IVF Cycle Two - Day 3 and 4 of Stimming

 

So far so good. Shots are going well. Headaches from Follistim are starting to rear it's head though. Got some poweraid to help with electrolytes and upping my water intake. Got to get back to the 3-4 liters a day of fluids. That should help with the headaches and help prevent ovarian hyper stimulation. Believing and trusting in God for good things this time around.

Been doing well on the diet, oatmeal or granola or a egg for breakfast, protein fruit shake for lunch, and light dinner. I am feeling more energy and healthier. Doing a green drink and getting enough fish oil in my diet is really good for me. I also am on a prenatal vitamin, extra folic acid, magnesium citrate, calcium citrate, DHEA, chromium, biotin, B-12, and Metformin 2,000mg.

Doing more research this cycle sent off a e-mail to my RE to ask a few questions on things I'd like to do different this time. I know the RPL blood test will tell us more too. After talking to a few others who have done IVF a lot of them have done some form of predisone. I looked it up and found this...

Prednisone / MethylPrednisolone and Dexamethasone (corticosteroid meds) quiets the immune system, prevent inflammation, helps the uterus not reject the embryo,  in case of any auto-immunity (NK). These medications can help allow the embryos the best chance to implant. The embryo is actually a foreign object b/c it is half another person's DNA so the body at times attacks the embryo thinking it's a threat to you. Steroids lower the chance of this happening.

So I asked the Dr. if I could try it this cycle if it may help. I deal with Fibromyalgia, Arthritis, and Asthma all things that have caused an increase in inflammation in my body. I am concerned that inflammation is another cause for my infertility.

This part of a article talks a little more about immune problems ...

"Compelling evidence suggests that an abnormally functioning maternal immune system often leads to poor reproductive performance (i.e., IVF failure, recurrent abortion, poor intrauterine growth and even fetal survival) and that identification and selective immunotherapy results in a significant improvement in IVF birth rates, intrauerine development and fetal survival. 

Almost across the board physicians who provide services in the field of Assisted Reproductive Technology (ART) tend to attribute recurrent unexplained treatment failures to sub-optimal embryo quality and then advise such patients that the only way to improve their subsequent chance of a successful outcome, is by changing clinical and laboratory protocols involved in ovarian stimulation, gamete and embryo preparation and/or the transfer of gametes or embryos to the woman's reproductive tract. Such logic fails to take into account the fact that it is "implantation failure" rather than poor egg/embryo number or quality that is often the root of the problem. A rational approach to subsequent treatment requires that a clear distinction be made between those factors that cause "true infertility" (defined the absence of normal fertilization and/or embryogenesis), and those that lead to "failed implantation," (namely; immunologic rejection of the embryo, local inflammation and pathology involving the uterine cavity). Only treatment directed at an identifiable probable cause of prior ART failure, can justify providing patients with renewed hope of success in a subsequent cycle of ART treatment." 

More interesting articles:
 
Vitamin D Boosts IVF Success

Immunology may be key to pregnancy loss


Devotional Thought:

Jesus Christ is the same yesterday and today and forever. Hebrews 13:8

You’ve all seen them. Those commercials that interrupt your favorite television program. Intimate glimpses into the blissful interactions of parent and infant. An awestruck toddler discovering the wonder of a frog. A bald, gurgling baby gleefully splashing as she is bathed in the kitchen sink. Yes, the voiceover on the commercial is correct. “Having a baby changes everything.”

Every time I hear that line, I also hear the anguished cry of millions infertile women: “Yeah? Well, not having a baby changes everything too!”

Infertility brings many life changes. Your dreams change. Your view of your future changes. Your plans change. Even your vacations change! After all, you can’t go rock climbing during that dreaded two week wait--just in case!

But there one thing that will never change, even through the ups and downs of infertility. Jesus Christ is the same yesterday and today and forever.

The same Jesus who wept with Mary and Martha when their hearts were broken, weeps with you as you stare brokenhearted at another negative pregnancy test. Jesus Christ is the same yesterday and today and forever.

The same Jesus who wouldn’t let go of Peter’s hand when the storm raged on is the same Jesus who holds you tight every time someone else announces a pregnancy. Jesus Christ is the same yesterday and today and forever.

Through your changed dreams and plans, through the changing seasons of your infertility, Jesus Christ is the same yesterday and today and forever. He will remain forever steady and unchanging, even as the calendar changes from month to month and year to year.

Jesus Christ is the same yesterday and today and forever.

IVF Cycle Two - Day 1 and 2 of Stimming

I had my blood test yesterday (hcg came back at 4 which they said was in the normal range anything under 5). Was relieved to have the miscarriage behind me as it has been a difficult few weeks.

I then talked with the IVF coordinator she asked if I had time to hang around and do the practice embryo transfer and ultrasound. I said sure, lets get this thing going. Husband and I went for breakfast then so I could drink tons of water to get my bladder full for the procedure. When I came back I ended up sitting in a room for an hour trying not to pee as they thought my bladder wasn't quite full enough. Waiting for the Dr. was pure torture, doing everything I could to keep my mind off the need to get to a bathroom and trying to focus on getting through the procedure. The reason for the full bladder is then they are able to see my uterus better, I guess it is a little tilted so the fuller my bladder the better he can see when inserting the tube. They did another practice on me as they said it has been shown in studies if you insert something in there it makes the real transfer better.

I had to go so bad after the practice transfer they let me toga it to the back bathroom then come back for the vag ultrasound. That is like the worst part is the practice transfer and the real transfer having to have a really really full bladder then not peeing yourself. Doc told me don't worry he's been peed on a few times it's sterile no big deal, I was thinking how embarrassing that would be if that happened to me.

Dr. said everything looked good, lining thickness good, no cysts, etc. and I could start cycle two TODAY! I was like really YAY. So I did my first shot yesterday night then another for next 5 days, 450iu of Follistim (took me a few min to remember how to take shots again lol but was glad I had leftover medication in my fridge to start right away).

I go back on Wed. for my first ultrasound and estrogen check. He said we could wait longer this time to check the follicles as he kinda knows from last time how I responded to the meds, so that was nice as not as much driving back and forth this time. Grow eggs grow :)

I had to check with my insurance yesterday to see if they would pay for RPL (recurrent miscarriage loss) blood panel and found out I do have coverage for that so I will do a blood draw of 9 vials for it on Wed. too. That should help give us a few answers as to why I miscarriage if something else is wrong. It's not all the immune testing I'd like to do but it's better than nothing. Even though I started stimming Dr. said that still gives them time to add things before transfer if something comes back as a concern.

He also said I can take a vitamin supplement DHEA 3x day 25mg while stimming. A friend told me about it as she has poor ovarian reserves and it is suppose to help with egg quality and quantity. Your suppose to take it 4-8 weeks before IVF cycle but as I just found out about it Dr. said it probably could help and worth taking if now if I wanted too. I am thankful for the support groups online I learned so many things off there that Dr.'s don't tell you. Best advice is to research research research all about IVF before you go through it. I've learned even more since the first try that I hope will help this time.

I am nervous and excited about it all. I was ready to get the ball rolling but figuring he'd say wait awhile so was a little surprised he said I don't have to wait for AF again and no BC or Nasal Spray we just start in. Today is day 18 of my cycle so not far off from when we started last time. I think the first cycle we started on day 16 or 17. I was thinking to myself why I had to even take the BC the first time after my bad reaction you would of thought they would of said just stop it, we can do the cycle without it. Very confusing and didn't get a clear answer on that question.


The chiropractor is really helping my back/neck feel better, I am hoping getting the lower back which is connected to reproductive organs in order will help with the blood flow and nerves that go to the uterus, thinking it should help give me better eggs and a healthier enviroment for when we do transfer. Yesterday he also did some electo's (kinda like a TENS unit but more powerful electrical current) on my neck with some ice it was relaxing and felt good. I also bought a huge thing of protein powder (Metagenics Ultra Inflam X 360 Plus/Medical Food) specially designed to lower inflammation from them as he said that should help with the autoimmune stuff I deal with. I figured I needed more protein while stimming again so why not. Going 3 times a week for another 3 weeks to the Chiropractor.

I've been making fruit smoothie drinks each day for either breakfast or lunch (very healthy meal): use 100% juice no added sugar or stuff in it, frozen fruit (I like a mix of strawberry, blueberry, raspberry, blackberry, sometimes I add in a piece of frozen bannana or pinapple), add a few ice cubes, sometimes I do a few spoonfuls of vanilla yogurt, otherwise I add in a scoup of protien powder and green drink like Pro Greens or Dynamic Fruits & Greens, you can also add in some flax seeds, handful of spinach, or oatmeal.

I wish I could do acupuncture this cycle too as there is a place that works with our fertility clinic but not sure if it will be in the budget right now. I am trying this time to do whatever I can afford to do to help this to work. I am most concerned about staying pregnant and not another miscarriage.


So I guess we are off with a flying leap with round two ... wish me luck and keep me in your prayers!


Devotional Thoughts
Hebrews 13:15 says, “Therefore let us continually offer the sacrifice of praise to God, that is, the fruit of our lips, giving thanks to His name.”
I praise Him, not because I am happy about it, but because He is worthy of praise. I praise Him because I know His ways are higher than mine. I praise Him because there is still hope. He has worked miracles before and has blessed us in amazing ways, and I know He can do it again.
The Power Of Praise And Worship When Facing Infertility



Never give up PRAYING! God hears your prayers and see's your tears, your desires to be a Mom/Dad and as he answered those who believed in the Bible so He will bless you.

Abraham and his wife, Sarah, received their first child when he was 100 years old and she was 90, because they exhibited faith in God's promise to them.

Genesis 15:6
And he believed in the LORD; and he counted it to him for righteousness.

Romans 4:17-18
Abraham's faith did not weaken, even though he knew that he was too old to be a father at the age of one hundred and that Sarah, his wife, had never been able to have children. He staggered not at the promise of God through unbelief; but was strong in faith, giving glory to God.

Hebrews 11:11
By faith Sarah herself also received strength to conceive seed, and she bore a child when she was past the age, because she judged Him faithful who had promised.

Rebekah conceived her first child in answer to Isaac's prayers.

Genesis 25:21
Isaac pleaded with the LORD on behalf of his wife, because she was unable to have children. The LORD answered Isaac's prayer, and Rebekah became pregnant with twins.

Hannah's prayers for a child were answered.

1 Samuel 1:27
I prayed for this child, and the LORD has granted me what I asked of him.

John the Baptist was conceived as the result of Zechariah's prayers.

Luke 1:13, 14
But the angel said to him, Do not be afraid, Zacharias, for your prayer is heard; and your wife Elizabeth will bear you a son, and you shall call his name John. And you will have joy and gladness, and many will rejoice at his birth.

Reproductive Immunology

Started to read a interesting book called; Is Your Body Baby Friendly? By: Alan E. Beer (It's on the side of my blog under my favorite resources if your interested in checking it out yourself)

It's open me up to all kinds of information on why IVF fails or ends in miscarriage. The book deals with reproductive immunology. I've been researching the subject all day, posting some links and info below if anyone is interested in how having a immune disorder could effect infertility.

What is an autoimmune disease? The term autoimmune disease refers to a varied group of more than 80 serious, chronic illnesses that involve almost every human organ system. In all of these diseases, the body's immune system becomes misdirected, attacking the very organs it was designed to protect. About 75% of autoimmune diseases occur in women, most frequently during the childbearing years. Autoimmune diseases can affect connective tissue. (This is the tissue which binds together various tissues and organs.) It can also affect the nerves, muscles, endocrine system, and gastrointestinal system.

Abnormal Autoimmunity and Infertility

Good article about how immunology could be the key to pregnancy loss at this link.

IVF Protocol/labs and treatment for immune problems at this link.

Alan E. Beer Center for Reproductive Immunology & Genetics: Treatment for recurrent miscarriages and unexplained infertility at this link.

Baby Next Time - What Is Reproductive Immunology; Facebook Group

Reproductive Immunology Yahoo Support Group; Topics will include, but are not limited to, immune related miscarriage, infertility, IVF failure, pregnancy complications and "unexplained" pregnancy loss.

Myth: Reproductive Immunology Treatments Do Not Work

________________

Was researching today what tests my insurance will cover based on the tests suggested in the book  - I just love insurance they are so frustrating. I had to scan a ton of clinical insurance bulletins with what they will and won't cover depending on what condition it is for. 

Some of the suggested tests for infertility and immune problems
Level 1 Tests 
1. Full blood count, Fasting glucose, Urea and Electrolytes, liver function tests
2. Thyroid function tests (must include both free T4 and TSH)
3. Anticardiolipin antibodies (both IgG and IgM)
4. Thrombophilia screen (must include lupus anticoagulant, Activated Protein C resistance, Factor V Leiden, Protein C, Protein S, PAl-1 Gene Polymorphism, Antithrombin III and Factor II Prothrombin gene mutation, Methylene Tetrahydrofolate Reductase (MTHFR) Gene Mutation (most NHS hospitals will be unable to do these).
5. Autoimmune antibodies (must include anti-nuclear antibodies, thyroid peroxidase and anti-mitochondrial antibodies)
6. Karyotype (both partners)

Level 2 Tests
most common immune testing are:
• NK Assay & immunophenotype
• Cytokine ratio
• DQa
• LAD
• Tests for inherited thrombophilia
• Uterine NK biopsy 

I did number 1 and 2 of level 1 tests before we did IVF. I wonder why they don't do the rest if it may be important to show other reasons why you don't get pregnant or why you may miscarry.

So far I've found out they will cover:
Anticardiolipin (IgG or IgM) antibodies and lupus anticoagulant
Thrombophilia screen - (MTHFR)
Karyotype - if 2 or more losses (I've only had 1 I know of wonder if the Dr. can fudge that)
Anti-sperm antibodies

From what I can tell they considers antiprothrombin antibody testing experimental and investigational because its clinical value has not been established when it relates to infertility. AHHH!!! It did go on to say in the bulletin: Most patients with antiphospholipid syndrome have lupus anticoagulant and anticardiolipin antibodies. However, some patients with antiphospholipid syndrome have either lupus anticoagulant or anticardiolipin antibodies, but not both. Thus, tests for both antibodies should be performed to confirm the diagnosis of antiphospholipid syndrome. So I have no idea if that means they will cover those other two tests. Sent them a e-mail to find out.

Also says they won't cover the natural killer (NK)-like cells test. One of the tests I really was interested in doing.

Found out that they consider the following treatments experimental and investigational for recurrent pregnancy loss because they have not been shown to be effective for that indication:
Intravenous immunoglobulin (IVIG) therapy (which is what I was reading they recommend you do if you have immune problems so your body does not reject the embryo and it is really expensive if not covered by insurance). Not sure if they would cover Intralipid (IL), is a synthetic product that can be used instead didn't say anything about it so e-mailed them about that one too. 

Still researching out the rest - I've found while going through this all that it's like you got to be your own Dr. research out things yourself.