IVF 8: trigger and CD138

Yesterday I went in for this cycle's final monitoring. Those lab techs are the best I've seen - one stick every time for bloodwork. Results came back and we triggered last night. Egg retrieval is scheduled for tomorrow first thing in the morning so I took off Thurs and Fri from work.

During my hysteroscopy in June they took a biopsy for a test that the RPL specialist recommended called the CD138 stain. The hysteroscopy was one way of checking for inflammation (and possible other issues) and this stain was another test for something similar, looking for micro inflammation not as easily visible and oftentimes overlooked. It took a while to get the results back and then send them out again for more testing - a total of 7 weeks for the process. 

My doctor called me yesterday with the results: turns out the test came back positive for micro inflammation, aka chronic endometritis. This is a known factor to hinder normal implantation of an embryo and its subsequent development. When I got the news I kind of just took it, asked the doctor my initial questions, and listened to the next steps. As the afternoon wore on and the more I thought about and researched it, I was overwhelmed by emotions:

• Hope: this is finally it - the reason for all the loss
• Skepticism: some articles say that past history of abortion causes CE, so maybe it's not the original cause of the issues but rather a side effect of all our treatment
• Sadness: why wasn't this thought of sooner. it's such a simple fix, why did we go through all that we did if this is answer
• Fear: what if treatment doesn't fix the issue. what if we fix this issue and still lose the pregnancy. what if we fix the issue and it comes back before the transfer.

According to this article, "pregnancy outcomes after treatment for CE in women with RPL are encouraging." The treatment is a dose of antibiotics. I just want to cry.

So what does this mean now? After the retrieval both my husband and I take a round of antibiotics. Then we wait for my period and retest this CD138 stain next cycle. We'll wait for the results before scheduling the ERA/transfer because obviously we want to ensure that the lining has been cleared up before attempting a transfer.

We were originally going to take September off for the Jewish holidays, but now I'll plan to do this biopsy during my September cycle. It wasn't feasible to do a natural ERA cycle with all the yamim tovim, but a scheduled biopsy is plannable and there's no reason to wait, especially if results take a while to come back.

I've stalled on my diet. Not because I'm eating differently but I think I'm retaining fluid from my expanding ovaries. Is that a thing? I also lost a lot last week so I think may just be a natural plateau. In prep for the retrieval I started drinking smart water yesterday so that it's already in my system. I'm also looking at nearby gyms and will consider joining if I can make it work with my schedule. The weather has been too unpredictable to be outside and as much as I want to make it work, I'm just not working out enough at home. I got my cleaning crew in yesterday and caught up with laundry to make sure I'm not tempted to overdo it after retrieval.

I really hope this is it. I don't know how many eggs will be retrieved. I don't know how many will fertilize and make it to blast and through the other side of genetic testing. Of our previous seven cycles, three cycles results in no embryos to transfer. Going into our eight egg retrieval, I know the next weeks are going to be a roller coaster of emotions. I can only hope we get a few good embryos to finally start our family.