In other good news, P4 (progesterone) bloodwork came back today under 0.2, which means that no ovulation has occurred and we're all set to move forward with our FET on Tuesday 9/3. Yay! We've decided to transfer 2 embryos this time around to increase our chances of success slightly. Given our previous failed attempts, my age (35), and my diagnosis of DOR, transferring two just makes more sense.
I met with a perinatologist yesterday as well for a pre-pregnancy consult. This might seem premature since I'm not yet pregnant, but I had some questions I figured he could answer. My OB/GYN is not exactly on top of things as far as I'm concerned, and I do not plan to stay with her once I'm expecting. Plus, perinatologists are the real pros at assessing risk factors, screening, and dealing with high risk patients.
Previously, my hematologist found the blood clotting stuff and the MTHFR, gave me a script for Lovenox and said, "Take this and baby aspirin when you get pregnant" with no other real instructions on monitoring of anything. Do I just need a preventative dose (40 mg) or a higher therapeutic dose? Is there a test I should take at any point to assess it's efficacy and when/how often? What about folate supplementation for the MTHFR, Rx strength Folgard or Metanyx, etc? How exactly does MTHFR factor into things when it's coupled with the 3 other clotting factors? No one has ever given me any real direction on this stuff. I'm basically just going off of what I've learned from other women and my own virtual research. The internet is full of opposing viewpoints, which change pretty drastically based on each person's set of test results and circumstances.
I'd like to know ahead of time if there is something I'm supposed to be doing, rather than after the fact if you know what I mean. I also asked him about his first hand experience with IVF pregnancies and IVF babies. He actually mentioned a couple things I hadn't even thought of, like the fact that he sees increased risk of pre-term delivery from things like incomplete cervix more often with IVF moms-to-be, perhaps because of all the procedures done on IVF patients before they are pregnant? (his theory) Wow, hadn't even thought of that as a result of too much speculum all up in there.
He also mentioned that IVF twins tend to be lower birth weight and earlier deliveries than even naturally conceived twins. He talked about his patients who have experienced embryo splits (transferring only two embryos and ending up with triplets) and other risk factors. It was great to get the feedback and learn some interesting new tidbits...the type of stuff RE's don't advertise too loudly.
And of course, I asked him about the whole controversial topic of increased natural killer cells, prednisone during pregnancy, and other preventative measures against miscarriage. You may know that this can stir controversy among some doctors, but prednisone has also been seen as the magic bullet for many women who've experienced multiple losses. I do not fall into the category of "multiple losses" at this point. I've only had two losses, and one of them was ectopic (they consider this an "explained loss").
Still, I don't want to have to have 3+ unexplained losses before I ask these questions and then say, "What about prednisone? Can it help prevent this from happening in the first place?" We spoke about autoimmunity, how it may/may not relate to my own situation, where to go from here once I become pregnant, and risks & benefits associated with various drugs being used. He said that he has no problem prescribing prednisone during early pregnancy as an added security blanket against miscarriage once pregnancy occurs, if it's something we want to do.
All in all, well worth the time and cost of the visit. I'm glad I went, because it answered some questions that have been floating around in my head. Hey, if you have questions and they aren't being answered by your current provider, I say go to someone who can try to answer them! It doesn't mean you're trying to create a problem that isn't there or that you're being some sort of hypochondriac. It just means you care about your body and you recognize the fact that you didn't personally go to medical school. It only makes sense to find someone who deals with whatever questions you have, right?
Outside of that, it's hubby's 37th birthday today! We celebrated by getting 2 hour massages and doing lunch afterwards. Maybe some Breaking Bad, Hell on Wheels, and Mad Men on tap for our viewing pleasure this evening. We'll by in bed by 9 PM though I'm sure. Ha!...just being good little boys and girls over here as usual. And then we wait...for a HOPEFULLY successful transfer with two beautifully blessed sparks of life 5 days from now!
You are absolutely in the right path to get some answers to your questions. If your current Dr can't answer everything, why not go elsewhere? I do believe a lot of Drs withhold information for whatever reason and its not right bc we trust in them to be 100% honest with us. Best of luck with ur FET.
ReplyDeleteI am new to your blog and have enjoyed reading.
ReplyDeleteI am in the middle of an IVF cycle and thought I would share with you that I started doing lovenox injections twice a day (40 mg every 12 hours) the same day that I started my meds to stimulate my ovaries/follicles (DAY 4). I stopped lovenox when I did my trigger shot and was advised to start again the day after my egg retrieval (now I'm doing 30mg/40mg/30mg every 8 hours). My egg transfer is on Saturday. I believe they will have me stop the lovenox again for a couple days before I start again.
For my previous IVF cycle, the dr. did not have me do a blood test for the lovenox until during my 2ww. When I tested and they got the results, the dr. then had me increase my lovenox dosage. I asked if this is a sign of pregnancy and they said it could be. The next day I got my positive pregnancy blood test (first one ever), but it turned out to be a chemical pregnancy.
Before this current IVF round we are doing, we went to Mexico twice for Lymphocyte Immune Therapy (LIT) because my doctor believed my body may be attacking the embryo (resulting in the chemical pregnancy).
Sorry for writing a book, but I have been on lovenox for a large majority of my fertility treatments and my fertility doctor is a strong believer in using it, so I thought I would share- hope that maybe it helps.
Happy for your lining thickened and wishing you the best with your FET :)
It sounds like you are seeing an RI...guessing Beers' clinic since you're using LIT? I'm definitely interested in your progress, since I'm always trying to learn more about the more aggressive protocols that use immunology based treatment.
DeleteI used Lovenox my entire cycle for our last FET, which didn't work. I detest those shots and have decided to follow what some other clinics do that have really great success rates, but that aren't necessarily RI clinics....going to begin Lovenox 40 mg/day day of transfer and until hCG test this time around. All I can do is give it a whirl and see what happens I suppose!
My own RE still keeps telling me Lovenox isn't proven to increase implantation or pregnancy rates, but I do think there's something to it assisting with implantation and reducing the autoimmune activity BEFORE a confirmed pregnancy....esp. in someone who has some pesky little blood clotting things going on. I haven't had the full autoimmune work-up done though. Thank you so much for your perspective Jennifer!
You are welcome :)
DeleteMy RI isn't with the Beers' clinic but he definitely thinks more outside the box than maybe a lot of fertility doctor's. He offers an immune balancing protocol, I do an intralipid IV at the beginning of each cycle, growth hormone, lovenox, etc. We feel lucky to have found a dr. to tell us about LIT. He actually suggested it after a failed FET in January, but I blew it off and just thought that was crazy to be going to Mexico for that. Then we did IVF in May resulting in the chemical pregnancy and this time I listened to the dr. and we went to Mexico. It actually ended up being a great experience, and hopefully it was the last thing we need to help us have a baby.
The shots do burn! I have found that if I put the needle in quick and inject it slowly, it sometimes isn't too bad.
I have never done any testing as far as clotting issues or full autoimmune testing either, but its good you are doing what you believe you need to to have a baby regardless of what your RE is telling you.
If you want to follow my journey to have a baby, my blog is http://2daymightbetheday.blogspot.com
Our transfer is first thing tomorrow morning!
If you have any other questions, I'm happy to answer what I know.
I'll be following you (I relate to so much of what I have read on your blog- thank you)... and hopefully we both get the babies we are hoping for much sooner than later!!!
I will definitely be following you and offering support. I really hope this is your cycle. You have put so much into finding something that will help, and you deserve your happy ending!
DeleteHappy Birthday to your hubs!!
ReplyDeleteI'm so glad you went to that appointment (and that you shared it with us!!) - it sounds like you were able I come away from it with lots of info.
And YAY!! for 8 mm!!! I will be praying for you next week :). XOXO
I'm so glad that everything is looking good and the transfer is a go! And I am also glad you had a good appointment and could get so many questions answered. Good luck with everything and I can't wait to read the update after transfer. Sending lots of good vibes your way!
ReplyDeleteHappy Birthday to your hubby! So glad your lining and P4 are looking good! Thinking of you praying for your upcoming FET!
ReplyDeleteWow, wow! So many questions and I love that you are getting answers. Fingers crossed and praying hard for Sept 3!!
ReplyDeleteGreat news! Big prayers to you!
ReplyDeleteYes! Such great news! So glad to hear your lining is cooperating! Praying for you Emily!
ReplyDeleteYAY!! Good job to you and your uterus!! So glad things are a go and I'm pulling for you so hard up here in the midwest. You've got this!!
ReplyDeleteBig happy birthday to your hubs, sounds like the perfect birthday day!
Yay for 8mm!! I am sending you tons of sticky vibes:) I hope this transfer is the one, or maybe two ;)
ReplyDeleteI'm so excited your uterus thickened up, that's awesome! I'm also glad you mentioned prednisone. I've heard it mentioned here and there but had no idea it what it was or that it was given to ladies with recurrent miscarriages. Hello, this is me, how do I not know about this?! I am hopping on the google wheel as soon as I finish typing this to find more info, I'm intrigued! I hope that you and your hubby have a GREAT weekend and thoroughly enjoy your massages, ya'll deserve them!
ReplyDeleteYayayay!! I'm so glad your lining got all nice and plump for your baby(ies). I'm really excited about your upcoming FET and VERY glad your appt with the peri went so well. I totally agree with finding someone to answer your questions if your dr won't. Lots and lots of thoughts and prayers for a perfect FET on Tuesday!! As for prednisone, I know of quite a few people on DOR threads and other threads with multiple BFNs until that one little ingredient was added and boom, BFP. Happy Bday to your DH!! Sounds like a wonderful time planned.
ReplyDeleteIt's nice to know I'm not the only one that felt the need to see someone else! I feel like infertility is a fragile area and I've quickly learned that not all doctors see eye to eye when it comes treatment.
ReplyDeleteI'm really interested in what you have done to get your lining thicker. I looked at your calendar, and I've done pretty much the same. I've tried everything (I think) in the book and 7mm has been my record thickness. This new RE doesn't seem to be as concerned about my lining, but it always bothers me to know it's not that thick!
Have a great weekend :)
Well I'm not sure that 8 mm is that much better than 7 mm at the end of the day, but the voices inside my head think it is. ha!
DeleteAs for the lining, I was just following the protocol on the calendar, along with weekly acupuncture. When they measured my lining at 7.4 last week though, I pulled out all the stops...switched all my estradiol doses to vaginal, did warm castor oil packs on my abdomen daily, soaked my feet in hot water, ate plenty of warm foods, even visualized the lining growing thicker while meditating. Yep, I'm cray cray like that. We shall see what happens!
Plus, baby aspirin daily of course!
DeletePraying for you! Great post. Inspiring me to be a little more proactive in my medication research before IVF #3 (eeek!). xo
ReplyDeleteHooray for a good lining! So glad the extra time paid off! I am really keeping my fingers crossed for you and keeping you in my prayers as always! Hope you and the hubs had a great time celebrating his birthday!
ReplyDeleteJust wanted to let you know I'm thinking about you and praying that tomorrow is a perfect day for you and those embryos!
ReplyDelete