IF Testing & Treatment week of 7/9

rallykat14

@50Wife Im either bad ass or insane, I haven't decided lol. 

50Wife

@rallykat14 sometimes I think it's a combination of both

Avrilmai

@lulu1180 Just for a perspective on the crazier things have happened...I did clomid for 2 cycles, I have a low AMH and my second cycle on it created multiple cysts. No trying to scare you, just sharing my experience that they're is the possibility of issues with Clomid and low AMH.

***TW
@rallykat14 IVIG is IV immunoglobulin, I have a friend who had it after RPL. Her RE believed she may have had some underlying, un-diagnosed autoimmune issue or possibly natural killer cells. As I understand it, the IVIg suppresses your immune system so your body doesn't attack the embryo. She did 3 infusions i want to say it was all in the first tri. it was successful. End TW***

rallykat14

Thanks @Avrilmai it kind of looks like I'll pick and choose what to add based on price and inconvenience .  Got a call that they can do a scratch but not the hysteroscopy because the machine is out for repair...WTF

KristoKekerooni

Guys, I'm sorry I haven't been around much and haven't responded to the countless tags and PMs. I seriously love and appreciate you all, I just can't hardly form words or responses that aren't totally lame. But like. @50Wife , you are 100000% correct. Everyone here is so badass. And incredible. Like. I have never met a group of women that has struggled SO fucking hard, but still fought like warriors AND had the empathy of a god. It's just. Incredible. And I don't say that in a general "you guys" kind of way. Like. Individually, you guys are fucking rockstars. @rallykat14 , and @madspunk , and @lulu1180 , and @Aurora1973 , and @50Wife , and @Avrilmai , and @suzycupcake , and @nitnat007 , and @jrm_14 , and @purplg8r , and @AlohaKumu , and @emmasemm and @tamalahoops ... and probably a few more I forgot. But you guys. I love you. You are amazing. Regardless of where you are in the process, you guys amaze me. There are times when I'm at home COMPLETELY  falling apart and I tink about you guys and how much you guys fight and I feel better. 


Anywayyyyyyy... my hormones are weird lately.... 

@suzycupcake , @50Wife is spot on. IVF seems like this hugely scary, insurmountable thing. But when you come right down to it, it's 5-10 minutes out of your day. Day to day, it's rather easy. If I am being honest, for me (and maybe it's just me?), IVF was WAY easier than cycle after cycle of TI and IUIs. It was more involved, but I felt productive. Like I was an active participant, rather than a passive body that couldn't control anything... but we also know I have control issues. No matter what, you'll make it through, especially with a group of women like all of us to help guide you through the scary moments.

@rallykat14 , IVIG is similar to intralipids in how they work- by lowering the number of NK cells. IVIG is like, one step up, they're a little more potent, so to speak. Most people start with the intralipids though because they do work just fine for most people and they are FAR, FAR cheaper than IVIG. @jrm_14 , gave you info on the Plaq and Humira, these are two that I was on. The are being used more and more to prevent miscarriages and help implantation. Neupogen has many uses in IVF, depending on when you take it. It helps egg quality, increases lining, supports placental growth, and more. SO basically, it helps egg quality, implantation, and prevents miscarriage. The scratch is one of those things that doesn't have a lot of evidence either way. The idea is that when the endometrin is "injured" it increases growth factors and cells, which can lead to better implantation rates. LIT therapy is interesting. Another thing that hasn't had a ton of study. It's where they take WBC from dad and inject them into you. The idea is that the maternal body attacks the embryo because it sees it as non-self. So they inject dad into you so your body can recognize that DNA when the embryo is transferred. It's way more complicated than that, but that's the general sense. It's really new, so like I said, not much info. I'd be SUPER interested if you did this. Anyway, if you want more info, I'd be happy to help explain further.

lulu1180

@KristoKekerooni


And also,

tamalahoops

@KristoKekerooni

holly321

Dirty lurker here... I saw about plaquenil and helping against miscarriage, what does it do to help?  I read a bit about clotting issues, but wasn't sure if there was something else I am missing.  I ask because my obgyn really wants me to not be on plaquenil when pregnant, but maybe I should push the subject.

suzycupcake

@KristoKekerooni @rallykat14 and @50Wife Thanks ladies  

Ivf will be all out of pocket for us. Our state doesn't mandate that type of coverage, nor any for that matter. California has a mandate in place stating that every health service plan must offer coverage for it but it doesn't require them to provide it nor does it require employers to include it in their plans, which makes no sense at all. At my previous job, I did have 50% coverage for everything besides ivf, which was great. It was a British company I worked for who also provided paid maternity leave. 

I thought that when my husband and I started our own business, that we would be able to add a fertility rider to our insurance plan, but insurers have a requirement for more employees than we have currently. I can't remember exactly what the minimum was, but I'm not sure we will ever want to have that many employees for the type of work that we do. 

I did find a clinic nearby with a 60% success rate for ivf as well as a two fresh cycle package deal for $15K https://d1l9wtg77iuzz5.cloudfront.net/assets/3625/217357/original.pdf?1517428351 They also have a mini ivf option at $4500 for one fresh cycle, $7500 for two fresh, and $12K for three (I'll most likely choose one of these options due to over responding to clomid during iui) https://d1l9wtg77iuzz5.cloudfront.net/assets/3625/217359/original.pdf?1517428431

IUI is three cycles for $1500 total, not per, which includes everything except for meds.  

The things I'm scared of:

• The reaction I might have to the increase in meds since my body is sensitive to meds. We had to stop clomid because of over responding and getting huge cysts, having to go on complete pelvic rest both times. We tried 100mg, then 50.
• The stress. Too much stress can trigger an MS relapse. We'd have to have a really good plan in place to reduce stress which will cost even more money. 
• The needles. It was difficult to get myself to do the trigger shots but then I got used to them. Is the ivf needle the same as that? How often do you inject?
• Being put under for egg retrieval
• If I do choose mini ivf which means less meds, the anxiety that all of the eggs they retrieve are not good quality because I have pcos.
• If it doesn't work and then I just put my body through all of that.
• To transfer 1 or 2 dilemma. Everyone seems to be okay with the idea of twins, but not me. That puts my body at risk and puts babies at risk. Is that selfish to think that way and does it mean I secretly/subconsciously don't really want a baby?

Kristo, I like the idea of feeling like I have more control since I also have control issues  

jrm_14

@holly321 @KristoKekerooni may have a more detailed answer. Basically, as Plaquenil decreases inflammation, it can help the body from attacking the embryo. I read somewhere about it helping with natural killer cells. My RE was satisfied I’m already on it. As you clearly know, if you have been taking it to help with autoimmune stuff, that can flare back up & cause issues. For me, the potential benefit outweighs the very minimal risk. 

KristoKekerooni

@holly321 Plaq helps reduce the chance of miscarriage due to lowering inflammation in the body. The idea is that the body is in an inflamed state, thus attacking everything-including an embryo. The idea behind using plaq is that it helps bring inflammation down by repressing the immune system a bit, allowing the embryo to go "unnoticed" by the immune system. 

@suzycupcake , that's a lot to stress over. First things first, NO. It's not selfish. You are ABSOLUTELY within your right to not want twins. Girl. Really. It doesn't mean you don't want this bad enough just because you don't want the risks associated with two. I didn't realize you had MS. @ mrsdaddario does as well, and PCOS. She might be a reference for you, if needed... though she didn't do IVF. I can't help most of your fears, because they aren't related to anything I have experienced. Except the needles. I think I told you guys about my first stim night. I didn't expect it to be a big deal, because I have zero fear of needles... but it was because stabbing yourself in your own house is different and weird. I cried. Not just like tears, but full on sobbed. H gave them to me. But eventually, out of necessity, I started doing them. And eventually, I started doing my own PIO. I would pull my pants down in a busy airport, shoot up and be on my way with NBD. I did it at parties in the bathroom. It really becomes second nature SO fast. SO FAST. 

rallykat14

So I don't know what to do.  Dr. Suggested an endoscopy scratch and wants me to stay on PIO to trick my body (Tuesday wasn't last dose). I'd have the scratch on tues and stay on PIO for another week and then wait for a period to transfer next month. Orrrr I can relax..do baseline testing when I get my period.. the scratch on day 21 and then wait for next cycle to transfer.  On one hand this failed cycle has made me really negative and i kind of want the break...on the other hand I just want to move forward so it can either work or not and I can move on with my life. 

suzycupcake

@rallykat14 I don't have any advice. Sending more hugs your way as you make yet another difficult decision. You'll decide what's best for you and it will be what's best because you decided.  

purplg8r

@lulu1180 it’ll depend on when AF shows up. I teach Kindergarten and I don’t want to miss any days the first couple of weeks. So I think if AF stays away until the middle of August, I will. (Although I just looked at FF and it looks like it will hit a little too early. Maybe they can put me on bcp ). 

@suzycupcake I agree with @50Wife and @KristoKekerooni it seems so overwhelming but when you look back, it feels like it went by so fast. I absolutely hate needles.  But I did all of my own injections. It kinda just becomes second nature (although not gonna lie—freaking out about the PIO). I started with one injection in morning and one at night then increased to two in the morning. Being put under was a breeze. I’m going back under on Monday and I prefer it to being awake. I can only speak on doing the first half, but you’ve got this!

@rallykat14 I don’t have any good advice, but if it were me, I think I’d keep going. I hate waiting any longer than I have to. 

So  since my results came back so quickly, I am able to get my hysteroscopy and endometrial biopsy done this cycle—we’re doing it on Monday (cd 10 which is the last day they’ll do it ). I’ll be put back under anesthesia which I’m quite happy about. 

madspunk

@purplg8r I'm so happy your embryos both came back as normal! And that you'll be able to get the rest of the testing done this month!

@50Wife @KristoKekerooni Amen to that.

@suzycupcake

I had the same fear about what will my body do with an increase in medications? I have PCOS too with a high AMH and a history of over-responding on low-dose injectables. I let my clinic know I was nervous and they kept my dose for IVF low which helped alleviate some of my concerns. Ask about the Lupron trigger. It greatly reduces the risk of OHSS (https://www.advancedfertility.com/lupron-trigger-prevent-hyperstimulation.htm - says there's almost no risk with Lupron). Every time I did an IUI, I was nervous I was going to over-respond and get cancelled. In that respect, stimming for IVF was easier in some ways because I didn't have to worry about that any more.
I found the most stressful part of IVF for me was making the decision to do it and the unknown (when will ER day be? will my eggs fertilize?). From day 1 of stimming to ER was less than 2 weeks for me, so it is a fairly short timeframe you're actually in the midst of it. During IVF to help manage stress, I kept thinking, "This is just 2 weeks of my life. Whether or not the result is good, I'm doing what I want to do and I will take a break either way in 2 weeks." I never planned on going right into a FET, which I think was helpful for me because it segmented the stress into smaller parts.
If you do mini-IVF or low-dose you might just be on an FSH and then an injection to prevent ovulation. I used Gonal-F - that needle was very small, and much easier than the trigger shot. It comes in a pen so you just stick a tiny (tiny!) needle on and inject, and I didn't find this painful at all. I used Cetrotide to prevent ovulation, but you don't start that until at least a few days into stimming. That one is more like a trigger shot. I was injecting once a day and then twice a day. There's also PIO (the butt injection and the needle is longer). I think that one is the worst of the ones I'll do/have done, but the good news is you don't need that until FET and it's once a day. So again, you can separate this in your mind from the other injections if you take a break between ER and FET. I agree with everyone else that the needles very quickly become just a part of life. I actually like doing them myself better than someone else doing them. And you feel like superwoman after doing your first shot (small perks?).
All fertility treatment is (as someone else here put it) like Vegas on speed. It sucks because there is no way to tell how many eggs will fertilize and how many will make it to freeze whether you do mini-IVF or conventional. I'd put together a list of your pros and cons for conventional versus mini-IVF: cost, chances of success, stress level with more versus less meds, etc. Then, either way you go, when you start thinking about either "why did I spend more for this?" or "why didn't I try to go for more eggs?" you can remind yourself of all the reasons.
And about transferring 1 vs 2... You're not bad for not wanting to put the stress of twins on your body! The good news is with IVF, you have more control than you do with IUI and can choose to transfer just one if you want.

@rallykat14 Tough decision. I think either choice is fine and reasonable. Sorry that's probably not helpful... Let us know what you end up doing.

holly321

Thanks @jrm_14 and @KristoKekerooni for the info.  I will bring it up with him again.  

TW loss

The issue it prevents would not change anything with my losses.  My first loss was from fetal hydrops due to a chromosome trisomy, and PMP is just crappy luck. But still, I would assume I am at an elevated risk for the other issues.  Now to go down the rabbit hole of reading all my blood work results during my pregnancy....  I do know my WBC was really high during my preop for my d&c (oncologist said it was probably the cancer.)

suzycupcake

Thank you again ladies. I'm feeling much more at peace about the idea of ivf. I'm gonna talk to my husband about going straight for it rather than going through more rounds of iui. At least then there is a 60% success rate I have to look forward to with this new clinic. I know it's $1500 for three cycles of iui, but I could do one cycle of ivf, retrieve and then just do transfers, doing them when I want to, and not be on some sort of a clock like with iui. Well..... well, you get what I mean. I'm just gonna assert myself and say no to transferring more than one. 

@madspunk Thank you for explaining the different needles and for taking the time to post all of that. What is pio? If that is progesterone, can I opt for suppositories instead? I've never met another over-responder so it's comforting to know that I'm not the only one and that I can get through it. The pros and cons list is a great idea. I'm actually a list queen so I think it would really help to alleviate anxiety and reduce stress. Thank you