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orphancookie69 · 1 year

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My Infertility Journey: Part 4

Yeah, future me needs to go in the past and tell past me to not be crazy. Well, they have not arrived yet-part four starts. The sooner I get in the drivers seat the sooner I park my car in the winners circle I hope....Just hopping on late? Here is Part 1, Part 2, and Part 3.

August 2022:

A week after the ERA comes a cycle. This is highly unusual as it does not normally come that soon. Second half of the month is the start of round 4. Initial ultrasound and bloodwork scheduled to see if the body is on the starting line. Now let’s talk about the definition of insanity, it is doing the same thing over and over again expecting different results. Based on the ERA, I am perfectly fine and we have been doing this with proper timing-so initially they said we are going to move forward with no changes. At consultation, they mentioned adding Intralipids-IV injected twice during the process. I am open to this idea, more than the anti-coagulants, because I think my body can only handle so many injections. I only have two more embryos at this point, and while I want to make sure they have the best odds of sucess-there are physical limitations of being...ya know...human?

The results from the blood work came back, my hormones were too high. So they are having me wait and we will reassess on next cycle. I am happy that this news came from the doctor, I felt like it was better to wait and give the body a break. But for some reason, it felt like it would not have as much credence as it does coming from the doctor backed by “data”. I am looking forward to my break and plan on getting a family trip to Havasu in before my next cycle. PARTAY! No but otherwise this is a great time to hunker down and see if I can’t get some good training in for game day. Using muscle stims, heat, massage, and exercise to promote healing of the area. Maintaining diet and exercise to see if I can’t lose anymore weight before then.

September 2022:

Have I ever mentioned how much of this process is PLAYING THE WAITING GAME? But waiting has its own perks. So far just waiting for a cycle to come, estimated to come around the middle of the month according to P Tracker, and see if hormone levels are good enough to move forward. Also, I am (heavily) playing with the idea of implanting two instead of just one. My own doctor says the odds are better with just one, but I have heard a lot of other doctors/patients have success with 2. Part of me really likes the idea of implanting both and having this be the last round, for better or for worse. We will see what the doctor says.

So my body decided to get stuck in “period limbo” this cycle. I get all the feels but none of the results. Doctor did a “wellness check” on me and decided to reset my cycle with a week’s worth of Birth Control. Then we are going to move on the next cycle. I picked up my prescription and then took them, one a day, for a week. My doctor puts me on Enskyce, and man I usually get all of the side effects: migraines, nausea, and lack of energy.

October 2022:

Body goes into cycle and then on Cycle Day 5, we went in for an appointment. Ultrasound and bloodwork looked good, we updated my thyroid panel as well. Now starts injections and the new element this time-intralipids. They are to be done at a third party facility, Oso Home Care in Irvine, in week 4 (before transfer) and after transfer. I am (attempting) to schedule an appointment with Oso Home Care after my next Ultrasound/Bloodwork appointment with Fertility Care in Brea. Ya know the one appointment(s) before implant. It is kind of crazy how much happens in a month.

Drugs: EV (Estradiol Valerate), Dex (Dexamethasone), P4 (Progesterone), hCG, Valium, Doxy (Doxycycline Hyclate), Medrol (methylprednisolone),

Vitamins: Baby Aspirin, Prenatal vitamins (NAC, Prenatal, Omega 3, L Arginine, Coq10, Myo Inositol, D3)

Suggestions: Keto diet/Fasting, Exercise, Proper Injection Guidelines.

Price: $5,000+ (Fertility Care), $100+ (MDR Pharmacy), $550 (Oso Home Care),

Here are some Injection Guidelines:

Before: Ice the area

During: Inject the right area, Massage it after

After: Walk it off a bit, Use a heating pad

In Between: Arnica, Massaging to promote healing

Check: Infection (red, raised/bumpy, burning, itchy)

Note: Injections are intramuscular, and depending on the injection, there are only so many spots you can inject. Just because there are other muscles, does not mean you can use them even if your areas are “out of commission”. You just gotta keep them in commission!

The phone tag that was had was fun by all? Honestly as much as this is not my first rodeo and this should not worry me, the intralipids worry me a bit. Really the scheduling process being the slowest thing ever doesn’t help anything either. Be careful when doing research too, it is not always as helpful as you would think to know what you are signing up for. Also, the slow time between the first and second appointment where there is only an injection every 3 days is lovely. So I barely got my appointment for the intralipid place, if I did not call, that might not have happened. Then went in for the next ultrasound, the last one before implant. Ultrasound was good and blood work was TBD.

This starts the next phase of the process. From here we add 4 hCG shots, add 2 times a day of p4, and continue with EV every 3 days. Also, for the hCG...the first injection has to be in the back area, but the smaller ones can go in the stomach to give the back a bit of a break. Round one of the Intralipids happens. The dexamethasone comes off the schedule just before implant-a couple of meds get added for a couple days around implant. Implant happens, this time it will be a boy (currently between the names Roland and Kai). After implant it is suggested for up to 3 days of rest. Then we move into November (after playing the waiting game) to confirm the pregnancy.

Oso Home Care...Intralipids: Its a cute little place in Irvine. Kind of disorganized and busy but it would seem a lot people go to a facility like this. I got there early. I spent 2.5 hours in the chair. Yeah, kind of a long time. The gals that work there are sweet, but I don’t like how they had to prick both my arms to get it to work. I felt strange after? I am not sure how I was supposed to feel. Based on when I left and where home is, it took an hour to get home. But I hope in the future that since I am already in the system that booking is easier, and I kind of have a better idea of what to expect. Dress comfortable, don’t bring a book.

Ovation Fertility...Implant: I always forget COVID never stopped being a reality for hospital establishments. I always forget to bring a mask to these things. Arrive 15 minutes early in Newport Beach, take a Valium an hour before. Implant goes well-go home and rest. Also, if they let your partner in-film the implant.

Implant day is a day of rest, and this time I am trying to take two more days of rest after. I am an awful patient and this is hard for me to do. Post transfer we ran low on p4 so we transitioned to 1/2 crinone and 1/2 p4 for the every 12 hour injections. There are enough drugs on hand to get through to the pregnancy test and once confirmed, we stick with this or go all crinone. I don’t remember my last boys’ implant well but this time around, my left uterus feels like a battle zone a bit.

Trimester Breakdown:

Part 1: 10/7-1/8

Part 2: 1/9-4/12

Part 3: 4/13-7/15

November 2022:

An appointment was set up to have a blood draw/pregnancy test on 11/7. What was the time like before? I felt most, if not all, the symptoms. Pray tell, what are the symptoms of the first trimester?

First Trimester Signs: Nausea, Metallic Taste, Foggy Brain, Cramps, Tiredness, Breast Tenderness,

For me, and according to old wives tales, boys are supposed to be worse. This round definitely felt different as I felt very sore for up to a week after implant. Google says this is ok but man, it was kind of odd. The first blood test of Week 4/5 happened and TBD. If this goes well, I go two more times-two days apart. In theory the HCG a pregnant body produces should double every day. The first time you are able to view anything on an ultrasound is week 6. The next, and final, intralipid appointment would also happen that week.

The first blood test was good and positive, the next blood test the values should of doubled...and they did not. They increased but did not double. The office wants me to see the third test before jumping to any conclusions. The second blood draw was a 15% rise. The third blood draw was a 66% rise, so they kept us on the schedule and we scheduled the first ultrasound at 6 weeks 4 days. They also had me schedule my second, and last, intralipid appointment for that same day. Prior to going to going into the first ultrasound, there were 50/50 odds that this is a viable pregnancy.

We went in for an ultrasound and there was a gestational sac, but nothing that could be seen in the sac. They did a blood draw, to confirm the hCG is rising as a pregnant body should be. I had an intralipid appointment but they wanted me to move it, and wait for the results. The beta was rising, so we stay in the game another week. Order more drugs from MDR Pharmacy and scheduled another ultrasound for the end of the week. The intralipid appointment was moved to the same day as the next ultrasound.

Oso Home Care...Intralipids: This trip was shorter, already in the system and they have an idea of how quickly you take the liquids and what not. I believe this time was about 3 hours?

Also, I am keeping track of my weight, as women who are overweight before need to be careful how much weight they put on. When I checked on it, I actually had lost weight. Between my keto diet, morning sickness, and other pregnancy symptoms. In the first trimester one can lose a bit, but should this trend keep up in the second trimester...we got problems. Went in for the next appointment and while it was still not where it was supposed to be, there was improvement in both Beta (blood draw) and ultrasound findings. By this time I am almost 8 weeks along and there should be some major organs created, like the heart.

December 2022:

The next ultrasound would be interesting as it was kind of the determined trip to “call it”. Why would I want to call it? Because since implant, it has been very “we don’t have good news but we have not bad news so keep injecting”. And the body can only take so much for something that they said was most likely to end in bad news? But the doctor makes a good point that while certain things should be in place by this appointment, babies can be “past their due date” so if they are slow to grow, as long as they grow, it is fine? As the train carrying the passenger, the “limbo” is annoying as hell.

The Week 8 Ultrasound: Yeah, so that went about as good as that was going to. The doctor finally called it. It is sad, bumming, annoying, frustrating, relieving yet unwantedly so. They are three options to resolve this round: to let it happen naturally, use drugs to help “speed things along”, or get a D&C. For now, we are going to cancel medications and assess in another couple of days. Did a blood draw to see where the beta is, and establish a comparison point for declines in the future.

For the next blood draw, I could of gone to my Fertility Care office-but with us at the sad end of the process-and them not being part of our insurance-we decided to finish the process in slightly more complicated insured way. They ordered the blood draw at Quest Diagnostics. I made an appointment and the results were sent to Fertility Care. I have seen some insurance that covers infertility, but for the most part that is a sad joke. Some jobs cover that too. If you need that as an option, it’s worth looking into.

Pay attention to your body. I had sharp pains on my lower left abdomen area the day before the blood draw. Like, bad enough to make me basically pointless the rest of the night. The next day they continued, and I called it in. I am now on the alert for heavy bleeding and those pains, as the combination means bad news. But should be signs the body is starting the miscarriage process. To speed things up, they put me on Letrozole and Acetaminophen-COD. This will be my first time having a drug induced natural miscarriage.

Four pills at night for 7 nights, bleeding can last up to a week. Blood was being drawn at Quest Diagnostics and the beta hcg was going down. I used pads for a week to “measure” how much I was bleeding, more than two pads in two hours was bad news. Blood draw to see where we were at, luckily enough for all involved-there was no hemorrhaging. The second week of miscarriage recovery-less blood, less medications, but no less feels? Research shows it could take up to 6 weeks for my body to get back to “normal”. There are some herbs and vitamins I can take to help, but mostly it was rest and food and relaxation.

So, what happened? While there are no answers, there is a scientific name for this. Funny how that works out huh? Here is what I think happened:

“ A blighted ovum, also called an anembryonic pregnancy, occurs when an early embryo never develops or stops developing, is resorbed and leaves an empty gestational sac. The reason this occurs is often unknown, but it may be due to chromosomal abnormalities in the fertilized egg.” (Source: https://www.mayoclinic.org/diseases-conditions/pregnancy-loss-miscarriage/expert-answers/blighted-ovum/faq-20057783)

Because this is an IVF process, and everything is tested and in some ways controlled, I doubt it is because of any chromosomal abnormalities. But it is crazy how many variations of miscarriages are out there. And really, even in the same person’s journey-no two are the same. Oh to know so much yet so little.

Honestly, this is a very tough process. I am not sure what to think. Doctor thinks we should implant (IN ME) the last embryo, possibly changing nothing, and see if it works when I am mentally and emotionally ready. For now, the only thing for sure is its BREAK TIME. Is it too soon for a surrogate? I don’t understand how I can be such a medical mystery. It is a very strange feeling.

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