Week of Jan 7

[seeyalater52]

How’s it going this week? Any updates?

[seeyalater52]

I just got my ERA results and I’m reeling a little. My uterine lining was normal/receptive. So no additional answers. But since my clinic’s protocol has transfer at 133 hours of progesterone exposure I do suspect I’d have come back pre-receptive on the typical 120 hour protocol, so at least that’s one less thing I need to worry about.

I’m just so frustrated that there doesn’t seem to be anything we can fix for next time.

Speaking of next time, my RE would like us to do a double embryo transfer next time. It’s fresking me out. On the one hand there’s no reason to believe that it presents a huge additional risk as we’ve had 3 transfers and no viable pregnancies And it's somethjng we can change which (see above) feels very appealing. AND if we do it this way we can have another retrieval after this transfer rather than going again, since I need to have fewer than 3 embryos in the bank. On the other hand, we are incredibly twin averse and pretty much every decision we had made to date has been to decrease the chance of a twin pregnancy. So it feels very counterintuitive to go in this direction. I am 99% sure we are going to do it though, because wtf else are we supposed to do?

[msmerymac]

seeyalater52 for my third transfer I transferred two and only one stuck. I can't remember - did you do genetic testing? I transferred two non-concurrent embryos.

Still waiting on insurance stuff. My H is supposed to be following up today with the financial coordinator.

The good news is that my episode of Jeopardy is on tonight. When I auditioned and asked what I would use the money for, I said my husband and I wanted children and we may need to look into adoption, so I'd need a big pile of money.

Later, when I talked to my mom about my audition, she said, "You should have told them you needed the money to adopt!" and I said, "I did."

[G22]

seeyalater52, I completely understand the hesitation with transferring more than 1. Last time around we transferred 2 embryos for both our fresh IVFs. First time neither took, second time 1 did. This time around I'm torn on whether to do 1 or 2 with our FET. I'm leaning towards 1, as we have a child already this time and would prefer no multiples. But we also only have 2 frozen embryos. After that I'm looking at my 3rd egg retrieval if they both fail. All that to say, theres no 1 right answer and eventually you just need to decide what you guys are comforted with.

[G22]

I have my mock transfer on Thursday, as well as a meeting to go over my labs and biopsy from Oct. I should get guidance and info on getting my meds too, since I start them in a couple weeks.

[seeyalater52]

Jan 7, 2019 12:05:59 GMT -5 msmerymac said:

seeyalater52 for my third transfer I transferred two and only one stuck. I can't remember - did you do genetic testing? I transferred two non-concurrent embryos.

Sadly, not tested. We definitely would not transfer two PGS normals at this point, but I’m inclined to transfer two untested given our track record so far.

Mostly I’m just counting down to another retrieval where we will do testing and this also helps us get to that point more quickly, which is appealing.

[chocolatepie]

seeyalater52 I am so sorry that the latest testing gave no answers. Blessings to you both as you make decisions regarding 2 vs 1 when the time comes. When will you be able to transfer again?

msmerymac that is so cool you're on Jeopardy! I will have to set it to record

I posted a ridiculously long update from my coordinator meeting on Friday in that thread if you wanna read a novel but the short version is that due to their screwup, I have to manipulate my cycle this month in order to get some labs that are insurance required. Which means 3 periods in January and my calendar got moved back a week.

I'm anxiously awaiting a call from the insurance company nurse for more information; fingers crossed she doesn't say we have to do X or Y before approval - it's fairly cut and dry why IVF is the only option for us. We didn't know we had to register for infertility treatments so we're trying to play catch-up and not set our timing back any.

And the IF doc is requiring a mammogram before starting meds so I get to do that next week for the first time. I'm guessing because I'm 40?

[G22]

chocolatepie, I'm sorry your dealing with a mix up! That's frustrating and I hope you can get things moving soon!

I'm thinking the mammogram requirement may be age related. I've never had to do it, but I'm in my early 30s (and was in my mid-late 20s last time I did IF treatments).

[oneslybookworm]

msmerymac, i had no idea you were considering adoption! Not sure if anyone remembers me from the board a few years ago, but DH and I adopted our son after failed IF treatments in 2017. Let me know if you have any questions!

[ilovecandy]

Chocolate pie that sucks

See ya later we did 2 on our first fresh transfer then the following two fets we did 3 each. I was worried a little bit but we are not averse to twins. Triplets scare me some though but we went with Dr recommendation

I got my period today and I am sick and h was a big jackass this morning and I am hoping he realizes it and when he comes home hopefully he will apologise.

[shoeless]

seeyalater52 I definitely get the appeal of transferring 2 after so many early miscarriages. Did you do any testing for immune issues? I know some RE believe it and some don’t.

[seeyalater52]

Jan 7, 2019 15:22:33 GMT -5 shoeless said:

seeyalater52 I definitely get the appeal of transferring 2 after so many early miscarriages. Did you do any testing for immune issues? I know some RE believe it and some don’t.

We did the full panel of immune testing that my RE will do as a standard (non immunology specialist) RE after my second loss and it showed absolutely nothing. I know some select few specialists will do a more advanced panel, but she isn't enough of an expert to be able to really make recommendations there around either treatment or testing beyond medrol, predisone, etc. and insurance doesn't believe in it so they won't pay for anything beyond normal covered meds and adding something like intralipids would be pretty expensive and I don't feel convinced by the available evidence to justify it. The good news is that she doesn't not believe in it, and I have done some level of immune testing, it just hasn't been all that helpful. 

I do have a consult scheduled with Dr. Braverman for August... which I booked a while back and it's not until forever. So if August rolls around and I'm still struggling I'll definitely have a better avenue to explore additional immune tests and protocols if we're willing to pay the big bucks for him to consult with my RE. 

[seeyalater52]

Jan 7, 2019 15:21:23 GMT -5 ilovecandy said:

Chocolate pie that sucks

See ya later we did 2 on our first fresh transfer then the following two fets we did 3 each. I was worried a little bit but we are not averse to twins. Triplets scare me some though but we went with Dr recommendation

I got my period today and I am sick and h was a big jackass this morning and I am hoping he realizes it and when he comes home hopefully he will apologise.

Our office is so conservative about double transfers and has an extremely low incidence of twins, and our insurance rules around single transfers are also quite strict, so the fact that we now qualify for a covered double transfer AND my RE is suggesting it is throwing me for a loop. I was sure they wouldn't recommend or authorize it and we wouldn't have to make this decision.

I'm so sorry you're not having a good day! I hope your husband apologizes. 

[seeyalater52]

Jan 7, 2019 14:41:41 GMT -5 oneslybookworm said:

msmerymac , i had no idea you were considering adoption! Not sure if anyone remembers me from the board a few years ago, but DH and I adopted our son after failed IF treatments in 2017. Let me know if you have any questions!

We are also exploring adoption, even as we move toward a second IVF retrieval. It would take us years to save for adoption and we have IVF coverage, otherwise we'd be all-in for adoption right now. I actually have a phone meeting with an agency tomorrow that I think might be a good fit... we have had a little trouble finding an agency that feels good about finding us a match as a same-sex couple and with my wife's chronic mental health issue (despite the fact that her providers are more than happy to provide info during the home study attesting to her suitability to parent.) The first agency we met with locally basically told us they'd take our money but they didn't think they could match us successfully, the second disqualified us from their adoption program all together without a home study (they don't accept anyone with this particular mental health issue). I'd love to talk more with you about this sometime. 

[oneslybookworm]

Jan 7, 2019 16:31:38 GMT -5 seeyalater52 said:

Jan 7, 2019 14:41:41 GMT -5 oneslybookworm said:

msmerymac , i had no idea you were considering adoption! Not sure if anyone remembers me from the board a few years ago, but DH and I adopted our son after failed IF treatments in 2017. Let me know if you have any questions!

We are also exploring adoption, even as we move toward a second IVF retrieval. It would take us years to save for adoption and we have IVF coverage, otherwise we'd be all-in for adoption right now. I actually have a phone meeting with an agency tomorrow that I think might be a good fit... we have had a little trouble finding an agency that feels good about finding us a match as a same-sex couple and with my wife's chronic mental health issue (despite the fact that her providers are more than happy to provide info during the home study attesting to her suitability to parent.) The first agency we met with locally basically told us they'd take our money but they didn't think they could match us successfully, the second disqualified us from their adoption program all together without a home study (they don't accept anyone with this particular mental health issue). I'd love to talk more with you about this sometime. 

Sure, I’d be more than happy to talk! Feel free to PM or just ask questions!

[vmars]

I got an apt with my OB for tomorrow at 8 am. The receptionist was less than helpful with my questions and basically wouldn’t answer me and said I had to talk to the doctor. 🙄 do you think I need to be fasting at all for my bloodwork? Also, I am assuming if she wants a sperm analysis this is something that can be done at home and dropped off at a lab? She didn’t mention one, just that DH would be “tested”.

[seeyalater52]

Jan 7, 2019 18:08:08 GMT -5 vmars said:

I got an apt with my OB for tomorrow at 8 am. The receptionist was less than helpful with my questions and basically wouldn’t answer me and said I had to talk to the doctor. 🙄 do you think I need to be fasting at all for my bloodwork? Also, I am assuming if she wants a sperm analysis this is something that can be done at home and dropped off at a lab? She didn’t mention one, just that DH would be “tested”.

I know nothing about sperm, but you shouldn’t need to fast for any of the bloodwork (at least my clinic never had me fast, and I asked about it because I’m extra.) Sorry they’re not being helpful.

[fairfax]

Jan 7, 2019 11:40:38 GMT -5 seeyalater52 said:

I just got my ERA results and I’m reeling a little. My uterine lining was normal/receptive. So no additional answers. But since my clinic’s protocol has transfer at 133 hours of progesterone exposure I do suspect I’d have come back pre-receptive on the typical 120 hour protocol, so at least that’s one less thing I need to worry about.

I’m just so frustrated that there doesn’t seem to be anything we can fix for next time.

Speaking of next time, my RE would like us to do a double embryo transfer next time. It’s fresking me out. On the one hand there’s no reason to believe that it presents a huge additional risk as we’ve had 3 transfers and no viable pregnancies And it's somethjng we can change which (see above) feels very appealing. AND if we do it this way we can have another retrieval after this transfer rather than going again, since I need to have fewer than 3 embryos in the bank. On the other hand, we are incredibly twin averse and pretty much every decision we had made to date has been to decrease the chance of a twin pregnancy. So it feels very counterintuitive to go in this direction. I am 99% sure we are going to do it though, because wtf else are we supposed to do?

Ugh, I wish this had given you some answers! I would transfer 2 - it seems like a measured risk. But I would be nervous about it too!

[katespade]

vmars - H was given the option of doing his SA at home, but there was a really short timeframe for how quickly he had to get it to the lab because they need it to be fresh for testing. He ended up choosing to go to the lab to do it.

[vmars]

Jan 7, 2019 18:45:34 GMT -5 katespade said:

vmars - H was given the option of doing his SA at home, but there was a really short timeframe for how quickly he had to get it to the lab because they need it to be fresh for testing. He ended up choosing to go to the lab to do it.

Does it just go to a labcorp or something similar? We live within 10 minutes of one so I am sure he’d rather do it home and drive there.

[katespade]

Jan 7, 2019 18:50:20 GMT -5 vmars said:

Jan 7, 2019 18:45:34 GMT -5 katespade said:

vmars - H was given the option of doing his SA at home, but there was a really short timeframe for how quickly he had to get it to the lab because they need it to be fresh for testing. He ended up choosing to go to the lab to do it.

Does it just go to a labcorp or something similar? We live within 10 minutes of one so I am sure he’d rather do it home and drive there.

Whatever lab your RE uses, I’d assume. Mine did it through their on-site lab, so he just had to go to their office and they had a room in their lab for him to use. If your RE does all of their lab testing through labcorp, I would guess that’s where he’ll need to get the SA to, also.

[vmars]

Jan 7, 2019 19:10:52 GMT -5 katespade said:

Jan 7, 2019 18:50:20 GMT -5 vmars said:

Does it just go to a labcorp or something similar? We live within 10 minutes of one so I am sure he’d rather do it home and drive there.

Whatever lab your RE uses, I’d assume. Mine did it through their on-site lab, so he just had to go to their office and they had a room in their lab for him to use. If your RE does all of their lab testing through labcorp, I would guess that’s where he’ll need to get the SA to, also.

I don’t have an RE just a regular OB.

[katespade]

Jan 7, 2019 19:25:53 GMT -5 vmars said:

Jan 7, 2019 19:10:52 GMT -5 katespade said:

Whatever lab your RE uses, I’d assume. Mine did it through their on-site lab, so he just had to go to their office and they had a room in their lab for him to use. If your RE does all of their lab testing through labcorp, I would guess that’s where he’ll need to get the SA to, also.

I don’t have an RE just a regular OB.

Ah. I wasn’t sure. My H’s was done through a regular OB, too. They were able to run it through the lab like they do anything else, even though he wasn’t technically their patient.

[shoeless]

seeyalater52 August for Dr. Braverman?!?! Ouch. I was just starting to look into him and the other normally recommended immunology RE (can’t remember her name but I think she’s out west). I didn’t realize the wait times were so long. Fingers crossed you won’t need anymore testing. When are you going to do your transfer?

[Jalapeñomel]

Had a cyst aspirated today that was grumpy and leftover from that wonky break through cycle. I start cycling on Wednesday for a new transfer date of 1/22ish.

[pinkpeony08]

seeyalater52 and shoeless - I have also been looking at reproductive immunology. I'm closest to Dr. Kwak Kim outside of Chicago, so I'm working on scheduling an appointment there, though I also fear it will be along way off. I've looked at Dr. Braverman as well. It seems like Dr. Kwak Kim takes insurance while Braverman doesn't? Has anyone else here seen reproductive immunology??

[seeyalater52]

Jan 7, 2019 20:18:47 GMT -5 shoeless said:

seeyalater52 August for Dr. Braverman?!?! Ouch. I was just starting to look into him and the other normally recommended immunology RE (can’t remember her name but I think she’s out west). I didn’t realize the wait times were so long. Fingers crossed you won’t need anymore testing. When are you going to do your transfer?

Yeah it’s nuts. He is closer to me geographically but my insurance won’t cover anything out of network so options are a little limited. But it might be nice to get another opinion if August rolls around and we are still waiting for a success.

Transfer should be mid-Feb if I’m reading my ovulation signs correctly.

[seeyalater52]

Jan 7, 2019 21:12:22 GMT -5 pinkpeony08 said:

seeyalater52 and shoeless - I have also been looking at reproductive immunology. I'm closest to Dr. Kwak Kim outside of Chicago, so I'm working on scheduling an appointment there, though I also fear it will be along way off. I've looked at Dr. Braverman as well. It seems like Dr. Kwak Kim takes insurance while Braverman doesn't? Has anyone else here seen reproductive immunology??

It seems like all the specialists have really long wait lists. I hope you can get in! My insurance won’t cover specialists out of network so I havent looked too far into who takes insurance, but aside from the consults, most of what they will recommend will likely not be covered - specialized testing, immune interventions or additions to protocols, etc. Reproductive immunology doesn’t have much in the way of evidence base yet so insurance is pretty wary. And it’s true, the evidence isn’t necessarily there in the way of large trials and published research but these specialists all have incredible success rates with tricky cases so I definitely think it’s worth exploring if you have the money and patience.

[pinkpeony08]

seeyalater52 from what I have read, Dr. Kwak Kim uses immunology diagnosis codes so more testing is covered? I am finishing the paperwork tonight to fax in tomorrow. Hopefully my records arrive soon so I can schedule... will let you know how far out it is. I don’t even know for sure if we want to try again, but if someone could give insight into why this keeps happening, it would be really helpful.

[seeyalater52]

Jan 7, 2019 21:43:01 GMT -5 pinkpeony08 said:

seeyalater52 from what I have read, Dr. Kwak Kim uses immunology diagnosis codes so more testing is covered? I am finishing the paperwork tonight to fax in tomorrow. Hopefully my records arrive soon so I can schedule... will let you know how far out it is. I don’t even know for sure if we want to try again, but if someone could give insight into why this keeps happening, it would be really helpful.

You know I’m a huge supporter of getting answers! I think it’s trickier when you’re doing RI stuff in conjunction with IVF when infertility treatments are covered by insurance because the process is so much more tightly controlled in terms of what is covered, but I recognize that is an incredibly small segment of the population since coverage is hard to come by. I’m a special snowflake.