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!!!

LOST

I always say when it rains is pours. Yesterday I let myself grieve this not working again and was ready to pick up the pieces and put together a new plan and go forward with another try. My RE has been out due to surgery but I was reassured the other RE would be fine with helping me do another cycle. I have Dr. Kwak on my case too and she will advise on anything she wants to change on what she is handling. Well one of the things that Dr. K will not do is prescribe Intralipids IV infusions (what I need to lower my NK killer cells so they don't attack the embryo's) she feels IVIG (a blood product) is better (but I was denied coverage for it) so Intralipids are a synthetic alternative to IVIG and much cheaper. My RE in WI agreed to help me and prescribed two dosages for me this past FET cycle. I gave him all the studies and he talked with Coram Infusions where I go to have it done and seemed to be all ok with this protocol. I was told today that neither him nor the other RE will prescribe the Intralipids for me again for this new FET cycle. They would not tell me why all the way and pulled out the our lawyers said it was unsafe card. Needless to say I am livid. I finally found a plan, it was working my numbers came down and the second cycle should be even better than the first and now my RE says nope I won't help you with any immune protocol the only thing I will do is transfer your embryo's. Get someone else to do it. I am so stressed over this I can not eat, I can not think, I physically and mentally am wiped out. Why would they do this to me? I went today and had my second Intralipids Infusion before they would not let me do that one. I was to do it if I got pregnant but figured since it worked go do either way to prep for the next cycle. Now it seems I won't be able to do it again putting me at risk of mc. Monday morning I am going to start calling around other RE's and see if anyone else is willing to work with me and be ok with prescribing intralipids and working with Dr. Kwak as a consultant on my case. I don't know what else to do. Dr. Kwak also wants me to do endometrial scratching after I get my period and my RE should do it but he won't either. What is going on God enough is enough!!


8-16 - After many sleepless hours of trying to figure out what to do. I am looking another clinic right now. Inquiring if they agree with a immune protocol and intralipids and how/if I can transfer embryo's for a FET with them. Sent them a message to begin the conversation. If I can't transfer embryo's and it's just too costly. Then my only other option is to see if a third Dr. like my family one or my obgyn can help me out with the scratching and intralipids and grin and bear it thru another cycle with the old RE or I should say his wife. 

8-18 - Well there goes my idea of working with another clinic. Just got a message from one I contacted and nope we can not transfer embryo's and most all clinics won't allow it they told me you have to stay with the one they are at. And they won't work with Dr. K. There goes that. Back to being screwed. So stressed am physically sick over this all right now. 

8-19 - Going to go see my family Dr. next week wed. Try to explain the whole situation to him (he is already aware of some of it) and see if he will be willing to continue my prescription of Intralipids for the next FET round. Otherwise I guess I am out of options and will have to do it without. The Intralipids are such a crucial part of my treatment plan and did wonders in lowering my NK killer cells so without them I take the risk again of my body attacking the embryo's and/or mc. So please pray that my family Dr. will be my saving grace in this all. I really need a break and something to work out right.

FET #1 BFN

My beta was a negative hcg less than 1. Pretty much what I thought it would be. Didn't have any real symptoms of being pregnant this time around and just had a gut feeling it did not happen.

Hoping my period comes quick, they did say most of the time once you stop the progesterone you get your period in a few days otherwise they can give me some provera next week.

Still doing my second Intralipids IV on Sat. morning. Figure since we are going to go right into a second FET it can't hurt to still do it and continue to lower my killer cells.

Have to wait to see if Dr. Kwak-Kim my RI (reproductive immunologist) will give me any new recommendations for cycle 2. Maybe starting with 30mg of predisone instead of ending with it and doing 80mg of the lovenox instead of 40mg then upping to 80mg.

Really don't get why it did not work we had great looking 5 day embryo's that unthawed perfect, I had blood flow, my thyroid was good, lowered my NK killer cells, and still nothing. 

Trying to hold it together but really hard day. 4 transfers, 11 yrs, 4 mc and still empty arms. My dreams and hopes of being a family of becoming a mom are going down the tubes. I don't know how I will have the strength to go through another cycle, I have a lot fears the next one will fail too then we are done and how will I live with never getting to be a parent. I don't know if I will be able to cope. :'( 

 

God I am not sure what your plan is anymore. So many years ago I felt you told me to prepare to hold fast in my faith and all would be ok. I am worn I am tired I am weary.