IF Testing and Treatment w/o 10/11

shortstack930

@optimistgardener @kiki047 thank you for the tips!! Super grateful!!!

acleverusername

@kiki047 ask if you can do Cetrotide in the morning. I’ve done that one in the mornings for both of my retrievals thus far.

optimistgardener

I've been haunting pubmed again. I'm dropping this article here in case anyone else wants to have a look. Long story short, the study suggests euploidy rates are not affected by gonadotropin dosing, length of stimulation, # of oocytes retrieved, oocyte size (<20mm vs >20mm), etc. This study contradicts  earlier studies suggesting dosage can make a difference, as well as what is to my mind the conventional wisdom out on the internet re: "overcooked" eggs or the possible benefits of a mini-IVF or mild stimulation. I'm not saying I agree or disagree, but I find it mildly reassuring in the face of a present train of thought I've been dealing with over here re: whether the standard issue short antagonist protocol with high dosing that my RE has me doing could be related to my bad embryos last round.

kiki047

@optimistgardener that's how my old clinic was too, spaced out throughout the day and I liked it that way. This clinic only dispenses the drugs as needed so like, I only have a single day's worth of cetrotide right now. What if I f*** it up? lol it hasn't happened yet but it might. They gave me the option of swapping out the needle that came with the kit and use one of the extras I have from my menopur. I think I will do that since you're the second person to mention the blunt needle. Barf! Thank you for the heads up. 
Just seeing your second post now re: the pubmed article. That's an interesting theory. I am also in a similar boat in that we also had terrible PGT results, despite having great fert and blast rates. Doesn't make me feel great about aging, but that is also why we're planning on banking embryos now for full-family planning (goal of 8-10 euploid which "should" equate to 1-3 THBs). 
@acleverusername I want to do cetrotide in the morning but I only have enough for the first day and I won't get my second dose until after monitoring on Sunday, so realistically that will be around 10am. I've been gradually pushing my Gonal-F forward by a half hour each day and menopur back by a half hour so they're spaced out by an hour and a half or so now. I much preferred doing lupron at 7am, G-F at 1pm and Menopur at 7pm. I still have my alarms set that way. 

bumblebee0210

@optimistgardener. Thanks for sharing that study. FWIW, it completely aligns with what the genetic counselor told me from Cooper Genomics-- that basicaly they have never really found anything that correlates with euploidy other than age. She also said it's not always super consistent within women (good news for you and @kiki047). When we were on the phone she said she had just had a woman who had tested 5 blasts, all abnormal, and then sent 7 more in and 5 were normal. And for me it has been pretty true- they told me 50% normal at my age, and of 10 blasts, we've had 4 normal, 4 abnormal, and 2 mosaic. 

@kiki047 (a) that is *super* annoying about your clinic doling out one shot at a time. I'm glad you're in the banking mindset, and just know I am here for you through the slog. It's so long and arduous, especially if you may want more than the standard 2 kids (I don't even know that we do for sure, I just want options). If I can give you any advice, I would just make sure your clinic is 100% on board, and you do all you can to do back-to-back retrievals (subject to your own health/sanity)


AFM: Not great news, I'm afraid (stas below in spoiler), but I'm not too down because we are moving on to trannsfer! I am expecting AF early next week and then we will get the show on the road. The plan is for a lining check around day 10, and a transfer ~6 days later. It's kind fo surreal to be so close!

Out of our 4 fertilized eggs, there was one biopsy-able blast, a day-6 4BB. The embryologist told me it didn't look great-- apparently it had a thick trophoblast, which I think he said he tried to poke through to like help it along a bit (I guess this is probably similar to assisted hatching?). Anyway, they biopsied it and sent it off but I am not like, holding my breath on that one. 

inthewoods23

@bumblebee0210 aw man that sucks. Does that kinda mean it was barely a grade 4 if the trophoblast was still thick?


Afm, had my saline sono this morning. As far as I could tell looking at the monitor and thinking about how it looked during my 2 abnormal saline sonos from years ago, I think it looked clean! I sure hope that's what they say because I'd much rather not go through another hysteroscopy/polypectomy surgery. Rewarded myself with another frappuccino on the way home lol.

optimistgardener

@bumblebee0210 argh about that one lonely day 6 blast with the thick skin. i've got my fingers crossed for it but am so jazzed that you're headed into transfer land now! yay!

@kiki047 what the heck about your clinic doling out shots like that. do they like, not trust their clients to not inject everything all at once or something? really weird.

@inthewoods23 just saw your post as i think we were posting at the same time. I hope the saline sonogram results are clean!! it's so funny how we develop weird skills through this, like self-interpreting U/S imaging.

AFM I'm still waiting on what I presume will be depressing AMH results, but my FSH # came back from bloodwork and it is WAY lower than the last time I tested nearly a year ago. Last year's test had my FSH at a concerning 13.2. This year I am testing at a relatively normal 8.9. I've hunted around and it seems that both DHEA and CoQ12 are thought to drive FSH numbers down, but I've also seen like, general chatter I guess, that FSH just moves around a lot and it's the highest number you've tested at that should stick. I am gonna aim for optimism here that this much better FSH number may bode well for me this time around. I'm also, uh, thinking of doing a last-minute last-cycle-before-retrieval#2 donor insemination effort. it will no doubt come to nothing but, well, I guess I can't help myself.

hanshotfirst77

@bumblebee0210 that sucks about the less than great blast results but so happy you’re so close to transfer time!

@inthewoods23 fx for a clean saline Sono!

@optimistgardener fx for your attempt! When is your next ER supposed to be? Hopefully you don’t need it. 

kiki047

@bumblebee0210 that's a bummer after the windfall eggs you got this cycle. I'm glad you're at peace with moving on with what you have banked so far. You have been an absolute champion through this whole process and I have so much respect and admiration for you. I am SO freaking excited that you get to move on to transfer those embies!! As for my banking cycles, he's totally on board with banking and in fact they have a 3-for-2 policy where I pay for 2 cycles and get 3, or pay for 3 and get 5, and so on and so forth. The plan is to do 3, now whether they're back to back I don't know but that's what I'm hoping. 
@inthewoods23 FX the sono was as clear as it looked!! 
@optimistgardener I think it's a little extreme too, like I barely have enough Gonal-F to get me through tomorrow. It'll be down to the last drop, literally. I've been googling how to get the overfill out of the pen just in case. I think it has to do with wastage because they only had me put down a deposit for the meds and then I settle the balance at the end. This way I don't get any extra. But like, at least give me one or two extra days' worth, ya know? I'll request it next time. This part stresses me out. I say go for your donor insemination attempt if you think you can swing it. It's totally worth a shot. 

optimistgardener

@hanshotfirst77 my stims are supposed to start in late november. I'm in my last unmedicated cycle and then next cd1 I put in a nuvaring for the downregulation process.

inthewoods23

Update! Report came in.

Normal uterine cavity, no cysts, or masses! Woohoo!

One interesting fact I learned is that I have a retroverted uterus. This was never noted on any ultrasound I had with the RE! What the heck? The good news is that it doesn't seem to affect anything in terms of fertility or pregnancy from what I've read. Thoughts/comments on that welcome.

hanshotfirst77

@optimistgardener ok thanks I think I remember you saying that but I wasn’t sure. Makes total sense to me to try in this last cycle. 

@inthewoods23 yay. For good results! And I have a retroverted uterus as well. Odd they never caught that before. But I wouldn’t worry, I believe what you’ve found is correct that it won’t affect anything. 

acleverusername

@optimistgardener great article. Thanks for being a PubMed sleuth. I can learn a thing or 2 from you. Hehe. I would say go forth and self-inseminate. It can't hurt (except for the bottom line). 

@inthewoods23 I hope your self-interpretation of the saline sono was correct. Does it take long for you to get results back? 

@bumblebee0210 I know you weren't expecting much from this cycle, but I know that even if you're in that mind-frame, you're still hoping deep down that it'll turn out unexpectedly great. However, I am SOOOOO excited that you're moving on to transfer. Just tickled pink really. 

@kiki047 bummer about the lack of Cetrotide. I do think the rationing is a little extreme, but I guess the bottom line is that you pay less for meds. They can't take medications back, right, so if they give you an extra Gonal-F pen, you're paying for it and if you don't use it, you're stuck with it. Did you figure out how to get the overfill? In the gonal-f video that my clinic makes us watch, they told me that only the 300IU pen has overfill. Has anyone found differently? 

AFM, I'm SO MAD. I submitted the invoice for my oocyte transfer to my insurance company, and they came back and told me that only "standard" transfer is covered and so the expense is ineligible. WTF?!??!?!?!?!!??!?!?!?!?!?! I had called them about it 2 or 3 times, each time asking what will be covered. No one ever mentioned that there was "standard" or any other type of transfer. I replied to the email saying that "I've been misled and reimburse please at least the cost of a standard transfer." THOSE F******ERS! 

On top of that, I got rear-ended last night on my way home from work (actually went to the office yesterday; need to start getting back into that habit). And it was the stupidest situation: we were both stopped at a red light and then the person behind me took his eyes off the road and foot of the brake pedal, and his car rode into mine. I was in my small convertible and he in a heavy Volvo station wagon. So, because I pretty quickly developed headache, neck/back pain so DH insisted I go to emerg to rule out a concussion. 

Honestly, my week went from good to shit pretty quickly. 

inthewoods23

@hanshotfirst77 I even went back to my first baseline ultrasound thinking they would maybe mention that there and wouldn't have a need to note it again so it's not noted on the saline sonos. Nope, wasn't there either. I wonder where the whole "a tilted uterus makes it difficult to get pregnant" even came from. I vividly remember being on the bus in high school on the way to a swim conference and one of the girls mentioned finding out she had a tilted uterus and how it would be difficult to get pregnant. Old school thinking back then??

@acleverusername I did update above. Everything does in fact look normal! I think they will still call to discuss the results by Monday. I think we can all agree that insurance is the worst!!! It's like the time I finally followed up with the financial coordinator at my RE's office because my account said something like $8k was still pending and wasn't part of my bills. Apparently my insurance didn't like whatever code they used for the egg retrieval but like... what other code could there be besides infertility/IVF??? What garbage. I'm sorry your week has gone shitty! Did you end up going to the ER to check for a concussion?

acleverusername

@inthewoods23 somehow missed the update! Wooo. I'm glad to hear that your ute is in the clear. Now if only to get those blood tests done!

And yes, I did go to the ER. No concussion and no broken bones. Just soft tissue injuries which I'm sure I'll need to go to chiropractic/osteopathy for. Grrrrrrrr. 

hanshotfirst77

@inthewoods23 yeah idk it’s crazy where these things come from. I remember being scared when I found out about mine that it would cause me issues. Later I found out my sister and mom both have them too. So idk maybe hereditary?

optimistgardener

@acleverusername oh cripes I'm so sorry. what a sh**ty day/week. I hope your physical injuries from the accident prove fleeting (but also WTF with the guy behind you just rolling into you? Dude pay attention! you're piloting a potentially lethal weapon!). As for the insurance, it seems like a common complaint around here these days. As if we didn't all have enough to deal with already without insurance companies dropping the ball on communicating basic, crucial-to-our-lives information in a timely fashion.

Update: you guys! It isn't just my FSH levels looking rosier, but my AMH levels have also improved (ok not by a lot but still) since last year! Last November my AMH level tested at .30. Today it is .51, which is ballpark what I tested at back in early 2019 the first time I did fertility bloodwork as a dewy and youthful 36-year-old (.54). @bumblebee0210 your miraculous AMH recovery is of course waaaay more impressive than mine but if lab #s alone are any kind of meaningful measure, we're getting something right around these parts.

edited because it turns out i misread my AMH results last year... they were even worse than I thought (.30 not .36, as I had remembered them).

acleverusername

Update:


...is here!

Also, TEW shows are BACK! Currently making butternut squash soup, drinking a glass of wine, and listening to her. So I wanted to share what she calls "SMBC": Independent Mother by Choice. I LOVE that. I hope @hanshotfirst77 & @optimistgardener you will too. 

optimistgardener

@acleverusername i like that! it's only a one-word difference but i think it is an important difference. "independent" feels a lot more positive and also a lot more like what i think i'm trying to undertake here than "single."

acleverusername

@optimistgardener actually, I didn't quite transmit the information correctly. She just calls them "independent mothers", no "by choice". That's even more powerful, imho. Can you please start a movement so that we do away from SMBC? 

hanshotfirst77

@acleverusername I like that as well. All of the groups I am a part of use the SMBC title and I’d so much rather independent. Feels much more empowering imo. 

bumblebee0210

also FWIW, I think "SMBC" kind of stigmatizes other SMs, like "oh no I'm not divorced, or accidentally knocked up, heaven forbid".  I mean I know in TTGP, the "BC" is sort of obvious, but later on I do think it matters. 

optimistgardener

@acleverusername oh definitely even better! as to what @bumblebee0210 says i've actually thought a lot about what that will/would be like if i do manage to get pregnant and bring a child into the world. like the endless awkward beating about the bush type Qs that are really aimed at "so who's the dad then?" and i've always felt my reaction would be to walk into those interactions with full frankness and no shame. but you're right that there is an implied judgement for some folks in the term "single mom." so i've also thought about whether people would respond differently to my story of intentional pregnancy "oh I spent lots of money tears and blood to make this happen" vs. the alternative one "one night stand gone horribly right/dude skipped town but i decided to keep the result." i do think there is a possibility that for some people my blood sweat and tears narrative would somehow validate the result in a way that the woops! narrative would not (which is ridiculous because my god what I wouldn't give to have all my ttc problems solved by one boozy night with a cute stranger I picked up at the bar). But i think my conclusion is that the kind of people who might be judgy about a one-night-stand baby would probably also be judgy about my decision to raise a kid on my own no matter what, so i'll never win with them and that's their loss.

kiki047

@acleverusername I'm playing catch-up from last week but grrrrr about your insurance woes, what a load of BS. And also, great big wtf to the guy that rear-ended you! Hope you're feeling ok this week and aren't too stiff. 
But helllooo Sergio! Woo hoo! 

hanshotfirst77

@optimistgardener @bumblebee0210 I’m going to say yes I think there would be judgment from some narrow minded people either way. I know I have experienced sort of both sides of it. Not so much the one night thing but from divorce. I think changing the words helps limit the stigma. But it will still probably be felt in some instances unfortunately. I’ve found if you don’t fit into this box of what is considered normal there will always be people who judge. And tbh I don’t think I fit into any of the boxes or titles 🤷🏻‍♀️

keikilove

Posted in wrong week.