Thoughts FET#2 ...

9/8 - Start shots in one more day. I am not looking forward to this FET - out of all our ttc cycles I think this one is the worse I have no gumption to go through it just worry and stress that it's not going to work again - really down today. I know if we don't go through it we have no chance of becoming parents but it's hard to feel hopeful after so many failed cycles. Things have not worked out either for me to do the endometrial scratching I won't be able to do it. I don't get it why Dr. K would not write the referral, only thing I got out of them was it was up to my RE to do it but he won't. Almost 11 years of struggle and coming up on the anniversary of last years mc I am sure is not helping my emotions either. I keep asking God why and all I get is silence.

9/10 - Did my first 10IU Lupron shot today. Guess the ball is rolling now. The plan is baseline on the 19th but if I don't get a period by the 17th to call and things will be delayed by a week again as it was last FET. I doubt I will get one before then I am always around 32 days so it be more like the 20th or 21st before AF arrives. This FET has been a struggle right from the start. Today I checked with my insurance and found out they are reviewing the two times I sent in my blood work to Chicago to test for NK killer cells and Cystine levels to see if it was medically necessary to have it tested two more times. I was suppose to send in my blood this week again but with this hiccup I can't as if my insurance denies the past 2 times at $900 ea time I am stuck with that bill.  It's like I can't win. It can take up to 30 days for them to review things and they asked for records to show why she ordered them. I don't know if they will pay for them now as most immune issues are experimental stuff. Praying this works itself out but it won't be in time for this cycle. I have to e-mail Dr. Kwak-Kim and let her know I just can't send in more blood this time due to this issue. I don't know if she will be to happy about this and it's a important blood panel so we know how much predisone and intralipds I need. I guess all they can do is just go off what I did last couple months and expect it is the same this time around. UGH I sure hope this does not cause anymore issues.

9/11 - I e-mailed my RI about not being able to send in my blood work right now cause of insurance reasons. I didn't hear back yet. I hope they can go off last results for my predisone dosage. Nothing much more I can do right now. Did my second shot and doing what I can to not stress. Giving it to God as if he wants this to work then it will.

9/14 - Day 5 of Lupron shots - had some pain in the ovary this morning seemed to go away but kinda worried me - they had me do this cycle without a u/s before starting in on lupron so I hope I had no big follicles and nothing turning into cysts. I doubt AF will arrive before my apt on the 19th I am sure I will be calling to cancel it and do it the following week. I get frustrated my RE does not listen to me I think I know my body well enough by now to know when AF will arrive. Tiredness is kicking in and headaches so had to up my water again. I think this is the hardest cycle I have ever been through. My RI did get  back to me but instead of sending information to my insurance she sends it to me so now I will have to call my insurance on Monday and see how I can get them the letter about why I need the NK killer cell blood tests to be repeated. 

9/ 17 - So Baseline this week is postponed for my FET. Like I already knew it would be. No AF yet so it will be next Thursday unless it shows up yet this week then we can do it a little earlier. So ready to get the ball rolling. Did talk to my IVF coordinator about another fresh cycle if this FET fails, that we want to transfer 3 of the 5 frozen embryos this time, that leaves 2 and if this FET fails do a fresh cycle and if by some reason I don't produce any eggs or good mature embryo's we got the 2 frozen to transfer. Not sure if that will be the plan but I am always thinking ahead as time and finances are running out for us. So hopefully by next week I will be starting in on estrogen, lovenox and getting my lining ready for transfer. Sending out a letter to my insurance tomorrow and fx they pay for and continue to pay for the labs I need to do for Dr. K.

9/22 - AF still has not shown up. It should of by this weekend. CD33 today and it usually comes by now. Getting worried how this will effect our FET. We moved my baseline to this coming Thurs. as AF didn't show up last week. Could use some prayers it shows up ASAP as it needs to come and be done before Thurs. or things get delayed again.

9/24 - Never got AF to start my FET. We postponed my base line visit till this week and still no AF. So I go 8:45am tomorrow to fertility clinic - do progesterone and u/s to find out what is going on - they may have to induce a period which means more waiting - I am so tired of this - why can my body not cooperate!! It's so hard to continue to stay positive. Time is running out this year for us to try and have insurance coverage. God why is what I keep asking and please help things to work out. It's coming up on the 1yr anniversary of our pregnancy and mc of last year and my heart is hurting. I just want to get the ball rolling and get to our transfer again. 

9/ 27 - AF is finally here - e-mailed my clinic waiting to hear what the plan will be for baseline visit - hopefully we can finally get things going :)

Stressed!

Just wonderful now I get a message from Dr. K nurse that she is now not recommending the endometrial scratching and can't send my obgyn a referral to do it. I wrote back and was like WHAT? I got a message on 8/16 from Margaret her assistant that she did recommend it and even talked with Margaret on the phone that my RE was gone but my obgyn can do it and she said she would have a referral sent. I am so confused. I want this procedure done. STRESSED!!!

Only 4 more days and I am to start in on Lupron shots again. Can't figure why this is always a struggle for us. :(

Good News

Thank you everyone for praying for me. I am so relieved my family Dr. agreed today to refill my Intralipids and even called the infusion center while I was there to get it going for me. 

Can not tell you guys what a HUGE weight has been lifted. I was so nervous about going to see him today and brought all my test results and paperwork on the intralipids and he looked it over and was like yes I want to help you've been thru enough. So relieved. 

Next hurdle is getting the referral from Dr. Kwak to my local obgyn to do the endometrial scratching and hoping they can do it for me. So please keep praying. It's been such a challenge doing this all and having to now involve 2 more Dr. so it's like having 4 Dr. now for this FET.

What is Endometrial Biopsy Scratching

What is Endometrial Biopsy Scratching
 
Endometrial Biopsy is a gentle endometrial injury caused by scratching patient’s uterine lining prior to embryo transfer. New research in the field of infertility shows that gentle injury to the lining of the uterus can actually make the uterus more receptive to an implanting embryo and thus increase one’s chances of pregnancy. Several studies conducted by top fertility clinics showed that endometrial biopsy scratching almost doubled the chance of pregnancy for patient who received scratch biopsy prior to their IVF treatments.

The process of endometrial scratching as it relates to embryo implantation is not entirely understood and some questions still remain unanswered. Scientists involved in studies believe that there may be two causes of increased implantation rates: white blood cells and gene switching. In the first case, it appears that endometrial injury increases the production of white blood cells. White blood cells secrete so called growth factors which in turn control embryo implantation.

In case of gene switching, scientists speculate that sometimes embryos fail to implant due to genetic switching related to endometrial receptivity. That is, genes responsible for implantation of embryos are not switched on during the time when embryos are supposed to implant. Endometrial biopsy may increase expression of genes (switching of genes) thought to be responsible for preparation of endometrium for implantation.


The endometrial biopsy is a relatively simple procedure that can be performed either by our fertility doctors or by your local Ob/Gyn familiar with this procedure. The procedure is commonly referred to as a four quadrant uterine biopsy. Physicians use this biopsy technique to collect tissue samples from the surface of the uterus in order to check for pathology. Scratch biopsy causes very little discomfort and poses little risk (e.g. infection) to the patient.

MedVacation fertility doctors have been using endometrial biopsy scratching for some time now and it has been successful for several of our patients. Although the benefits of endometrial biopsy scratching are undeniable, the exact timing and the number of biopsies are still being debated by fertility specialists. Fertility doctors agree that the scratch biopsy needs to be done once or twice before embryo transfer. The scratch biopsy can also be done on the same day as the saline sono. The endometrial scratching should be done first, followed by the saline sonogram. One recent study shows that women who underwent an endometrial biopsy one or two weeks prior to embryo transfer had a 48% live birth rate compared to women who didn’t.
Another option is to have the scratch biopsy done in the second half of the cycle, usually just a few days before menstruation is expected. It can be done in the same cycle as one in which the patient is trying to get pregnant. The risk of miscarriage from the biopsy is only about 1%. Therefore, given the increased chances of getting pregnant, the benefits of having the endometrial scratching done overweigh the risks associated with it.

More links on this topic:
http://www.bionews.org.uk/page_190071.asp
http://www.guysandstthomas.nhs.uk/news-and-events/2012-news/20121001-womb-lining-ivf.aspx
http://www.infertilitydoc.net/blog/2010/12/18/endometrial-biopsy-scratching-for-failed-47480

FET#2 cycle day 3

Interesting morning. Dr. K assistant called me and we went over my FET schedule.

Dr. K is gone till next week Friday so when she returns she is going to have her write up her recommendations on the endometrial scratching and fax it to my obgn so hopefully they can do it there. I guess it is to be done after my next period after bleeding is stopped, not this one so we got time. I just hope my obgyn will be able to do it that they have the time to fit it in and know how to do it. All there nurse told me yesterday was that they needed a order from the Dr. recommending it so hopefully with one they can do what needs to be done. Not that I am looking forward to the endometrial scratching as some say it's painful but I want to try it and see if it won't help this time around.

They are sending me another blood collection kit so we can test my NK killer cells beginning of Sept and can adjust my predisone from there and know if I need Intralipids again. I am going to assume I will. Starting Lovenox at only 1 shot after next period bleeding stops so a little sooner than last cycle.

So looking at another trip to IL around Oct. 4 or 11th just depends when my next AF comes as last time it was a week late so everything got delayed and I am going to assume it will be delayed again as I don't have 28 day cycles I have 32 day one's.

Baseline and trial transfer depending on when my next period arrives will be around Sept. 19 or 26th. Transfer Oct 12th or 19th something like that. Just all depends when my next AF arrives then we go from there.

FET's take so long having to go through two periods before you even start.

Feel a little better today that things are coming together. All I need yet is a Dr. to refill the Intralipids ... fx I can talk my family Dr. into it. I don't trust all the way that Mandy can do it on the sly from my RE office.

FET #2 Cycle Day 1

Today is cycle day 1 as AF arrived. Mandy my IVF coordinator gave me a call today. She was really nice, she is going to do my calendar and help me through this next FET. Start Lupron again on Sept. 10th.

She also said she is going to see what she can do to talk to my RE as he is back from medical leave some afternoons and go over what is going on.

That she will try and see about somehow getting my Intralipids refilled on the sly. Told Mandy how upset I was and unhappy with the clinic. I guess my RE Dr. Olive will be back by the time I do my baseline visit in Sept. so that is good news.

I thanked her for letting me know that and for calling me and talking with me. It just makes no sense why the other RE said what she did to me. She is not my Dr. so I can't understand why she has any say in my case. Please keep praying that this works out and I get my intralipids filled again.

I still have a free phone consult with the RE in IL from the Sher clinic on Sept 10th (sent him all my paperwork and records yesterday) who does believe in the use of Intralipids and seeing my family Dr. next wed too. Want to make sure I got back up plan if Mandy can not come thru for me on the Lipids refill.

I was so upset on the phone with her I almost cried cause this is getting to be more than I can handle. I am glad she pleasantly surprised me with her kindness and willingness to do whatever she can to make sure I can get in another FET with the medications I need.

Still don't know who can do a endometrial scratching as I contacted my local obgyn and they wanted records and exactly what needed to be done and I told them all I got is the recommendations of Dr. Kwak-Kim that is should be done after this period before ovulation. The nurse seemed to think that was not enough information for them to help. So doubt I will be able to do this.

Praying so hard this cycle works for us that I don't have to do it again. That I get the medications I need. I just want to be a mom and for us to be a family. I never knew this would be so hard that Infertility would suck all joy out of life. I so want it to be over with and for us to have a child of our own.

Pourings out of my heart ...

That's all we dream of being parents, family - a dream it looks like we will never see in this lifetime. Broken crushed desires of our hearts  - Where is God, this can not be his plan, it is not what is written in his word. Trust me, remain faithful, stay in prayer, keep the hope, we do time and time again, but where is God? Where is He? He can heal the sick and open the eyes of the blind then why not me? Obstacle road block one after another one falls down and one is right after. I fight, I push, I do all of my part. I know He can take it away, he told me to believe, to be patient, his timing is perfect, so I have and we have and we do but where is He, Where is HE?? The pain the torture of this disease is more than I can take, my knee is constantly bended, my tears are ever present on my cheeks, I praise in the storms the good the bad and all I ask is HEAL ME take this from us, allow us the blessings you say in your word that are in store for those that love him. God I need you, we need you see our hearts heal me please Lord heal me of this infirmity this curse that overwhelms every waking and sleeping hour of my life. Make us whole give us a family a child. Please Lord hear our prayers!!!