A small hitch

So apparently my chicken pox immunity came back indeterminate.

That means I need the chicken pox vaccine before any attempt at IVF. The clinic will require proof that I received this before starting.

The hitch is that the vaccine is administered in 2 doses 4 weeks apart. And it will take another 4 weeks for the immunity to settle in.

I’m booked for my first shot on Monday (Mar 6) with my family doc. So next shot will be April 6-ish. Immunity to take effect by May 6. So in theory even if I start my IVF cycle around April 17 as predicted. I should be nearing transfer time by the time the full immunity kicks in. Hopefully this is ok for Dr. Go and we won’t have to wait until May to get started.

What pisses me off is that my blood tests were done on Jan 31. It has been over 1 month and they know we are scheduled for a start date in April. Why did it take the clinic so long to get back to me with this.

I wish I had said something to the nurse that called. I will mention it to Dr. Go next time I see him. I am not too happy with the responsivenes especially when timing is so important for this sort of thing.

Also Dr. Go’s office has not got back to me on the PTX/Vitamin E issue. Which is annoying as well. 

Not too pleased with the responsiveness of the clinic right now.

Update: I wrote the above yesterday and must have forgot to hit post. Today the office called and asked that I come in for a meeting to discuss the PTX/Vitamin E issue in more detail with Dr. Go. So I take back the previous comment on responsiveness. THey are back in my good books.

Eeep!

Email from DEB USA just came in:

“Great news! This email is to confirm that your eggs are on-site with Mount Sinai Fertility. Please allow 24-48 hours for the medical staff to process.

We wish you the best of luck on your cycle!”

Eeeep!

Telling Work

Told work today.

I really didn’t expect this to go too badly. They are all very supportive. The company is small (20 employees) so I expect everyone will know sooner or later. But for now I only told the HR manager (whom I share an office with) and the President (my manager).

Both needed a bit of an explanation as to what IVF actually is. The HR manager (female) needed much less explaining, whereas President (male) needed a bit more. English is not his first language, to that probably had something to do with it. But it was a bit comical:

Me: Jamil and I…

President: Who’s Jamil?

Me: My husband.

P: Oh right.

Me: So Jamil and I are planning to do in vitro fertilization this year.

P: Whats that?

Me: Like when you try to have a baby but need a doctor to help.

P: oh ok.

Me: I just wanted to let you know as it will require me to go to doctors appointments during the day and probably a few days off in May for the procedure. It won’t be a lot of time off but I did want to let you know now so you aren’t wondering where I am off to over the next few months.

P: Oh that’s fine, (with a big smile on his face) go ahead do it! Now can you review this contract for me…

It was a very brief conversation. But I feel much better now that things are out in the open with work. Now I can actually tell them why I need to step out at random times during the work day.

Plus we can start to properly plan for any future mat leave since I am essentially the only person that can do my work. We will need a clear succession plan for if and when I am not in the office. All things that we will likely discuss in the summer if all goes well, but it makes that conversation easier when everyone is expecting it to come.

Lets hope we do get to have that conversation as well.

 

Telling the In-Laws

The in-laws will be back from their winter in India in few weeks.

A few weeks ago DH did try to tell them over the phone about our decision to start DE IVF this year. Unfortunately it went something like:

DH: Mom we are going to start IVF in April to try for a baby.

MIL: What? I didn’t understand what you said. What are you doing?

DH: IVF to try for a baby.

MIL: Oh ok. Hows the weather there?

(She is a bit hard of hearing and the shody VOIP phone connection probably did not help matters.)

But even after he explained what he could, it seems they didn’t quite understand what was going on. (Probably not a conversation DH should have started on the phone. But I was not there for any of this so had little to do with how DH handled it).

Last night I had a chat with the MIL and she said: ‘AG mentioned you will be doing some procedure in April. I didn’t really understand what it is so can we talk about it when we come to visit when we are back?’

I sometimes forget that they do not have a medical background. I grew up surrounded by doctors. Both my parents are doctors. Growing up all my friends parents were doctors, and now both DH and my brother are following the same path. Add to that my long medical history and as a family our ‘basic’ understanding of modern medicine is probably a bit more advanced than most families. In comparison, telling my parents about IVF was simple, in that they understand the basics already.

So the whole IVF thing might be a little bit much to explain over the phone for the In-laws. In my opinion AG should probably have waited till we saw them in person next. But with both them and AG being away, we all might not see each other in person until the IVF cycle is well underway. So I understand why he told them when he did.

I am glad they want to talk about it. I still feel a bit awkward about it. Not so much the IVF part. But more so the DE part. I am afraid they may have a strong opinion about their son’s sperm and another woman’t egg. Maybe they will want to know who the donor is in more detail. Or they might not like our choice of donor. All of these are of course not going to change our decision, but it will make things harder for us. Again, just my overactive imagination thinking of worst case scenarios. But I need to be prepared so I know how to handle it if it happens. For now only DH and I know the details about our donor. And I think I want to keep it that way. That information will probably be shared with any future child when the time comes. But that is it. I don’t see any benefit in sharing the information with others.

So there will need to be a more detailed conversation to be had with them. It might be worth having both sets of parents together for the talk so that they all know what is happening. I would like for DH to be there too, but he is not back until mid-April, so lets see if it can wait that long.

 

#MicroblogMonday: The DE IVF Game

Game Title: DE IVF: The Quest for ParenthoodMicroblog_Mondays

Number of Players: 3 players

Level of Difficulty: Unknown

Synopsis: In this arcade style game, each player will participate in a series of challenges in the quest to achieve the ultimate goal: parenthood. It starts with Player One, who must provide one or more oocytes to the other two players. Player One’s turn may occur well before Player Two and Three enter the game. The more oocytes delivered the more chances the players have to achieve the ultimate goal.

Player Two’s role is short lived, but critical. It is all about the timing. He must create and deliver a perfect sperm sample exactly 5 days before Transfer Day. Should the timing of delivery fail, all players must start over. Should the sample fail to be adequate, all players must start over. Should he choke up and fail to perform in the moment, you guessed it, start over. After Transfer Day his role is to assist with Player Three in navigating the rest of the game but will have little control over the outcome.

Player Three must start by preparing a habitable environment to grow an embryo. The challenge is to also overcome the life obstacles that will get in the way of reaching the end. Work or family commitments will interfere with strict drug schedules. Fibroids may prevent implantation. Thin uterine lining may threaten to cancel a cycle or cause a miscarriage. If a hurdle gets in the way,  Player Three must start over. Player Three must also be careful to balance the hormonal imbalances against obstacles such as pregnant bellies and new born babies which will appear at the most inopportune moments throughout the game.

Nothing is guaranteed. All players may perform perfectly and yet a cycle may fail to produce a viable pregnancy. A pregnancy may result, but may not lead to a live birth. Any time a cycle fails, all players must start over.

This game keeps you guessing as it will end in a different result each and every time you play. Never boring. Not for the faint of heart. But all for the ultimate reward!

Do you have what it takes to win the DE IVF game?

*Must be over 18 to play, contains some nudity.

(DH is a gamer. Can you tell video games feature prominently in our lives?)


Check out more #MicroblogMonday posts at StirrupQueens

Back to those studies

I did another quick google search to see if anything new has popped up on dealing with thin uterine lining especially after chemo and total body radiation.

Nothing new. But I did revisit this article published by Biomed Research International in 2014.

The paper mentions one study that had success with a mix of pentoxifylline (PTX) and tocopherol (Vitamin E) in increasing blood flow to the uterus that had been damaged due to radiation.

One study only looked at 6 women who took hormone replacement but also supplemented with 400mg PTX and 500IU of Vitamin E twice a day for 9 months. “Improvements in endometrial thickness, ( 6.2 v 3.2 mm), myometrial dimensions (44 [±5] x30 [±3] x20 [±2] versus 30 [±7]x  22 [±3] x16 [±2] mm), and diastolic uterine artery flow were observed”.

In another case 18 patients who had endometrial thickness of < 6mm took the same combo of PTX and Vitamin E for 6 months. Of these women five became pregnant during the study, two of those women had previously experience total body irradiation. For all of them, endometrial thickness increased from 4.9 to 6.2 on average.

Even though these sample sizes are really small, I feel that given the evidence it can’t hurt for me to try taking the combo of PTX and Vitamin E now to start boosting blood flow. I have emailed the clinic coordinator to see if she can get in touch with Dr. Go to see if he will agree to write me a Rx for PTX.

The paper also confirmed that I am at higher risk for pregnancy complications.  “Analysis of singleton pregnancies has shown that these women (who previously had total body irradiation) had significantly higher rates of caesarean section (42% versus 16%), preterm delivery (20% versus 6%), and low birth weight singleton offspring (23% versus 6%) compared to the general population”. Hence the recommendation that I be monitored as a high risk pregnancy when the time comes. In that case, at least we will know what to look for and can hopefully address it before it becomes an issue.

In my highly unscientific and totally non-expert opinion, most of these complications can be linked to the damage to the normal blood flow to the uterus.

Without adequate blood flow, the uterine lining will not thicken, any growing baby will not get sufficient nutrients through the blood to be able to grow sufficiently and to term. So it all boils down to boosting blood flow to boost lining and create a more hospitable environment for the embryo.

In previous cycles I have tried increasing my estrace dosage (using both pills and patches) alone but this was minimally helpful. The last round of mock cycles I also added in acupuncture, 400IU Vitamin E, as well as used Sildenafil, and my lining improved. So maybe adding the PTX and upping my Vitamin E dosage will be the last little boost I need to get up to 7mm.

I have already started supplementing with Vitamin E 400IU a day in anticipation. I am now considering increasing my dosage to 1000IU a day and starting PTX. So long as I am given the go ahead by Dr. Go.

Conducting my own little study of 1.

 

 

 

 

 

 

 

 

All is well

Two things:

  1. Hysteroscopy went off without a hitch. They said everything looks fine. No issues. And I was back at work in an hour and a half. Things have calmed down a bit at work and I feel like I can breathe again.
  2. DEB USA just sent me this: “…this email is to inform you that your shipment has been initiated.  Please allow two weeks (more or less) for your shipment to arrive at your practice, which will be on or by, 03/09/2017.” Eeep!

Ducks are getting in a row quite nicely now.

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