Almost halftime!

I had my check up today with the doctor to see that everything is progressing as they want. Even though it's never been a problem in the past, I was a tad nervous about this appointment since we are on a different drug protocol. However, like usual, those nerves were for naught. Everything has checked out ok (if the blood work comes back funky, they may call me later).

I got more instructions, as well as circles drawn on my backside to show where the shots go.  Those start tonight. I also was told to start taking low-dose aspirin every day. This is a technique doctors use with women who have had multiple losses. They think it helps prevent clots that could mess with embryo growth, but it's not 100% proven. But it also doesn't hurt anything, so we are trying it. So much new stuff this round we will never know exactly which part needed to change if it works. But at least we will have finally stumbled upon the right recipe for success (hopefully).

Anyways, there isn't much more to report. Shots and pills for 6 days, then we should transfer two embryos on Monday, Nov. 21st around lunchtime. Blood test is on Nov. 30th and hopefully I'll have more to schedule after that. Keep sending us good thoughts please!

Ready, set, go!

I went to the doctor on Friday for a follow-up to my follow-up appointment a few weeks ago. Originally, the doctor had said that he wanted to do an ultrasound in a few weeks to check that everything was healing ok. Then based on those results, we might be able to jump into another frozen transfer (FET) cycle. We never really spoke about specifics or paid any money, so I wasn't expecting much to happen really soon. Our last clinic was so methodical about stuff like that; we'd have paperwork and payment due (plus order meds) before ever getting scheduled for an ultrasound.

Boy, was I wrong about what to expect! My appointment started with a blood draw so they can check hormone levels. Then an ultrasound to check for cysts and see how my lining looks. Turns out everything looked ok, because the nurse told me to get dressed and meet her in the consult room when she finished the exam. She came in with the instructions for our FET cycle, much to my surprise!

We scraped the lupron we have used in the last few cycles. This saves us several weeks, about $500, and a couple dozen shots; so no tears over that change in protocol. I start taking Estrace (an estrogen supplement) twice a day for about two weeks. Then I go back to the doctor for another lining check. If that looks good, then we are all set to move onto the next step- progesterone shots. Not looking forward to these, but Spencer's always been good about giving them so I'm not concerned. Less than a week after we start the progesterone, we get to do the transfer. Then a 9-day wait before my first pregnancy test. It all takes less than a month, so it seems so much quicker than I'm used to. Kind of like a whirlwind.

In addition to the directions, I got consent forms to fill out and then sent to the front desk to check out and pay. It was a total of $2950, so a little more than our last clinic, but the lupron savings offsets the extra cost. I was still in a little shock by the time I left the office. If everything cooperates, we could do the transfer before Thanksgiving!

So, as usual, please send lots of good thoughts our way as we begin this process again. I'm feeling very confident that this is our cycle. The fourth one will be the lucky one. New doctor, cleaner insides, new protocol.

Transfer impending

Sorry for being so quiet these last few weeks.  It's been a busy month or so.  I've been rather busy with trying to finish up my homework before graduation on Friday!  I also got to attend the Texas Library Association annual conference in Houston.  I've been doing physical therapy for my back ache that just wouldn't go away.  I was house sitting for my parents while they were out of town.  It's been very busy to say the least.  Allow me to catch you up on how our cycle is going.

The lupron shots went well.  Some nights they stung a bit more than others.  I had to take them with me to the conference, so the swankiest place I've given myself a shot is now the restroom of a Hilton hotel. I didn't notice too many symptoms from the lupron; either I didn't have any or I was too busy to notice.  My second appointment went well. Everything looked just like they wanted it to. I added in the estrogen pills about two weeks ago.  And a week ago, my lining check looked great; good and fluffy and ready to have an embryo snuggle in.  I've stopped the lupron shots now, replacing them with the progesterone in oil shots that Spencer has to give me.  He has done a great job with them; my left side hurts, but the right side usually goes off with very little discomfort.  Finally, in preparation for transfer, I was on a steroid and antibiotic for a few days.  I think I was taking about 8-9 pills a day for a few days!  This process sure does require a lot of medications.

Tomorrow afternoon is our transfer day.  We ask for good thoughts and prayers for a successful transfer.  I am at a loss for what else to say about it. Third time is the charm!

Round 2

We decided to jump right back in with a second round, this time with our frozen embryos.  We paid our $2500 fee last month when we learned that we could start a frozen cycle almost immediately and it would not interfere with our holiday plans.  The medication was ordered and after a week of not hearing anything about setting up the shipment, I called the insurance company to check on it.  They thought it was just an approval, so it kind of got lost in the shuffle.  They finally got it sorted out, but wanted to charge me $600 for one of the medications (Lupron), so I decided to look elsewhere.  I asked the IVF coordinator to send the entire prescription to the place we used last time, but turns out they only sent the order for the super-expensive medication.  So I just ordered that one, and called back the insurance to order the others instead of messing with the doctor's office again.  After being told the exact opposite about coverage as I heard the day before, and after thirty minutes and five people later, it got sorted out and ordered the rest of my medications (which were all covered by insurance!).

Medications came on Tuesday and my appointment for the first sonogram was yesterday.  They checked my lining, which was 3.6 mm; the nurse said this looked right on track.  After I got dressed again, the nurse went over my calendar and injections.  I start Lupron injections today and continue those for several weeks. I won't start progesterone shots until December and our transfer is early December some time.  I also met with one of the embryologists about our frozen embryos.  We have 4 perfect embryos, so they will just pick one or two of those randomly and thaw.  We have to decide how many to transfer so they know how many to thaw.  

Both the doctor and embryologist said one embryo ought to take just fine, and that two is not necessary, but they'll do it if we want.  The embryologist also said we could thaw one and if it didn't thaw perfectly, we could thaw another and switch to transferring two last minute.  I'm so torn on what to do.  Last time was supposed to work just fine too, so I'm a tad skeptical when they say that one ought to take just fine.  I want to do two to increase our odds, but it also increases our odds of twins drastically. I don't think I'd mind twins, but that would be a lot of change all at once, a lot of extra expenses that I don't know we can afford just yet, and could possibly lead to major complications with the pregnancy.  I'd like to transfer one, but I'm afraid it won't take and we will have to pay again to do another round.  I'm just so torn on what to do; I've done lots of research and there is still no easy decision.  I'm leaning towards just one (two if the one thawed one doesn't look as perfect), but I'm so nervous about that decision.  I just want someone to tell me what to do and take this huge decision out of my hands, while guaranteeing whatever they decide will work out as planned (a girl can dream, right?).

So here are some numbers that I have found in my research and impact my decisions.

Odds:
Our clinic has historically had about 30% success rate with frozen transfers resulting in a baby; the average transfer rate is 1.7, so many people transferred more than one.  The fresh cycle shows a similar average transfer rate and about 42% chance of twins.  Based on my diagnosis, my individualized cumulative odds of success are 48% probability of live birth after one cycle; 69% after two cycles; and 81% after three cycles.  My odds of two cycles with one embryo is 68% probability of live birth and only 3% chance of twins. If I do one cycle with two embryos my probability drops to 57% of live birth and 41% chance of twins.

Risks of transferring one:

• Could not take and we have to try yet again
• Could take and still face complications with the pregnancy
• Could still split into twins

Risks of transferring two:

• Multiple births increase the risk of premature birth and low birth weight in infants. This can affect survival and well-being of newborns. These babies may require special care immediately after birth and at times, can face life-long problems such as developmental disabilities and delays.
• Women who carry multiples may be more likely to need Caesarean sections which may require a longer period of recovery, and at times, can increase the risk of hemorrhage during and after delivery.
• Some who become pregnant with multiples may find one or more cannot survive to term or even a premature birth. This may lead to a medical need to perform fetal reduction.