IF Testing and Treatment w/o 7.26

inthewoods23

This is a place for those of us who have already started TTC, but have started infertility testing and/or treatments. You can express your thoughts, feelings, and frustrations on infertility. TTC can be a long journey naturally, then add in the difficulties associated with infertility, and it becomes a whole new ball game. The road to infertility can be lonely, frustrating, and complicated, so let's make this a place where we can vent, ask questions, and support one another. Feel free to resurrect this thread at any point in the week if you have something to say. Treat this as an ongoing conversation.

Diagnosis (if you've been):  

Status (WTO/TWW/TTA):  

What are you doing this cycle? (Testing? Treatment?):  

How are things going?:  

Any questions?:  

GTKY: Name a totally underrated item that you own and why you love it.

optimistgardener

Diagnosis (if you've been):  AMA, DOR, 1 ovary

Status (WTO/TWW/TTA):  Waiting for test results, CD2

What are you doing this cycle? (Testing? Treatment?):  Both? I'm still chewing my fingernails off. Clinic nurse thinks we'll hear back this week or next on the testing. The tentative plan is that if I get a normal embryo, I will do a transfer in October. I set up a calendar for the transfer cycle with the clinic nurse this morning and the prep they do for a transfer cycle is way more involved than I was expecting! I'd love to hear other people's experiences with this, but they basically have me do a month on birth control, overlapping with about 4 weeks of Lupron declining over time from 10 units to 5 units, overlapping with estradiol valerate, which in turn overlaps with progesterone. This means I have to start birth control tomorrow to manage an October transfer. So that's one possible avenue.

The other avenue is that if I don't get any normal embryos, I'm tentatively on the schedule for a late November egg retrieval. It sounds like there is some uncertainty with the clinic as to whether they'll do a late November retrieval cycle though, and it sounds like they're probably not going to do a Dec cycle at all. They're a small clinic, so I respect that they are prioritizing having their employees get a little down time, but I'm also a wee bit stressed about whether I'd be able to sneak in another retrieval if I needed it.

How are things going?:  Kind of just twiddling my thumbs. I'm back to running again and trying to get back to feeling fully normal after the retrieval. I feel like I've been at about 95% since 3-4 days after the retrieval, but that last 5% is kind of stubbornly sticking with me. Maybe it will help that my period started yesterday.

Any questions?:  Not at the moment unless folks who have gone through transfer cycles want to chat about the drugs they took beforehand and why.

GTKY: Name a totally underrated item that you own and why you love it. Ooh good question. I feel like a lot of the stuff I really love is stuff that doesn't count as "underrated." Still, I could choose my bike, because I am minor-key in love with it and when I used to live in a tiny studio in Oakland I would often catch myself staring at its lines. But in some ways it is actually the bike saddle, which is a rich reddish-brown leather and has beautiful shape, that is the "thing" that really makes the bike. The color of the leather is nicely set off by the black frame and the silver metalwork. Importantly, the saddle is pretty, but it's also super comfortable. I can ride on it for miles and miles without pain. The only challenge is that during rainy weather I have to bring a plastic bag to cover it when I park anywhere. In case this is too bike geeky for everyone, my alternate undervalued item is a perfectly shaped metal spatula that I use every time I cook. It's some unusual thing that turned up in my grandmother's kitchen drawer decades and decades ago. No clue on manufacturer or age, but it's ideal for using with cast iron or stainless steel pots and pans, and I am afraid that if anything should ever happen to it, I would never find another one like it.

kiki047

@optimistgardener I love your story about your metal spatula - I have similar artefacts from my late Nana's kitchen that I'm scared to use for fear of wrecking it. Her wooden rolling pin is SO much better than anything else I've bought over the years but there's really nothing special about it. As for your FET protocol, that's not something I've done personally but doesn't seem entirely far-fetched. The lupron sounds like a downreg protocol that I've mostly seen used for women with endo - I remember you've had fibroids in the past but I don't recall any mention of endometriosis? 


Diagnosis (if you've been):  PCOS, RPL/RIF, MFI 

Status (WTO/TWW/TTA):  TWW 

What are you doing this cycle? (Testing? Treatment?):  Still in limbo, and while I did take the letrozole this cycle I was also careful not to pressure MH too much to the point where he couldn't perform so who knows what our timing was like. I wasn't temping so based on CM and CP alone (and other physical symptoms like sore boobs and acne) I'm expecting AF this week. I will only POAS if AF doesn't show before we leave for the cottage on Sunday. 

How are things going?: Good! We had the first of our two consults today and I really liked the Dr. He was direct and to the point, and immediately picked up on changes he would make based on past results.

I'll put this in a spoiler because it's long and rather specific. TLDR: He's positive he can diagnose/treat the root causes of our RIF/RPL, and recommended we get started right away to try to bank some good quality euploid embryos then we'll do the immune testing to tweak our FET protocol. 

First and foremost he was shocked that we retrieved so few eggs based on my higher AFC at baseline so he is definitely on board with pushing me more/changing my protocol, especially knowing that we have issues accessing the left ovary due to that pesky fibroid. He also wants to order a private karyotyping test for MH, just to rule out any genetic issues that could have caused such a high aneuploidy rate for our 2nd ER. He doesn't expect to find anything, and the test MH did when he was doing IVF with his ex wife was normal he said, but it's one more box to tick. 
Second, our results from our repeat DNA fragmentation test weren't sent over with our file, which makes me think my clinic never got them, even though I paid for the test. So we want to either track down the results or re-run the test. I had to pay OOP for it though so I'm kind of mad that I will probably have to pay another $300 to run it again with a new clinic. (and as a side note, as part of my deep dive on the research @keikilove was doing about "flushing out the pipes" so to speak with frequent ejaculation, a lot of the studies and stuff I've read have indicated that regular (i.e. daily) ejaculation can help with DNA fragmentation without sacrificing too much in count, but that's going to be a struggle to get MH on board with that just because he already has such bad performance anxiety when he's pressured to finish on command)
Third, we talked about the timing of starting a new retrieval cycle vs doing the testing first. He said there's two ways to look at it - we can do all the tests, and try to model the retrieval and subsequent transfer of any euploid embryos around the results. Or we do new baseline tests to fill in some gaps in the RPL testing I just did in April and jump right into IVF to bank as many euploid embryos as we can, then do the immune testing. He likened it to trying to predict the weather for a wedding 8 months out knowing the weather can and does change. He said any blood clotting, thyroid, etc factors likely won't change in that timeframe but your immune system changes all the time so why do the testing this far out not knowing if/when we might get enough embryos to transfer. I was fully on board with that plan. He said his failure rate for transfers of euploid embryos with his testing/treatment protocol is only 5%. I know he's a new clinic and all and I don't really buy into those kinds of statistics but he said all the right things and I'm inclined to believe that he would do the right thing. I also didn't have to ask about testing for things like NKCs and having them send the results to Dr KK's lab in Chicago because he said it right upfront that he runs tests that nobody else does in Canada *yet* and from what I've read in the Reproductive Immunology group that keikilove referred me to, I believe him. Everyone else seems to either just do the kitchen sink approach without doing the right kinds of testing, or the patients go stateside for RI testing and just have their local RE administer the protocol. 

I don't know what this means for timing yet but I'm hopeful we can get everything sorted for a September start. He seemed keen to get started. I'll keep my August appt as well but this Dr left a good impression and I was already leaning towards using him because of the RI angle. 

Any questions?:  My mind is still racing right now so can't think of anything specific. 

GTKY: Name a totally underrated item that you own and why you love it. 
A heated towel rack in our master bathroom. It's super bougie but it came with the house (along with heated floors) in the master bath, whereas all the other bathrooms in the house are original. It's such a simple thing but OMG there is just something about getting out of the shower to a warm towel. I like to think we save energy on heating in the winter because a warm towel/floors make up for the room being cold. I tell MH all the time that it's so extra, but I love it and I need it. 

optimistgardener

@kiki047 i do have "mild" endo. they found some when i had my myomectomy. apparently it had glued my ovary to the abdominal wall (which doesn't sound mild? but the surgeon did use the word mild, so 🤷‍♀️) and he cut things free while also dealing with the fibroids. The doc at my fertility clinic has never spoken with me about the endo diagnosis even though it's clear in my charts, but maybe that's what he has in mind. I'll ask next time I catch the nurse's ear there. Thanks for the super-plausible explanation!

Edit to say also I am so jazzed to hear that you had a positive appointment with the new clinic and that a plan is beginning to emerge!

inthewoods23

@optimistgardener your FET protocol sounds pretty much like what I did. My retrieval was in June. Then I was on BC for about 2 months to mid August. Started Lupron about a week before I finished the BC (mine stayed at 10U for FET). Baseline CD2-4 testing to confirm I could start the estradiol valerate 2 days later (those injections were twice a week). Continue that for another week or 2 until my last set of labs and ultrasound before transfer. 2 days after that is when I started the PIO every day and stopped taking the lupron. They also had me on Endometrin starting 4 days before transfer, plus Medrol and an antibiotic. My clinic also has you take this other progesterone suppository within 2 hours of your transfer time. After transfer I continued only with the PIO, Endometrin, and estradiol valerate. If I can get a screenshot of my calendar I'll put them in a spoiler but my laptop doesn't seem to like to copy things into Chrome when in incognito mode.

optimistgardener

@inthewoods23 our protocols sound very similar re: dosing and with the suppositories as well but minus the endometrin, medrol, and antibiotic. I'll ask about the antibiotic, though, since they made me do one when prepping for my first (canceled) retrieval. don't worry about the calendar screenshot unless it is easy. thanks!

daisy0322

@kiki047 heated towels are like a goal of mine lol I’ve always wanted to get one if those I’m glad you think it’s worth it! 

@optimistgardener I’m looking forward to your pgs results! Do they normally take this long? I have no idea. 

daisy0322

Sorry I was SUPER busy the last few weeks and I was really upset last week after I couldn’t get monitored. I’m hoping not to be a total flake this week

Diagnosis (if you've been):  
POI 

Status (WTO/TWW/TTA):  
TWW I think

What are you doing this cycle? (Testing? Treatment?):  
I did Letrozole 

How are things going?:  
I’m kind of just waiting it out- my doctors kind of oddly bailed. I don’t e en know if I ovulated. To answer everyone there’s no way for me to temp anymore with the HRT it mimics what I should be doing anyway. My CM makes me think I actually ovulated but I’m not sure if that’s the same boat as HRT and temp. 

Any questions?:  no I’m basically just waiting for AF or if Letrozole miraculously worked. Other than that we are still #7 on the adoption list for embryos 

GTKY: Name a totally underrated item that you own and why you love it.
hmmm this is so hard! I’m going to say keyless entry on my car. I never thought it would be a big deal but now that I e had it like 2 years it’s amazing and when I barrow hubby’s car his doesn’t have it and I have a first world problem temper tantrum lol his car is a 2019 and mine is a 2018 though so his is a little nicer one other ways.  

bows22

@optimistgardener is October the timeframe you wanted for the transfer for work purposes? If so that works out nicely that the prep for an October transfer starts tomorrow! 

@kiki047 your new doctor had me at “recommended we get started right away”! I’m so happy the consult went well and that you already have next steps planned 

@daisy0322 I don’t blame you for being upset. I just don’t get how everyone was so on board and giving you hope and then all of a sudden bailed. Are you supposed to call them if this cycle doesn’t work or what are the next steps? 

Diagnosis (if you've been): unexplained,AMA,endometrial polyps/thickening 

Status (WTO/TWW/TTA): wto but benched 

What are you doing this cycle? (Testing? Treatment?) need to have a full cycle off of bcp before doing an endometrial biopsy next cycle 

How are things going? Good. I was happy to see my withdrawal bleed show up yesterday. I feel like I’m doing a lot of mental math like “if it takes x days to get a bleed, and I ovulate normally/early/late, and my LP is 12 days like it used to be or 10 days like it has been recently, then my next period will show up on this day and my biopsy will be around this day” so it’s just nice to have hit the first milestone to get this cycle kicked off and add a little more certainty to the dates. Next step is to ovulate! I’m planning on doing BBT + OPKs just to be sure in case it’s delayed. So I think that will make me feel productive too. 

Any questions? Nope

GTKY: Name a totally underrated item that you own and why you love it. We have this dual reclining loveseat with cup holders + USB charging ports. I don’t understand why everyone doesn’t own one haha. It is the best feeling at the end of the day once all of the nighttime stuff is done to sit down and put my feet up with a drink and watch TV. We used to have an L shaped sectional and DH would lay on the side that he could put his feet straight out and I always had to be sideways to the TV. So the new couch has been a game changer for me! (I swear I’m not that lazy I just really really enjoy our nightly couch time haha). 

daisy0322

@bows22 I have 2 more round of Letrozole I could use. I talked to the one of the other docs and was professionally like WTH we had a deal. And he basically said he just didn’t think this is going to work after seeing my AMH but he will finish what he told me he’d do and give me the gandotropin shots in 3 months if I insisted. But honestly I was really miserable on the Letrozole and it’s probably not going to work. So I don’t know if I’ll try that again or not but I think for the most part it’s just time to move on to the embryo adoption list. We are #7 in line it’ll probably take 18ish months. We will hopefully be able to save for a lot if the fees by then and we can research and prepare. In the meantime o have a 5% chance of getting Pregnant my own. PS my parents have a couch like that and I love it too! They are so nice. They also have one that you can rearrange all the pieces and the automan a ton of different ways and I like that one too 

optimistgardener

@bows22 yeah the timing is pretty good! but the superstitious part of my brain that is suddenly asserting itself with a vengeance is having a bit of a freak out about taking steps forward on the path towards this plan before i know if the embryos are a go. if that makes any sense. like i'll jinx it by demonstrating any degree of belief in it.

@daisy0322 i'm so sorry. i wonder why the doc went ahead with the treatment before knowing your amh. if that number is make or break, then why leap ahead (and give you false hope) until he knows it's workable. you don't have to answer, but is your amh a measurable number? fx that your 5% chance pans out.

inthewoods23

@kiki047 your update makes me so happy! I think some of the places we stayed in Iceland had heated towel racks and ohh does that feel so good. I will have to see if we could add one when we do our bathroom remodel. Does that get hard wired in to the house or does it get plugged into an outlet?

@optimistgardener it's not hard at all to post it, the paste function just doesn't work. Ugh. Might just have to do a screenshot from my phone or something.

@daisy0322 have you been continuing to temp? Or did you stop since they were supposed to be monitoring you? I wonder too how OPKs look when using letrozole 🤔. So many questions so few answers

@bows22 oh I definitely would love a recliner in our living room! We have chairs/couches and some ottomans but it's not the same.

Diagnosis (if you've been): low morph, otherwise unexplained or something immune related

Status (WTO/TWW/TTA): WTO

What are you doing this cycle? (Testing? Treatment?): gf and df diet, covid vaccine at the end of the week, debating if I should get on a wait list for an RI

How are things going?: I'm having conflicting feelings with my upcoming vaccine appointment. I'm actually anxious with the delta variant going around so you'd think I'd be happy to start the vaccine process. At the same time,  maybe if I get sick with it I'll get KU that way too so maybe don't get the vaccine. Please knock some sense into me ha 😅

Any questions?: The first shot of the vaccine isn't bad right? Just a sore arm and such? It's the second one that sucks right?

GTKY: Name a totally underrated item that you own and why you love it. Adaptive cruise control in my car because I don't have to change the speed myself. That was hard to remember at times when I was driving my Equinox when I had the taste of it in the Tesla. The other thing is our subscription robotic lawn mower. And I'm not even the one that ever mowed the lawn! It saves DH so much time and keeps him out of the heat. Sure it's more expensive over time, but should someone try to steal it from our yard the company has it insured so we're not on the hook for replacing it nor do we need to do the maintenance on it.

kiki047

@optimistgardener ah yes, it's coming back to me now about the adhesion of your ovary to your abdominal wall. My goodness, when you talk about starting BCP today for an Oct transfer, that blew my mind because HOW is October only 3 cycles away?! 
@daisy0322 oh yes, the heated towel rack is most definitely worth it. I chuckled at the keyless entry thing because the same thing happens to me, MH's van isn't keyless and I'm forever forgetting that I have to dig the keys out of my purse to open the door/start the car. I set the alarm off all the time because I don't unlock it before trying to wrench the door open   Sorry if you answered this the last time I asked it but you mentioned before that you had a friend that offered you an embryo? Is that something you're still considering? 
@bows22 they already emailed us the requisition for the karyotyping (oof, it's $600 OOP) and the supplement he wants MH on (it's called ProFortil? Anyone heard of/used it?). It's stupendously expensive but given the ingredient list I suppose I'm already paying for some of those supplements on their own so this is just a one-stop-shop for antioxidant support. Yay for your bleed showing up as expected, and hopefully your cycle stays on track so you're ready to go for your biopsy/IUI! 
@inthewoods23 "maybe if I get sick with it I'll get KU that way too so maybe don't get the vaccine", as in maybe if you get Covid you don't need the vaccine? No no no no no friend, please just get the shot. This is not an either-or situation, the variant is no joke and while vaccines have known possible side-effects, they're short-lived - if you have any at all. My only real side effect was a sore arm and some fatigue. We don't know the long-term effects of Covid and catching it also doesn't offer you lasting immunity the way the vaccine does so it's still recommended you get vaccinated even if you've already had Covid. Other than your own anecdotal story about your last PG, this idea that triggering an immune response to somehow confuse your body into not attacking a potentially implanting embryo is highly, highly improbable and nearly impossible to replicate. Don't talk yourself out of getting vaccinated for your own health and safety, and that of the people around you, because you think catching the disease itself might make you just as receptive to a pregnancy. That's not how it works. 

optimistgardener

@inthewoods23 i'm gonna jump on the @kiki047 bandwagon here and say get that covid vaccine! the delta variant is scary. my first shot was a piece of cake, just a sore arm. the 2nd shot was like having a weird flu for 24 hours. i felt really sorry for myself at the time but it was nbd in retrospect. the other thing to consider here is that if you don't get vaccinated, and then wind up getting covid while you're pregnant, the risk of complications for you and for the baby are very serious. get that vaccine! (I am getting the 3rd MMR shot of my life today because for some reason I am apparently non-immune for Rubella, even though I got the shot as a baby and again in my 20s when I traveled to India for the first time. I wish there were some way I could transfer this vaccination to you for you to experiment with. All it's gonna do for me is ruin my arm for a day. And hopefully make me immune to Rubella, obvs.)

inthewoods23

@kiki047 Now that I reread what I said that is not at all what I intended 🤦‍♀️. My brain must still be tired this morning. I guess I am anxious about how I'm going to feel after getting it but like you said, the variant is no joke so why would I want to experience that over the lighter side effects of the vaccine (although I have heard some have gotten really sick from it). I'm around too many people who don't plan on getting it right now (sometime in the future when it's actually FDA approved.... I hope) and I'm feeling judged in my decision even though I haven't mentioned it to anyone but Dave and my supportive friend during this IF process (she's vaccinated). Maybe I feel judged because why did I wait so long to go through with it. And I think I'm mad at myself for banking so much on my past experience getting KU. Add other personal stuff on top of that too 😕

inthewoods23

@optimistgardener funny that you say that because had I not sought a 2nd opinion at another RE I wouldn't have known I wasn't immune to measles! Apparently that can wear off after some years. I definitely got it as a baby and I think again before college or something. And you're absolutely right, I can't risk getting covid while PG. Turned out fine for my sister when she caught it earlier this year (or late last year, can't remember) but she had a mild case and only lost taste and smell. Can't assume it will be mild for me.

Just to be clear in case people are worried, I have no plans to back out of my appointment on Friday. I'm moving forward regardless of my anxieties.

How well protected am I after 1 shot anyway? I'm reading the majority of hospitalized people are unvaccinated or partially vaccinated so I'd still have to be cautious for the next month

kiki047

@inthewoods23 sorry friend, I re-read that several times and in every interpretation that's how I understood what you were trying to say. I'm sorry you're feeling judged about choosing to get vaccinated. It is a deeply personal choice, but at the same time it's not really, I'd say it's a selfish choice not to get vaccinated. But I know that's a sensitive topic so I'll steer clear of the preachy part of that. I can certainly understand that your situation is complex, and don't blame you for being hesitant but also wanting so badly to find reason in all the unknowns. My concern was that it sounded like you were using that experience as a basis for making a potentially dangerous decision regarding your health, and I'm relieved you're saying that's not the case.
I know the potential for negative side-effects has been a major deterrent for a lot of people, but FWIW, that "robust immune response" is a desired effect in the sense that it means it's working... even if it does make you feel crappy for a day or two. I would take that over the fear/anxiety of possibly contracting Covid, especially if/when you do get KU. I have a friend who is an ER doc and he said he has a disproportionate # of pregnant patients in the ICU because the were too scared to get vaccinated before or during their pregnancies, and their bodies just have to fight that much harder. 
The first dose still offers a great deal of protection, but it takes a full 2 weeks for the immune response to kick in, and tbh I think most people assume they're like 100% ready to go the minute they get their first shot and let their guard down too soon. 

inthewoods23

@kiki047 no worries! Frankly any of your interpretations were probably correct based on what I wrote because I suck at writing my thoughts out so that's on me. I'm on my phone today instead of the computer so I don't really have the time to carefully craft my messages.

Did you ever get your second vaccine? I remember a while ago you said supply/roll out was going poorly so they were delaying people from getting the last shot.

kiki047

@inthewoods23 all good, glad we're on the same page. I'm relieved for you that you're going ahead with it, even more so if people around you are holding off. 
I did get my second dose, a full 2 months ahead of schedule too. Canada had some major supply chain issues so they were stretching out that 2nd dose as far as they could, in most cases 12 weeks, but as supply became more readily available and they opened up more mass clinics they relaxed the eligibility so I was able to move it up. I'm so relieved, otherwise I wouldn't have gotten my 2nd dose until mid-end of August. 

inthewoods23

@kiki047 good! I'm glad you got that well ahead of time. I remember all the news talking about how vaccines would be going to waste/expiring here in the US if the daily vaccination rate was going to continue dropping so much and the whole time I'm like heellllloooo somebody please consider sending our "surplus" to Canada and Europe instead of bitching about it in the news!! 

bumblebee0210

Hi! I have been on vacation and taking a break from screens and it has been glorious but I have been lurking a tad....

@optimistgardener the waiting is brutal, but with 4 embryos you have a good shot that that transfer is happening on schedule. 

@kiki047 It sounds like you have a really engaged doc which is amazing. Fx!

@bows22. OMG I am constantly doing elaborate period math.

@inthewoods23. Get that vax! The first shot is totally fine. 

@Daisy22. That is sort of crazy about your docs-- what is the harm in trying? Do you think they are worried about stats or something?

AFM:

Just stopped in to say that we got the results back on our one measly blast and it was normal!! I really did not have high hopes, but there you go! So I am psyched about that. And if anyone is curious, I have now had 5 embryos tested and (1) they were just about 50% (2 normal, 2 abnormal, 1 mosaic), and (2) the aneuploidy correlated very well with the embryo grades. I know that is not always the case, but my two aneuploids were 5BB-, and the euploids were 5AB and 5BA (I think the mosaic was also 5AB). 

Our next step I think is going to be an estrogen-primed duostim. 

optimistgardener

@bumblebee0210 OMG YAY!!! I've been quietly waiting and crossing my fingers hard for your update on that blast and am so happy it's a normie! Also v interesting about the euploidy/anuploidy correlation with grading. I've been doing reading on that and it does seem to be fairly well established that there is a relationship. Not enough of a relationship that I've allowed my embryos' decent grading to calm my nerves, but enough that I am not bereft of hope, haha.

kiki047

@bumblebee0210 Ahh that's wonderful news that this cycle wasn't a complete bust. Yay for euploid embies! Interesting stat about the grading - it's true that our grading for our 2nd ER was much lower than the 1st and that happened to be the one with all the aneuploid embryos but we've been told repeatedly that quality does not equal or predict PGT-A so not to get too hung up on it. I like that your clinic is so willing to switch up your protocols to keep trying different things for each cycle. I'm curious, how much of that is you pushing for it and how much of that is them being proactive?

@inthewoods23 right??? I wondered that about the US supply too. I know they gave us a bunch of AZ in the spring that was going to expire but that they also waited until the last possible second to do it. 

daisy0322

@kiki047 our friends did offer but we decided against it - I don’t think it would be a great situation. They desperately want another child but they can’t afford a surrogate again. 

@inthewoods23 i quit temping because the HRT will over ride it. My OPKS are always super positive now. At a party this weekend e dry or asked me if I was pregnant it was awful but if I didn’t know I’d wonder too the letrozole made me gain weight awkwardly in my stomach 

optimistgardener

@daisy0322 seriously wtf is wrong with people asking someone if she's pregnant. i'm so indignant on your behalf!

daisy0322

@optimistgardener yeeeah i mean like i see it but I wouldn’t ask. But dang if I didn’t get rocked be letrozole lol I always get every side effect from drugs 

acleverusername

@inthewoods23 may I commend you on your choice of this week's image for the thread? 

@optimistgardener hopefully you'll get some positive news re: your embryos soon. 🤞🏻 My jaw dropped that you'd be starting bcp tomorrow for an October transfer. So... are you starting BCP? Can you get off it in the (hopefully unlikely) case that you need to do another retrieval in November? Good on you for getting back into running already! You're a champ. I feel like the last 5% isn't back yet because you're using it for all the "cycle math" you're having to do!

@kiki047 good golly your updated made me so happy! I am loving this new doctor and his ideas and attitude! What do you need to get done between now and your Sep cycle start? I'm pretty jazzed though... sounds like even if the next consult is a bust, you're in great hands. And who knows, maybe you'll like the other doctor even more? Wouldn't that be a nice problem to have?

@daisy0322 No need to apologize for flaking, especially after the week you'd had. *hugs* Hey, so question... are you for sure done done with exploring treatment for yourself, and 100% committed to embryos donation (btw... good call on not taking your friend up on her offer given the context you described...)? Reason I'm asking is that – if you're still interested – I would 10000% recommend you reach out to TEW for a second opinion consult. I bet she would LOVE to take on a case like yours. But it's totally up to you if you just want to end that chapter and just move on with your plan B. 

@bows22 smart idea keeping busy with bbt and opk tracking. Hopefully this cycle flies by for you. As for "period math," yep... that is our life, isn't it? I had to explain my period math to my sister a few weeks ago (had to explain when I could potentially book my flight home) and yeah, I don't think I succeeded. 

@inthewoods23 I won't belabor the point others have already made. I am really sorry that you're having to defend your choice to get vaccinated though. It just sucks. And wrt to Canada vaccine supply issues... it's funny how 2 months ago, there was no supply there and they were booking 2nd appointments 12 weeks out, and now almost 80% of all Canadians have had 1st dose, and 50+% are fully vaccinated. Compare that to stateside... Anyways, I have opinions on that. Have you and YH discussed when you'd consider another FET? Do you think you'll want to consult with an RI first? 

@bumblebee0210 Hooray for your euploid embryo! Thanks for sharing your own research on correlation of grading and euploidy. Interesting. I have definitely heard many times on TEW show that grades and euploidy do not correlate. However, this article also suggests otherwise! 

Allow me to go on a tangent here for a sec: speaking of PGS testing, TEW had Dr. Lucky Sekhon of RMA NYC on this weekend talking about genetic testing. I even asked a question that was answered!

Oh, I guess I'm done all my tags! 

Diagnosis (if you've been):  Hashimoto's, AMA, MFI

Status (WTO/TWW/TTA):  TWW technically

What are you doing this cycle? (Testing? Treatment?): attempt #2 at ER #1

How are things going?:  Hiiiiiii. Okay, now that I got that out of my system, I can say that things are just OK. I had my 2nd ultrasound yesterday morning, and things weren't quite as rosy as on Friday. 💩Stats and discussion in spoiler: 

My E2 was 262; on Friday it had been 148.
Follicle sizes
Left: 13.1, 10.3, 4.3, 4.3
Right: 11.3, 10.9, 8.9, 9.7, 8.5

The doctor said that those 4.3mm ones aren't really contenders, so we're looking at 6 maybe 7 mature follicles by ER time. So yeah 🤷‍♀️I'm going to go through with this cycle even though I'm disappointed because I want to learn about our fertilization and blastulation rates. But I will be looking to have a convo with the doctor afterwards about what we can do to make my ovaries more receptive to medication so that more of them respond. 

Interestingly, I've been looking at research, and found this interesting meta analysis of protocols and patient types. It appears that a protocol using a glucocosticosteroid (i.e. dexamethasone) might be something worth trying given that I have thyroid autoimmunity. Oh, and the testing I did for functional medicine doctor is indicating I have some kind of issue with my adrenal glands. I have a follow up with her on Thursday, so I will see about getting tested for Addison's disease. 

As you might have guessed it, I also emailed TEW to ask for her advice on what to do next. I am considering getting a consult with another RE in the area who actually specializes in immune issues. We shall see... for now I'm just going to focus on getting through this ER and then regroup. 

Any questions?: Is it normal that I started my antagonist so soon into my cycle (started on Sunday)? Given that my E2 is only 262, after 2 days of antagonist injections. 

GTKY: Name a totally underrated item that you own and why you love it. I honestly can't think of anything right now. I'm overanalyzing what is meant by "totally underrated." 

acleverusername

Also, @kiki047 YGPM!

daisy0322

@acleverusername i May do the letrozole one more time mainly for my husband to get closure but I think I’m just done honestly. I like the idea of embryo adoption I get to do all the parts I want but my addiction prone, crap fertility, fragile x carrier,  dyslexic genetics won’t get passed down lol I have a lot of peace with it I think. I’m sorry to hear your hitting some road blocks I’m not as good at understanding the numbers as others here but I definitely know the roller coaster ❤️ Hopefully TEW can have some Insight 

optimistgardener

@acleverusername my jaw dropped too! part of it is just that i refuse to believe that October is really that close, but the other part of it is that October is really not all that close. It's just a really involved transfer protocol. Hopefully the clinic does it that way because they like the results! I'm kind of anxious about all that lupron, both because what if i need to be able to wake my ovary back up again afterwards 😴, but also mainly because the prospect of lecturing while suffering through what i presume will be some hellacious hot flashes sounds unappealing. I am sure I can get off the bc if it turns out I won't be doing a transfer in Oct. I lol'ed about the cycle math! (@bows22 and @bumblebee0210 too). I feel like my last three years have just been one endless game of "ok so if I bleed in three days then maybe i'll O on [grabs calendar, starts counting], and then that would mean..." I'm always coming up with elaborate excuses for why i need my calendar to be mysteriously completely open and flexible exactly 12 days in the future.

As for your update and your question about cetrotide, firstly... I know it's disappointing that you're having an issue with non-recruitment of follicles, and you wish you could get more to join, but for those that have joined, they're making headway and hopefully you'll get a good crop from them! re: cetrotide, i will admit i was a little surprised that your doc started you on it so early. I can only pass along what my clinic did, but this was how it went down at my clinic: i know my doc probably started me on it a little later than he would have preferred... he was definitely surprised to find my lead already at 16 on the day he had hoped to see follicles in the 10-13 range. if he had found them in the 10-13 range, he would have started me on cetrotide 2 days later (right around the time the largest "would have" hit 16ish). Instead he put me on cetrotide the same day. I've read that most clinics put women on cetrotide after they've done 5-6 days of stims, which when i do  the math i was right in the ballpark on that. What day did you go on? I'm sure your doctor has a theory for their early application of cetrotide and i'd be curious to hear what it is!

Edit to note that my E2 was 470ish when i went on cetrotride.

optimistgardener

also @kiki047 re: PGT-A testing, my impression is that even though a relationship exists, it is not remotely close to a 1=1 type relationship, so there remain lots of morphologically beautiful embryos that turn out to be aneuploid and lots of so-so embryos that turn out to be euploid. apart from the article Clever posted, here's another with similar results. But it is my impression that there is not a huge amount of difference in euploidy rates between "good" vs "average" embryo grades, and any sort of embryo with fair grading on up has a solid chance of being euploid, so like your clinic said, it's not something that merits a lot of extra thought (as i've unfortunately allowed myself to do here, obviously). It's more when you start getting into the "excellent" vs "poor" range that things begin to look dramatic, but then we already knew that "poor" grade embryos have less impressive implantation rates than the pretty ones. @acleverusername i'll listen to your egg whisperer discussion later today sometime.

zwink1

@acleverusername, I'm sorry to hear that Mon's tracking wasn't as inspiring as Fri's results.  It's so rough when you're trying to find answers to questions and solutions when there are still so many knowledge holes in this whole process.  My R ovary looked great on scans during my retrieval, and because my L ovary got trapped behind my uterus and wasn't performing as well, all signs pointed to the R being the "good side."  On retrieval day, every follicle but one in my R ovary was empty. Lefty ended up having more mature follicles than anticipated, so things worked out okay, but I still haven't found any good answer as to what happened with my R ovary and how all of the signs could've been so wrong during tracking.  

@optimistgardener - FX for good test results on your embies (and that, by extension, you have been able to start transfer prep)!!  I'd have to dig out my flow sheet to confirm, but your prep sounds similar to what I did last time.  I don't recall having started BC quite so early, but there's a solid chance I'm remembering the timeline wrong.  

@kiki047, I'm so happy to hear that your first consult went well!  The RE sounds like he has some good ideas for how to move forward.  

@inthewoods23, honestly, I don't think I really had any side effects to either dose of the vaccine beyond a sore arm.  I may have been vaguely fatigued by the second dose, but it's hard for me to say whether that was caused by the vaccine or just life in general.  Ignoring those loud voices in the background can be rough, but if you know you're making the right choice for you stick with it and do your best to block them out.  (Or tell them to f off if you want too, always an option too, lol)

@bumblebee0210 - excellent news that your blast is normal!!!!

Diagnosis (if you've been):  primarily MFI (OAT).  

Status (WTO/TWW/TTA):  currently WTO, but really waiting for my consult

What are you doing this cycle? (Testing? Treatment?):  Gathering info/supplies to prep for my consult that is now less than a month away!

How are things going?:  not bad.  I finally tracked down my old RE's (virtually all paper) records and am working on getting the necessary info transferred, so that's good.  I was also able to talk to a nurse at the new RE's office for a while earlier this week and it doesn't sound like we're going to run into much trouble on that end just moving to a FET (after running new blood work of course).  Obviously she's not the RE so I'm taking that with a grain of salt, but it was a little reassuring.  

Any questions?:  not really 

GTKY: Name a totally underrated item that you own and why you love it.
Ill stick with the car theme and say my heated seats.  I didn't even want them at first because I didn't think they made a difference or were necessary.  What an idiot I was.  Now I don't think I could buy a car without them.  Game changer in the dead of winter.  

inthewoods23

@bumblebee0210 hurray for a normal blast! How many more cycles are you doing?

@kiki047 ugh it was so ridiculous! Didn't the US also do a shit job helping out India when they had major outbreaks earlier this year? 🤦‍♀️

@daisy0322 aw man you can't catch a break! That sucks that the HRT makes temping and OPKs pointless.

@acleverusername I definitely want to see an RI first before doing another FET. I just feel so lost on moving forward with it. Gotta figure out who will work best for us and if anyone is actually in network. Do I need to go through the BS of confirming my insurance covers the test? All that nonsense. If it helps with the GTKY, is there anything simple/small that is a big deal for you that makes your life easier?

@zwink1 oh yes heated seats! That was an absolute must when I bought my first new car a few years ago. Remote start is also fantastic to help warm up the cabin. Hope time goes fast until your consult!

optimistgardener

@zwink1 heated seats makes me think of when my grandmother was still alive and my mom gave her a ride one winter day. she switched my gran's seat warmer on without warning her in advance. a few minutes later as its effects became apparent, my grandmother yelped in surprise and started feeling around her seat. after confirming that she had not, in fact, peed herself, she began interrogating my mother about this newfangled luxury. a few minutes later, she had basically melted into her seat, sighing occasionally in bliss.

inthewoods23

@optimistgardener my grandma had the same thoughts about heated seats too!! 😂

acleverusername

You know what really sucks? Bloating / pain from your stims, on top of your period pain. Blergh! Also, I'm having diarrhea all day for some reason. Normally I have bowel issues when AF comes around, but I think it's made worse by the fact that I've been taking Miralax for the past few days to get ahead of "blockage" I might get. 

Anyway, sorry for the TMI... had to get it off my chest. 

@optimistgardener thanks for sharing your experience with Cetrotide and E2. I think my case is complicated (in terms of comparing to others') because I started mid-luteal phase, so any natural E2 rise isn't factored into my numbers (i.e. the natural E2 rise that happens in early follicular phase). Tomorrow, when I go for my monitoring, I'll need to ask if the E2 curve for mid-luteal starts is the same as for CD 2-3 starts. I suspect that not. As for not many follicles responding, I just keep telling myself that it's quality over quantity. I will wait and see what we end up with at ER, fert and blast rates. But I'm already preparing myself for 0 genetically normal embryos. And if that happens, I'll be looking to switch doctors. 🤷‍♀️Good luck with BCP! In terms of Lupron, here's a vid from TEW on how to survive Depo Lupron. 

@zwink1 thanks for sharing your ER experience. Did you end up doing multiple ERs? Glad that you were able to track down all the paperwork from the old clinic, and that the initial info from nurse was promising. 

@inthewoods23 Just keeping putting one foot in front of the other vis-a-vis RI. Maybe @keikilove can share the RI Facebook page she's refered Kiki to? 

@daisy0322 the embryo adoption makes a lot of sense for you. 

Quick update: my email to TEW yielded a puzzling/not reassuring response: "Question: why are we lowering your doses?" 

inthewoods23

@acleverusername don't worry I'm already in that group! Just lurking and learning right now. Hope you start feeling better soon! Are you sure it wasn't something you ate?

daisy0322

@acleverusername TEW did ask a good question- are you going to bring that to your RE?

@zwink1 I’ve not had heated seats but my moms car has seat coolers and it’s amazing!

mokay19

Diagnosis (if you've been):  PCOS

Status (WTO/TWW/TTA):  WFAF

What are you doing this cycle? (Testing? Treatment?):  Letrozole/Clomid combo, trigger, TI, progesterone 

How are things going?:  I had my post op follow up today. Total waste of 10 minutes. Literally she just said the results were benign (I knew that) and that we’re doing the protocol that we already discussed. I stopped the BC and will start next cycle when I bleed!

Any questions?: What are some lifestyle things and foods to thicken my lining? Every time I’ve taken Clomid it’s been on the thin side. Never thin enough to need estrogen, but I’d like to try to plump it up!

GTKY: Name a totally underrated item that you own and why you love it.
Specialty ice cube trays for cocktails. Having large ice cubes for nicer drinks is very nice so it doesn’t water down the beverage!

acleverusername

@daisy0322 I'm not going to raise it to my RE because I know what his answer is going to be (he's repeated it often enough). This clinic's policy is to taper medications starting mid cycle to get more even growth of follicles. Every doctor does it differently, but you're right, TEW did raise an important question. Tomorrow will be a telling appointment. Today MH and I discussed potentially cancelling again. We shall see... 

@mokay19 Argh, sorry gurl... that is SO frustrating. Hopefully you'll get your bleed soon so this show can get on the road. IN terms of foods/lifestyle things, are you open to supplements? I believe @kiki047 had some great success with thickening up her lining with NAC and likely a bunch of other stuff. She can give you the deets.

optimistgardener

@acleverusername hahahaaha  eep that depo lupron survival guide is terrifying!