TESTS & MEDS! What happens after the pregnancy test

WHO THIS POST IS FOR:

Folks with a BIG FAT POSITIVE (as they call it in the IVF world :)).

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Until May I had no idea what happened AFTER the infamous 2 week wait. Each and every time I got a call that said it didn’t work and that we needed to talk. However May 31st 2o16 was different. It was a Tuesday afternoon when our doctor called. Our doctor was deeply invested in our success by transfer #5 so him calling wasn’t a tell. Stephen and I were together when we picked up the phone. Dr. C let us know that we were indeed positive and not only that but our HCG levels were incredibly high, like off the charts high. He also let us know that the this was just the beginning of testing. We would need to return 2 days later and weekly to ensure that my levels continued to climb.

Thursday I went in for my second test. Wednesday was the most stressful day of my life. I called all of my IVF friends and asked them how they coped with the wait. I couldn’t believe that I would go into the doctor and everything would be fine. Nothing had gone right up until this point so why now would things run smoothly.

Thursday I found out that not only did my numbers double, they almost quadrupled. In fact, we were on the charts for twins!

BETA TEST TIMELINE: (This varies with each practice but from what I have read its pretty much some variation of this across the board)

Some things to note:

By the time you are moving into your ultrasound weeks, you are already 4-5 weeks pregnant. You can review your HCG chart HERE.

TEST #1 Pregnancy Test – Looks for HCG levels

TEST #2 HCG Test (2 days later— for me this was a Thursday). They check to make sure your HCG levels double

TEST #3 Blood Work and Ultra sound (the following week) – checking for the sac and embryo *** If things dont look great they may have you come back again a few days afterwards

Test #4 Ultra Sound– checking for the sac and embryo— happens the following week— this week we also heard a heartbeat.

At this point your doctor may release you. I was released at 7 weeks pregnant. This was an incredibly hard thing for me to handle. I didn’t feel completely safe going to a ob/gyno. For so long I trusted Dr. C with EVERYTHING, he knew my pain and struggle. I was able to get into my doctor at 9 weeks, which helped ease my anxiety a tad.

 

MEDS

Once you are pregnant the meds don’t go away. In fact, you stay on them for a long while. I had to continue taking my progesterone inserts and estrogen pills. My fertility doctor communicated with my gyno when he wanted me to end my meds which ended up being at 13 weeks, EESH! Every doctor releases patients at different times. My doctor’s mindset was: it took us forever to get here, lets not mess with anything (this also included no sex).

I know from my new fertility support group (one for folks who are pregnant) everyone ends meds at different times. I know also know from discussion being released from your meds can be terrifying. You rely on them to get you to pregnancy and then POOF you have to hope your body all of a sudden knows what to do and can handle the load. Its a scary process for sure.

I can say from my expierience that things went smoothly and I felt so much better after getting off my meds. Keep in mind, during your first trimester your body is going bananas naturally, add meds on top of it and WOOF, its a whole other layer of intensity.


In the coming weeks I will write about Post Traumatic Fertility Disorder, going to your gyno and more. Hope this was helpful!

 

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Boys Don’t Cry

WHO THIS POST IS FOR:

  • Couples going through IVF

 

Over the course of the past few months I have spent a lot of time thinking about my husband’s feelings and how I can support him. I know from my IVF group and conversations with friends that I am not alone in feeling like I don’t know how to support my husband in a way that truly nourishes his need to talk and experience his own stress regarding IVF while also managing to exist.

This is timely because a one of the big ol’ trending articles right now follows the story of a couple “told from the perspective of the husband.” You can read more HERE.

I am an independent, self sufficient, g0-getter. For 27 of my 29 years I have been the sole bearer of my emotional well-being. During past experiences with trauma I have had to pick myself up by the bootstraps and find the resources and support I needed to be healthy. As a teen I did not have family to help, I figured out how to thrive on my own. My husband  was there for me but due to circumstances didn’t always know what to say, which was completely fair given the context. I provide this information because IVF has completely shifted how I cope with trauma. Perhaps I deal with IVF differently because its not an singular experience, I am enduring all that I do for myself and my husband, and thus I am much more okay with sharing the burden of my emotional wreckage with him. We talk all of the time about IVF and feelings, but digging into his feelings isn’t always part of the conversation.

The result  is that at times he manages both of our stress. Because I am not only emotionally unwell  but also physically sick he keeps his feelings confined until he gets to therapy, etc. His friends are wonderful humans but may not know what to say (understandably). It hurts my heart typing these sentences because I wish so very badly I had the emotional capacity to take on his pain too.

There must be a space for men (who aren’t infertile) to talk. I have seen very little around this issue and it kills me because men need to talk too (oh hey masculinity confines). IVF isn’t discussed and the repercussions for all those involved are profound. We need to move the conversation for men away from the few chuckles every husband shares about their embarrassing experience providing their sample in a cup to one of depth.  There are IVF groups for couples, women, and infertile men but I have yet to find something for supportive partners. Has anyone found a resource or group they care to share?

-ANNIE

 

 

In case you missed it: Best of Infertility Awareness Week

WHO THIS POST IS FOR:

EVERYONE!


Last week was National Infertility Awareness week, the internet was booming with awesome articles about infertility. It was excited to see folks engage in dialogue and feel a little less alone in all of this. Below is some of the best articles I read this past week. I hope you can share continue to spread the word outside of this designated week.

The Loneliness Of Infertility featured in Elle Magazine ->Absolutely beautiful piece- poetic.

The Pain of Infertility Never Goes away featured in Scary Mommy

Why Infertility Awareness Week Should Matter to Moms  featured in Romper

Start Traveling: See ya later IVF

WHO THIS IS FOR:

Couples going through infertility treatments

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When you start infertility treatments you lose all control. Control of your body, mind, and schedule. For a long while this included travel however I bring to you a few full proof tips for taking back some control through travel. I hope these tips and tricks help bring a little bit of control back in your life and a bit of liberation.

Since January I have had 3 procedures, I have travelled out-of-state three times. I am leaving on a jet plane tonight and have another procedure a week from today. I also have a girls weekend planned in May. I am proof this is feasible!

WHEN TO SCHEDULE TRIPS

I am not talking big 2 week trips here. While we do have one planned for later in the year, if you do not want to delay treatment, big trips may be out of the picture for a bit. Three day trips are completely feasible.

  • Find out when your doctor does transfers.
    • My doctor does transfers on Thursdays. I schedule trips on Fridays if I know a transfer is in the works. I schedule trips after transfers Friday evenings through Mondays. With this schedule I do not have to worry about pushing myself too hard.
  • Give yourself wiggle room
    • Schedule 2 or so weeks in advanced, do not get ahead of yourself and do months ahead of time unless you are okay with potentially delaying a round.
  • Know your cycle
    • Once you get into the groove of treatments you tend to figure out when you will get your period, how many days on meds before transfer, etc. Use this knowledge to your advantage.

TRAVELING WITH MEDS

I traveled in February with ALL of my shots and here is what I learned, TSA could care less about having a bag full of needles. I took a ton of precautions and none of it mattered. BUT to be safe, here is what you need to do to travel with meds:

  • Make a list of all of your meds days in advanced so that you don’t have to worry and stress. Check them off the night before when you pack. Recheck the next morning.
  • Have your doctor write you a note stating its okay you have needles.
  • Tell the TSA agent you have medication.
  • PRE PLAN! Go through what you have days in advanced so that if you need  refills while you are away, you have them taken care of beforehand.
  • Put all of your meds in your carry on. You don’t want to leave the fate of your meds up to airline staff.

SCHEDULING YOUR PROCEDURES

If you are in my boat you presume you are having transfers for ever and ever. Thus, I know the drill at this point.

How to prep:

  • Tell your doctor your dates in advanced. Write to him/her in email to verify. Have coordinators verify. Stay on top of this.
  • If you are doing a transfer it may be as simple as just moving your check in appointments
    • For example my doctor likes to do lining check-ins on Fridays, instead I have moved them to Thursdays, no one seems to care.
  • You can manipulate your period if need be.
    • If things need to be delayed a week, this may be feasible. Of course consult your doctor. Last year I knew there was no way I could do a transfer when my body wanted, we were able to push things off by a week and it all worked out (the procedure happened… of course I didn’t get pregnant).

HOW TO PAY FOR YOUR TRIP

Let’s be real, you are not swimming in cash because well… you are reading this blog.

  • Sign up for a credit card with rewards (specifically travel)
    • We have a Southwest card, it has been awesome
  • Charge all of your IVF expenses to your account, before you know it you will have a  ton of points- turn this lemon into lemonade
    • IVF has paid for 6 round trip tickets and counting

I can’t live your life thinking, “when I am pregnant.” It was a hard pill to swallow but the reality of it is I  may never get there and so I must live my life with the understanding that I can’t plan to be pregnant. I do know that I will be a mom, but that may not happen from my own body. And thus, living life as if it were “normal” is all I can do.

-Annie

#StartAsking

WHO THIS POST IS FOR:

EVERYONE YOU KNOW.

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April 24th- 30th is National Infertility Awareness Week, but let’s get ahead and #startasking now! That’s right, there is a whole month dedicated to educating the masses and holy moly, the masses need it. According to the CDC 12% of women between the ages of 14-44 are  struggle with infertility, thats an insane amount of people. For something that is so far reaching, we need to engage in more dialogue so that we can create a supportive community that fosters positivity so that this horrific process can be a touch better.

I have met countless couples who tell me that they suffered alone for so long. Their friends, their family, colleagues had NO IDEA what they were going through. I can’t imagine living my life without people knowing because infertility consumes your entire being. I am not 100% myself most of the time and for me I need folks to know what is going on so that my behavior or physical state is understood.

But  I digress, so many people keep it a secret because infertility is not discussed in the public space and thus it makes is shameful. Women are often made to feel it is their fault, providing little space to feel comfortable sharing their circumstance. For men, our culture of masculinity confines them to a box that says, “Man+ sperm + “spreading your seed”= MANLY.” Heck, one time I was chatting with someone who I know quite well and is pregnant, and she said, “He feels like a man,” when I asked her how her husband felt about the news of her pregnancy.  

WHAT CAN YOU DO?

Advocate for Legislation

Help ensure legislation passes that protects infertile couples and ensures states require insurance cover treatment. Check out the current pieces of legislation out there and learn what representatives are sponsoring what bills HERE.

Empathize

I write about this a lot but I can not emphasize it enough. If you learn a friend is going through treatment do NOT say, “Oh I know someone who went through IVF, they are pregnant now, it will all work out.” While its great you want to show support and try to provide hope, your friends experience is just that, their experience. We don’t want to hear about it, we just want someone to listen and recognize our own struggle.

Join a support group

Resolve has a great list of groups access the country, find one and join. Having a community that truly understands your feelings and thoughts is invaluable.

#StartAsking

Resolve is hosting a campaign this week to get folks engaging in dialogue around infertility awareness. With infertility comes a slew of questions from “How is this fair?” to “Does my insurance cover this?” to “Where do I start with adoption?” When we ask these questions alone, they begin to eat away at you. When we ask these as a collective, we receive a robust compilation of answers to sift through. While the answers may not always be what we want to hear and they don’t always change your situation, knowledge is power and having an ounce of power during a time when you are utterly powerless is sacred.

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-Annie

ERA: The Test You Never Knew About

WHO THIS POST IS FOR:

  • IVF couples who have defied every statistic thrown their way despite her body doing everything its “supposed” to do.

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Last week was a tough week to say the least. We learned Wednesday (after waiting two extra days in our 2WW— a whole other drag) that we are once again not pregnant. While I am no longer shocked by this news, this one stung a little harder because they used 2 perfect embryos (my $13,000 investment in PGD tells us this) and my lining was the thickest its ever been (around a 9.5). But despite the perfect conditions, once again the transfer failed.

LETS TALK STATS

As a 29 year old woman with no explanation for my infertility, I should have been pregnant well…. 2 years ago. But if we are going by science/stats, we are talking two transfers ago. I have now entered the zone where I am in the extreme minority of IVF parents. We know I have awesome embryos (7 out of 18 are genetically perfect) and my lining is being very cooperative. We can presume from the PGD test that its not an egg or sperm issue (although we can not say this definitively). I have had a  hysteroscopy to make sure my uterus was squeaky clean and HSNs periodically to make sure it remained polyp/scar tissue free. The only place left to examine is when my uterus is most likely to receive an embryo and now we are doing just that.

ERA TEST

I learned of the ERA (Endometrial Receptivity Array Test) test prior to our transfer when we talked potential outcomes with our doctor. He explained that 99.99999999% of women only need progesterone for 6 days before a transfer. For example if you have a transfer on a Thursday, you start your progesterone on Saturday night. The 6 day period gets your uterus to accept an embryo at the peak time for a transfer. However .0000001% (I made that up but its something like that) of women may need one or two or three days more of progesterone to give the embryo the perfect opportunity to find a new home. Thus, the next step for us is to examine if my uterus needs some extra time to bake.

WHY THE ERA TEST MAKES MY BLOOD BOIL

I know I post about this ALL of the time but I REALLY HATE BEING ON TRANSFER MEDS. I feel and look like shit. I am usually physically ill and always mentally exhausted. I wallow in a place of low self confidence when I am on meds and yearn to be off of them entirely or to be on them and pregnant (in which case I will suck it up and love each side effect).  I am a positive person and can put a rose-y  lens on most things but when I am on my meds I struggle to find the sunshine in the clouds. I have now spent over 150 days on these meds and the end is no where in sight.

In order to do the ERA test you have to do a mock transfer. Yup thats right, I have to go through an entire cycle of meds but do not get the opportunity to transfer. What this means is, once I get my period (it has arrived) I will start back on estrogen, I will go to the doctors twice a week, start on progesterone and go to the hospital for my “procedure.” However instead of having a transfer, they will scrape my uterus, grab a sample and send it to the lab to be biopsied. HURRAY! I will then have a 2WW for my test results (HURRRRRAYYYYY- can you feel the sarcasm oozing out of my pores) and then start back up on my meds for a transfer.

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IS IT THE RIGHT TEST?

Of course only time will tell but from all of the literature Ive read, I am the prime candidate. My doctor did this test with a patient recently and she is pregnant. At this point in the game, that gives me little hope because each time I go through something new, I am told a story by someone that fits this framework.

“OH so many people have a successful transfer by the 2nd time.”

“Statistically most women are pregnant by the 3rd transfer, thats why insurance covers 4 retrievals.”

“This one patient couldn’t get pregnant but once she got her embryos tested she was successful her first time.”

The list goes on.

In a month or so we will once again be waiting patiently to find out test results. The highs will be high and the lows will be incredibly low. We are still on the worst rollercoaster that never seems to end.

**** I called my insurance to ask if its covered because I was told by doctor it wasn’t. (side note: Thankfully this is not near the cost of PGD). It is such a new and rare test that they had never heard of it (neither did the genetic counseling center that manages my referrals). I asked the doctor to submit it with a letter making the case as to why I need it. We shall see if they agree. If you are on the road to the ERA its worth calling your insurance directly to ask because your doctor may presume they won’t cover it which may not be the case.

-Annie

Is a failed retrieval the end?

WHO THIS POST IS FOR:

  • Couples who are about to start IVF
  • Couples who have had a failed retrieval

A quick recap, a retrieval is when the doctor removes eggs from your ovaries. You may have this done to retrieve eggs for a later use or use those eggs to create embryos. You can learns the ins and outs of the procedure HERE. This post though is not about the basics and the minutia of a procedure, rather its about what happens if things go wrong. Sadly I can tell you about this experience. I am not a doctor, do not take this as medical advice. Rather, this is post to let you know there is hope and you have some control in this situation.

FEBRUARY 2015

I was scheduled for my first retrieval. I was prepped and ready. I was told things were “perfect” days leading up to it. I went in for surgery with 48 or so follicles. I woke up from surgery and my doctor was sitting in my room. She said she had bad news. I looked at my husband and he confirmed (he was told while I was out). She wasn’t able to retrieve a single egg.

I was in shock, how could this be? It didn’t make ANY sense. She said she hadn’t seen this happen before and told me she was so sorry.

Suffice it to say I was devastated. This was a complete whirlwind going from exploring infertility to IVF to a failed transfer all within 4 months.

We scheduled a meeting with her shortly after to discuss options. She let us know she consulted other doctors because she hadn’t had this happen in the past. She didn’t have a  definitive plan, she did have some ideas though. Her uncertainty made me uneasy, I left and made an appointment for a second opinion.

CHECKING YOUR HORMONES THE DAY BEFORE THE PROCEDURE

We met our new doctor and immediately were compelled to switch. While he was surprised at the outcome, it didn’t stump him. He had a slew of potential reasons and explained in great detail what most likely happened.

He then asked one key question, “Did they check your hormones the day after your trigger shot (day before surgery)?” I let him know that was the ONE day I didn’t go in. He looked perplexed and then explained that this was not standard practice. It IS standard practice to check your hormone level the day before to ensure the trigger worked. If your hormones indicate it didn’t work, no big deal, they will give you another and let you bake a few more days.

I have had 3 incredibly successful retrievals since switching doctors. My doctor has retrieved 72 eggs.

TIME IS OF THE ESSENCE

The switch in doctors taught me how incredibly important timing is for a retrieval. As you prepare for a retrieval it is SO important you understand the timeline so that you can advocate for yourself. It is your body and you should have the ability to make the call as to wether you need your blood taken, etc.

There are many retrievals that fail for other reasons (egg quality and quantity) which are difficult/near impossible to prevent or predict. Timing can be managed. I hope this is helpful as you prepare to talk with your doctor.

-Annie