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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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

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

IVF approved Workout Part 2

WHO THIS IS FOR:

  • Women who are in IVF and are told to do low impact exercises while on a cycle
  • Women who overstimulate but want to workout leading up to a retrieval

WARNIG: I am not a doctor.  The advice I am providing is from my own experience. You must listen to your body and do what is right for your treatment.  Of course consult your doctor before participating in any of the exercises, if they give you the go-ahead, indulge and enjoy!

I wrote about working out a while back, check it out HERE. What makes me qualified to chat about workouts? I am a 200 RYT yoga instructor but more importantly, I am a work out nut. Prior to IVF I went hard, really hard with HIIT workouts. That unfortunately has changed over the past 1.5 years because of IVF and a big ol’ broken big toe. Speaking of which, I learned yesterday that I may never run again… add that to the file of shit I have been handed as of late. But I digress… the workouts below have a big impact with a few small movements.

This post is focused  on TRX workouts. If you haven’t taken a TRX class, I recommend finding one in your city. Definitely let your instructor know if you can’t do high impact exercise because of doctors orders.  Some classes use jumping (usually with squats) but you could easily modify with regular squats.

If you cant make a class, here are some great circuits to try. I recommend using the app Seconds so that you can have consistent circuits.

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TRX-Workout

See them in action here: https://www.trxtraining.com/train/exercises

I found a great article on keeping form in the case you can’t get to the class. 

-Annie

Picking A Fertility Doctor

WHO THIS POST IS FOR:
  • Couples who want to seek treatment for infertility.
  • Couples who know they will struggle to get pregnant due to illness
  • LGBTQ couples who are beginning to family plan.
  • Women who interested in becoming pregnant.

Picking a gyno can be an overwhelming process, finding a fertility doctor can be downright exhausting. If you have only done IUIs or haven’t even started the process yet, my best piece of advice is go into this search with a defined set of qualities you want. Their success rates are important but its equally important to feel comfortable with the entire staff, their process, and your doctor.

THIS IS NOT A GYNO VISIT. During each cycle you are going to be at your doctor’s office between 3-5 times a week (depends on their protocol). I read on another blog, infertility is a full time job, and thats  a fairly accurate description. Because this will take up a large part of your life,  it is incredibly important you are comfortable asking your doctor questions and feel like you have a strong support system.

UTILIZE RELIABLE RESOURCES

Center for Disease Control

Since infertility is not super uncommon (despite all the hush hush) there are awesome resources out there that can be incredibly helpful. The Center for Disease Control did a big ol’ study entitled Assisted Reproductive Technology Report. Surprisingly, this report is fairly easy to navigate. You can select the state in which you are seeking treatment, find your potential infertility clinic and read all about their success and failures. Dig into your search by click here.

Resolve

Resolve- National Infertility Association is also a fabulous resource. They can help you sort through what’s important to know and help you find support groups (a future post). They have a professional services resource page that can be quite helpful. 

ASK YOUR FRIENDS/COMMUNITY

Remember, you are not alone. You may not know who in your circle has gone to a fertility doctor but its a great conversation to start having. Ask your circle of trust if they know of anyone who has gone through fertility treatments and have them connect you to their friends. Find out who they went to, what their experience was (the good, the bad, the in-between), and use this information to help you steer your search towards a decision.

QUESTIONS TO ASK THE DOCTOR TO DETERMINE IF THEY ARE THE RIGHT FIT:
  • How does staff communicate your results each day? You want an easy system that is reliable. You are going to get a lot of information each day. The less you have to manage the better, you want this to be as seamless as possible.
  • How do you contact staff after hours? You will want this information in the case you have a question about your meds, you are having bad side effects, you have a question about your upcoming procedure, etc..
  • What is their philosophy to infertility?  What I mean by  this is, find out what what drives the doctor to make decisions. My current doctor is AMAZING. In one of our long conversations he said, “My job isn’t to get you pregnant, my job is to get you a healthy baby.” His underlying philosophy  helps guide the medications he uses, number of embryos he transplants, and opportunities he presents us.

My first doctor was super caring and asked a lot of personal questions. I felt acknowledged by her. While her bedside manner felt good, bedside manner  wont get you pregnant. I felt like she would cushion information to protect my feelings. She would tell me what I wanted to hear from time-to-time rather than what I needed to hear.

My current doctor is caring and straight forward. He may not ask personal questions and know everything about my personal life, but he does give me information without beating around the bush. He uses stats to help us guide decisions and is always thinking two steps ahead. Personally I find this comforting because I know that if things don’t work out, we will have a strategic plan in place that suits us.

  • How do you contact your doctor if you have a question? A doctor who is available is the best kind of doctor. You may have questions that creep up in the middle of the night and having access to your doctor is so important.
DON’T BE AFRAID TO SWITCH DOCTORS ALONG THE WAY

I speak from experience when I say, switching  doctors is scary. It’s terrifying for a number of reasons.

  • When you are drugged up and in the midst of things, having to find a new doctor is incredibly overwhelming.
  • Starting over is hard. You develop a rhythm going to your doctor each day and the thought of having to reestablish your groove can seem daunting.
  • Lastly, I felt like I was betraying my doctor. I was scared to hurt her feelings.

Despite all of these reasons it’s important to remember your end goal: get pregnant. As a friend told me, a second opinion never hurts. Knowledge is power, remember this when you are doubting your decision.

YOU HAVE YOUR DOCTOR, GO FORTH!

Once you select a doctor the questions you have to ask are going to be personal to your situation. The most important thing is, ask whatever you want. Don’t hold back, no question is a stupid question. Also, if something doesn’t feel right or sound right, don’t be afraid to push back. You know your body and you are the best advocate you have.

-Annie