FET Update #1

I officially started this cycle today with BCPs, so here we go again! I began bleeding early Friday morning, as expected, and the nurse then sent over our new schedule. Lots going on this week with a final Beta blood test tomorrow to assure it's decreased, then a Baseline Ultrasound on Tuesday, and, assuming that's all clear, starting Lupron on Thursday. Our transfer is scheduled for October 23rd. We plan to transfer two again and look forward to talking to the embryologist about which of our remaining 15 (!) frozen embryos he would recommend.

Both RC and I have continued to feel some sadness here and there about our first try not working. He has been more deeply sad about it, I think, because I have gone through so many similar disappointments. Unfortunately, I have some callouses built up around my heart. That sounds strange to say, but hopefully that makes sense to some of you. I do know I'll be over the moon when we get a positive outcome... and it will probably take a while to sink in. I also think I had already started to accept that our cycle hadn't worked, first with the negative HPTs, and then with the super low beta, on top of just not feeling much those last few days.

Today, I'm actually excited to go into a new cycle and am feeling positive about it. I heard three different examples this week of second IVF tries (FETs) working for people, and that feels very encouraging. One was a blogging friend from the Cal IVF FB site who actually just got her positive on the second try with a frozen embryo transfer from her donor IVF cycle.

The second was on a television show I watch in which one of the main character just happened to be going through an IVF cycle. I really related to when she tried to "do everything right" and had her hopes up with a 70% chance of success. Her second try, she and her husband tried to mediate their expectations; she said she felt similarly to the first cycle in terms of symptoms... but it was a success!

When I went to a friend's house for dinner last night to catch up and share the experience, she gave me the third example. She told me about the daughter of a friend who had gone through a lot of infertility ups and downs and, after adopting two children, ended up pregnant with twins on her second IVF round with an FET.

We will be adding a couple new medical strategies to the protocol this time. Firstly, I started taking Trental, a type of Viagra or vasodialator to increase uterine blood flow. Secondly, as I hoped, I will be taking more estrogen from the start of that stage - both patches and pills - to hopefully increase my lining more gradually and fully. I would love it if I could reach at least an 11 or 12mm thickness with my lining. If you had success with an IVF or FET, do you remember what your lining reached prior to transfer?

This cycle, I also intend to meditate more from the beginning. Do you think it's worth spending $59 on a specific FET meditation program from Circle & B1oom? It includes 11 meditations corresponding with different stages of the FET process and sounds like it really focuses on relaxation, stress relief, and empowerment during the post-transfer wait, which was anxiety-provoking and challenging for me last time. I found a few meditations in my meditation app, but I'm not yet sure of their production quality.

Lastly, we talked about getting out of town during the two-week-really 9-day-wait... maybe going to the coast and staying at an air bnb location for two or three days. When we were in the Sacramento hotel for a day and a half after the transfer, I felt like we were in a nurturing bubble. I felt close to RC, relaxed and cozy. I hope all these changes will improve our chances and support our embabies to implant!

New Doctor, New Protocol

The appointment with my new doctor finally came today.  The office assistant was kind of crabby - I overheard her say she hadn't had a break or chance to eat so this is understandable - and the nurse was quite rushed, pulling me about like a piece of meat.

But once I got into the good doctor's office, ahhh.  Very calm, intelligent, and trust-inspiring.  She took lots of time - sometimes a bit more detail than even I cared for, which is saying something - but it was welcome.  We discussed questions and topics I want to thoroughly understand, like immune testing, potential uterine and egg issues, and recommended protocol.

I will not be able to do the conversation about immune testing (MTHRFR and NK Cells, etc.) justice here.  Suffice to say, Kai.ser lab is inexperienced with these tests, so she would have to send me to an outside lab at full cost.  Also, she prefers not to order tests unless there is real data indicating there may be a problem.  This data comes through sp.erm testing and IVF, neither of which relate to me.  Lastly, this falls under the uterine issue percentage listed below, and she believes my issue is in the egg category.

But, she admitted there is so much they don't know, and research is underfunded because the affected population is relatively small. :(  All facts considered, I'm not pursuing these tests right now.  I did have prior clotting-related Lupus anticoagulant and Cardiolipin ab tests, which came back negative.

Regarding potential uterine issues:

• She said 2-5% of problems are based on uterine issues.  It was kind of cute, as much as a uterine metaphor can be cute:  she talked about the uterus as a good child, sitting there waiting, but usually the problems happen prior to the uterus even getting involved.

• I asked about ureaplasma infection, which I understand can cause problems, and she said they treat every patient with Doxycycline, because the testing for ureaplasma is difficult and expensive.  I'm okay with that and will begin taking Doxycycline when my period starts.

• She reassured me that they could see polyps on the ultrasound but occasionally there are spots on the uterus wall, like the start of a polyp or something, and they can more readily see these if they do a saline-infused sonogram.  So, I guess that's an option if I choose, but the longer we talked, the more I agree that it's probably egg-related issues...

Regarding potential egg-related issues (this info. may be old news for some of you):

• She said some of the follicles don't even have eggs in them.  What?  It's true.  So, they can look fine on the monitor, growing well etc., but the egg is crap and disintegrated (she definitely did not use the word crap!).  They know this from IVF harvesting.  She did say that, considering my tests/FSH, it's highly unlikely all three or four follicles would be empty.

• Some eggs fertilize but have three sets of chromosomes.  These don't make it past Day 2 or 3.

• Usually, the problem is an extra chromosome, like with Down's Syndrome or Trisomy 16, etc.  These will usually form a blastocyst, but then I guess they stop developing at some point.  If they reach blastocyst, though, they have the potential to implant.

• She gave an example of one 42-year-old patient undergoing IVF:  On day 3, 50% of embryos made it to blastocyst and of these, 50% were normal.  Soooo, I'm taking from that, relating to me and an injectable cycle, starting with 4-6 eggs would be a good thing if you're cutting in half and then half again!  I had 3 eggs last time... which brings us to protocol...

Protocol for Upcoming Cycle (in possibly as soon as 9 days!)

• I'm getting my thyroid and 21-day fertility tests in a few days, even though I'll be on progesterone again so that result doesn't matter much.

• We're going for a more "gentle" protocol, since I responded so quickly.  Did I mention I love this new doctor?  She looked at my results, and she saw ways they could be improved.  Dr. Negative looked at them and said, "Meh, might as well do the same thing."

• So as mentioned, I'm going to take the Doxycycline to get rid of any infection that may mess with things.  Sounds good.  And, stage two, I'll take Letro.zole for five days.  Then, finally, I'll inject Meno.pur again, but less aggressively at two vials a day versus three, and no Lu.pron.  Hopefully, this will help line things up, and I can collect all my eggs, instead of half.

Now, to decide if I want to go with the same donor...

*On a side note, the doctor was very encouraging and positive about doing international IVF.  She said they collaborate with other clinics (doing everything but egg retrieval and putting embryos back), and she's worked with folks in India and Europe.  She thought Canada would be even easier.  I located a good clinic in Vancouver, but I would definitely need to also find a lending source, even with the dramatic cost reduction.