Friday, May 17, 2013

I'm getting ready to cycle again!

There hasn't been much to report on with me until today. But as of a few hours ago, I actually do have a few updates for you. This is going to be a long post!

First, a big one....Libby and her husband got their blood drawn which is a requirement by the FDA for them to donate. Can you believe what a superwoman she is? She just gave birth to a baby on Sunday yet both she and her husband graciously went to the lab to get poked for this lab draw for us. I am so grateful for them. THEY ARE AWESOME. Giant checkmark in that box!

The other big update, this afternoon my RE and I discussed a tentative plan for my next cycle. I also had a chance to discuss the blood work results with her from my massive 24 vial draw way back from April 19th.

Okay, now, where do I start? We talked about so much!

As far as blood work goes, most of the labs came back normal such as Factor V, Protein C, etc. What a relief! I don't want to list all of the tests I had run, but just know that nearly all of them were normal.

The abnormal labs were where we spent most of our conversation:

MTHFR - One copy of the c667t
Vitamin D - Low
Liver enzymes slightly elevated
Factor IX and XI slightly elevated
Plasminogen slightly elevated
Fibrinogen slightly elevated
Testosterone slightly elevated
Blood glucose slightly elevated

My RE said that she doesn't believe that the MTHFR had anything to do with my miscarriage. That was a huge relief. But that being said, she still thinks it would be prudent to put me on Folgard which is a high dose of folic acid. I was thrilled to hear we would do something, because I guess some REs just choose to ignore this. She also plans to have me start on baby aspirin a few days after transfer.

I will be starting a prescription dose of 50,000 units of vitamin D for six weeks then take an OTC supplement after that and through my pregnancy. Interestingly enough, she said that she recently attended a donor egg seminar where there was strong evidence presented that donor embryo/egg implantation failure can be due to low vitamin D. Crazy! Well, no complaints on replenishing my vitamin D then!

She believes that the elevated plasminogen, fibrinogen and factor IX and XI issues are related to the fact that it had only been three weeks post D&C when my blood was drawn. Pregnancy is certainly known to increase these levels, so we are going to rerun them now that I am over a month past my D&C.

Liver enzymes - The fact these were elevated was a little bizarre. It could be due to the Metformin that I've been taking for almost two years. I was originally put on it because my OB had suspected PCOS, but under the care of an RE we learned I do not actually have PCOS. They opted to keep me on it because of my insulin resistance but it is in question now if I need to be on such a high dose. My PCP should be able to assist with investigating this. I also researched that elevated liver enzymes can even be caused by IM injections and progesterone which I had recently stopped prior to the blood draw. My levels were low enough that they did not concern my RE about an infection or hepatitis. But for good measure, she told me to see my PCP to get her take on all of it.

Testosterone - She said I'm kind of a conundrum for this because I've always had elevated testosterone (lovely, huh?) but I don't have PCOS, yet I do have insulin resistance which all points to PCOS. And I've had mild issues with testosterone hirsutism since puberty, so it's nothing new. I asked her if this would impact pregnancy, and she said definitely not so we're not worrying about it.

Based on our lengthy discussion, I scheduled an appointment with my PCP. Can you believe I got an appointment for this coming Monday at 9am when I called Friday at 4:45pm? It must be my lucky day! I'll be glad to knock that out!

I am also instructed to start BCPs with my next period which should be here in the next couple of weeks. I will also have another saline ultrasound after being on BCPs just to make sure all is looking good in my uterus since no one has had a look post D&C. My RE isn't worried whatsoever that there might be a problem.

I'll start taking all the new prescriptions like Folgard and Vitamin D on Monday once the prescription gets called in by the nurse. The nurse will also reorder the above mentioned blood tests for me to get drawn next week. We are very optimistic that the clotting labs will come back normal now that I'm not even close to pregnant anymore.

Oh and she wants me to do acupuncture during this cycle which will I will reluctantly do because in the past I found it costly, ineffective, and a hassle during our fresh IVF cycle but I'll listen to her advice and do this because I want to give it my 110%.

And on the embryo front, we are still waiting for my RE's clinic to get approval from the attorneys at their sister company in NY. My RE mentioned that the team from my clinic is actually meeting in NY this week about a whole bunch of things, and they should be getting an answer on my contract as one of them. They return Monday so we expect to have our approval in hand then. Then we can sign the contracts and get these wonderful embryos shipped to us!

As I was finishing up my discussion with my RE, she was so sweet to tell me how much she had enjoyed being a part of our journey and she was grateful for us allowing her to be part of it. She is the third party reproduction director at my clinic, but they don't actually have an in-house embryo program. She has been learning a lot on the process of obtaining embryos through us, and she's really enjoyed being my partner in it all. I could tell she was sincere! I was honored to hear my RE say that because here I thought I was the appreciative one for all she's done to make this happen for me.

All in all, it was a very good discussion and I'm excited (and terrified of course) to be starting it all over again.

Time to go, just found out Kevin got rear-ended on the way home from work. He's okay, but.... Oy!

21 comments:

  1. Wow! A lot certainly has happened in a short period of time. So glad that you have received your results and that nothing stands out. I started my Vit D a few weeks ago and hope that it helps. I did acupuncture when I got pg with Maddie. Not sure if it helped or not, but it is worth trying. Praying that everything else falls into place very quickly and we can be cycle buddies!!!

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    1. When my RE mentioned the Vitamin D deficiency and how it can hinder implantation, I immediately thought of you. I really hope it's one piece of the puzzle to create success for you. :) And I think it would be so fun to be cycle/pregnancy buddies!

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  2. A lot going on! I hope everything pushes through quickly for you!

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  3. All this sounds so positive! Your doctor sounds so thorough. You have been such an inspiration-you deserve so much happiness and I truly believe it is coming your way.

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    1. I want to just hug my RE sometimes. Not only is she thorough, she really is my partner. She never makes me feel like shes the all-authoritative one and I'm the ignorant patient. We really do work together for a common goal. When I talk to her, I feel like I'm talking to a good girlfriend. I am so lucky to have her!

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  4. Yay for cycling again! Many prayers that it's a textbook perfect cycle with no drama or surprises!! FX Kevin is still feeling ok and his car isn't too damaged. -DoubleP

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    1. Thanks so much! Kevin's car only has minor damage. I'm sure it will get repaired soon.

      FX for your embies to find you and for you to start a cycle too. I'm always thinking about you!

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  5. Hi Liz! How great to have learned so much info from your blood work! I am in a similar boat with the MTHFR c667t mutation except both of my copies are mutated. I just picked up my prescription of Folgard today and was pleasantly pleased that the pharmacy had it...sometimes they don't carry vitamin based medication. Maybe that will be the answer for us...or at least a piece of the puzzle! Such a difficult puzzle!! :o)

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    1. Do you mind me asking which pharmacy had it? I was wondering about that too - whether or not the local ones would carry it. Answers and information is power, so I'm glad both of us have more power over our situation now than we did before. :) Good ulck with the Folgard.

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  6. Glad your next cycle is getting under way. That sucks about the accident but glad your hubby is okay.

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  7. Wow, that is a lot going on! So glad you're making progress though, and it sounds like none of the test results were too concerning. Good luck with everything!

    As for acupuncture, I really like it. It's nice to have an hour of dedicated me time. I don't know about your area, but here we have a few community acupuncture places, with a sliding scale to keep it affordable. It's a little weird being in a recliner next to other people, but you get used to it (and I usually take a nap!) You might want to see if there's one near you. It wouldn't be fertility specialized, but as long as you go over your history and why you're there, I think it would be OK. :)

    Sorry about the rear end! Glad Kevin is OK, and hope the car is too! <3

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    1. The car is just scratched, thankfully. I'll do acupuncture, but when we did it for my fresh IVF cycle it was kind of a pain to leave work to do it, to pay out of pocket, etc etc. Otherwise I wouldn't call it bad. But I didn't feel like it was super helpful, but who knows? I'll give it the good ol' college try again. :)

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  8. So much going on, but it's sounds like things are progressing. Starting to cross fingers and toes for you.

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  9. Yaaaaaaay for moving forward!!!!
    Oh no RE: getting rear ended. What a pain!

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  10. sorry for the added stress of the accident, but so excited that you are moving forward with the embyros!!

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  11. Lots going on! It all sounds really promising! I'm sorry about the fender bender, though. It sounds like it was minor, at least, and I hope not presenting much of a headache for you!

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  12. It's so exciting that you are moving forward so quickly on everything. Sounds like you have a very good plan in place. A couple more weeks and you will be on those bcp's and on your way to the next stage!

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