Saturday, August 27, 2016

It's in there!

Aaaaaannnnd it's done! Our 2nd transfer happened yesterday! (And of course, my 1st transfer led to my 19mo toddler.) So officially - our 2AA embryo which was fertilized the same day as my living, breathing CHILD, was just thawed and transferred to my uterus. It's an AMAZING thing.

It's in there! Let's hope I get Prego!!
The day went basically just like the last time (which I linked to in my first paragraph so if you want details, go read that one).

When I did my last transfer in 2014, it was at a different location than we went to this time. So this new location was N-I-I-I-I-CE compared to the previous. My acupuncture location had also moved to the same building as the fertility center (they were together at the last one too) which makes acupuncture pre/post transfer SUPER easy.

Acupuncture:
With my last pregnancy I did acupuncture for almost my entire pregnancy - starting with twice a week in the first trimester and moving to once a week/every other week after that. Because of that, I'm obviously very familiar with this acupuncture practice.

I called them up, basically like I did last time, to come in once before my transfer (I could have been treated for a couple months prior and it would certainly not have hurt anything, but my insurance only covers a maximum number of sessions/year so I preferred to concentrate those on the transfer/pregnancy rather than before.)

The day of the transfer they suggest you do an acupuncture session before the transfer and then do one after the transfer. I love this actually - because I step out of my acupuncture sessions feeling so calm and relaxed and being relaxed is very important during the transfer.

The day is here!

The Transfer Day:
Transfer appt: 12:30pm (check-in 12:15pm)

For transfer they want your bladder full as it helps to guide them as they look at the ultrasound picture during the transfer. So about 10:30am I measured 16oz of water into my bottle and started sipping on it.

We scheduled my acupuncture (typically about a half hour session) for 11:30am. So I spent my half hour doing acupuncture and then as soon as they were done I took my valium. Dr. A wanted me to take a valium about a half hour before the transfer because this also helps to keep you calm so that adrenaline doesn't make your uterus contract and mess up the transfer!

By now it was 12pm so Hubby and I walked over to the fertility center. It was all so calm and quiet and not stressful. The new (to me) facility is beautiful. We were escorted into a waiting room beyond the waiting room - my guess is this is for discretionary reasons. Then escorted into the transfer room. I joked in my last transfer that the room was no larger than a handicapped bathroom stall but this room was MUCH larger. Like the size of a normal exam room.

I really had to pee at this point. Actually I did even during my acupuncture and was wondering if I could pee "a little bit" out but I decided not to - didn't' want to mess everything up! It's a good thing too because the nurse who was assisting said that my bladder was "Perfect"! Said nurse got me all situated in the giant-chair-with-stirrups, which actually reclined much more this time than I remember being last time.

Dr. A came in and handed us our baby's first picture!

Hopefully, hopefully a sibling for our LO!
Our 2AA embryo all ready for transfer.

We gazed at the photo which is even more meaningful to me now, because I have seen it come full circle. I remember getting this same photo at our first transfer and now I think of all the hundreds of thousands of photos we've taken of our "5AA" AFTER birth! So incredible.

Then we got down to business! Just like last time: speculum (fun!), catheter, everything cleaned out and in order and we wait....
.....
.......
........
and then the embryologist comes in! I had to sign some forms (yes while holding that position) and then we were good to go.

I know last time Dr. A was able to get pictures for me that she printed but I guess she can no longer print photos of the ultrasound pictures, SOOOOO if you want to take any photos of the little tiny shining embryo that now rests inside your uterus - you'll have to do so with your own camera pointed at the screen. And no, you can't actually SEE the embryo (it is microscopic). What you see on the screen is the liquid surrounding the embryo.

I was asked to rest there for a little bit (maybe 5 minutes) and then I could finally head across the hallway to relieve my bladder! WHEW!! And insert a Crinone (which I had brought along from my stash at home). That'll be 3 Crinone applicators today.

And then we were out - and heading back to acupuncture for another session.

So relaxing...no really!

I think we were leaving the fertility center by 1:45pm. It all happens so fast!

Taking it easy was much harder this time around than for our first transfer because now, of course there is: Kiddo. Kiddo is extremely demanding and always NEEDS Mama. Mama is by far the favorite all around. But Hubby is great and very good at distraction (he is well seasoned by now.) So after we got home, I ate my half a pineapple core* and settled into my bed to watch some movies and TV shows while listening to toddler squeals and daddy chuckles out my window. I felt like I was getting away with something!!!

Dr. A suggested I not carry anything heavier than 20 pounds, if possible, up until my first ultrasound (2.5 weeks after transfer). Lemme tell you: it is going to be IMPOSSIBLE to not carry my almost-30 pound monster around. IMPOSSIBLE. But I shall try my hardest. Today and yesterday (since this is implantation time) I am being quite strict about the carrying thing, but I may ease up a little by 4 days past transfer since implantation should be completed by then (you can find information about the stages after transfer, on my first transfer blog post which I linked to in the first paragraph). The not carrying my child, is just not something I can sustain so we'll see how things go over the next few days.

If and when we [hopefully, hopefully] get pregnant again, I don't think I'll have the time to do weekly posts through my pregnancy like I did with my first born, but I will still try to keep track of these days post-transfer.

In fact, here's a little bit about yesterday and today for you since you're chomping at the bit:

Day of Transfer:
Felt very gassy and my stomach was very gurgly. I took it SUPER easy. Watched TV all afternoon while Daddy played with LO. Tried to remain in a reclined position as much as I could today.

1 Day Post Transfer (today):
Not as much of that gassy feeling. Actually felt totally normal so it was hard to not do my normal things. I didn’t leave the house but I was up and around a little more - still not carrying/lifting LO, but prepared meals and made a simple dinner for us. One thing that was noteworthy is how tired I was. I took a 2 hour nap (very unlike me). It seems odd since I wasn’t too tired yesterday. Is the valium kicking in a day late!? I may have felt a tiny bit of cramping - but I swear I was feeling that before the transfer! LOL.

Eat the core of a pineapple (only) to aid in implantation

*Pineapple core: you may recall from our first transfer, that I consumed the core of a pineapple over the days after my transfer. This stems from the "Eastern Medicine" portion of my transfer instructions. The core of the pineapple (not the meat) contains bromelain, an enzyme which can aid in implantation by acting as a blood thinner/anticoagulant and also acting as an anti-inflammatory agent. Cut a pineapple widthwise into 4 pieces, then use a cookie cutter to remove the core. Eat 2 of these core pieces on an empty stomach, the day of your transfer and the day following your transfer: therefore 1 entire pineapple core within 2 days time. (Last time I ate it over 4 days instead of 2: 2 years later, instructions have changed!) Don't eat the meat of the pineapple (supposedly tropical fruits should be avoided in early pregnancy if you follow an Eastern Medicine diet) just the core and only those first 2 days.

And that's my post for Transfer #2! I'm still in disbelief that we're going through all of this again. But it's happening and there is certainly no turning back now! :)

Sunday, August 21, 2016

Polyps and Thyroids and Vitamins, oh my!

Mother Nature and I haven't tangoed too much recently. But as soon as we started the dance to prepare for this second transfer, she IMMEDIATELY reminded me that it is *SHE* and absolutely, completely and totally *not I*, who is in charge. I was cruising into this transfer thinking like "yea...I got this. I been here. Whatevs....no big." And so of course she started throwing me curve balls like it was no ones business.

"Curve ball for you, curve ball for you..."

After my July period ended (during which, I started birth control pills on Cycle Day 2), I went into Dr. A's office to start things off. I had a water ultrasound appointment right at the end of July - to check that everything looked great in my uterus. And I WAS fully expecting everything to look great. I mean, I'm a rockstar seasoned IVF/transfer/pregnancy/mommy Pro-with-a-capital-P now. Everything was gonna look great!

It did not...

I had another polyp (or maybe 2 actually). Dr. A found a polyp back in Sept 2013 before my first stimulation/retrieval and that little guy had come out too. Uterine polyps are nothing too scary for the most part. They COULD cause you trouble getting pregnant (if you're trying naturally and your egg fertilizes, depending on where the polyp is - the embryo may not be able to implant in your uterus.) Typically they are not cancerous, but they are always biopsied after removal to be sure. Polyps tend to be more common in slightly older women (like post-40) and for the most part have no obvious symptoms. BUT these guys had to come out before we did a transfer, for sure. And for me, there was a timeline to keep. I was still on BCPs at this point and needed to remain on just up to the polyp removal. But I had to stop the BCPs no less than 5 days prior to starting the transfer hormones (Estrace/Estradiol/Estrogen to build up my uterine lining), so if I wanted to keep the 8/26 transfer date then we had a very small window to work in. We needed to get into the surgical center ASAP. I mean their first available opening!

Here's how it went ended up going down:

Sunday Monday Tuesday Wed Thursday Friday Saturday
7/31 8/1 8/2 8/3 8/4 8/5 8/6
Last BCP Polyp Removal Period started
Start Estrace Period Ended

Fortunately the EARLIEST appointment the surgical center had was basically the LAST appointment we could do and still stay on schedule. WHEW!!!

Whew!!!!

So that was curve-ball number 1. But I hit that curve ball (or more like Dr. A did!) and was feeling all confident again. Let's do this transfer!!! Gonna kick the $#!+ out of this! 

Cuve balls number 2 and 3:
Another thing Dr. A did at my water ultrasound appt was to take blood to make sure things/levels and such were looking good there too. For some reason there was a big delay in getting the results (to be honest I didn't even know I was waiting for results until I got an email from Dr. A with those additional curve-balls!) Almost 2 weeks after my polyp removal, which was just a week before we'd start Crinone/Progesterone, I got word that my TSH and Prolactin levels were high and we absolutely needed to get them down or we'd have to postpone our transfer. 

What the what?!
Come again?

I'd never even heard of TSH or Prolactin.

Oh and I had a slight Vitamin D deficiency. ACK?!!

I was supposed to be all hardy and able-bodied and was going to just cruise into this transfer!

Argh! Poor me!

Soooo the Vitamin D curve ball was not a major one. My level was 28.2 ng/mL and the normal range is 30-100 ng/mL. I didn't even ask Dr. A about this one but of course we don't want to go into a pregnancy with low vitamin D levels. Our bodies need Vitamin D to maintain proper levels of calcium and phosphorus, which help build Baby's bones and teeth. Dr. A asked me to start taking a 5000 iu supplement so I got on top of that one right away!

Back to the TSH/Prolactin thing:
TSH = thyroid stimulating hormone. The pituitary gland at the base of the brain controls hormone production in your body. It makes TSH which tells the thyroid gland how much T4 and T3 (thyroid hormones) to produce. The TSH level in your blood reveals how much T4 your pituitary gland is asking your thyroid gland to make. If your TSH levels are abnormally high, it could mean you have an underactive thyroid. This is important for many reasons. A high TSH level could affect implantation and could cause miscarriages, premature birth, pre-eclampsia, low birth weight and mental problems in the baby. Basically you want your thyroid to be operating very normally before you try to get pregnant!

Prolactin elevation is typically due to TSH elevation so Dr. A said not to worry about that one (it should come down when we get the TSH down.)

So the bad news - my numbers:
TSH: 4.04 uIU/mL 
Normal range: 0.45 - 4.5 uIU/mL
But for Pregnancy: under 2.5 uIU/mL

Prolactin: 35.5 ng/mL 
Normal range: 4.8 - 23.3 ng/mL

The good news:
With 50 mcg of Synthroid/day I should be able to bring the TSH down. This is good news, because we're up against ANOTHER close timeline!!! We want to see those TSH/Prolactin levels come down before we start the Crinone. Once we start Crinone and the final transfer meds (Doxycycline and Medrol) we're moving towards transfer!

Sunday Monday Tuesday Wed Thursday Friday Saturday
8/7 8/8 8/9 8/10 8/11 8/12 8/13





Start
Synthroid
8/14 8/15 8/16 8/17 8/18 8/19 8/20




Lining & Blood Check Start Crinone

Dr. A said the Synthroid (I was taking the generic, Levothyroxine) could help within 5 days. And if my levels still weren't down by my check on the 19th, we could try a bolus dose which has been known to help as well. Ai yai yai this is all nuts!

So I went in for my lining check on Friday which (ok, finally some good news) was BEAUTIFUL!
"My, what a beautiful lining you have..."
Thankful for that - the Estrace is doing its job! Dr. A also took my blood that day and I waited impatiently for the results. I'd started the Synthroid last Saturday so it would have been 7 days of taking it and she said it can work in as few as 5. We wouldn't get the TSH results back until the next day, but my estrogen level was 390 pg/mL which she deemed "excellent"!

By that next day (yesterday: the day I was supposed to start Crinone in the evening, if we were a go) Dr. A was having some difficulty getting my TSH results from the lab, so she had me go to a different lab who could turn it around the same day. Good thing I didn't have plans yesterday and could run out to get more blood work done! KUHRAYZEE!

Finally, finally, finally at 8pm last night I heard from Dr. A:
TSH: 1.8 uIU/mL
Prolactin: 9 ng/mL

Yes! Yes!! YES!!!
We are a GO!!!

 We were a go for transfer!!

OHMYGAW... I ran upstairs and inserted my first Crinone (ahh, Crinone - how I [have not] missed you).

What a frantic couple weeks! But I drop-kicked the polyps, tackled my thyroid and even took on some vitamins and HOPEFULLY, HOPEFULLY my body is fully ready to accept our perfect little 2AA embryo on Friday!

I seriously have no idea how anyone gets pregnant without the help of modern medicine. NO idea. I need to lie down and take a nap after writing this blog post. Exhausting.

Transfer post coming up next. Keep us in your good thoughts!!