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.

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