Embryo Transfer #6: Welcome Home Mochi

Two days ago, on a beautiful Friday morning, DW and I headed to the fertility clinic for her single blastocyst transfer. She’s been on a long list of meds for this cycle, in the hopes that it will combat whatever has been causing her recurrent miscarriages, and maximize little Mochi’s chances of a successful implantation and growth:

Since day 15 of her cycle, she’s been on: 

– 4mg Estrace 

– 3 x 100mg Endometrin (suppositories), 300mg Prometrium (orally)

– 20 mg prednisone

– 5000IU Fragmin injections

– 25 mcg + 6.25 mcg Synthroid

– 1800 mg Omega 3 Fish Oils (3:2 of EPA:DHA)

– 400IU vitamin E

– 300 mg vitamin B6

– 4000IU vitamin D

– 100mg zinc

– Pregvit Folic 5 multivitamin

The clinic was running really late that day, as they seemed to have the RE (who is an OB) booked with OB-GYN patients in addition to his regular fertility patients. DW’s transfer didn’t happen until about 1.5 hours after she was scheduled. But as usual, the transfer went smoothly, with no pain or discomfort at all (she has a very friendly cervix, as opposed to my angry s-shaped cervix). 

 Little Mochi in DW’s uterus:  
Now, in case you’re not familiar with the deliciousness that are Mochi, they are a Japanese dessert made of an outer sweet glutinous rice layer, and then usually a flavoured filling. DW loves Mochi, particularly the Taro flavour.

Many flavours of Mochi:   
(Above image from:  http://blog.wagashi-net.de/category/wagashi-sweets/mochi-wagashi/)

After our transfer, we headed to one of our favourite Korean restaurants for lunch. For the past couple of days, we’ve been chilling at home, trying to get DW not to do chores or yard work. It’s hard for her, since she’s such a busy body! 

Tonight, we’re heading to the cottage for a week of lakeside relaxation. See ya when we get back on Friday! 

Fingers, toes, and your dog’s pads crossed for good news in a week! Please keep us and Little Mochi in your thoughts and prayers. Thank you friends!

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Now That’s a Big Dumplin’! And DW’s Transfer Date!

  
(Photo from: http://www.boozyburbs.com/2012/10/18/brand-new-mandu-factory-northvale-nj/)

Today we went downtown for our 28 week biophysical profile ultrasound at Mt. Sinai. I’m only 27 weeks 5 days, but close enough. Not everyone has this ultrasound, but after our scary NT scare at 12 weeks (thank goodness everything turned out okay), we get all sorts of fun precautionary appointments. Seriously though, we love the extra opportunities to see Dumplin’, and what he’s up to in there. The reassurance that all is good is also very nice. And like I’ve mentioned before, the peeps over at Mt. Sinai are da bomb and might be getting an Edible Arrangement from us. 

The ultrasound itself was actually really short in duration. Previous ultrasounds at 14 weeks and 18 weeks were about 45 minutes, we saw lots of stuff, and were given a pretty good commentary by the ultrasound tech. Today however, it was 8 minutes, and the guy doing it barely said two words. I guess he’s not a morning person? 

Pro Tip: Bring a hand mirror to your ultrasound appointments- so you can watch and see baby as they’re doing the scan! This is what we’ve been doing.

We got to see Dumplin’s positioning- he is already head down, right by my cervix, which is 3.4 cm right now. His face is looking at the left side of my back, and his legs are tucked near my far right ribs. Which is exactly the position that I predicted! When I feel movement, it’s usually strong kicks near my right ribs, and punches near the bottom of my left belly. Sometimes I feel both at the same time. I also rarely feel what feels like bubbles or popcorn popping near my cervix. I’m guessing that that might be hiccups?

Anyway the specialist said that at this point, there’s less space so Dumplin’ is unlikely to change position. So I’m really happy that he’s already setting himself up in a good birth position.

Functionally, he scored an 8/8 on his Biophysical tests- amniotic fluid, fetal movement, fetal tone, fetal breathing. Mommies are very happy about this!

The blood pressure in his umbilical artery is perfect, and my placental integrity is a grade 1 (best).

Size-wise, little Dumplin’ ain’t so little. His head is measuring 30 weeks, his legs are measuring 29 weeks, and overall, he’s measuring 1 week and 1 day ahead. He weighs 1260 grams = 2lbs 13oz, which puts him at the 80th percentile for his gestational age. 

I’m sorry if I’m boasting too much. We’re just so relieved that all is good with our little man. Ultrasounds have been kind of traumatic for us after all of the fertility treatments, sad miscarriages, and horrific NT scans. To have a “perfectly normal” scan is something to be celebrated!

So yeah, that’s one big Dumplin’!

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In other news, DW’s started her daily regime of 27 pills (13 different drugs/vitamins) + 1 injection, and FRIDAY IS TRANSFER DAY!!! We are nervous and excited about it, and I’ve been giving her “spa” treatments everyday- massages and acupuncture on alternating days. We are begging the universe for some good vibes.

Pregnancy update to follow in a few days… 

Embryo Transfer #6: Frustrations

So DW is on cycle day 9 today of her FET cycle. So far, she’s had blood work and ultrasounds done during her previous cycle, and during this treatment cycle on day 3, and her next will be on day 12 (Friday). We have been with this clinic since 2012, and it really hasn’t been feasible for us to change clinics because of all the monitoring that needs to be done before work. This clinic has 4 locations, which makes them fairly convenient for us, since we work in two different cities. However, our relationship with them isn’t without significant frustration…. 

I’ve had time to cool off about it, so I will just casually list off the ridiculousness and incompetences that we’ve had to deal with:

1. Nonsense: When DW went in for her monitoring last cycle, they kept insisting that I had to come in to update my bloodwork since she hadn’t been active for almost a year. I suspect that this must be protocol for heterosexual couples, but we’re a same-sex couple, and my blood work has nothing to do with DW’s FET or the status of our embryos. Plus, the nurses know who I am (I mean, 3 years, 4IUI’s, 2IVF’s, 5 transfers, and 50 grand later, they better know who we are!), so logically, why do they need my blood? We argued with them for a while, and all they said was that they needed updated bloodwork because the embryos came from me (still doesn’t make sense!). Anyways, we just keep ignoring their requests because I ain’t getting poked to satisfy their stupidity and inability to critically think.

2. Inconsistencies: So on her last cycle and during this cycle, DW had elevated prolactin on her both of her day 3 blood draws. They told her that anything over 30 (don’t remember the units) was elevated and then made her repeat her prolactin bloodwork the next day while fasting (in fact her day 3s were also done fasting coincidentally), and her repeat levels were normal (29) for her monitoring cycle and 39 for her treatment cycle. They then said that the normal range was 40 or less, and that her prolactin values were fine. WTF? How did the normal range change from 30 to 40? This nurse has made major mistakes in the past and I’ve argued incessantly with her but it just makes her even more unwilling to check her facts. Also, I know that high prolactin can affect implantation, and have read that other RE’s consider normal as 25 or less, and ladies with anything higher are put on bromocriptine or Dostinex to bring it down before transfer. Sadly, there’s nothing we can do about this because this nurse is not very open to other opinions and the RE is very uninvolved in checking levels it seems. 

3. Incompetences: so my endocrinologist (who is awesome, and I trust very much) says that TSH should be less than 2 preconception, and when I was trying to get pregnant, she vigilantly had my blood TSH, T3 and T4 levels checked monthly to keep me under 2. Last cycle, DW’s TSH was 3.8, and the damn fertility clinic seemed to think this was fine. I argued with them about it, and apparently my RE seems to believe that a TSH under 4 is acceptable. I’m so upset about this because for our 4IUI’s with me, my TSH was around 3.9 and my endocrinologist (looking back at old bloodwork print offs that I demanded from the fertility clinic) thought it was unacceptably high. I’m frustrated that the fertility clinic doesn’t seem to prioritize optimal hormonal levels, but instead is just happy with us trying under suboptimal conditions, wasting sperm, wasting embryos, wasting time and money. I feel so strongly about this that after her day 3 bloodwork last cycle, we “unofficially” started DW on 25mcg of Synthroid from my stash. In one month, that brought her TSH down from 3.8 to 2.8, so we added another 12.5mcg daily = 27.5 mcg daily to hopefully bring it down a touch more. Frustratingly, the fertility clinic only checks her TSH once in a cycle, so we have to just keep our fingers crossed that her levels are hovering around 2 or less. I’m also a big stressed because I’m still taking Synthroid and my stash of pills isn’t large enough to be supplying both of us until my next refill is eligible. But my priority is giving her body enough thyroid hormone to support a pregnancy. It just sucks to have to be so clandestine about it. We’re also doing the same thing with her and prednisone. 

I know I’m a bit over analytical about all of this baby-making, but DW has suffered 2 miscarriages of 4 of our best day 5 blastocysts. Despite their “investigations” the clinic has not been able to identify any reason for her losses. They have demonstrated inconsistencies, incompetencies, and don’t seem to critically think about our unique circumstances, but rather treat everyone with the same “cookie cutter” approach. Changing clinics at this point is pointless, since most clinics around here function very similarly (what’s the incentive in improving when you’ve got a 3-6 month wait list of patients?). So basically, our approach is to just go ahead with the transfer, hoping that by lowering her TSH her prolactin might balance out too, and that the autoimmune meds help deal with the unexplained RPL. As I mentioned before, this is DW’s last go at it. She took a year off after her last loss to be ready to face this juncture again. We hope that it works, because I can’t even imagine the heartbreak if it doesn’t. 

If you have any experience with prolactin or TSH levels, I’d love to hear from you. 

As usual, your support is invaluable to us. 

IVF#2: To Exercise, or Not to Exercise?

This question plagues me every single time we get close to an FET/IVF/TWW, and to be honest, I am no where closer to a solid answer on this.

As most of you know, I am a very physically active person. I played multiple sports on a competitive level. My regular schedule of activity before TTC was intense hockey games 2-3 days a week, plus weight lifting 3-4 days a week. My body loved it, my mind loved it. Sometimes I wonder if that’s how I managed to keep my depression at bay without meds for so long.

When we started doing the IUIs, I continued playing hockey twice a week, weight lifted 2-3 days a week, and limited my exercise to regular daily activities during the TWW (no hockey, no weights). In between BFN’s, I would go back to playing hockey and lifting. In total, I had 4 BFNs from IUIs.

When we moved to IVF last year, I went down to playing ice hockey once a week, and continued weight lifting. Once my ovaries started becoming palpable from the outside (approx stim day 8), I stopped everything except for walking the dogs. We got lots of eggs that round. 21 mature –> 14 fertilized –> 7 day five blastocysts.

Embryo transfers 1 and 2 were DW’s, and she weight lifted once a week plus dog walks before the fresh transfer, and only dog walks during her TWW. After her 5 week miscarriage she joined me back playing hockey once a week. After her second transfer, she only did dog walks, until her miscarriage again at 5 weeks.

Prior to embryo transfer #3, I was playing ball hockey twice a week, and walking the dogs almost daily until the TWW. During pregnancy, I only did dog walks a couple of days a week, until 6 weeks when I went back to weight lifting, and then miscarried sometime during week 7/8.

I returned to the gym a week after my D&C at week 9, and for three months, lifted heavy weights and did compound lifts (squats, deadlifts) 3-4 days a week. I also did sprints 2 days a week. This is until embryo transfer #4, after which I did nothing but dog walks.

After embryo transfer #4 = BFN, I look two weeks off due to being depressed and Christmas holidays. For the past two weeks, I have been working through this high volume fitness competition program. I am on week three of the muscle building phase. Since I started it, I’ve packed on three pounds, but it’s hard to know if it’s just water weight from re-introducing carbs (from 15% to 35% of my macros), muscle mass, or gosh fat (from eating nearly 500 more calories daily than before). I am loving the program so far, and find that I am so hungry even with the increase in calories (from more muscles?), but realize that I shouldn’t be continuing this program once I start stims. The program has me lifting for 90 minutes 6 days a week, plus the 3 days of cardio that I’m not doing (I don’t want to create a calorie deficit). I realize that this is too much, and too frequent for a body trying to optimize reproduction.

Now, I’m trying to decide whether to limit myself to dog walks soon, or whether it’s safe to keep lifting, but at a much lighter resistance.

During my research, I find things like this, which has me thinking that since I have worked out regularly for over 15 years now, no matter what I do, my outcome will be the same. This study essentially says that women who have a history of exercising regularly for five or more years generally have poorer outcomes than sedentary women, regardless of if they exercised during IVF or not.

Then of course, there’s this, which has me totally thinking that I shouldn’t exercise during the first 18 weeks of pregnancy because of the greater risk of miscarriage, but then confuses me by showing studies that say exercise helps to prevent miscarriage. Though, neither really matters to me right now because my concern is about IVF outcomes.

The alternative medicine doctor part of me thinks that all strenuous activity (things that make you sweat, hold your breath, increase your intraabdominal pressure) should take a back seat during stims and the TWW because these kinds of activities drain the resources (Qi) needed to make and nourish developing eggs/embryos. From a primal/paleo perspective, these activities would mimic the unfavourable conditions of running away from predators, or having to hunt/forage, both of which indicate to the body that right now food is scarce and not a good time for baby making. Also, heavy lifting encourages the cycle of muscle damage and repair, which is the basis of muscle building. This increases the oxidative load on the body, and the resultant increase in metabolism increases the amount of free radicals floating around, which is also bad.

As for light exercise such as walking, and light cleaning, I believe these activities are good during stims and the TWW. They increase the circulation through the body, and get some good endorphins flowing.

What I would love to see is a study comparing consecutive IVF cycles- one with exercise and one without, with identical treatment plans, and what the resultant embryo numbers and qualities are. Too bad I can’t find anything like that, as it would shed some light on what I should do.

What I do Know
– I have already stopped doing cardio because it is counterproductive to try to burn calories
– I will keep my calories the same as right now (well-fed and higher than maintenance).
– I will definitely not put myself at risk of ovarian torsion.
– I will not exercise while my ovaries are healing from egg retrieval (last time took two weeks to have a non-painful poop)

Those of you who have done IVF- what kind of activity did you maintain during your stims? What kind of outcome did you have from your IVF? What would you do if you had to do IVF again? What was recommended to you by your RE?

Infertility as a Prison

Okay, so I’m back. I spent some time the entire time sulking about our last blastocyst not sticking around, about our grand IVF failing, about being two years older, 3 miscarriages wiser, and thirty plus grand poorer.

Infertility as a Prison
The only way I can describe how I feel is by comparing it to being in prison (which, is quite a silly analogy because I’ve never been to prison, and I’m sure that my assumptions will piss a whole whack of people off). I feel like we are stuck in IF (infertility) prison- friends and family visit once in a while, sharing details of their normal daily lives, which feels foreign to me because my life has been all about IF prison and getting out of it. Visitors try to express their sympathies for me, but it just comes off as pity, which makes me sort of angry, but I’ll take anything because I feel so alone. They tell me stories of how so-and-so’s SIL got out of IF prison once she stopped stressing about it, and how IF prison can’t be that bad- you’re off work and get to work out and go to yoga classes in the slammer. Friends are either scared to tell you that they were granted Furlough, because no one gets Furlough, and really, they will be super stressed the entire time that they are out of IF prison, scared that they will be sent back there early, a miscarriage. You develop friendships with other IF prisoners, a real sisterhood, sharing your dreams of getting out, oooohing and awwing at sistahs-who-got-out’s baby bumps, which you are genuinely happy about, but it still stings a bit because you’re still stuck in IF prison, without any chance at parol in the near future. That is, until you start a new IUI or IVF, and you start planning your appeal/speech at your parol hearing, when new hope is restored that you will finally get out of this shithole, especially with your good behaviour. And you believe it. You believe that the cocktail of drugs, infusions, herbs, acupuncture, energy healing, and exorbitantly expensive amounts of CoQ10 will do the trick. You try and try, getting more desperate each time, and if you’re like us, and have been at it for a long time, all of the IF rookies you started with have gotten out and are enjoying their lives with their babies, and you feel particularly slighted by fate. When will it be your turn? Rest assured, will get out of IF prison, with or without a baby, if it doesn’t break your spirit first. In the meantime, we watch longingly from the sad side of the fence.

Don’t worry, I managed to pick myself up off the floor, and there is a plan in place, which I will share with y’all after the massive leg day I do in the IF prison yard today.

FET#4: 10DP5DT or 15DPO: Results

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I thought that some nice pictures of the dogs might ease you all into bad news.

We just got the call from the clinic.

BFN.

We are devastated, but not surprised. I guess the Dollarama pregnancy tests were more correct than that stupid Clearblue Easy Plus.

I’m supposed to stop all my meds, aside from my thyroxine, and AF should arrive within 2-5 days.

I feel like I need a vacation. Take me away from this cold, terrible place.

Never did I ever think that we would blow through all seven blastocysts and be worse off than before we started. Some believe that there is a lesson in each failed IVF cycle. What have we learned?

– DW can’t hold a pregnancy past the first week
– I can’t hold a pregnancy to heartbeat viability

The reasons for DW’s failed attempts are unknown, and my diagnosis is weak at best.

Where do we go from here?

FET#4: 8DP5DT or 13DPO

We got some snow overnight, and the roads were not plowed early enough for the morning rush hour.

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Our bedroom window.

I got up early because the 30% increase in Levothyroxine makes me jittery in the morning, and tried out one of those MediCare Dollarama Pregnancy tests.

BFN.

Now, I haven’t really posted much about symptoms because well, I haven’t really had any- aside from a permanent dizzy and brain fog feeling ever since 2DP5DT. I also had some minor cramping 1-2DP5DT. The only other time that I’ve experienced the brain fog and dizziness is during last pregnancy. Since I’ve been on these meds 5 days prior to the transfer, and didn’t feel the dizziness or brain fog then, I’m pretty sure that they are a sign of pregnancy for me.

Secretly, I also tested on 7DP5DT (yesterday) using my last Clearblue Easy Plus and got a faint positive.

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Do you see it?

But after the BFN today, I’m confused, and feeling absolutely devastated. I’ve been laying in bed all day, feeling hopeless and depressed.

Do we have implantation failure? How have NONE of our 7 day 5 blastocysts worked in either of us?

Should we switch clinics? Or will it just be more of the same bullshit no matter where we go?

Our beta is on Saturday, and I feel guilty for not feeling hopeful.

I should’ve listened to my wife and never have bought those cheap dollar store tests.

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