Week of July 29th

[joenali]

I have nothing ttc related going on this week at all. I’m on a waiting list for my follow up appointment, but I doubt I’ll get in sooner than the 14th.

I’ve been thinking about what to do in the near future. DH keeps saying we won’t give up, but I think the Well has run dry in terms of money. And I believe that using a donor egg is the only option as far as carrying a baby. I don’t have the answers yet.

I went back to working out full force on Saturday. It’s taken awhile to feel better, we were traveling and I’ve also had two periods this month. That was fun. It felt so good to workout. I also went swimming yesterday and wrote myself a good workout to do. It felt great! DH is going to be my kayaker this week for an open water swim that I want to do.

I hope everyone’s week has a bright spot! Good luck to you all, wherever you are!

[megstoo]

I have nothing ttc related either right now. Tomorrow is my last provera pill. This is my 3rd round trying to force a cycle and I was on it for 10 days. I have a bad feeling this coming cycle (if it comes) is going to be HORRIBLE. If all is good and there's no fluid we will do our final FET probably middle of Aug if my timing is right.

I'm on an antihistamine protocol that I started last week so I'm doing mucinx twice a day now to try and dry up fluid that was seen on my last ultrasound (not hydro as a I had a lap beginning of May). Once I start baseline meds I'll go on more antihistamine stuff and a full immune protocol as well. We decided if this transfer doesn't work we'll do 1 more retrieval and that'll be it (we're transferring 2 this time).

[moonriver]

I have a HSG this afternoon (any tips I should know?). I’m on letrozole this cycle rather than clomid. I haven’t noticed any side effects so that’s been nice. Usually I get hot flashes with clomid. I have a monitoring appointment on Friday and if all goes well, I will have an IUI next week sometime. My H has a 200 mile bike race on the 10th so I’m hoping we’re done with TI by then because a) he will be out of town for a day and a half for the race and b) he would be exhausted. He had a bit of an ankle injury this weekend while hiking so there’s a chance he will have to skip the race altogether.

[ilovecandy]

Moonriver just take 600-800mg of ibproufuen and you should be okay.

Just waiting on my Dr to call to set up an appointment to go over time table and protocol. They said it would the first week of August so I am not expecting it this week. Hopefully by end of next week.

[starryfish]

moonriver, just ibuprofen is needed. its not bad.

got the offical BFN from doctor today but have to go back wednesday for end of study bloodwork. Will do a transfer in sept hopefully.

[seeyalater52]

megstoo I hope this last round of meds brings on your cycle.

moonriver it shouldn’t be too bad. I echo the ibuprofen. It stops hurting pretty quickly once the procedure is over, just some unpleasant leakage and cramping.

ilovecandy good luck!

[seeyalater52]

I had my D&C follow up/IVF regroup appointment this morning at our current clinic. For those of you who don’t know we were (are?) considering switching to a local CCRM satellite. I left feeling really good about our current clinic and also very frustrated and confused. My current RE is willing to do almost anything we ask her to. She is so collaborative and helpful and just really wants this to work and is patient with my endless questions and suggestions.

Per this appointment we would do the following to try to improve chances:
-PGS testing (they use Invitae which reports mosaics and we can opt to keep and later transfer mosaics if we want to)
-Small changes to stims, including adding some LH (menopur) to the protocol, when I only had FSH (gonal-f) last time. My dose was already pretty small but she is willing to work with it.
-hCG only trigger (5,000 units) rather than dual with Lupron
-No fresh transfer (makes the hCG trigger easier) which I’m thankful for because I don’t want to fuck around with untested embryos anymore - they have to get a waiver from insurance but she is confident she can get it
-I’m adding myo-inositol to the coq10 for the 3 months before the cycle
-They drew A1C today and will see about fasting glucose etc when I’ve actually fasted
-We will do a hysteroscopy before my IVF cycle and a biopsy for endometritis at the same time. Insurance would have required a renewed saline ultrasound anyways but will accept the hysteroscopy which I’m more comfortable with anyways to ensure that the D&C didn’t leave any damage
-Rather than doing the ReceptivaDx biopsy ($$$) or a lap, she is willing to put me on 2 months of depot Lupron before transfer. This wouldn’t be for my first transfer - I’d like to do another natural transfer (can’t do Lupron depot before that) with a PGS embryo first, but this is in the back pocket.
-They will accept my wife as a transfer patient assuming her workup and uterine testing comes back normal. This is great news because after hearing she wouldn’t be accepted at CCRM due to her BMI I started to panic.

The prednisone for transfer is a hard no. It is the only thing I asked about that she flat out said she wouldn’t do. It makes me want to tear my hair out because I really, really, really don’t want to transfer again without it. So if I stay with this clinic I’ll need to figure out another solution.
They don’t allow sex selection of embryos which is mostly nbd although maybe kind of annoying.

CCRM got back to me and they basically won’t allow natural transfers, are still insistent that we would have to do (and pay out of pocket for) ICSI, and only do dexamethasone for transfers, stopping after beta (so doesn’t fully solve my prednisone/longer course steroid issue.) Add to that the 1 hour drive to closest satellite and 2 hour drive to main clinic location, and the price tag which is more than 3 times what a cycle would be at our current clinic, PLUS their communication sucks so far and I’m not feeling as wedded to switching as I once was. I love our doctor and I’m confident she is doing whatever she can to make this happen. I’m just worried about having regrets later on, but honestly I think if this doesn’t work we would have regrets either way.

[ilovecandy]

@seeyalater

If you think either way you would regret then don't switch. Especially for communication I have had three re in my time (thanks to moves) and the one we have no is far far more responsive than any other one we have had and I love it. It sounds like she is willing to work with you. I would definitely suggest the testing. We have only done one ivf three years ago but didn't get testing done. This time we are doing the additional embryo testing. I can't remember have you done an era? If they are doing an endometriosis biopsy they can do the era biopsy at the same time. Not sure if your insurance will pay (mine didn't) but it is only $800.

[moonriver]

seeyalater52 I’m glad it sounds like you’ve got some options. I feel like I’d stay with your current dr, if it were me. Why won’t she get on board with prednisone?

[seeyalater52]

Jul 29, 2019 18:41:31 GMT -5 moonriver said:

seeyalater52 I’m glad it sounds like you’ve got some options. I feel like I’d stay with your current dr, if it were me. Why won’t she get on board with prednisone?

I am leaning that way for sure and so is my wife.

She just doesn’t believe in reproductive immunology at all (not unique, no one around here does.) And is very concerned about the side effects and risk of cleft palate. I honestly think I am more familiar with the literature on this than she is, which is frustrating. But it is one concern in a list of LOTS of concerns and prednisone isn’t a super highly controlled substance so I feel like we can work around it if we need to even though that is not ideal.

[seeyalater52]

Jul 29, 2019 18:20:14 GMT -5 ilovecandy said:

@seeyalater

If you think either way you would regret then don't switch. Especially for communication I have had three re in my time (thanks to moves) and the one we have no is far far more responsive than any other one we have had and I love it. It sounds like she is willing to work with you. I would definitely suggest the testing. We have only done one ivf three years ago but didn't get testing done. This time we are doing the additional embryo testing. I can't remember have you done an era? If they are doing an endometriosis biopsy they can do the era biopsy at the same time. Not sure if your insurance will pay (mine didn't) but it is only $800.

I am inclined to agree re: the clinic. I’m totally spoiled with the good communication and individual attention. We definitely need to do PGS testing. No question. My tolerance for a 5th miscarriage (!!!) is very low. I want to do everything possible to minimize that risk.

We have had an ERA already (receptive on a medicated protocol) although I also had implantation and my longest pregnancy yet with a natural cycle. Progesterone exposure is apparently not my issue. My body loves to implant but doesn’t want to grow anything apparently. 🙄

[pinkpeony08]

Jul 29, 2019 15:16:27 GMT -5 seeyalater52 said:

I had my D&C follow up/IVF regroup appointment this morning at our current clinic. For those of you who don’t know we were (are?) considering switching to a local CCRM satellite. I left feeling really good about our current clinic and also very frustrated and confused. My current RE is willing to do almost anything we ask her to. She is so collaborative and helpful and just really wants this to work and is patient with my endless questions and suggestions.

Per this appointment we would do the following to try to improve chances:
-PGS testing (they use Invitae which reports mosaics and we can opt to keep and later transfer mosaics if we want to)
-Small changes to stims, including adding some LH (menopur) to the protocol, when I only had FSH (gonal-f) last time. My dose was already pretty small but she is willing to work with it.
-hCG only trigger (5,000 units) rather than dual with Lupron
-No fresh transfer (makes the hCG trigger easier) which I’m thankful for because I don’t want to fuck around with untested embryos anymore - they have to get a waiver from insurance but she is confident she can get it
-I’m adding myo-inositol to the coq10 for the 3 months before the cycle
-They drew A1C today and will see about fasting glucose etc when I’ve actually fasted
-We will do a hysteroscopy before my IVF cycle and a biopsy for endometritis at the same time. Insurance would have required a renewed saline ultrasound anyways but will accept the hysteroscopy which I’m more comfortable with anyways to ensure that the D&C didn’t leave any damage
-Rather than doing the ReceptivaDx biopsy ($$$) or a lap, she is willing to put me on 2 months of depot Lupron before transfer. This wouldn’t be for my first transfer - I’d like to do another natural transfer (can’t do Lupron depot before that) with a PGS embryo first, but this is in the back pocket.
-They will accept my wife as a transfer patient assuming her workup and uterine testing comes back normal. This is great news because after hearing she wouldn’t be accepted at CCRM due to her BMI I started to panic.

The prednisone for transfer is a hard no. It is the only thing I asked about that she flat out said she wouldn’t do. It makes me want to tear my hair out because I really, really, really don’t want to transfer again without it. So if I stay with this clinic I’ll need to figure out another solution.
They don’t allow sex selection of embryos which is mostly nbd although maybe kind of annoying.

CCRM got back to me and they basically won’t allow natural transfers, are still insistent that we would have to do (and pay out of pocket for) ICSI, and only do dexamethasone for transfers, stopping after beta (so doesn’t fully solve my prednisone/longer course steroid issue.) Add to that the 1 hour drive to closest satellite and 2 hour drive to main clinic location, and the price tag which is more than 3 times what a cycle would be at our current clinic, PLUS their communication sucks so far and I’m not feeling as wedded to switching as I once was. I love our doctor and I’m confident she is doing whatever she can to make this happen. I’m just worried about having regrets later on, but honestly I think if this doesn’t work we would have regrets either way.

It sounds like you were able to have a lot of good discussion. I hope you can move forward with what makes you and your wife most comfortable. There certainly is no harm in bringing the literature you have found to your re if you think it is helpful!

[pinkpeony08]

We are just in waiting mode this week. I have my follow up next week with reproductive immunology when we will get all the results. It will be a crazy day- that appointment then dentist, haircut, and book club. Really packing my day off of work.

I’ve read mixed things about endometrial biopsy delaying your period. Anyone have experience either way? It’s due to start later this week.

[moonriver]

HSG went fine, no blockages. I suppose that’s good news, but it also makes it more unclear why I’m not getting pregnant.

[joenali]

Jul 29, 2019 19:52:34 GMT -5 moonriver said:

HSG went fine, no blockages. I suppose that’s good news, but it also makes it more unclear why I’m not getting pregnant.

I had everything tested under the sun. Diagnosis: unexplained infertility.

[seeyalater52]

Jul 29, 2019 19:52:34 GMT -5 moonriver said:

HSG went fine, no blockages. I suppose that’s good news, but it also makes it more unclear why I’m not getting pregnant.

I’m sorry. I’m 100% unexplained (for both infertility and RPL) and while I’m glad nothing is “wrong” with me it is incredibly frustrating not to get answers, especially as our testing has gotten more and more in depth.

[moonriver]

Jul 29, 2019 20:02:50 GMT -5 seeyalater52 said:

Jul 29, 2019 19:52:34 GMT -5 moonriver said:

HSG went fine, no blockages. I suppose that’s good news, but it also makes it more unclear why I’m not getting pregnant.

I’m sorry. I’m 100% unexplained (for both infertility and RPL) and while I’m glad nothing is “wrong” with me it is incredibly frustrating not to get answers, especially as our testing has gotten more and more in depth.

My only clear answers right now are that I have PCOS, and don’t always ovulate on my own.

I cried in the HSG room today because I’m just... tired. I’m tired of all the appointments.

[seeyalater52]

Jul 29, 2019 20:14:42 GMT -5 moonriver said:

Jul 29, 2019 20:02:50 GMT -5 seeyalater52 said:

I’m sorry. I’m 100% unexplained (for both infertility and RPL) and while I’m glad nothing is “wrong” with me it is incredibly frustrating not to get answers, especially as our testing has gotten more and more in depth.

My only clear answers right now are that I have PCOS, and don’t always ovulate on my own.

I cried in the HSG room today because I’m just... tired. I’m tired of all the appointments.

I hear you. It is so exhausting.

[moonriver]

Jul 29, 2019 20:19:05 GMT -5 seeyalater52 said:

Jul 29, 2019 20:14:42 GMT -5 moonriver said:

My only clear answers right now are that I have PCOS, and don’t always ovulate on my own.

I cried in the HSG room today because I’m just... tired. I’m tired of all the appointments.

I hear you. It is so exhausting.

Thanks for the support. I’m sorry you’ve gone through so much.

[ilovecandy]

Jul 29, 2019 20:14:42 GMT -5 moonriver said:

Jul 29, 2019 20:02:50 GMT -5 seeyalater52 said:

I’m sorry. I’m 100% unexplained (for both infertility and RPL) and while I’m glad nothing is “wrong” with me it is incredibly frustrating not to get answers, especially as our testing has gotten more and more in depth.

My only clear answers right now are that I have PCOS, and don’t always ovulate on my own.

I cried in the HSG room today because I’m just... tired. I’m tired of all the appointments.

Hugs. We were and I think still kinda of are unexplained and it sucks so bad. I do have a touch of endometriosis but yeh. It is hard.

[ilovecandy]

Jul 29, 2019 18:53:18 GMT -5 seeyalater52 said:

Jul 29, 2019 18:20:14 GMT -5 ilovecandy said:

@seeyalater

If you think either way you would regret then don't switch. Especially for communication I have had three re in my time (thanks to moves) and the one we have no is far far more responsive than any other one we have had and I love it. It sounds like she is willing to work with you. I would definitely suggest the testing. We have only done one ivf three years ago but didn't get testing done. This time we are doing the additional embryo testing. I can't remember have you done an era? If they are doing an endometriosis biopsy they can do the era biopsy at the same time. Not sure if your insurance will pay (mine didn't) but it is only $800.

I am inclined to agree re: the clinic. I’m totally spoiled with the good communication and individual attention. We definitely need to do PGS testing. No question. My tolerance for a 5th miscarriage (!!!) is very low. I want to do everything possible to minimize that risk.

We have had an ERA already (receptive on a medicated protocol) although I also had implantation and my longest pregnancy yet with a natural cycle. Progesterone exposure is apparently not my issue. My body loves to implant but doesn’t want to grow anything apparently. 🙄

Ahhh. I also want to say if it feels better switch do so obviously you have to be happy with your Dr. I just know for me the communication is a big thing.

We are afraid that I have implantation issues. Since I had a chemical pregnancy with ivf and they can't find anything wrong. Guess the embryo testing will tell if we just have not great embryos and if it implantation and my. Body. We both get frustrated by it. But as I tell my husband medicine has come so far but still can't always detect or fix everything unfortunately. Infertility sucks

[starryfish]

seeyalater52, glad you had a good talk with your clinic. I would stay there too. PM me again to remind me to check. Sorry I am terrible. I am adding it to my phone to check tonight tho!

[VacayVaca]

seeyalater52 I'm glad the RE went in depth with you as far as what has worked and what can change to make a good plan moving forward. The new protocol you landed on sounds really similar to what I had this spring as a 35-year old first time IVF patient with a high AMH. We did PGS testing and the clinic required us to use ICSI. When we inquired about removing that step, they said it's to prevent additional sperm from contributing genetic material on the outside of the egg and contaminating the biopsy later. We dropped the issue at that point, but I was a little bit uncomfortable with using ICSI, although I think it came out ok.

It sounds like they had a lot of new considerations and you can hopefully get around the immune protocol. I'm glad they'll consider your wife as a transfer candidate. How do they remove the sex selection option for the embryo transfer? Do they not tell you what the PGS testing comes back with? Or just not allow you to choose which to transfer?

[seeyalater52]

Jul 30, 2019 11:42:23 GMT -5 VacayVaca said:

seeyalater52 I'm glad the RE went in depth with you as far as what has worked and what can change to make a good plan moving forward. The new protocol you landed on sounds really similar to what I had this spring as a 35-year old first time IVF patient with a high AMH. We did PGS testing and the clinic required us to use ICSI. When we inquired about removing that step, they said it's to prevent additional sperm from contributing genetic material on the outside of the egg and contaminating the biopsy later. We dropped the issue at that point, but I was a little bit uncomfortable with using ICSI, although I think it came out ok.

It sounds like they had a lot of new considerations and you can hopefully get around the immune protocol. I'm glad they'll consider your wife as a transfer candidate. How do they remove the sex selection option for the embryo transfer? Do they not tell you what the PGS testing comes back with? Or just not allow you to choose which to transfer?

Thank you! It seems most labs are no longer concerned with the fertilization method impacting PGS results, although that used to be the case. Only one out of 5 clinics we consulted at would have required it (for success reasons not for testing reasons) which makes the requirement and also the upcharge for it kind of annoying. I'm glad it worked out for you! 

For the sex selection the clinic blinds themselves as well as the patient from the embryo sexes. They don't want patients to choose but also don't want their lab staff to be influenced by sex in their selection of embryos. They also only transfer the highest graded euploid embryo first so it is a bit moot unless you have two embryos the exact same grade, but they don't take chances with it. Apparently you can find out the sex immediately after transfer, which I think we would do. We were a bit ambivalent to the idea of actually selecting sex to begin with (assuming we even had enough embryos to make a selection) so this just removes one piece we hadn't come to a conclusion about from our sphere of influence, which actually feels kind of nice.