Saturday, May 11, 2013

Wash, Rinse, Repeat.... Aaaaand start all over again.

Sometimes TTC feels like following instructions on a shampoo bottle. We were so well intentioned this month. It was supposed to be our little "break" leading up to a FET (frozen embryo transfer), but we were determined to take advantage of TTC on our own (without science). Time is a tickin' and neither of us is interested in taking months off completely when all we want is a baby.

We were busily babydancing away, and I got all pumped when a second line appeared on my Wondo OPK. Then, next day line disappears. Then it reappears, then disappears, and reappears and....well you get it. No smiley face making an appearance on the digital OPK either, even though the Wondfo looked pretty dark one of the days (I always test with both brands to confirm for this very reason). WTH? I had never seen this type of activity EVER before and I knew something was off kilter.

So, on CD21 I requested to take a P4 (progesterone test) to see if there was any chance I had ovulated days after a fairly dark test line. P4 came back at 0.2, so no way I had ovulated. I then requested an ultrasound the following day, because I had already been testing with OPK's for 10 days, twice a day, and was about to pull my hair out from seeing the wonky results and no signs of a real ovulation impending. I needed to know where the heck I was at in this crazy cycle.

At the ultrasound appointment Dr. Vaughn says, "Well looks like you aren't going to ovulate this month."  Lining was only 4.5 mm and I had one 9 mm follie. So yeah, no where near an ovulation on CD22. Well this hasn't happened in a loooong time, but I'm guessing my body is all whacked out from being poked, prodded and pumped full of meds the month prior. Hubby made a good point too, that my body just gave up 17 eggs during IVF and it's probably being stingy this month.

Obviously, there is no trying on our own this month anymore. You've gotta have an egg to make a baby! Dr. V gives me two options...

A) Wait for anovulatory bleeding (spotting) to occur God knows when, which would be considered the start of a new cycle. Could be 2 weeks or 100 days or predicting how long an anovulatory cycle can drag on.

B) Take something to reset my body's clock (progesterone pills or BCP's) which will induce a period and give us control over when I start a new cycle.

Being the control freak that I am, of course I picked option B. I was actually anovulatory for almost 3 YEARS at one point (see timeline on the right >>>), which I think scarred me for life.  I'm not about to sit around and wait for days or months on end for a new cycle to start all. over. again. We are just ready to get the show on the road with our FET if I'm not going to release an egg naturally this month.

I filled the script and began taking Provera (progesterone pills) that day.  Today is day 3 taking the pills. l'll take Provera for 10 days (which will artificially give me the hormones typically released post-ovulation). Then, when I stop those, a new cycle will start within 2 or 3 days and this will be the start of our FET cycle. This is how the FET will play out basically...

Once a new cycle starts, I'll begin taking Estrace (estrogen pills) on CD2 and take those for 10 days. This will help ensure that my endometrial lining gets nice and healthy for an implanted embryo to attach to. It will also prevent my body from ovulating naturally. Obviously, I don't need my body to ovulate because we're implanting an already fertilized embryo.

I will also begin supplementing with Crinone (progesterone suppositories) during this time, but not sure when that starts. This will also help with my lining.

Additionally, I'll begin taking daily Lovenox injections right around transfer time. This was not part of my protocol with our first IVF attempt. Because I have blood clotting factors present, using this blood thinner will hopefully increase blood flow to the uterus and assist with successful implantation. My RE says that as long as I begin them prior to implantation, the medicine will do it's job before an embryo ever tries to implant. Although, just for the record, he's NOT convinced that Lovenox increases success rates for those with clotting factors whatsoever. After much discussion, we have agreed to disagree on this theory. However, he said it can't hurt anything, and I was given clearance to go for it with the Lovenox.

I tried them out this cycle. Hands down these are the
WORST shots I have EVER done IN MY LIFE!

These fockers hurt like a SONOFABITCH, so they better help combat my body's stupid blood clotting issues! I'll be taking baby aspirin daily for it's anticoagulant properties the entire cycle as well.

Then, a beauty contest will be held and one lucky embryo will be chosen for transfer. Take a sneak peak at the contenders for Miss/Mr. June FET...

Day 5 blastocysts: Both roughly BC quality (150-200+ cells)
Day 6 blastocysts: 2 Grade BB + 1 Grade CB (all 150-200+ cells)

I'm guessing we will choose one of the Day 6 grade BB blasts. The lucky winner will be thawed, given a shiny sash with a glittery title, and will be implanted through a simple ultrasound guided insemination, which does not require anesthesia. We had a discussion with Dr. V on number of embryos to transfer and all parties agreed on doing an eSET (elective single embryo transfer).

For one thing, I've already been vocal about the fact that I don't want to waste all of our embryos if the addition of Lovenox will not help and/or our next one or two FET's don't produce a pregnancy.
It seems MUCH harder emotionally to have a negative pregnancy result if you've implanted two embryos vs. one. Logistically, we're trying to conserve them while also trying to see if it's really a "bad embryo" problem or if there is something more underlying our issues.

For two, we would rather not have twins. The goal this whole time has been one baby. Sure twins are so cute! However, there are real risks to the babies, mostly surrounding premature birth. We haven't come this far only to have a difficult pregnancy we could have avoided by being prudent and just transferring one embryo at a time. Nor do we want to have a child with issues stemming from premature birth...less likely with a singleton.

We did decide to transfer two embryos at the time of our fresh IVF cycle, but at that time we had no idea if we'd even have extra embryos survive long enough to freeze. In our minds, we wanted the best shot possible and thought we should maximize our only chance at using fresh embryos. Now that we know we actually have 5 frozen embryos, we feel like we have more flexibility in choosing the # to transfer and know how many will be left. This changes our approach slightly.

Many RE's will actually suggest transferring two vs. one because it does increase the pregnancy rate slightly. Of course RE's want their pregnancy rates high right? They are required to publish them through the CDC. Well, as Dr. Vaughn pointed out, using two embryos does also increase the risk of multiples and the risks that accompany them. He is actually a proponent of always electing to transfer one embryo when possible. I like that about him. He's genuinely more concerned about the risks to the future babies rather than his SART data. He agreed that we didn't come all this way, only to have a risky pregnancy or childbirth.

He also pointed out that it's a financial thing for most people, who don't want to keep throwing $2200+ at each FET. All of the little charges do add up...

Does not include Crinone ($196) or Lovenox ($150)

Most people figure transferring more embryos will increase their odds while reducing the amount of money they spend in the long run (since there will be less FET's done). While this is true, we feel it's worth it to us to take it a little slower, conserve our embryos, and reduce our risk for multiples.

Then, after the transfer we shall wait. We are getting pretty good at this part by now. Well not really, but you know what I mean. We have practice.

No matter how many times I read this quote, it makes me tear up. Sniff sniff

Oh, and NO home pregnancy testing this time around. I will already be taking Lovenox, so I'm not concerned with my start date for that if I am indeed pregnant. I won't be driving myself crazy with that whole mess again. Nuh uh. Not gonna do it!

Now that I've told you guys all about it, I'm getting excited! Wish us luck and pray for us please!


  1. First of all, I'm sorry for the wonky cycle. BTDT and they suck. Boo. However!!! I'm so glad that you started the provera in order to get this FET party started! Transferring 1 sounds like the wise way to go. You've certainly given me a lot to think about for any of our upcoming cycles. I will certainly be praying, hoping and cheering you along!!

  2. I think the Provera is a good choice!… I would have made the same one! And kudos to you for going with the single… that will be such a hard choice when the time comes for us, but I think you're being really smart! Good for you! Hoping things get off to a great start!

  3. I would have chosen option B as well!! I'm glad you're taking matters into your own hands and that you're starting everything up again. My fingers are crossed for you my dear friend!!! xoxo

  4. I love, love, love everything about this post. I love your take it slow attitude. You guys are amazing and I'm praying so much for the glittery, sash wearing grade bb day 6 embryo chosen to be your child.

  5. Sorry for your wacky cycle. But at least you have some great looking blasts ready to be transferred. We are with you! Just want one healthy wouldn't think that'd be so darn difficult. Glad you're getting the show on the road and getting excited about it. Of course, I'll be prayin' and cheering you on!

  6. Must be the month for wonky cycles! ugh! so sorry! =(
    BUT yay for a plan!!!!!! Eeeek!!!!

  7. I absolutely hate wonky cycles!! This was my first cycle getting a false + on my OPK as well. Totally sucked. Going with option b was a great choice. Who wants to wait around for the witch to show up?? Wise decision on conserving your embryos and choosing to just go with one. You both will be in my prayers.

  8. Great plan to straighten out your wonky cycle! I totally agree with the new no early testing strategy. I tested during IVF and refused last FET. Our next FET could be around the same time as yours. Fingers crossed!

  9. Holy crap please organize my life and thoughts.

    Iiiii think this is an A++ fantastico plan and I am crossing all things on my person except for my uterus because that bitch is messed up enough.

    I feel good about this and I am very, very powerful.

  10. I think you guys have made all the right decisions -- anovulatory cycles suck and need to be wrangled into submission! They can just linger for ages and mess everything up. And as someone who also transferred a single embryo, I agree with that choice too -- if you can afford to keep doing another few FETs, then better to go slow and give each one a proper chance on its own.

    Despite what your doc says about Lovenox, I am so glad you're doing it -- I realize anecdotal evidence isn't technically evidence at all, but SOOO many bloggers with immune/clotting issues and repeat miscarriages have had success their first time taking it.

    Fingers crossed super hard for you guys!

  11. Sending TONS of postive vibes your way. and of course I am praying. XOXO!

  12. I just wanted you to know that even though I don't comment much, I always read and pray for you! It's hard to comment on my phone when it's not a wordpress blog, and I don't get on the computer to comment much. I appreciate all your comments and I'm still praying for you!

  13. Wow, June will be here before you know it and one of those beautiful looking embryos will be safely inside you. Eekkkk...I am nervous and excited for you all at the same time. I still pray for you daily and will continue to do so through these upcoming crucial days. I just know your time is coming and one of those embryos pictured above is your beautiful take home baby.

    Lots of love and hugs,

  14. Trying to conceive is such a bitch sometimes. Sorry your cycle is all messed up, but it sounds like you've got a great plan ready for your next FET. Maybe we'll be cycle buddies? My next transfer is scheduled for 6/25. Oh, and I know you already have the Lovenox, but can you do heparin instead? That's what I was taking for my clotting issues and I didn't think it hurt at all. I didn't bruise very badly either. Just a thought.