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!!