IF Weekly Testing & Treatment w/o 2/7

keikilove · February 2022

@cleverusername I haven’t been stationary yet. Will update in about an hour, I promise? (I’m scrolling through here while running food errands that MH didn’t do while I was gone for transfer.😄 There's nothing in the house to eat!)

shortstack930 · February 2022

@anniemarie887 @acleverusername @optimistgardener @keikilove thank you all for the well wishes!! The transfer went super smoothly, even better than the last one did. My RE was the one doing the transfer herself and this was the first time she was able to do it (two of her colleagues did my previous transfers) so I'm hoping that bodes well. We transferred a sweet little already hatching embryo!

keikilove · February 2022

Posting my updated and then tagging after. Sorry to do it in this order, but I can't seem to get anything done so I want to at least post the transfer update.

I arrived at my clinic for transfer at 9 am. Since I monitor out of state, my RE wanted to check my lining first, then do bloodwork to make sure it was really a good environment for transfer. The clinic was extremely busy because it had been a holiday the day before and everyone who would've been seen on Monday was there on Tuesday instead. Just to get these two monitoring steps done with my RE took two hours. Then she told me everything looked great and that we'd transfer in about 1-2 hours, so around 12-1 pm. I sat in the waiting room until 2 pm. Between 2 and 3 pm I began to worry that my embryo maybe hadn't survived the thaw. I texted MH that I was getting worried that it was all for nothing. He said he was sure everything was fine and that they probably delayed the thaw since they were so busy, and that I'd get called back within the next 10 minutes. Lo and behold, they called my name just after 3 pm. The transfer went smoothly, *except* that when the embryologist took the catheter back to double-check that the embryo had made it into my uterus, it had not. It had gotten sucked back into the catheter. Transfer attempt #2 worked perfectly. As I laid on the table to relax, the doctors and all staff went out to another 'appointment'. It was the embryologist's birthday and they were having a party for her in the conference room. The whole staff sang her a bunch of songs and were laughing and having a great time. I could hear it all; it was actually a really nice way to rest after the transfer. I was the last patient in the clinic when I left. I got back to my hotel at 5 or 6 pm and rested. Then a headache started and I had to drag myself to get some dinner. The grilled salmon and spinach tasted funny; I wondered if I was getting sick.

I went to bed with a really bad headache that got much worse overnight. I woke up in the morning yesterday with a migraine and a low fever. I had major nausea whenever I walked around the room and began throwing up non-stop. When I finally caught my breath I called MH and told him what was happening. I started crying (which I rarely do). I told him I thought it was all over because I'd been vomiting so violently that there was no way the embryo could've survived all those muscle contractions. Again, he reassured me and told me to rest. He told me to skip my flight home that afternoon and just try to get better. I stayed in bed the entire day yesterday, sick as a dog. In the afternoon I finally called the airline to explain that I needed to reschedule my flight for the next day. I was so out of it that when they asked me what was the reason for rescheduling, I told them the truth. They said those were COVID symptoms and there was no way they could let me fly for 3 days minimum. Even through I argued that I was having a reaction to medical treatment, they wouldn't budge, of course. I went back to sleep and when I finally woke up just before sunset I was feeling somewhat better. I bought a new ticket on a different airline and flew home today, a day delayed. It turns out that my illness was a delayed reaction to my IVIg infusion--a full 5 days after infusion. This happens to me sometimes, either 3, 4, or 5 days after the infusion, always with these same symptoms. It sucks and I never know when it's going to happen. The only good thing is that it only lasts for a day and then I'm better. It was freaking terrible timing this time.

So, that's how the transfer went. And today when I flew home, I immediately got bloodwork done when I landed because I didn't have enough meds with me for the extra day I was there and I was concerned about my levels. Sure enough, my progesterone and estradiol that had been great on transfer day both plummeted since then. So now I've spent the evening trying to do "rescue dosing" to get my levels back up to where they should be. Needless to say, with all that happened after the transfer, I don't have very high hopes for this TWW.

optimistgardener · February 2022

sending a big hug, @keikilove

acleverusername · February 2022

@keikilove sending you hugs girl. I know it sounds like a lost cause, but I've heard of worse. I.e. the host of hilariously_infertile was telling about her second transfer and both she and the entire family got a violent stomach flu right after transfer and she was afraid she's shit the embryo out. I know this is probably not helpful, but try and keep some hope alive. And if you can't, I'll do it for you!

kiki047 · February 2022

@shortstack930 glad everything went well for your transfer!

Hope that little embie is snuggling in there. It is nice when your own RE is able to do the transfer, isn't it? Of my 5 transfers, only once has my own RE been able to do it and it just hits differently. FX this is the one!

@keikilove ohh my goodness, what an ordeal you've been through! Hugs friend, I'm glad you made it home safely and are feeling better. I'm keeping all that positive energy flowing for your resilient little embie. I hope s/he is a fighter like their mama!

keikilove · February 2022

@shortstack930 Hooray that your embryo was already hatching when you transferred! How wonderful that your RE was the one to do your procedure this time. I'm also hoping along with you that it is a good omen.

@acleverusernam I'm sorry you've experienced your first "lapping". It is not a fun one. There have been so many familiar names back here in TTGP the last few months that it's been kind of depressing for me personally. Of course, always happy for them, sad for me. And for you.

@mambo5-2 Welcome to our cozy little corner of the internet! I am sorry for your many losses. That is definitely way too many to not have been addressed. I saw your details in the Intro thread too. **TW: Mention of LC**

I am going to ask in the Intro thread as a more appropriate place to discuss, but I wonder if your micro-preemie's early birth has any relationship to what goes in in your body to cause your losses?

**End TW**
On another note, please do tell about this Pink Champagne cake! I've never heard of it but it sounds divine.

@walkawaynee Glad to hear that the new clinic is such a breath fo fresh air. 45 minutes to go over all the details--amazing! I hope it all leads to good things.

@kiki047 I actually started responding to your question at the start of the week but just never got it posted. Your thinking about delaying transfer until your normal ovulation window makes logical sense to me, even though technically a medicated transfer can happen at anytime. Your reasoning makes sense; by chance I just saw someone else post the very same question online today, and for the exact same reason about being a slightly delayed ovulator. So your instincts are right on. Also, it does sound like a very long day of prep you have coming up. If I were in your shoes I'd also want my first lining check to happen a bit sooner, so that you could do at least 2 PRPs if necessary to build that lining, etc.
And yes, you did read it correctly that my RE said no intense exercise like running because it diverts blood away from the uterus to the muscles that are doing the hard work. It sounds like the group already came to a consensus on this and the heart rate as a guide to which exercises mare ok.

Running is out for me because my heart rate immediately goes above 140 when jogging and into the 165+ range when running. I'd think cycling would still be ok if you take it easy and don't do hills, for example. Yoga, walking, stretching--those are always ok.// And YUM to your fave cake! Your description makes it sound very similar to my favorite.

@acleverusername Wow, lots to decipher in that report. I'd heard that Dr. Vidali just started using this test that he created. I had no idea it was this detailed. And colorful!

I'm sure your researcher brain is already aware: Vidali was the partner of renowned Reproductive Immunologist Dr. Braverman before Braverman passed away. Vidali now runs Braverman's RI practice in NYC. And Vidali is THE guy to go to for laparoscopy. Anyway, back to your results. I don't know all about all of these, but I know about some of them:

1) Very good that they caught the anti-HY stuff: they noticed that if you have boys first that you will likely have losses afterward. Saving you a lot of heartache there.

2) Anti-HLA is usually treated with IVIg or Neupogen, I believe. Some RIs will just increase prednisone, hydroxychloroquine, and/or Tacrolimus to combat the rejection mechanism that can kick in there (instead of using the cost-prohibitive IVIg or what some consider dangerous Neupogen).

3) PAI-4G/4G is the worst mutation to have, sorry. I am heterozygous for this one, whereas you are homozygous. We both need enoxaparin, aka Lovenox, for this. Baby aspirin too. You likely need a higher dose of Lovenox than I do due to the increased likelihood of blood clots with your particular mutation. The theory is that it causes no problems outside of pregnancy, but during pregnancy the PAI-activity increases, potentially causing micro-clots in the placenta and cord, leading to loss.

4) The very high AMH and fairly high testosterone do indicate PCOS. However, maybe your intake of DHEA led to the testosterone increase? That's common. The AMH is really the telltale here. Yes, AMH does fluctuate with each cycle but that's an extreme number. AMH is definitely correlated to the number of eggs being produced in a cycle. Still, AMH of 5.55 is far beyond the normal range for anyone's age. What number are you used to seeing when you get your AMH tested?

5) Leptin: Not familiar, sorry. But a quick google skim says it's great for keeping weight in check and helping people feel full. So maybe this one is a positive?

Also, if it's not in check it can lead to overeating and obesity.

Hope this helped even a little bit! // Please let us know how it goes if you do attempt the gluten/dairy/egg free cake. because all I can imagine is a flat rubbery pancake.

@optimistgardener HA! about the TWW feeling like you need to be under psychiatric observation! "Sometimes it bes like that."

I hope you're doing better today. I have NO tricks for you, as I 'love' to torture myself with useless symptom spotting.

@abjm0325 I am sorry you're considering joining in here. Dealing with the mysteries of IF is no walk in the park. In your case, it could go either way: many women have a loss and a chemical and go on to have success with no other problems. But many go on to have continued losses. You might ask your midwife to check your homocysteine levels, thyroid is a super smart idea, also get prolactin checked. When the time comes have your CD21 levels checked (actually taken 7 days past ovulate) to make sure you produce enough progesterone to support pregnancy, and if she's a miracle worker, you can ask her to test your natural killer cells through the ReproSource lab. These are the basic underlying issues that cause losses before it becomes even harder to figure out. There's also all the ultrasounds and HSGs, SHGs, etc to check for uterine anomalies, polyps, fibroids, etc. Good luck!

@caseys02 Thanks for the insight with the exercise! Vey helpful to have some guidelines. Before I had all my TTC issues I was a regular runner who kept it up no matter how life changed. But since all the TTC challenges I've had to tone it way way down.

@anniemarie887 I'm sorry you're finding yourself here as well, but you are most welcome. I echo Clever's thoughts on Shady Grove--some love them, some hate them, it really seems 50/50. If your insurance covers CCRM that's your better option. They're considered one of the top clinics in the nation, but pricey thanks to that reputation.

keikilove · February 2022

@optimistgardener @acleverusername @kiki047 Thanks for all the hugs, friends

I am going to try to keep hope alive despite the logical reality.

Clever, I almost spit out my tea when you said that the host of hilariously_infertile thought she'd sh*t out her embryo!!! If she had success then I can definitely hang on to a shred of hope!

keikilove · February 2022

ETA: @abjm0325 You may also want to get some blood-clotting panels run. These are typical in an RPL workup. I know that many doctors won't run RPL testing until you've had 3 losses, but more modern doctors are willing to run these after 2 losses. Not sure if your midwife can order an RPL Panel for you, but that's where you may want to start.

acleverusername · February 2022

@keikilove I'm here for your daily dose of spit-inducing standup comedy! Lol. But yes, hilarioulsy_infertile did go on to have success with that transfer. I wonder if I can find the episode where she talks about it.

THANK YOU THANK YOU THANK YOU so much for your interpretation of the RI results. You can't imagine how much you sharing your wealth of knowledge means to me. I think I'm gonna have to join that RI Facebook group now because honestly I need to start learning more about this. I have a huddle with TEW on Tuesday so I'll update here re: how it goes.

In terms of AMH, here is what my numbers were previously:
Mar 2020: 2.30
Jun 2020: 2.38
Dec 2020: 2.68
Dec 2021: 5.55

One thing to note though is... I recently did a repeat 24-hr cortisol test and my cortisol levels are now in the "normal" range where as previously they were too low. I had been taking supplements to support my androgen production. So whereas my previous testosterone had been super low, I have a feeling that the work I've been doing there has leveled out my testosterone and so taking DHEA probably put it into overdrive. And a PubMed article definitely pointed to DHEA affecting AMH levels. So I think mystery is solved there, although I might ask TEW to retest me.

acleverusername · February 2022

@shortstack930 yay for what sounds like a successful transfer!!! I hope the fact that your own RE did it is a good open. Now... snuggle well, and snuggle deep little embie!

acleverusername · February 2022

On and @keikilove I can only imagine and you and @kiki047 and our recent grads are all used to being lapped so I can't feel too sorry for myself. I can confirm that it ABSOLUTELY POSITIVE SUCKS ASH!

mambo5-2 · February 2022

AF started this morning so I felt so goofy calling my RE after I was just there yesterday and being like I need to schedule my blood work. HSN scheduled, 1 round of blood work scheduled. More blood work in the works, SO MANY THINGS!

anniemarie887 · February 2022

@acleverusername hugs lady
@keikilove that sounds like you got put through the ringer, but i'm so glad you are home now and hopefully getting some rest. sending all the good thoughts your way!! appreciate the intel re SG, i will reach out to CCRM. can't hurt to do the intake stuff with more than one place and see their thougths/process, right?
@abjm0325 hope you can get your OB to do some bloodwork for you, worth asking for it IMO even if they don't bring it up
@shortstack930 yay, hope you are having a relaxing restful day!
@mambo5-2 sounds like good timing to me!

shortstack930 · February 2022

@keikilove I am still holding out hope for you!! I can’t imagine how stressful that whole situation must have been. I’m glad you’re home safe and feeling better.

kiki047 · February 2022

@acleverusername ugh, I'm sorry to say that it doesn't get any easier when you get lapped like that. In fact, I'd argue it gets harder the longer you have to wait. Hugs, friend.

@mambo5-2 guess we should thank AF that she didn't keep you waiting and now you can get the show on the road. Always feels like there's sooo much bloodwork to be done, I think my record is 23 vials in one sitting. Barf!

@keikilove Thankfully I will still get two PRPs done before my transfer, the first is a week before and the second will be 2-3 days prior, so hopefully next Monday. It's also a holiday here so I'm hoping I can convince MH to come downtown with me and we can go for breakfast somewhere while they prep the plasma, then I can just go back in for the infusion and be done with it.

@optimistgardener I meant to ask this at the beginning of the week but when is your actual birthday?? I will eat some cake in your honour.

mambo5-2 · February 2022

@kiki047 my record was 16 👍 I'm always thankful I'm an easy poke and I shall give my blood away.

kiki047 · February 2022

@mambo5-2 LOL, IF has absolved me of all of my inhibitions over the years... want some blood? Sure, take it. Need me to take my pants off and lie with my legs in the air while you shine a literal spotlight on my crotch and poke around? By all means, don't even bother closing the curtain. Oh, hello med student, welcome to my party. Does it matter that I've had fewer sexual partners in my lifetime than the number of people currently in this room? NOPE.

Image: https://media.giphy.com/media/3NhDWNjpFExRiyondC/giphy.gif

acleverusername · February 2022

@kiki047 IT’S A VAG PARTY AND EVERYONE IS INVITED!!! Loooooool.

optimistgardener · February 2022

@kiki047 lol at IF and our loss of inhibition. i felt only the barest hint of weirdness at having my mom in the room for my cervical hose-down at transfer, and that whole theater thing the clinic does where they're like, "take your pants off and then cover yourself with this piece of paper and we'll be back in a minute!" and then they knock discretely before coming in? It always makes me laugh.
Birthday is tomorrow!

kiki047 · February 2022

@acleverusername LOLOLOL

Image: https://media.giphy.com/media/rumR5iFBxFjdC/giphy.gif

Image: https://media.giphy.com/media/uvkZ55tHoDc0E/giphy.gif

@optimistgardener speaking of parties, haaappy early birthday to you!! Did any of this cake talk inspire you to make something special for yourself for tomorrow? Any special plans?

optimistgardener · February 2022

@kiki047 i dunno i am still strongly considering my old standby, the chocolate cake. but we shall see if i actually motivate to go to the store for supplies.

anniemarie887 · February 2022

@optimistgardener happy early birthday!

mambo5-2 · February 2022

@optimistgardener happy birthday human whom I have just met. I hope it is FABULOUS

fantasyflyte · February 2022

@optimistgardener happy almost birthday!

acleverusername · February 2022

@optimistgardener Happy Birthday in advance you lovely lady that I've gotten to know you rather well in the last year. I hope the birthday is a good omen for you Beta on Sunday.

keikilove · February 2022

@optimistgardener Happy birthday, friend! I’m wishing you a lovely day this Sunday! 🥳 🎂 💝

Kiki’s gifs are pretty hilarious and not to be outdone.😄 Just in case you need more party energy:

Image: https://us.v-cdn.net/5020794/uploads/editor/xd/cs9thsw2j562.gif

Image: https://us.v-cdn.net/5020794/uploads/editor/4a/u3b60i41jh2z.gif

optimistgardener · February 2022

@keikilove your gif game is A+! I'd not be opposed to the cake behind spoiler #1, though, to be honest.

acleverusername · February 2022

Grrr... got a 7DPO progesterone test and it came back at 7.6. That's while i'm taking 100mg of vaginal progesterone. Anyways, at this point, I've decided to go with a fully medicated transfer cycle, so that I don't run into any issues with this sh*t when it really matter. Bring on the PIO!!!

shortstack930 · February 2022

@optimistgardener happy birthday!!!!

mambo5-2 · February 2022

CD 3 blood work drawn, 6 am on a Sunday is so early

acleverusername · February 2022

@mambo5-2 OMG, that's totally too early. But hopefully worth it!

acleverusername · February 2022

I've been internalizing the details from my Pregume report all week, and I have come to terms that my immune system has been the problem all along. In talking through it with a friend, I've decided that the best analogy is a mean guard dog (my immune system) protecting my uterus. My happy lil' embryo be floating down my Fallops all ready to snuggle in and the guard dog be like...

Image: https://us.v-cdn.net/5020794/uploads/editor/ke/i4scaqj2yzqd.gif

keikilove · February 2022

@acleverusername That analogy makes sense. But I’d definitely wait until you have the appointment to go through all your report results before drawing any definitive conclusions. I was thinking about my feedback to you on that report and basically this sums it up:

Please take my input with a grain of salt! I’m only an expert in my own experience.😉

acleverusername · February 2022

@keikilove loooool. That comic. Hehehe. Don’t worry… it wasn’t just your interpretation of the results (where that helped me is to understand the possible treatment). It was mostly reading though the foot/end notes and seeing things like:

The presence of one allele 4G (heterozygous patient) was shown to increase a patient risk for miscarriage by 46%23 while being homozygous (4G/4G) increases a patient risk for a miscarriage by 89%-100%.

And…

However, when combined with other analysis in this report, the presence of specific alleles/haplotypes can provide valuable insight into the state of the patient's immune system that could be contributing to failure to initiate or maintain pregnancy. HLA alleles and haplotypes that contribute to autoimmunity may also directly lead to an inability to appropriately establish maternal immune tolerance to an embryo or fetus.

acleverusername · February 2022

But yeah… I’m still holding on to some hope. Tuesday will be telling.

optimistgardener · February 2022

ugh. hi. I'm just gonna put this here because I don't have the brainpower to come up with a good GTKY right now to start a new weekly thread.

TL/DR: The transfer didn’t work.
The long version *TW, CP*

On Friday, at 7dp6dt, I broke down and tested. I was greeted, to my utter shock, by the first positive test I’ve ever seen in my 3.5 years-and-counting of TTGP. It wasn’t a super bold line, but it was a clearly visible line on a frer. I cried, and I thought about all the disappointments I’ve gone through, and about how it was all worth it. And I thought about the little XX embryo growing inside me, and I told her to stick. I started composing my TTGP Grad Announcement in my head (I know, I know). I floated through the day on a little cloud of hope. And then I realized that that was my last frer, and so I headed out to the store to buy another. For some reason, all the stores in town were out of frers, so i wound up buying a natalist brand test (which, btw, claims to be better for the environment because less plastic, and i’m all for that). got home, held my pee for a few hours, and tested again that evening. Only the faintest smudge showed up. I panicked, but then reminded myself this is a different test, maybe it will be stronger tomorrow. Well, it wasn’t. The next morning it was still a faint smudge. I, by this time nearly out of my mind, hunted through all the stores in this little town again, and came up with a frer. took it home and peed on it and, yep. the line was definitely no stronger, maybe a little fainter than the previous day’s.
A thing I discovered, by the way, for the science-minded amongst us, is that you can, in fact, use LH strips to confirm an HPT, when in a pinch. Normally this is a super dumb thing to do (like in a normal, non-medicated cycle) because LH often rises at the end of a natural cycle and so it’s anyone’s guess as to whether the test is registering LH or its near cousin, HCG. During a fully medicated FET and with a confirmed positive HPT, however, there is no chance of LH being in your system. And so I’ve been using my giant box of LH cheapies to follow the HCG downwards. They're actually more sensitive than a frer. Two days ago I was turning what I would have called an “almost positive” OPK. This morning the line is still there but is a faint echo.
My birthday, by the way, sucked. I had a phone call with my mom first thing (I was born in the morning around 7:20 and she always calls me early on my birthday) in which I broke down and told her about my fading positives, and then had to explain to her what a chemical pregnancy is, and she was just as disappointed if not more so than me. So I had to be the brave one in the conversation and tell her that I'm ok and things are fine. Which, as this long essay into the ether indicates, they are absolutely not fine. And then I spent the rest of my birthday writing lectures. I cancelled a hike with a colleague/friend because I didn't want to explain why I'm a wreck, and got myself a giant smorgasbord of self-pity Thai takeout in the evening. Maybe I'll make a cake next year when I'm 40.
Yesterday morning was my beta, which was a sh** show in and of itself, first because I drove to the next town over to the big hospital to get my blood drawn, and then realized just as I was popping off the freeway that I’d left my paperwork authorizing the bloodwork at home, so had to drive all the way home, tear apart the house looking for the paperwork, and then drive back and wait for an hour to do the bloodwork. The phlebotomist couldn’t get any blood out of me, probably because I was a nervous wreck and when I’m nervous my veins cinch down and become impenetrable fortresses. She had to poke me several times before she found a bleeder. And then, to top it all off, I never got any results from the beta. I went to this big hospital specifically because my RE told me it was the only place in my region that he trusted to turn a test result around on a Sunday, but here it is, Monday morning, and I still have no results. I waited all day for a call from my clinic or for results to come up in my mychart, and neither happened. So reluctantly I gave myself one more shot in the ass last night. I guess technically, this means I am still waiting and I could be surprised by good news, but at this point my tests are, while still not exactly negative, not nearly as convincing as that first double line I saw on Friday. I am not a unicorn and I understand that fading HPTs mean I am having a chemical pregnancy.

Anyway I don't know what the plan is now.

shortstack930 · February 2022

@optimistgardener I’m so sorry, friend. I’m still holding out hope that you just have a slow grower and the beta results will surprise you but I know how hard it is to have that hope for yourself after everything you’ve been through. Please keep us updated and take care of yourself.

kiki047 · February 2022

Oh @optimistgardener, I am so very very sorry. For all of it. That pain is all too familiar, especially the part about taking on some of your Mom's pain on top of your own fresh, raw grief. Sending love and a great big hug. It's so unfair.

abjm0325 · February 2022

@optimistgardener I'm so, so sorry to hear this. Holding out for good news from your beta, but I understand needing to protect your heart. Sending you big, creepy Internet hugs this morning.

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