CD 1 / No Lupron

Was up in the night with cramps, heating pad on my belly and plenty of Advil in it. But by the time I awoke, the pain was mostly gone, and I was happy to see bright red blood and a full flow of it. The pregnancy losses I’ve had, the things I’ve seen during and after…they make seeing healthy reds and bright pinks a cause for a wide smile and a sense of peace.

Body: thanks. Really. You just keep on going.

So…this is it. The very beginning of the FET cycle. And quite likely my last treatment cycle ever. Possibly not. But likely.

After some research and consultations with RBA and CFHR (that’s Center for Human Reproduction, Dr. San Roman), I’m pretty sure I’m going to try a non-Lupron cycle this time. Dr. Shapiro says there is a 1% chance that I will develop a dominant follicle and the cycle will be cancelled—I think I can live with that chance. I need to talk more with Dr. San Roman about the risks of Lupron, but I know that he is not a fan of using it.

Anyone taking Lupron—I don’t want you to worry. The dose is very small and the risks are, too. But I am particulalry concerned about Lupron’s association with bone loss, as I am turning 40 in about a second. I didn’t have terrible side effects with the Lupron, but I figure if I can get away with putting one less thing in my system, I should do that. Also: fewer injections! Fewer injections = more peace. I want this to be the most peaceful cycle yet.

Without Lupron I will be doing much closer monitoring this month. I’ll go in for Day 3 bloodwork on Tuesday, and again around CD11 to check what’s going on, ovulation-wise. Then I’ll check for my surge with a home ovulation kit, and come in afterward. This way we will know precisely when I ovulate this month, and will time the endometrial scratch biopsy 7 days afterward. (RBA does still recommend the endometrial scratch biopsy, after all.) Instead of starting Lupron, I will then just wait for my period to come, and will start using the Vivelle patches right away, within 3 days. The estrogen acts as a suppressor, instead of the Lupron. Estrogen suppresses the dominant follicle; this suppresses ovulation. If ovulation happens, progesterone would come into my system before we are ready for progesterone, and the cycle could be cancelled. (But 1% chance of this.)

Around the time of the scratch biopsy,  I will use z-pack and flagyl to sterilize the endometrium, for 10 days. It is an empiric treatment Dr. S uses for patients who have losses. I don’t yet know when I start the 40 mg of Lovenox, but the good news is: the Lovenox will be my only injection.

In addition to the ususal lining-check ultrasound, I’ll have to go in for an additional ultrasound and bloodwork at some point, because I’m not on Lupron. All in all, no Lupron is more of a time investment, a tad bit more table-time and blood-draws, but I think it will be worth it.

Other good news: Because of the pain I experienced during the last scratch biopsy, Dr. San Roman is prescribing me Vicodin and Valium to take before and after. Ha! That should be an interesting day for my husband.

I’ll keep you posted on how things progress. I’m going to go celebrate CD1 with a 90-minute massage.

Advertisements
Previous Post
Leave a comment

34 Comments

  1. Yay! exciting to be moving forward! i hope this cycle is it, but if its not and you decide this is it for you, i hope you are able to find peace with the decision. I really beleive there’s happiness at the end of the adoption road too, and you will get there one way or other.

    Reply
  2. Just curious about how this would be your last cycle (unless it works!)?? Are you willing to take the surcharge of a full cycle to get out of the FEA? I’m in the same place–I have to transfer my 2 frosties(which seems pointless for me) and then go back to the donor bank one more time before I can request a refund (a $3K admin fee for each cycle). I want out now but can’t take the $16500 single cycle surcharge. Wondering what you were doing?? Of course I hope it won’t be an issue and that this cycle will be your THB.

    Reply
    • Woah. What is crazy is that I have not looked at our contract since the beginning, when we signed it—and I had in mind all this time that we would be paying the $3K admin fee if we withdraw after this FET cycle (and it doesn’t work). I had *completely forgotten* that the fee is actually $16,500 if you withdraw after only one cycle, and the 3K rule doesn’t kick in until after 2 cycles. THANK YOU SO MUCH for bringing this to my attention. Of course I would have figured it out eventually, but the truth is, it was just one of those things I had memorized incorrectly—maybe an unconscious thing, wishful thinking? Am sitting here with jaw unhinged—how could I have incorrect something so important? But, on the other hand, it’s okay—I know we’ll figure out what to do, if it comes to it. But yes, thinking it would be a 3K admin fee (+ all med expenses, travel expenses, etc) we’ve been leaning toward withdrawing after this FET, if it doesn’t work, and moving on to adoption. But we’ve also considered trying donor sperm (if there are indications that we should) with a new donor. I hope all of this becomes inconsequential and that this cycle is the one. Again, thank you. I feel pretty silly right now.

      Reply
      • Don’t feel silly! Just wanted to make sure I was doing it “correctly” as well! I HATE that we’re even discussing it. I also remember reading in your blog how no one had dropped our of the FEA except for one who needed a GC.. Yeah, sad that we may change that statistic.

        Reply
        • You’ve really helped me by bringing this to my attention. My first instinct is: No way can we give up the 16K, we’d have to go forward with a second cycle, if only to ensure we get that money back for adoption! What a crazy dilemna, one I never thought I’d be in, either. But I feel oddly calm about it today—the truth is, I have a great deal of hope for this transfer, even if I’m trying to hold it loosely. Everything feels “in place” and I’m in a good headspace, relationship in good place, and am doing important work with a therapist, diet, exercise, so on—if any of this matters then I’ve got some reason to hope (I hope!). What are you leaning toward? A second cycle?

          Reply
          • I can’t lose the money either so I will have to force myself to do it. DH and I went into this to find answers. Perhaps I’ve always believed that this would never work for us. I just needed to know “why”. I also didn’t want to live with the regret of not knowing whether it was just not happening due to a bad clinic or not. It’s incredibly hard to continue this when you’re just going through the motions but each failed cycle solidifies for me what the “problem” is. It’s nothing I can fix. It’s not a decision in my power. It’s DH’s and he’s not willing to make it.

            Reply
  3. This sounds very similar to my FET protocols. I’ve never used Lupron either, just Estrace taken vaginally from CD3 or CD5 to suppress ovulation. It’s worked for me, although be warned I did have some ovulation signs at one point that got me stressed. It turned out just to be the effects of the estrogen in my system. Good luck!

    Reply
    • Yikes, I hope that doesn’t happen! I’m glad it ended up not being ovulation for you. I wonder if they’ll prescribe Estrace, and not just the Vivelle. I’ll find out soon!

      Reply
  4. For some reason I can’t reply to your last question. I think he is against DS for several reasons. First, I don’t think he believes it is him since all his tests are “fine”. Second, he feels like he’d be totally left out of the equation. He’s simply not needed. Even though its not my egg, I’d still be carrying and “part” of it. Not true with DS. I don’t think he can see past the pregnancy to know that part simply does not matter. It really makes no sense since he says he’d adopt. How is this different? Plus the benefits are ensuring you get “picked” since its in my womb plus ensuring good prenatal care. It’s also cheaper and as you call it– it’s the path of least resistance. But he won’t hear any of it. He never wanted to do DE so I think the entire thing is just “too much” for him to emotionally handle. I already know I’d have to do the entire adoption process–paperwork is not his thing.. I’m just not up for it.

    Reply
    • Oh, I think there is some automatic embedded-replies limit, I’ll have to change that.

      I see. There are always parts to this that I haven’t thought of. I guess I can see how he would feel left out, not needed. But all of the reasons you list, good prenatal care, cost, path of least resistance—I’m surprised he can’t see the sense in that and that all of those positives don’t outweight the negatives for him. It makes me so frustrated for you, even while I’m not in his shoes and know I can’t begin to really understand the complexities of his feelings.

      As for the adoption path, I hear you re: the paperwork. Thinking about all that is exhausting after going through the IF treatment route, which comes with its own giant batch of research and paperwork. DH says he will help me, and I know he will do what he can, but I also know—I think we both just know—that I will end up running the show (again). If he is okay with my working part-time, then I am okay with taking over the adoption project. There will have to be some sort of trade-off if I’m doing the majority of the work again, and I think he’s on board with that—we’ve talked about it some. So that gives me some relief, although the finances of it make me feel a little woozy. Especially when I think of my school loan debt.

      Reply
  5. Sounds like you’ve got a plan and are off to a good start with this cycle. I love that you can foster such a good relationship with your body. Certainly something I still struggle with.

    I’m still learn about endometrial scratching and the theory behind it, so I’m curious to hear more about your thoughts about the process and outcome.

    When I was on Lovenox, they had me start the injections once they confirmed my lining was sufficient to proceed with the FET, but I started baby aspirin when I started the Vivelle dots. It’s great that this will be your only injection.

    Quick question about progesterone: what time you be on? Since you’re bit using Lupron, will you be also utilizing the progesterone your body makes? For me, I still think that correcting my low progesterone levels made all the difference, hence why I ask.

    Reply
    • The idea for me is to do a “scratch” endmotrial biopsy, with pipelle, in order to cause a tiny bit of damage, which will call in the T-helper cells that we do want—the T-helper 2—and down-regulate the T-helper cells that we don’t want—the T-helper 1. This is instead of taking Prednisone, a steroid, to treat any possible immune problems that could be going on. It also helps a woman build up a thicker lining, but I haven’t had a problem with that; it would just be an added bonus for me. But I think a lot of women have it done for lining thickness alone. It is most effective if given in the cycle before transfer.

      I’ll be taking Crinone vaginally twice a day—that’s the progesterone supplement I took last time. I’m not sure exactly when it will be this time, but last time I started it about 5 days before transfer. Then you stay on it until about week 10 of pregnancy. I didn’t have any problems with progesterone levels last cycle.

      Reply
  6. HopefulMomtobe

     /  January 19, 2014

    Sending you positives thoughts and prayers for your upc You mentioned that you wod b taking Locenox. Is that bc of the recurrent miscarriages? I was reading info from Dr. Lessey in NC and he recommends that med for your issue and for those that are missing the protein in the endometrium and causes implantation failure…. Which my issue. It would be great to find out your experience with any side effects fe Lovenox!!

    Reply
    • I took Lovenox before, when doing IVF with OE at CCRM. I didn’t make it to transfer, so was not on it long. Lots of bruising of the belly, and some wonky pre-filled syringe problems that drove me bonkers (medicine squirting out all over), but other than that, nothing to speak of. It can burn going in. ): It’s being used becuase of my Factor V Leiden heterozygous—an unlikely culprit, esp since it is not homozygous, but just in case, it increases blood flow, safeguards against clots. I don’t know about this protein in the endometrium, never heard of that. What’s that?

      Reply
  7. Yay for a massage!!! I am so excited to hear how this cycle goes. I am hoping and crossing my fingers this is it for you :) And what would we do without heating pads????

    Reply
  8. Praying for you girlie!! I am hoping this is your last cycle for a LONG time because in 9 months you will be holding a healthy baby :) Have a great week!!

    waitingforbabybird.com

    Reply
  9. This was similar to my FETs. I only did Lupron for fresh cycles. For the FETs we just relied on a long estrogen protocol to prevent ovulation. Which worked fine cause I probably have no ovulated for like 10 years! Enjoy your massage!

    Reply
  10. I NOMINATED YOU :) check it out here! Have fun!

    http://waitingforbabybird.com/2014/01/20/its-a-major-award/

    Reply
    • Oh, I appreciate this! I am honored. I’ve actually already been nominated for this a while back (and for the sunshine award) but I took down my posts answering the questions in both cases because I got a little paranoid I’d revealed too much identifying info. (: But anyway, I appreciate the gesture so much, thaks WFBB!

      Reply
      • oh that’s totally okay. I completely understand if you don’t want to do it. The questions I asked where multiple choice and vague :) lol! I tried to be a bit different :) hehe

        Reply
  11. All my fingers and toes crossed this cycle goes perfectly for you!

    Reply
  12. My sweet friend I am filled with optimism and excitement at this upcoming adventure of yours. I will be watching eagerly and holding your hand patiently. We can compare bruised belly photos. Mine is entirely covered in heparin bruises but happily so. I love the control you are maintaining with this cycle hun, it makes me feel empowered for you! This is your destiny, you do whatever you feel is best. Sending you so much love xxx

    Reply
    • Ah, thanks for your kind words, and for being rock solid there. It’s also nice to hear you say that about the control and empowerment—that makes me feel even more empowered. Love back (and growey vibes for the nacho)! xoxo

      Reply
      • Ps happy birthday sweetie. I know how tough these milestones are but this will be a different year. Hugs xx

        Reply
        • Coming up on the 31st. ): Not excited. I’m just going to try to ignore it as much as possible. Thank you though. I hope it is different year for sure. xox

          Reply
  13. Yay for bright red blood! Thanks for celebrating that with us – I had no idea others thought the same thing when they see it! It’s kind of sad the “little” things we all celebrate. Glad you feel good about your plan and I’m crossing my fingers for this cycle!

    Reply

Leave a reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s

%d bloggers like this: