Ladies with lining issues - question!

sarcasticowl

Hi everyone! So today was my first FET ultrasound after the baseline last week. I am at a WHOPPING 12.15 mm, which is completely insane for me. Even at the height of IVF stims I never came close to this!

Only issue is, the trilaminar structure isn't quite there. They're having me come back on Friday to do another check but I'm worried that if the lining isn't three layered now there's no way it will be by then (CD 12). Have any of you ever had a not-quite-trilaminar lining that eventually worked itself out? I would hate to waste this amazing lining with a canceled cycle but everything in me is telling me I'm doomed

prudence9-2

Never even heard about the three layers lining... 

i don’t think this cycle is doomed. I doubt they would have made you come in 2 days if there was no hope.  

sarcasticowl

@prudence9-2 The trilaminar lining is apparently a much bigger deal than even lining thickness. It has to do with the makeup of the lining being more able to sustain a pregnancy than one that is homogeneous. Our RE will do a transfer with a bare minimum 6 or 7 as long as the "triple stripe" is there. No issues with this last time, so I'm hoping that my dang uterus does its freaking job!

dragonette505

In my case I generally get to the trilaminar stage, but usually just never get past 8 or so (I think my best lining LAST cycle was 8.8) My cycle before my last ivf I got above 11 all on my own (also trilaminar) so I dunno.... I think probably just see what they say on your next scan... It can change pretty fast actually. Last cycle I went from homogenous on a Monday to TL on my next scan (a Thursday), and who knows... it might have been TL the day before, but nobody looked.
I did do some poking around and while there is a percentage of women who are successful with Homogenous lining, it is much lower so obv in ART they prefer not to transfer without the TL. Many clinics will be more likely to transfer you with a thin lining that is TL than the other way around.
But it sounds like maybe your lining is in transition to TL so just hold on till next scan

prudence9-2

@sarcasticowl FX it has the three layers by Friday. 

Don’t lose hope just yet. 

sarcasticowl

@dragonette505 I was hoping you'd chime in on this, thank you! Good to know yours showed up within a couple of days of it not being there. Last time at this point I was at about 5.3 and it looked good enough to trigger that day and start estrace, and a couple of days later the PIO. I ended up with about 9.5 after all was said and done. Never really considered that TL would be my issue.

dragonette505

@sarcasticowl after my mini google fit on this I'm now a bit more concerned... one girl who never had problems said after so many years of IVF she now did have this issue and I'm like: diggety dang it!!! Like who needs more issues

I just found out I *may* have a new polyp or something so I absolutely don't want a new uterus issue!


But yeah... my last couple cycles I have taken note of my lining along with my follies so its easier for me to look back and track how I developed

sarcasticowl

@dragonette505 Hopefully that was just her body's reaction to the constant hormones and that's not a 'thing' for all of us. But yeah, what the eff? Just when you think you have a cycle figured out and can, for once, sort of plan out what your life will be like for the next week, your body can throw a pitch at you that you've never seen. Frankly I'd rather be on the thin side and structurally sound than be thick as all getout and have it be piss poor for implantation. I read that about a third of women with homogeneous linings were able to conceive but nothing about how many live births resulted. Harumph.

Are you going to have a hysteroscopy to take a better look at what might be going on up there? Luckily polyps are easy, but good grief. How is it that we can grow so many growths but not babies?? 

dragonette505

@sarcasticowl yeah... I didn't see a live birth study either....

AngryBull

@sarcasticowl I've had my lining work itself out and become TL after a few days. If Friday is only cycle day 12, it sounds like you might only be at CD 9 or 10 right now? Usually my US would show TL starting to develop around CD 10 and then they would have me come back a few days later and the TL would have happened by then (if I recall, it was usually between CD 12-15 that I got the TL stripes).  So I definitely think there's hope.

Also, as I'm sure you've figured out, there can be so much variation from day to day. For me, my lining always seemed to get its thickest at CD 12 and then would start to actually thin. It was so frustrating! I would literally go from a 6 to a 4.5 in 2 days.  But you've got so much to work with at 12.5 (!!!) that you should be good even if that were to happen.

It's wonderful that you've been able to get the thickness up - did you try any new meds this cycle?  And good luck with your FET!

dragonette505

Yeah... come to think of it... as @AngryBull says... what did you do to fluff it up this cycle??

sarcasticowl

@AngryBull That is EXACTLY the kind of thing I was hoping to hear. Thank you so much!

So, after my first cycle with just Estrace was canceled before I even got to the PIO stage (fluid in my uterus, thin lining), my RE suggested a Letrozole protocol to start rather than dive right into the Estrace, thinking that the Estrace caused too much fluid/mucus).

In addition to my regular vitamins, I added an extra 800 mg vitamin E pill, 1000 mg of L-Arginine, a 6-8 oz glass of pomegranate juice every day, one to two cups of raspberry leaf tea daily, drinking more water (I'm terrible at drinking water), getting up to move more often from my desk job, and lying in bed with my feet together and knees out to the side for about twenty minutes a day to try to help with blood flow. I started the 5 mg of Letrozole on CD3 (the day of baseline) and did that for just five days. On day 10 I came back in for u/s and bloodwork and that day I was only at about 5.3 or so but the structure was sound and I triggered that night, started Estrace 2mg 3x a day and started Lovenox shots that night. Two days later I added PIO. And those two days of 3x/daily Estrace were enough to get me to 9.5 which is nuts considering you supposedly don't continue growing lining after starting progesterone!

This cycle I did the same, starting off with 5 days of Letrozole, extra vitamin E and L-Arginine. Pom juice when I remember, tea when I feel like it (I've been so bad this cycle with paying much attention to my 'extras') so I thought the most I could hope for at today's appointment was a 5 or 6. Maybe my body is responding even better to the Letrozole this time because it's the second time around? Unsure. Whatever it is, I'm happy. Although, the nurse that did this ultrasound is the same one who overmeasured me during my first, canceled cycle because I had a fluid pocket; there's some fancy way to accurately measure the lining when there's a blip of fluid in the center and she didn't know how (!!!). We are not huge fans of this particular nurse so we're not 100% convinced I'm at 12 but the NP looked over her scans and didn't seem to think she was off. Just that my lining is not TL. I assume when I start PIO (if I get there!) that it will concentrate a bit more and not quite be as fluffy. I'm always reading that introducing progesterone tends to 'firm up' what is there.

I'm feeling a ton better about my chances now, though, thanks to you guys @dragonette505 @AngryBull. You made my day

dragonette505

@sarcasticowl that's why we're here!

AngryBull

@sarcasticowl That's amazing that your lining responded so well with just 2 days of Estrace! Were you taking it orally or vaginally?

There are a lot of studies out there that indicate Letrozole helps implantation during FET cycles. My RE would also have me take it for five days starting on CD 3. It's not clear if it helps lining per se but we need all the help we can get so I always took it!

Hope the Lovenox shots aren't too difficult - I hated them. After all the hundreds of shots they were the only ones that bruised and hurt like hell. But you gotta do what's necessary.  Best of luck!

sarcasticowl

@AngryBull I was soooo worried when they told me to trigger at 5 and do estrace for only two days (I did it vaginally). I thought there was no way in hell I would be thick enough for transfer, and I was. Shocking.

I am a huge fan of Letrozole now. Huge. I have heard the same thing about it resulting in more pregnancies and live births than standard hormonal protocols. I wish more people knew about it!

The Lovenox is not wonderful - they sting like a bastard don't they? I started getting pretty hefty bruises at the end- but it's all tolerable. It's actually worse to me than the PIO.

sarcasticowl

Side note, @AngryBull and @dragonette505, sorry if TMI but I just had a boatload of super thick EWCM that was slightly brown and I almost had a stroke. I'm like "SHIT, I'M OVULATING!" even though my LH was 7.37 yesterday. Thank GOD for OPK strips. Totally NOT ovulating but I almost just had a major crying fit thinking I blew this cycle. Going back in tomorrow for a lining check and more bloods. Fingers crossed I'm TL so I can start estrace and keep from O'ing!

dragonette505

@sarcasticowl I think there's so much to be nervous about! So glad you're not oing yet!!! 

sarcasticowl

So my lining was 8.3 today. Trilaminar, thank God, but EFF that nurse who measured me at 12.13. That's twice she's been off by more than 3 mm. Even my nurse today was like "yeeeeah, she measured incorrectly." DO SOMETHING ABOUT IT, PEOPLE! 

Also, totally surging If only I had been trilaminar on Wednesday... Still looking at transfer on 10/13. Can't think of a better day to try to get pregnant than Friday the 13th, ugh.

prudence9-2

@sarcasticowl glad to hear your lining is all good now!!! Good luck next week! Are you starting PIO soon?

sarcasticowl

@prudence9-2 Sunday we're back at it! Which is good because DH is camping with his friends tonight and tomorrow and I don't want to try to give myself the shot. Interestingly enough, I'm not on Estrace at all this time. I have no clue why. Definitely going to ask about that.

prudence9-2

@sarcasticowl I never used estrace. But I’m assuming Vivelle Dot is suppose to do the same thing? Fluffy lining... but seems like you’ve already got that. 

Friday the 13th! Nice! Must give you some good luck