S Dificiency.

In 2011 my husband (today, age 38),  was diagnosed with male factor infertility, specifically 1% morphology.

In July 2011, I had an early miscarriage.  And then a Saline Sonogram.  Both sucked.

In October 2011, we are scheduled for IVF with ICSI and PGD.  It will be an antagonist protocol, with Lovenox, but no Lupron or birth control.

And that picture above?  Those are my meds for the October IVF.    They just arrived.  I almost vomitted:  at the sheer amount of medications, but mainly at the overall cost.