Food

I'm down six lbs from my heaviest April weight. That's still 3 more than my pre-transfer weight in February. When I reach 10 lbs down I'm thinking of maybe buying a new purse - I have my eye on a MK knock-off. After that my new goal will be the next 10 lbs.

We've been eating better lately than we have in a while. Home cooked healthy meals every day. It's been a lifesaver to plan the week in advance, including breakfast, lunch, and dinners. It takes the edge off thinking and if the groceries are already in the house it makes it that much easier. Since they're all fresh ingredients I have to make sure to use them up quickly before they go bad.

When I don't eat sugar my appetite is very steady and I don't have those insatiable munchies. I miss cereal but I'm never hungry. So much so that sometimes I'll feel fine enough to delay eating to the point of feeling light headed. Then I remember that I can't do that and go eat my prepared snack. Still learning. Also still waiting for the RD to call me. I followed up today.

My research online told me that oatmeal, cinnamon, and apple cider vinegar are good for lowering sugar. I still don't know what lowers insulin but apparently a low sugar diet is a good start. So now I'm eating oatmeal with cinnamon for some breakfasts. I'm still figuring out how to use acv.

I found someone selling dehydrated fruit and vegetables and in a moment of weakness I placed an order for $30 worth of snacks. There's no added sugar, salt, or preservatives, plus the produce is all organic so I figured it's a good snack to include. I'm excited for the zucchini chips.

Rosh Hashana 5777

Rosh Hashana starts on Sunday night. I've planned menus and did most of the cooking. The things in the freezer include: roast with vegetables; stuffed chicken with mushrooms, onion, and spinach; sesame cake; various vegetable kugels; challah; two types of meatballs; and meat/bean roll ups. On Sunday I plan to make salmon, honey cake, rugelach, simanim, and salads. I've prepared more than needed for just this holiday in prep for the rest of the season, when we will be hosting my in-laws in a few weeks.

With the new year starting, I feel like we have a new shot. New beginning. New start. Now that I have the schedule for our new FET I can't help but mentally calculate everything as bFET and aFET: before and after. We got tickets to see a Sebastian Maniscalo (one of our fav comics) the weekend after the transfer and I can't help but worry that trying to get to the venue close to after Shabbat might be too stressful. It's probably fine.

My cousin is getting married in Israel in December and we joked about hypothetically making the trip because we both really want to visit. Then it wasn't so much a joke as an actual conversation about whether we're able to swing that. It comes down to not really being able to make a decision until we find out if the transfer took. At best, I'll be pregnant. At worst... well, not quite ready to think the worst yet.

That's not entirely true. We've had multiple conversations about what comes next. Extensive, thoughtful, intentional conversations. If FET #4 doesn't result in a pregnancy, we'll have one final healthy embryo to transfer. Our beta would be the week before Thanksgiving, so we'll know by then whether it took or not. It means that we'll have about 5-6 weeks before the new year which leaves us with a few options.

• Option 1 would be to do FET #5 with our last and final embryo, which would probably be right around Christmas, but I think that the clinic is closed for that week for retrievals, surgeries, and transfers, so it would likely be scheduled for the week after. 
• Option 2 would be to hold off until after Jan 1, once I'm back on the new insurance, and do another IVF cycle before another transfer. It would likely not be until February, once they can verify the new insurance which takes 4-6 weeks.

It's a solid plan, with a lot of hope of continuing to try and try until it works. But thinking about it now and putting it in writing makes it depressing to think that the ERA didn't help at all and the change in protocol it initiated wasn't helpful. I know that if the November transfer doesn't result in a pregnancy then the next time we do a transfer, whenever it will be, will include an endo scratch. That was the last and final option that the doctor suggested at our June wtf appointment, and the only thing we haven't tried yet. It has a 50/50 shot of working and there's not enough science to back it up, but it's an option I'm willing to try if everything else fails.

I'm going into the Jewish new year hopeful and scared. Optimistic and guarded. This time last year we had just finished our first IVF cycle and were getting ready for our first FET. We were so, so hopeful. So naive. So sure that by this Rosh Hashana we would be parents to a 2 month old baby. We were talking not about IF but WHEN at that point. I don't think that I could have gone through what we did over this past year if I had known then what I know now. I don't know that we would have done all those cycles, all those shots, spent all that money, if we knew that in one year from that day we would be no closer to being parents. Sometimes it's a blessing to be forced to take things one day at a time. The enormity of what we went through would have been too much to bear all once.

Even with all that, I can't help but feel lucky. Hopeful. Excited. Confident. I don't know what it is that makes me believe that this will happen for us. I know that I might be setting myself up for failure, but if I have no hope then I have nothing. Over the past year, with every devastating call about FET results, the first thing I would do is mentally calculate when we can try again. It was automatic. I knew it would take time to heal and time to wait for my period and time to start again, but at least starting again was an option. Until we're ready to really call it quits, there will always be a 'starting again' option.

I hope the new year brings with it lots of happiness, health, peace, and babies.

L'shana Tova U'metukah -- here's to a sweet new year!

Stalled

I've stalled on my diet plan. I wasn't as good watching my calories last week as I was the previous week, so while I didn't gain anything I also didn't lose anything. I guess that's also a win. So far I'm down 4 lbs of the 10 lbs I originally wanted to lose.

The truth is that while it's nice to lose the weight, I find that being strict on the diet helps me stay on track in other ways. One good choice leads to others which lead to a good healthy day. In contrast, I find that once I make a bad choice it's harder to switch back and make the other choices that day good. If I start the day out with ice cream for breakfast, there's a high probability that I won't work out that day and that I'll buy a high-calorie lunch or dinner.  But if I start the day by making my smoothie, I'll likely grab something light for lunch and make a healthy dinner, and make the effort to work out.

The biggest challenge is the prep. It's the thinking of menus and shopping for the ingredients and making sure the kitchen is well stocked with healthy options. It's an ongoing, exhausting process and as things get busier and busier at work I find less time and motivation to make it happen. This is why diets like Medifast are so popular and people stick to them even though the meals are disgusting. There is no thinking involved. There's also no enjoyment in any meals but at least there are quick results. I already decided that Medifast not for me so I have to make the effort doing it right, even if it takes more time and slower results. I know I want this to work and I'm powering through to prioritize good eating.

In other news, today I'm scheduled to take the fourth dose of del estrogen. It's been a while since my last FET and I didn't track much previously so I can't remember many of the details. For one thing, I'm seeing a lot of discharge that I don't remember from last time. Maybe it's new, maybe not. Another thing is that I had terrible memories of the intramuscular shots but in reality the del estrogen ones aren't so bad. It's still horrible to have to stick oneself with a huge needle in the thigh, but those shots are painless once it's over.  I was remembering the progesterone shots which go in the butt and are much more painful. The del estrogen is relatively pain free and is only administered every third day, so I kind of feel happy once it's done.

Later this week I go back for the halfway check to see if I'm ready for the PIO. Once that starts then transfer would be a few days later. Things are tentatively scheduled until the check up and bloodwork results come back from that appointment.  I scheduled a massage for the day before transfer. Transfers are usually scheduled in the afternoons (because the egg retrievals are always mornings) so I plan to go into work that morning and then leave for the appointment and take the rest of the day off, maybe the next day too.

We're still not in agreement about whether to tell people about a transfer. I want to keep it to ourselves. That's not accurate: the truth is that I just don't want to tell people who aren't going to care if it fails. Last time we told certain family members about a transfer and subsequent negative beta and I didn't get so much as a text or email of sympathy. I'm not asking for elaborate care packages or heartfelt handwritten notes (both of which are nice and always appreciated ;) but totally not necessary) but they didn't even call me or acknowledge the disappointment. I feel that there's no reason to give people like that private access to the ongoings of my uterus every step of the way. So while I would like to tell some people, I get that it's not fair for me to tell some people and for him not to, so I'm prepared to not tell anyone. There's still time to decide.

FET tips and tricks

I've been scouring the internet trying to research things that have worked for other people have successful FETs. Tips and tricks range from old wives tales to doing nothing different at all. There's no magic bullet.

Here's what I found so far:
- Eat pineapple core. On transfer day, days following transfer day, sometimes for all transfer week.
- Eat Brazilian nuts
- Drink pomegranate juice
- Eat green leafy veg and lots of protein
- Get acupuncture starting 3 months before transfer, with sessions on day of transfer before and after
- Bedrest after transfer, take time off
- Stay active after transfer with light walks, no need for bedrest
- Comedy after transfer
- Keep feet warm after transfer
- Eat warm foods, cooked foods after transfer

- Transfer more than one blast

- Test embryos with PGD testing

Some links:
Embryo Transfer: 10 Essential Tips for Success
Implantation after IVF: 10 Crucial Tips
7 Ways to Prepare for Transfer at Home
5 Steps to prepare for a Frozen Embryo Transfer

The bottom line is that if any of this stuff was necessary, it would be required by my clinic. I am happy to try different things within reason but these lists of preparations border on superstition/obsession. I get that people want to have the best chance possible, but I'm not sure these tricks are what tip the odds. Even so, I'm willing to try some of them. I'm still not sold on acupuncture even though so many places recommend it.  It's not readily offered here and it's more stressful to try and find a licensed therapist to do it so I'll skip it this time.  As of now, here's my plan.

In the weeks leading up to transfer and thereafter:

- Continue with the meds prescribed by the clinic: del estrogen and progesterone. This one seems obvious but it is the only part of the protocol actually required by the clinic and is the most significant of the FET protocol.

- Continue with prenatal vitamin daily. Add separate Vitamin D as suggested by clinic.

- Continue with healthy eating of a balanced diet with high protein and minimum processed food.

- Continue with exercise routine. Add strength training twice a week.


For week of transfer:

- Schedule a massage for day before transfer

- Plan to take the day off work for transfer day. Take it easy the rest of the week, but no need to stay home.

- Plan for some good movies/TV and reading material for transfer day. Always happy for a reason to watch my favorite comics.

- Make big pots of chicken soup and beef broth to keep hydrated before and after transfer day and for the following days after.

- Add pineapple core, pom juice, avocado, and Brazilian nuts to my morning smoothies. I'm drinking them anyway so can't hurt to add a few more ingredients.

- Keep feet warm after transfer. I already have this down - I bought fuzzy slippers back in February when I thought we'd have an April transfer.

- Get the house professionally cleaned week of transfer.

- Stay calm and relaxed throughout the two week wait. Easier said than done. I originally planned to not do any HPTs but even I know that's not a realistic goal to set. Logically I know that testing or not testing won't change anything that's actually happening in there, but I'll have to make a game time decision when it's actually relevant.

I rarely drink wine or coffee so cutting those won't be an issue. I'll have to remember to stop eating deli and sushi starting that week. I did a quick Google search about other foods to avoid during pregnancy and it doesn't look like any of those foods are generally in my regular diet (soft cheeses, sea food, raw egg products).

Will any of this make a difference? I'm not convinced either way, but I'm not adverse to putting in the effort and giving it a try. I'll focus on keeping calm and stress free, and getting through the 2ww with as little anxiety as I can manage. I've starting to accept that it won't work and we'll have to do this again in a few weeks, so it's negative thoughts like that which I need to keep out of my mind. 

Having only a handful of appointments is a big plus.  There's the baseline, halfway check, actual transfer, and beta blood test.  Four visits instead of the very tedious IVF protocol. Hoping and praying this is the right time for it to work.