IF Testing & Treatment w/o 6.28

inthewoods23

@bows22 I'm so excited for you! Yes I'm pretty sure you do (or can) ovulate following the withdrawal bleed since I know plenty of people have gotten KU the moment they're off BC. My cycles bounced right back immediately.

However, I did not appreciate the surprise 29 day cycle following my first two post-BC cycles of 33 days. 😂

acleverusername

Hey hey hey! Hella busy thread this week! And lots of laughter; I've been creeping but haven't had a chance to input. Anyways, lots to catch up on. Alright... *flexes* let's get to it: 

@inthewoods23 loving that you're taking matters into your own hands and trying something new with your cycles. I hope the Benadryl does the trick! Re: Receptiva Dx.... did a bit of searching an apparently the Receptiva Dx usually only looks at BCL6 marker. If your doctor ordered additional testing of the CD138 marker, that can identify endometritis. Might be worth looking through your reports. As for another pandemic vaccine... I don't know if this is true, but apparently the Pfizer vaccine needs a booster within 12 months! 

@daisy0322 yeah, as others have said, with your "cycle that never ends" out of whack hormones can be the reason for your spotting. Enjoy the fireworks show from the boat! That sounds fantastic!

@And846 what others have said about buying drugs. The other tip/trick is to shop around. It's possible that you'll be able to get better prices on some meds from one pharmacy, and on other meds from another pharmacy. IVFmeds.com is another source (this one is in UK). But, I've heard stories of some items being in different packaging than what's available here (i.e. Menopur apparently comes in glass bottles that you have to 'break' to get the liquid out? Apparently easily fixable if you ask you clinic for the mixing solution). This is what I'd have done if my company didn't suddenly get insurance coverage. Also love that you've pre-planned and pre-packed what you're going to wear! 

@kiwi2628 I hope the time away this weekend will bring you closer to your FET!

@keikilove I'm sorry that today's monitoring appointment wasn't as positive as you'd hoped at the beginning of the week; hopefully the dark spots you saw on the monitor will turn out to be follicles once you get to MX! 🤞🏻Thanks for sharing that article on Letrazole. I've booked marked it for latter reading. Also does NSFW still apply in the day and age of working from home? LOL. I think maybe nudes of other men might be NSFW now. Lol. 

@optimistgardener hey girl! You still alive?! Honestly, I can't believe the weather you're having. It's like everywhere is under a heat wave, and here in SF, it's foggy as sh*t with temperatures in the mid-50's. WTF? Climate change, man... Anyways, I don't want to jinx you, but I can't believe it's almost time!!! All my fingers and toes are crossed. Thanks for sharing your protocol, btw. It's super interesting to see others' combination of meds. 

@beakay8 As others have said, and LP of 10+ is not considered short. But the spotting is a sure sign of LPD. I've posted a bunch of resources about that in response to @paytonpedro in the June questions thread. TL;DR. LPD is a not a cause of infertility; it's a side-effect of another underlying issue. In the June thread, I've linked to a guideline from ARSM that lists potential causes of LPD. Also re: "weak ovulation" (CC: @inthewoods23)is such a terrible way to describe what it actually is: corpus luteum doesn't produce enough progesterone. I asked about this extensively in the Proov Facebook Group when I first joined TTGP (because I was having the same issues), and this is the best answer that was provided to me. 

Anyway, Letrazole should help, but we aware that you might also need to supplement with progesterone in the luteal phase to make sure that your P4 stays above 10mIU/mL. But also... "you're doing it wrong?!" FML, what an effing rude thing to say to someone who's at their wits end trying to get KU. Like really?! 

@kiki047 I'm sorry the hot tub was a trigger. Sending you "cooling" hugs. As for metformin, I mean yeah... it's a medication to lower your blood sugar levels, so in theory, when you do a check, you'd be checking to see if the medication is helping. But I could be talking out of my a$$ here. Anyway, Happy Canada Day! I'll be wearing all my red tomorrow (I guess today, when you read this) including to my meeting with our CEO/CTO. Also, laughing at YH's reaction when you call him buddy (others have already reacted appropriately to the WRONG HOLE comment.)

@mokay19 Honestly, I get so pissed off with attitudes (by men and women) about semen analysis. Seriously... it take A SPERM and AN EGG to meet in order for a baby to have a chance. Just because women's systems are more complicated, doesn't mean that we're the only ones who are responsible for failures in reproduction. Every time I see on a forum a woman say "I'm getting my testing" I always make a point to ask "what about YH, has he gotten tested?" and it most cases it's "no... not yet" or "it's too soon" or "he doesn't want to". Anyways, I hope YH swallows his pride and starts being the supportive partner that you need him to be. But, in the spirit of actually being helpful, perhaps doing the semen analysis at the doctor's office is an issue? If that's possible, you could consider doing an at-home SA through MeetFellow.com. This is CLIA-certified test that is recommended by REs if an in-office SA isn't possible (it was developed at UCSF, with guidance from the director of reproductive urology). Also, I'm sorry you're feeling so crapping on the norethindrone (is it Aygestin)? That's what I took for my "priming" during my last IVF attempt, and I was super bloated as well. 

@bows22 great to see you posting here again! Happy to hear that the pre-op appointment went well, and that you have good next steps lined up. Good call on not taking Clomid while on vacation with your fam. That's a win for all around, I'm sure (unless you're like me and doesn't get any side effects to Clomid! 🤞🏻). Enjoy your grandma's 90th celebration! 

acleverusername

Diagnosis (if you've been):  Hashimoto's, AMA, sperm-driven fertilization issues

Status (WTO/TWW/TTA):  WTO

What are you doing this cycle? (Testing? Treatment?): 2nd attempt at IVF ER #1, starting in the mid-luteal phase

How are things going?: Good good; I'm hella busy at work and in life (lots of doctor's appointments for various things), so it's keeping my mind off what is likely to be the longest wait to O. Argh. I got my draft calendar, and my coordinator thinks I should get a positive OPK by Jul 11, which would mean starting stims on Jul 15. Alas, in the past few unmedicated cycles, my O was usually around CD20, and who knows how it got messed up because of stims last cycle. 🤷‍♀️

I've also been doing a bunch of reading, and have decided not to adjust my dosages on my own. Mostly because I understood that if all of the follicle FSH receptors in the ovary are flooded, injecting more FSH is just a waste of medication; it's not going to make more follicles grow. So, I'll do a cycle with the dosages as recommended by my RE, and then we'll see for future cycles. 

***TW TMI***
This week I also had to do my 24hr cortisol test (4 saliva samples taken and different times during the day) as well as a 3-day stool sample. Since we're already talking about anal this week, let me tell you, that last test was so disgusting. Argh. Playing with poop is so gross! And because it was done over 3 days, I had to store samples in the fridge. Yeah, so I told MH: "may I remind you that we are married, so... "

Any questions?: For those of you who've had ERs, how has your ovulation the following cycle been affected? And also, what exactly affects the ovulation timing: the hormones or the actual retrieval procedure? 

GTKY: Any fun holiday plans for this weekend, or summer holidays in general? MH and I decided on a last minute trip to Carmel-by-the-Sea. We leave tomorrow at noon and come back on Saturday. And on Saturday PM our friends are having ppl over for a BBQ. MH is making Nanaimo bars since our friends are also Canadian. It's a joint Canada Day-Independence Day BBQ! 

inthewoods23

@acleverusername I'll have to check if my biopsy did look at CD138. I think it does! It's funny that you say that about the vaccine as I recently read they may last 10 years? But who the hell knows lol. The story keeps changing. Not long ago Pfizer and Moderns were upping production/inventory because it seemed like we would need booster shots before the end of the year. I would think a booster could be needed as there's more variants though. Thanks for adding to this week's TMI! 😂

Edit - yes my ReceptivaDX did look at CD138! No endometritis for me 😊

optimistgardener

@acleverusername and @And846: Clever is totally correct about the glass bottles--the Menopur comes this way from IVFPharmacy as well (it's the water for mixing that comes in them, so at least it isn't the "good stuff"). Also some of my drugs came with Turkish labels, but English inserts. I suppose these things could be deal-breakers for some women, but for the kind of savings they represent, I am perfectly willing to deal with inconvenient packaging. As to concerns about whether the drugs are subject to the same scrutiny as the US FDA would demand, they are the same drugs that the FDA has approved (and similarly approved by Israel's Min of Health, and, I believe, by the EU), just packaged for other markets.

mokay19

@bows22 I almost get more nervous about being on it than coming off... but without estrogen in the meds, now I just think about my acne and gross skin and bloat haha.  Also, for my last hysteroscopy and this one, too, they had me stop the norethindrone the day before the procedure. And then I never even got a withdrawal bleed so 12 days later they gave me Provera to kickstart a period and then let me do a treatment cycle immediately following that!

@acleverusername my husband has done 4 SA's all in doctor's offices with no problem... he's just a grouch about driving up to the office.  But since he has to take me to the hysteroscopy anyway, he's just doing it before that.  Also, my bottle just says norethindrone so I'm not sure if it's generic or what!  
I'm cracking up about the stool sample storage, too!

acleverusername

@mokay19 okay, if he's just being a grouch, it's good that he has a "reason to go". Phew! Bullet dodged. Good luck!

@And846 one more thing about the glass mixing bottles... if you have a local IVF Facebook Group, you can EASILY get some mixing solution from someone who went through a cycle. You NEVER use as much of the mixing solution as is package. For example, I use 2 bottles of medication for 1 bottle of mixing solution, so I already have a bunch of them collected. And some, who are on even higher Menopur dosing, use 1:3 or 1:4. So, if you do opt to go that route (and as per @optimistgardener, that what I was fully intending on doing if my insurance hadn't come through), the savings are WELL worth it. I also looked at buying meds from Canada, and it's cheaper than in the US, but not as cheap as IVFPharmacy / IVFmeds. But those products tend to come from Australia, New Zealand, UK, etc. I actually put together a cost comparison for all different options, so if you're interested, PM me, and I'll send you a link to my Google Sheet. 

keikilove

@inthewoods23 Thanks for your words of encouragement. When you said your RE only counted the bigger ones later in the cycle that really helped to ease my mind. And you were exactly right. Based on my next appointment that happened yeaterday, I think that’s exactly how my RE counted them at the appointment on Monday. Also, that’s awesome that your Receptiva test also checked for endometritis. So glad you can check those things off as being in the clear!  

@bows22 I’m so freaking excited that your plan is finally in progress! It’s good to hear that you’ve had some control over the timing of how things move forward; I hope you don’t have any of the monster-behavior side effects of Clomid. 😉😘 That is wonderful that your grandma is turning 90! What a blessing! Have fun with the family, and the rest of your weekend plans. 

@acleverusername Thank you for your kind words. I think they were follicles after all, based on yesterday’s appointment. Look at what experts we’ve all become during this process! 😄 I will post my update right after I finish these tags. I literally LOL-ed at your thoughts on what constitutes NSFW these days. And OH WOW at your stool sample story hahahah. “May I remind you that we are married so…” 😂😂😂 Yep! Let’s just keep this TMI going: **TW: TMI: Your story reminds me of when I was storing my period blood in the fridge to send off to Locus Medicus/Fertilysis in Greece for hidden infection testing. I said to MH: “It’s just a few drops of period blood. 🤷‍♀️ I will put it in the back so you don’t have to look at it.” Ah, the things we do on this journey. And ENJOY your weekend—it sounds fantastic! 

inthewoods23

@keikilove I'm sure they eyeball their size on the ultrasound and measure whatever appears to be over X mm (whatever benchmark they might have for grow after so many days of stims). Presumably at least that number of eggs should be mature at retrieval time. I did end up with more eggs than what they counted at my last monitoring appointment, although only a couple more than that number was how many were actually mature

Come on little follies!

acleverusername

Well since my TMI was so well received, can I just tell you how weird it is to have to poop into a cardboard container so that I can then scoop stool samples into a sample bottle. I think I now know what what “performance anxiety” is!

@keikilove lol @ period blood in the fridge 🩸. Lol. Our homes are basically laboratories. Also, you’re absolutely right about us being experts in all of this!!! Go us!

@inthewoods23 super happy that your RE had your endometritis marker checked! 

keikilove

My phone died earlier. 

UPDATE: 
So my instincts were super right on and my doses were definitely too low this second round of DuoStim stimming. My RE in MX said that the larger follicles my local RE saw were actually cysts left over from the last retrieval. She said this is very common in DuoStim and no problem. She said it’s very hard to read an ultrasound on the second half of DuoStim, that it takes a trained eye to see what’s really going on. 

She saw 5 smaller follicles that will be the ones we aim to retrieve this cycle. She said my left side is indeed taking its turn to grow the larger “better” follies this time. She doubled my dose so that I’m taking 2 vials of Pergoveris per day, which is 300 FSH and 150 LH. She said that we won’t add Follistim like last time because the follicles are super sensitive to FSH right now and it won’t make sense to blast them with more than they can handle. (Similar to the conclusion you came to @acleverusername.) She also prescribed 100mg of progesterone per day to keep me from ovulating. I peeked at my chart while waiting for her to come into the office to discuss and it said I have 7 follicles instead of 5, so who knows. She said she thinks we can get 5 good ones from this retrieval, so maybe the two smallest follies I saw on the chart don’t count. 

Last, she said I should get my period this weekend at the latest. Lo and behold, it started right when I left the appointment and got back to my hotel a few minutes later. Just grateful I won’t have it during retrieval next week! I asked her how it’s possible to have a period and shed the cysts but not the growing follicles. She said that the smaller follicles don’t have progesterone receptors yet so they don’t respond to the hormone fluctuations that happen, while the old corpus luteums (luteii?) or cysts do have the progesterone receptors and therefore respond to it by shedding with the lining. Fascinating stuff! 

ETA: My nerdy self looked it up: plural of corpus luteum is corpora lutea. Learn something new everyday! 

ETA: I get to fly home today and return on Monday. Dr expects that I will do the trigger shot that day and retrieve next Wednesday. It is such a relief to have an idea of a schedule! This go-with-the-flow has been a bit loosey-goosey & anxiety-inducing even for me, even though I tried to be as mellow as possible as a regular habit. Retrieval will very likely land on our aniiversary so I’m hoping that’s a good omen! I’m also hoping that I can have a margarita to toast us and this journey later that night after retrieval! (Alcohol is probably a strict no-no after a procedure, but we will see… 💃🏼)

And846

I’m in the middle of inventory prep for an inventory i am running at work next week and have only been able to pop on at night for a few moments! 

@bows22 i always forget about the coming off BC but i recall ovulating next cycle no issues! 

@acleverusername a google spreadshgwt is the way to my heart! Ill PM you in the AM! 

Back for tags in the morning! 

laura-kay

I’ve been reading daily and am rooting you all on!  It’s been a busy thread!

Diagnosis (if you've been):  unexplainable 

Status (WTO/TWW/TTA):  WTO

What are you doing this cycle? (Testing? Treatment?): on a break from medical treatments - just doing OPKs this month

How are things going?: Ok.  I’m trying to mellow out some during the break.  I still don’t know what we will be doing long term

Any questions?: NATM

GTKY: Any fun holiday plans for this weekend, or summer holidays in general? Family is coming this weekend from my hubby’s side.  Lots of family on my side are visiting for most of the summer (mostly staying at my parents’ house).  We are trying to set up a time away for a vacation as well which we are looking forward to!  I just interviewed for a new job (same branch but different position).  Lord going on!

optimistgardener

@keikilove thanks for your update! i find your description of the luteal-phase u/s (and the whole duostim process) fascinating, and thanks for describing the reasons for why the corpora lutea(!) disappear but the younger follicles do not! I'm also glad for you that you don't have to have your period during retrieval (i am also squeamish about this kind of thing). but as i try to remind myself for every day 3 u/s i've had to do in the past year and change, it's nothing they don't see every day.

@acleverusername i came back from India once with some mystery stomach ailment that refused to leave me be. I don't think they ever really figured out what was up with me, but i do recall, like you, finding myself with samples of my own poop in the fridge. It's worse when you have roommates.

I'm still a couple of days out from my baseline ultrasound, and am having a hard time keeping myself zen. I have convinced myself a dozen times over that my cycle is going to be delayed again, and then reversed my line of thinking. i took my nuvaring out a couple of days ago and, because i am like the princess and the pea when it comes to my reproductive organs, I swear i can feel every little tweaky sensation and ache that happens in there. so now that my own hormones are kicking back into gear again, everything is creaking back to life and i am ...hyper-attuned... my brain is so annoying.

acleverusername

Thinking about everyone who’s got treatments/appointments lined us this holiday weekend! @optimistgardener @keikilove @bumblebee0210

Also saw this on IG this morning and figured I’d share: https://www.instagram.com/p/CQ1Wud5DCs6/?utm_medium=copy_link

kiwi2628

I hate TB sometimes. It hasn’t let me on for a week for some dumb reason. And now it’s too late in the game to reply to everyone. Anyway- happy 4th everyone! And today is CD 1 for meeeeeee

optimistgardener

@kiwi2628 good luck with things this month! I'm so excited for you and have my fingers crossed.

@bumblebee0210 how're the stims going? i've been keeping an eye out for your update. i hope all is well.

@laura-kay i hope your low-key cycle is a restful break and that you get lucky.

Re: moi: I get to go ahead with the cycle! Yay! No cysts, and no runaway follicles. I start my first day of stims tomorrow morning. I'll update more then, on the fresh thread!

Edit: apparently i'm not much for holidays, but... enjoy the day, everyone! I hope it's relaxing and full of good food and friends and whatever family you choose to surround yourself with.

acleverusername

@optimistgardener weeeee! So excited for you.