Sept 2019: I had my first ever elective IV! I joined a friend for "cocktail hour." By "cocktail hour" I mean, we had the Meyer's Cocktail in our IV drip. Some friends go get pedicures together, we do IV's. It consisted of magnesium, B vitamins, and vitamin C plus a lot of fluid for hydration. IV's aren't exactly the most pleasant experience (esp since I got mine in my wrist) but it wasn't too bad. I was DEFINITELY well hydrated! I was due to start AF any minute and this time, I didn't need pain meds! I do wonder if my level of hydration played a part in that.
Oct 1, 2019: Well...we are starting the ball rolling for IVF again. It's not a definite thing by any means but I'm going in for a consult with the male doc in my current RE's clinic. I called Birmingham and asked to switch doctors. I know it isn't personal but it still feels funny since I'm sure I'll still end up seeing Dr. H-esp if she's the one to do the retrieval. I hope there are no hard feelings but I hate the way things all went down last time.
Things to consider: Do we try and transfer fresh to me? The only success we had was a 3 day fresh embryo (our Skittle!) and we've never done a 3 day since. Why? Well, no doc will do it anymore as 5 day embryos have given better implantation rates. I'm still going to ask about it with my new RE. I'd want to do an autoimmune protocol and I have no idea if this clinic would know the first thing about it. The second option is to freeze all like we did last time. The frozen embryo would then be transferred to a surrogate. The goal would be to get embryos made (if my body will produce eggs) before the end of the year. Is it possible? I'm not sure...the timing is pushing it. Do we pay to have another immune protocol drawn up by Dr. Braverman's clinic? I just don't know. Cost: $1600 + travel to NY for a new patient appt. Cost for appt: $500 with military discount
Oct 7, 2019: Here we go. I had my first appt with my new doc, Dr. A this morning. He's kind, a straight-shooter, and I felt like he actually listened to me. While I do think Dr. H listened and was somewhat empathetic, switching felt right. The appt was good but completely overwhelming. It was information overload and obviously this isn't my first go at this so if it was overwhelming for me, I can only imagine what it's like for new patients. I have so much to process that I need to write it all out to help. So here goes:
Dr. A agreed with Dr. Braverman (and get this! Dr. A actually KNEW who Dr. B was! So unlike Dr. H who acted like she had no idea who I was talking about!) that there is NO reason why my body can't carry a baby. He suggested an ERA-The ERA (Endometrial Receptivity Analysis) is a genetic test that evaluates the expression of genes to evaluate whether the endometrial lining is properly developed to accept an embryo (definition from Google). I honestly believe that I have autoimmune issues, not necessarily implantation issues but it would be another test I haven't done, another marker to better understand things. Now, the question comes in, if I don't try and carry, would I need that test? No, I wouldn't. Cost: around $1500 and no, insurance won't touch that.
I asked about what protocol they would put me on for stimming. He recommended one called AL2. It's pretty much the most aggressive protocol out there. He wants me to do a freeze all cycle and not do fresh so they can better prime the body for transfer (to me or a surrogate). I agree with that to a point...but I still always go back to that fact that Skittle was a 3 day fresh and not frozen. A frozen embryo has never worked...BUT maybe the ERA would help remedy that. SO MUCH TO THINK ABOUT. I would still do Prednisone, Lovenox, baby aspirin etc plus pretty much DOUBLE the amount of stim meds as last time, plus adding micro dose Lupron twice a day. I am supposed to start back up on the 4567 million vitamins/minerals TODAY.
PGT: This just opens a WHOLE can of worms, one that I'm not so keen on opening honestly. It was pushed pretty hard by both Dr. A and his nurse (my all time fav nurse by the way). PGT is Preimplantation Genetic Testing. It's done via a biopsy of what will become the placenta in an embryo. "For those people with recurrent pregnancy loss or those interested in defining chromosomal normalcy prior to implantation, PGT-A applies the technology from PGT to improve their chances for a successful pregnancy. Embryos are screened for aneuploidy (missing or additional numbers of chromosomes), which is a leading cause of miscarriage and implantation failure (failure of the embryo to implant into the uterus). The goal of PGT is to identify chromosomally normal embryos, so they can be transferred increasing the chance of pregnancy significantly." Sure, that all sounds fine but then what happens to the embryos deemed "abnormal"? They are discarded. While I see the reasoning completely, it's also a moral issue for me. Could it be that my body isn't allowing the embryo to continue to grow based on chromosomal issues? It very well could be. PGT-A testing- Cost: starts at $3500. That's additional to the rest of the cost for IVF. While Dr. A didn't say he wouldn't transfer to me without it, he sees the benefit since I've had so many failures. It's a big reason why Dr. A wants me to freeze all...so that they can be biopsied. My nurse said, "It's one box we haven't checked." I see that but I also don't think my immune system is under control enough either. When it comes down to it, PGT isn't something we are comfortable with. As a friend reminded me, we wouldn't abort a baby with down syndrome, so why would we allow a lab to "discard" it? As morbid as this sounds, I'd rather an embryo die inside my uterus than in a petri dish. I'd want to transfer ALL embryos, no matter their "normality" status-so what's the point in knowing? We are VERY much in the minority on this issue and will be going against doctor recommendations (just as we did last round). So, with all that being said, freezing all embryos may not be the best option. I'd still like to push for a fresh transfer and then freeze any remaining, which we would most likely transfer to a surrogate. Now, we have to actually get embryos to freeze for that scenario of course. And I need to figure out if I can do an autoimmune protocol for a fresh transfer. If not, fresh just isn't going to happen.
If you want some of the most fascinating scientific data I've seen on PGT-A read this: https://www.centerforhumanreprod.com/fertility/a-final-nail-in-the-coffin-of-pgs-pgt-a/
Basically, there's some shady stuff happening around PGT-A and under no circumstances will we be doing it after digging into the research studies on it.
Oct 8, 2019: I had a rough night processing everything yesterday. I pulled out all my supplements (because let's be real..I stopped all those bad boys when my last transfer failed), organized everything, and took my first doses. I felt a whole lot calmer after everything was laid out.
Oct 9, 2019: I had my physical today. I survived-even though I'm pretty sure my pulse was over 200bpm. It's just one of my least fav things to do. Sure, I've had a billion vaginal u/s's, blood draws, catheters to my uterus, etc but I still HATE having to do physicals. They rank up there with HSG's (dye tests). Oh well. It's done. I had to update my "every 6 months" bloodwork, get a chlamydia (REALLY!?) swab, breast exam, and have my heart/lungs checked. I'm interested to see what my FSH is at these days....I was supposed to have my Vit D levels checked too but apparently Tricare won't pay for it so it didn't happen.
Oct. 14, 2019: Something Dr. A mentioned, as has one of my doctors from San Antonio, was to start supplementing with DHEA. When it was first brought up to me 7ish years ago, it freaked me out. It's a hormone and one that can have some very unpleasant side effects. I refused to take it back then but as this is kind of our "Hail Mary" round, I decided to go ahead and try it. Dr. A wants me to take 25mg. I agreed to start with 10mg and see how I feel. I took the 10mg in the afternoon and I swear I had a hard time sleeping because of it. I'll try it earlier in the morning from now on.
Plan as of right now: Wait for AF to get a baseline u/s and blood work. Start the God awful birth control pills for stim cycle. Do SIS testing once on BCP. Beg Dr. A for a 3 day fresh cycle and any remaining embryos will be frozen and transferred to a surrogate. As of right now, I am not traveling to NY or paying the money for a new immune protocol. It's just too overwhelming and I don't want to transfer any more frozen embryos to me so in my opinion, it's not worth it. While I'd love to do an immune protocol with timed intercourse, we can't due to timing issues (thank you Air Force! and my procrastination/needing a break by not starting this sooner) as we'd have to wait until around Aug of next year to begin. My eggs aren't getting any younger....
Bravo to you if you've read this far! Love to you all!
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