Countdown to meeting Obi!

Lilypie - Personal pictureLilypie Maternity tickers

Tuesday, June 28, 2011

15 days until FET

I'll be going to CCRM 2 weeks from today. All continues to go well. My belly is distended and uncomfortable (that's right -- the booby-do is back!). I've discussed it with my nurse and there's nothing that can be done about it. The meds I'm on can cause weight gain, water retention, and gas any one of which could be causing the distension. So I just wear baggy clothes and count down the days until I'm off these meds.

Got test results from bloodwork done yesterday to check my estradiol levels. Anything over 50 is good at this stage. Mine's 90. So I'm responding well to the ERT. Today I've started two patches per day (had been doing one). I'll up the number of patches every other day -- in 2 days I'll wear 3, in 4 days I'll wear 4. Then I'll have an u/s and more bloodwork to see how my uterine lining is responding. Then we'll know for sure whether FET will be 7/13.

I scheduled my acupuncture appointment at CCRM so I'll get it done right before and right after FET. I probably won't to any locally before going. Instead I've been doing yoga 1-2 times per week but am going to up that to nearly daily as we get closer to FET.

Thursday, June 23, 2011

20 days until FET

Things are going well. I'm on day 3 of no caffeine and doing OK. I was down to just one cup a day anyway so I think cutting that last cup out was more a problem psychologically than it was any kind of physical addiction. Drinking hot herbal tea in the AM and mid-afternoon also helps. I just ordered a nice sampler of rooibos and other naturally decaf teas from adagio teas, a site recommended by a tea-drinking friend. I'm excited to try them.

ERT is also going well. I'm way less moody than I was on lupron alone (still doing lupron shots although they've gone down from 10 mgs to 5 mgs). The ERT seems to be clearing up my acne, too (my face broke out again when I started lupron). I continue to have bloating and some nausea but it's usually just at night so while not fun, not too interfering.

I found out that the 7/13 FET date is less firm than I thought. I have 2 appts between now and then that'll determine when the actual date will be. On Monday I'll have a blood test to check my estradoil levels to see if ERT is working. Later I'll have more bloodwork and an ultrasound to make sure my uterine lining is thickening as it should. The results of both of these tests will determine whether they need to change my protocol and/or calender. So we're glad we booked on Southwest so we can change our plane tix if necessary. I'm of course hoping there aren't any changes -- it'll be 3 months and 1 day from egg retrieval (4/12) to FET (7/13). I'm tired of waiting. I want to know if this is going to work already. So here's hoping ERT is doing it's thing just fine.

Tuesday, June 21, 2011

So far so good

Day 1 of ERT down and no adverse side effects. In fact, I felt less irritable yesterday with ERT + lupron than I did on lupron alone. So hopefully that will remain the case so the next couple of weeks can be relatively painless (well except for the lupron shots. And the blood draws).

Monday, June 20, 2011

Started ERT today

I have officially started estrogen replacement therapy (ERT). Exciting as it is feeling even more real that FET is just around the corner!

I've been scouring the internet trying to find recommendations regarding lifestyle changes to make in prep for FET. I can find very little, which isn't surprising as there's probably very little research on this issue. I emailed my nurse and here are her recommendations:

"For the frozen embryo transfer most of the same rules that you followed for ivf still apply. The only thing we are less worried about is exercise. We are not growing your follicles to capacity so we are not concerned about ovarian torsion. You should still stay away from caffeine products, use protection during sexual intercourse, and avoid taking any medication that we have not specifically put you on."

So the good news is I can still do spin and body pump which I really enjoy. The bad news is I have to give up my last caffeinated beverage. I'd been drinking 1 cup of black tea per day as Zita West recommends that 1/2 a cup has been linked to IVF success. And I really enjoyed my morning Early Grey. I guess I'll just have switch to a morning cup of peppermint or some other naturally decaf tea.

I'll be sure to let you know if ERT turns me into a crazy person. Or if/when my skin get irritated from the patches. Or if I have no side effects. Which would rock.

Sunday, June 19, 2011

Starting ERT tomorrow

I'm starting estrogen replacement therapy tomorrow to prep my uterus for transfer. We're very excited and terrified all at the same time. There are many pluses to FET including that I had a chance to recover from OHSS (and of course the doc's had time to test our embies for genetic and c-somal issues). One of the downsides is that it's lots of waiting and with the waiting comes the anticipatory anxiety. So I've been trying to combat the "what if" thoughts with information. This morning I taught myself more about what my meds will be doing over the next 3 weeks. Thought I'd share this info. I ripped this info from www.ivf1.com.

Protocols for frozen embryos transfer

Hormone preparation for FET

Using hormones to prepare the uterus is the most common way in which a frozen embryo transfer is performed. The first step is to suppress the pituitary gland. This is necessary to reduce the chances of ovulation occurring unexpectedly. Typically, Lupron is used for pituitary suppression. For most women, this will require approximately two weeks of daily Lupron injections.

The second step in a frozen embryo transfer cycle is to use hormones to duplicate the changes that normally occur in the uterus during a regular menstrual cycle. This requires the use of two hormone medications: estrogen and progesterone.

Estrogen preparation for FET

During a normal menstrual cycle, estrogen is produced by the developing follicle. This estrogen acts on the uterus to thicken and mature the uterine lining. Estrogen is given in a FET cycle for the same reason. There are many different ways that estrogen can be given in a frozen embryo transfer cycle:
  • Estrogen pills – Estrace, Premarin
  • Estrogen patches – Estraderm, Climera
  • Estrogen injections – Delestrogen (estradiol valerate), Depogen (estradiol cypionate)
  • Vaginal estrogen – Vagifem, Femring
There is no data that any one method works better than another and a method is usually chosen based on physician preference. [My Rx is for the patches, which I'll start tomorrow]

During the time when estrogen is given, the woman will come to the office periodically to be monitored. A transvaginal ultrasound is performed to determine the thickness of the uterine lining and a blood test is performed to look at the level of estrogen in the blood [fyi -- I'll be doing this at an imaging center rather than going to my local RE -- the imaging center is in-network (and my local RE is not) and they were very friendly at the imaging center (and my local RE no longer is now that we've gone to a different clinic)]. On occasion, if the lining is not thickening as it should, the dose or type of estrogen must be increased or prolonged. The length of time the estrogen can be given is very flexible. During this phase, for example, the duration of estrogen may be prolonged to delay the day of embryo transfer to accommodate the patient’s schedule.

The monitoring in a thaw cycle is very flexible. Unlike a fresh IVF cycle during which the required days for monitoring are determined by the growth of the follicles in the ovary, in an FET cycle, the days can be adjusted at any time. Thus, a frozen embryo transfer cycle is much less stressful on the patient. [although I think this is just this person's opinion I'm guessing. I'm sure some women find the waiting of FET more stressful than a fresh transfer]

Progesterone in an FET cycle

Once the uterine lining has been thickened sufficiently, progesterone is added. Once the progesterone is added, the Lupron may be stopped. Progesterone matures the uterine lining and makes it receptive to an embryo to implant. Once the progesterone is begun, there is a certain “window of implantation” during which the embryo must be transferred. The stage of the embryo must match the stage of development of the uterus. Therefore, the only factor that locks the patient into performing the transfer on a certain day is starting the progesterone. Once the progesterone is begun, if the embryo transfer is not performed on a certain day, the cycle must be cancelled and a new preparation with hormones must be begun after allowing a period to occur.

There are many different types of progesterone that can be used in a frozen embryo transfer cycle. Some of the more common methods include:
  • Progesterone pills – Prometrium
  • Progesterone injections
  • Progesterone vaginal suppositories
  • Progesterone vaginal gels – Crinone, Procheive
There is considerable uncertainty in the medical literature concerning which type of progesterone is the best for FET cycles. Again, the choice of progesterone for an FET cycle is up to the discretion of the physician. A few things, however, most experts would agree on. Progesterone given by mouth is unreliable due to variable absorption and subsequent metabolism in the liver. [my Rx is for suppositories -- 3x per day]

Once the uterine lining is adequately thickened with estrogen, the progesterone is usually started on a particular day to allow for scheduling of the embryo thaw and embryo transfer for a time that is convenient for the in vitro fertilization laboratory staff.

Saturday, June 18, 2011

AF arrived, with a wee bit of drama

AF came today -- which is good news because today is the day they estimated AF to come so my calendar doesn't need adjusted so our travel plans should be fine (leaving for CO on 7/12, FET 7/13, 2 days bedrest, fly home 7/15). But yesterday's PMS included severe nausea -- I could hardly move without wanting to puke. So I laid on the couch all night trying not to vomit.

And forgot to take my lupron shot!!!
 

DH has been in charge of giving me my shot and reminding me to take it given I've had so many wonky side effects with this bout of lupron. We think he must have been so distracted by how nauseas I was that he forgot. And lord knows I was thinking of nothing but not puking last night. So we forgot. 

We called the CCRM emergency nurse hotline today to find out what to do. The instructions for what to do if a lupron shot missed were not on our lupron instructions from CCRM. From what I read online it could go either way -- skip it or take it in the AM. The nurse said to go ahead and take it this AM (although she said either way would be fine - take it or skip it). She said that the lupron is to prevent me from ovulating because if I ovulate my uterine lining will thicken on its timeline which will be different from the timeline CCRM wants it to thicken. So the lupron isn't directly related to prepping my uterus for transfer. So we took it (better safe than sorry) and feel much better about our snafu. As you can imagine, we were freaking out that we had totally f'ed up our transfer.


But we both set our phone alarms to remind us each night from here on out to take my lupron.




In other news -- no more nausea today. Just a pretty normal (for me) AF. I'll start estrogen patches on Monday (ERT - so curious to see how that's going to go).

Friday, June 17, 2011

Quote

One of my CCRM friends posted this today and I think it is a nice way to think about the struggles we've been going through with IF:

"Although I may not be able to prevent the worst from happening, I am responsible for my attitude toward the inevitable misfortunes that darken life. Bad things do happen; how I respond to them defines my character and the quality of my life. I can choose to sit in perpetual sadness, immobilized by the gravity of my loss, or I can choose to rise from the pain and treasure the most precious gift I have - life itself"

Tuesday, June 14, 2011

Lupron side effects

I waited a couple of days to write about this bc I wanted to see if it happened again. It hasn't. So last time I took lupron was before ER.I had no side effects (that i remember from that). But this time I have so I thought I'd share in case any of my fellow IF ladies experience them as well (or want to know what to expect). I had my first shot on Fri. On Saturday I was really irritable. I left the house to do some grocery shopping to clear my head. And it worked. I felt better. I love Whole Foods. But then out of nowhere I burst into tears at WF. Embarrassing. I wrapped up grocery shopping and drove home. During the drive it became more and more difficult to see--vision getting very blurry. I thought it might have to do with the crying to didn't think much of it. But when I got home I was not at all crying but still having a hard time seeing. It lasted for ~ 45 minutes. Then it cleared up and I could see just fine. I consulted with Dr. Google and found that blurred vision a side effect of Lupron. Wacky.

Luckily no major side effects Sunday or yesterday. Shots are going fine. DH is administering them and doing a great job.

Sunday, June 12, 2011

Our journey's timeline thus far

As FET for our first IVF is starting to seem real, I was reflecting on how long this journey has been. I realized that I'm not usre I ever really shared much about our TTC back story in this blog so thought I'd put together a more comprehensive timeline -- both for myself (no wonder I'm exhausted -- we've had an action packed couple of years) but for those interested in what we've done prior to CCRM:


8/2009: started TTC (and charted. After a few months, realized I had short luteal phase so discussed with my OB/GYN)
1/2010: began IF treatment with my local OB/GYN -- Clomid alone- BFN
3/22/10: IUI #1 w/local RE (clomid) - BFN
4/19/10: IUI #2 w/local RE (clomid) - BFN
5/14/11: IUI #3 w/local RE (clomid) – BFN
6/12/10: IUI #4 w/local RE (clomid) - BFN
7/9/10: IUI #5 w/local RE (Menopur) - BFN
8/4/10: IUI #6 w/local RE (Menopur) - BFN
10/1/10: IUI #7 w/local RE  (Menopur) - BFN
11/21/10: IVF #1 w/local RE (terminated by RE because DH  & I both carriers for cystic fibrosis)
1/7/11: CCRM phone consult w/Dr. Surrey
1/28/11: CCRM ODWU
3/8/11: CCRM IVF#1 cycle begins
4/12/11: ER at CCRM (29 eggs retrieved, 22 fertilized w/ICSI, 14 embies made it to day 5 blast. stage, 11 failed CCS and/or PGD [5 failed CCS, failed PGD], 3 embies frozen for future transfers).
7/13/11 - tentative FET

Denver Trip Travel Plans booked

We went ahead and booked our travel plans today because word on the street is that fuel costs are going to continue to rise so we wanted to lock into reasonable prices while we could. Here's the plan:

Flights: Southwest (we got nonstop tix for $99 each way per passenger. Plus 1 checked bag per passenger free and can change tix without change fees)
Car rental: Hertz (with the CCRM discount code, the car will be ~$45 per day, nearly half what most big name companies are asking this time of year)
Hotel: We booked at Hampton Inn (with CCRM discount code it's $79 per day). Although we really enjoyed Candlewood Suites for ER, there are no rooms available for our timeframe this trip. Hampton Inn also has kitchens so we can cook our own meals to save money and be healthy. And since I'll be on bed rest two of the 3 days, we can't really go out to restaurants.

In other news ~ had my first lupron shot yesterday. DH administered it and did a great job! It feels good to be back to doing medical treatment again because it means FET is finally almost here!!! So curious to see how it goes!!!

Saturday, June 11, 2011

Shots start tonight

That's right. It's getting even more real. We start shots again tonight. Lupron. To start prepping my uterus for transfer. I had sushi dinner last night -- my last sushi until we find out this didn't work or until I have my baby.

I go off BCPs Wednesday. Once AF comes, my nurse will revise my calendar (if necessary) based on date of AF. Then we'll know for sure when transfer will be and can get tickets and start planning for real.

In other news I'm finally feeling better. I didn't post it earlier because I was worried I might jinx it :) But the baseline bloat that I've had since ER is finally gone. I can fit back into my pre-ER clothes. Which is nice because I was getting tired of the same 3 pairs of elastic waistband pants I had bought after ER (and look forward to wearing again when/if I'm preggers). And I have much more energy and no more pain in my ovarian region. It's been wonderful.

Monday, June 6, 2011

Ultrasound results -- stretched ovary it is!

Had my u/s today. The ultrasound guy said that everything looked great. He said my uterus is tilted (which everyone who looks at my uterus tells me -- but thought I'd throw that in for those who didn't know that fun little trivia about my reproductive organs. It doesn't affect fertility) and that one ovary is larger than the other. He showed me on the screen and it was definitely obviously bigger. So maybe that's the culprit of my discomfort. But  it's nothing to worry about he said. And he said my uterus and fallopian tubes all look good so there's no reason he can see why I can't continue to plan to do FET next month. And he used to work in maternal and fetal medicine so his background is in dealing with fertility patients.

So I'm relieved. Nothing is wrong. Just continuing to heal from ER. Glad I got checked so I didn't continue to wonder.

In other good news -- they do vaginal u/s at that imaging center and the guy I saw today said he could totally do any u/s I need leading up to FET!!! So I can go there (in network and super friendly) and not deal with my local RE (out of network and cold since I stopped being his "real" patient).

Sunday, June 5, 2011

Theories

Based on responses to the question of WTF is going on with my ovaries, I now have 3 theories:
1. My ovaries are just still enlarged from producing 29 eggies and although annoying, it's totally fine and my ovaries will continue to shrink and my pain will become less. I'm hoping this is the kind of thing they'll be able to see on the pelvic u/s tomorrow.
2. There's something wrong. A cyst or torsion. I'm hoping this is the kind of thing they'll be able to see on the pelvic u/s tomorrow. This is my least favorite theory as I don't want anything to be wrong that couuld delay FET.
3. Because of the weight gain (about 7 lbs mainly in my thighs and belly) I'm now walking differently and holding myself differently. And this is putting strain on my body and causing pains in my pelvis. This is my favorite theory because it means nothing's wrong other than the weight gain. So I can then start to be more active to try to lose the weight.

I'm hoping tomorrow's u/s can tell me whether it's 1 or 2. The u/s is at 1PM CST and then results will be sent to CCRM so I'll find out tomorrow or Tues what the verdict is. I'm hoping for body aches from weight gain or if that not, enlarged ovaries.

Saturday, June 4, 2011

Uhg -- more bloat

Looks like I spoke too soon about BCPs curing my bloat. I'm so big today I seriously look like I'm in my 2nd trimester. I can't fit into my clothes -- even my elastic waistband clothes are tight. And 2 new zits so BCPs didn't cure that either. A temp reprieve I guess. Can this still be OHSS? I read that it can last up to 3 months but it just seems silly that I still have OHSS. But bloat has never been an issue for me (in fact, I don't think I've ever been bloated before I started this IVF cycle) so it's hard to  not think it must be related to retrieval and/or all the hormones I was on in April.

I've looked online for tips to beat bloat. I drink lots of water and eat a low sodium diet. And I only drink one caffeinated beverage (Earl Grey Tea) per day. I don't eat much dairy these days  other than cheese (ever since April meds, the smell of yogurt makes me want to hurl which makes me sad) and no broccoli or cabbage in my diet these days as DH hates broc. I walk the dog 2-3 times per day (10-15 mins per walk) so am a bit active. Any other suggestions???

Friday, June 3, 2011

Ultrasound scheduled

I talked with my nurse today who consulted with Dr. S about the ovarian pain I've been having. They think it's unrelated to ER. Which makes no sense to me because I had no ovarian pain prior to having at least 29 follies produce eggs in April and now I have it whenever I experience any kind of impact in my pelvis. So I can't imagine it's unrelated.

Regardless, they wrote me an order for a pelvis u/s so they can take a look and see what might be going on. It's scheduled for Monday. Not going to my local RE because it's just awkward. Plus he's out of network. So I'm going to an imaging center (that's in network) who will send the results to CCRM who will then call me to tell me what's up.

I am so excited to find out what's wrong so I can treat it and get back in shape.

Thursday, June 2, 2011

checking in

Just checking in to say there's not much to report. The FET is definitely set for 7/13. We're looking into flights and hotels but it still seems so far away. In the meantime I've started BCPs and I feel SO much better. Acne gone. And I've lost 2 of the 5 lbs I gained after the ER since being back on The Pill. My body just way prefers being on the pill. I'm on it to shut down my natural hormones so CCRM  can control how much hormones I have to prep my uterus for the FET. I'm guessing that my shutting down my hormones, the Pill is also helping to rid my body of those nasty hormones that were causing the acne and bloat and weight gain. Whatever the reason, I'm a much happier camper these days.

I still have ovarian pain/soreness when I work out (I did 2/3 of a step DVD this AM and have some ovarian soreness). So I finally broke down and emailed my nurse about it. She's out today but I'll let you know if she thinks it's weird or if it's natural to continue to be healing 1.5 months after retrieving 29 eggs.