Transfer Day

It's here! Happy Rosh Chodesh Sivan! Also... transfer day!

I was up at 5:30 AM this morning excited and ready for the day. I had time to daven with hallel and make a healthy breakfast. We each went to work with the plan to meet at lunchtime. We got to the clinic right on time for a 1:15 PM appointment, fully prepared with a "moderately full bladder." Vitals checked out ok and I was given my name bracelet. We were given little booties instead of our shoes and taken back to a room. We barely waited 10 min before the doctor came in, verified details, and before I knew it they were done and wishing us luck. I sat around for another few minutes before getting up to use the bathroom and switching back to shoes. Quick, easy, simple. Life changing.

Instead of going back to work we both took the rest of the day off. We went out for lunch and then headed home. When we got home the house was 90 degrees. We opened all the windows and turned on several fans. I changed into house clothes and fell asleep almost immediately - I was pooped from the excitement of the day and the adrenaline I'd felt earlier just ran out. I napped for about an hour until our neighbor came by with her dogs for a visit. I'm glad I got woken up, otherwise I would have slept longer and ruined the night.

My deltoids are sore from the massage last night, but otherwise I feel fine. I drank a lot of water this morning to help flush out... something... I'm told it's helpful after a massage. I had some cramping after the procedure that I felt throughout lunch, a new symptom I don't remember from the other transfers, so I'm hoping it's a good sign but I'm trying not to obsess.

Things I didn't do:

- I forgot to take a HPT this morning. I had a brilliant plan to have one for comparison purposes but in the hype and excitment I forgot to save pee for it and then had to rush out to work so it didn't happen. I'm ok with that.

- I didn't wear my new pineapple socks for the transfer. I came straight from work and didn't bring them with me. I didn't even wear them at home when I got back because it was so warm. I might wear them after the AC gets fixed, but maybe not. We'll see.

- I didn't take off the whole day off. I also didn't take off tomorrow. I had to go in this morning for a meeting but I left at noon. Tomorrow I have the AC guy coming but until then I can't hang out in a house at 90 degrees. There's no requirement to be on bedrest so I just have to take it easy but for the most part I think it's better.

- I never got additional Vitamin D. I'm taking a complete prenatal vitamin and just never got around to adding the Vit D. I also heard too much of synthetic vitamins (i.e., not from food) aren't good for you, so I skipped it.

In my effort to not obsess about this, I keep forgetting and being spacy. For example, I forgot about the del estrogen shot until my phone reminder buzzed. I'm ok with this. I just have to remember to take it easy but otherwise I'm happy with this extreme instead of the constant thinking about it.

One final observation for the night...

I remember watching the TODAY show when Savannah Guthrie announced her pregnancy with her first child, Vale, who is now almost two years old. At the time we were just starting with testing for treatment. As I was getting ready for work this morning, Savannah announced that she's pregnant with number two.  Apparently this means she's not going to the Rio Olympics because of Zika. No one is immune!

I also noticed something else. When I started my blog in January this year, I was depressed and looking for an outlet and community of people who understood things like the discomfort of stims, the pain of PIOs, and the madness of the 2WW. Along the way I read several blogs but started getting attached to three blogs, linked on the side bar, and following their stories. As it stands, it turns out all three of those bloggers are expecting babies this coming year. I don't believe in coincidences but I don't think there's any connection. I am so happy for the circumstances that led each of these couples on their current journey and wish them all the best.

First day down, 13 days to go until beta.

Upcoming 2WW

My 2WW officially start as soon as the transfer is complete and I assume I won't be able to resist taking HPTs. Therefore, I decided to take one the morning of transfer day as a control.

Insane, some may say. Brilliant, says I!

During FET 2, I got fooled by the HCG trigger shot and mistook the second line as a positive pregnancy. I was taking daily HPTs and instead of getting darker the line was getting more faint as the days drew closer to the beta test. I chalked it up to having diluted pee or time of day, but in my heart I knew it didn't work and the pee sticks were lying to me about the second line.

Only after it was confirmed by the negative beta that it didn't work did I Google and realize my mistake. I'm not taking any chances this time! I'm getting a control line in the bank before we do anything so that I have something to compare it to.

I'm hoping I can hold out until after 6dpt to take any additional tests but I make no promises. In fact, if I want to believe this is going to work I'd want to know how soon I can get a positive so that I'll know for next baby! I'm giddy with excitement. Or it might be the hormones - the roller coasters are unpredictable.

Even though I'm going to give in to the HPTs, I need to rein in the crazy and take maximum one per day. One every other day is more reasonable. I will have to play it by ear and see how intense I'm feeling. The problem is that if it comes back positive then I'll be overjoyed and excited. But if it comes out negative, it's a soul crushing blow that makes it hard to remain positive and calm about how it may still be too early and there's still a chance it might work. For that alone I may be convinced not to take any HPTs. It's one thing to take that blow on beta day. It's another thing to take it daily and feel the disappointment time and again.

I've lined up fun things to do during my 2WW, including TV, movies, painting, adult coloring books, puzzles, working out DVDs, company/friends, and several new recipes I'd like to try. We also have a pottery class I'm excited to go to. I reserve the right to ignore the majority of these things and end up ranting obsessively on my blog instead - also a fun activity!

T minus 1

What a weekend! I had lots of wine, sushi, and deli - yum! Stocking up for what will hopefully be a long hiatus from those. I did the grocery shopping for the week and for Shavuot. I also started cooking and stocking the freezer. Over the weekend our AC conked out so now the house is incredibly hot and they can't get anyone here sooner than Wednesday to fix it.

I started today full of hope and excitement. I organized the house yesterday and sorted through all the mail in prep for the cleaning company today. I had the good kind of nervous butterflies all morning and texted my husband about it. Then my RE called around lunchtime with a random clinical question and after taking care of that, I was like, "Hey doc, while I got you on the phone..." and I asked whether there was a plan in case this transfer doesn't work. The conversation left me worried and anxious.

In general my doctor has an ok bedside manner but sometimes I feel like he's annoyed at me for asking questions. I don't care. We pay a lot of money for treatment and it's his job to answer whatever questions I have. This is the third FET of a strong, healthy, PGS-tested, 6 day blast. We're literally giving these embryos the best chance possible and success rates range around 60% so if there's something else that can be done to help it succeed, I want to know about it. According to my chart, everything is ok with lining and bloodwork, and there's no visible reason for it not to work. I asked what the plan is if it doesn't work and at first he kind of avoided the question, instead suggesting that we should be positive and hope for the best. After I pressed, he said can recommend an invasive test for $850 where they biopsy my uterus lining for two cycles in a row to try and get some answers as to why the embryos don't stick. Besides sounding painful and invasive, it doesn't sound like he thinks it will give any conclusive answers. I hope it doesn't get to that.

I had the house cleaned today and I love that it's all clean, even though it's hot. I also had my massage this evening and I feel ready. Hopefully the AC repair guys will find a quick fix for the AC in time to get it working for the long weekend. I have guests coming and I don't want to cancel but will if it's too hot - I wouldn't subject anyone to that.

I talked to a friend about my anxieties and it helped calm me down. It also happens to be Erev Rosh Chodesh Sivan and someone on FB posted that it's a special time to daven for children. I found the prayer online in Hebrew and English which is called A Parent's Prayer . It applies to parents-to-be as well, and I got choked up at, "Hear my plea and grant me sons and daughters" in the second paragraph. I know it's all up to Him and regardless of what I do it's He who decides whether we will merit having kids of our own.

Tomorrow is Rosh Chodesh Sivan and I plan to get up early in time to daven and say hallel. I'm grateful we got to this point and I appreciate all the good we've been given every step of the way. We're lucky we have three embryos to transfer and I feel blessed that we got this far. I hope that it is in His plan to help this FET be successful.

FET update

I went in for the halfway check for bloodwork and ultrasound. The first part of the FET protocol is three weeks of birth control pills. Then there's two weeks of del estrogen shots. Once the lining is thick enough, the next step is to add progesterone (for me it's in intramuscular PIO form).

In my mind the BC pills and del estrogen shots are the first half, even if it's the longer part of the process. Once the PIO shots start, things get real. My lining measured at 10 mm but I forgot to ask if it was good. According to Google, anything above 8 mm is acceptable. My first PIO shot was last night and it was really not so bad. I got the ok to do it later than the recommended 6 PM - 9 PM slot because I was working late and there was very little wiggle room with the schedule. If I needed to I obviously would have made my husband come to my office and done the shot at work, but having that flexibility made a world of difference. I'd like to add more details about work but in the interest of keeping this somewhat anonymous I'll keep it to simply saying that my busy season is over and summer chill time has begun!

First PIO shot wasn't terrible, possibly because I was tired and it was late, or maybe because it's the first of many and my butt isn't sore yet. Who knows. Either way, I'm grateful it went well. I have a good feeling about this FET and I hope I'm not setting myself up for disappointment. I can't pinpoint why things feel different this time, but they do. I hope this is our time. 

I was out shopping with a friend at a chotchkee store helping her find costume jewelry for an upcoming occasion and happened upon a pair of pineapple socks! How funny is that? What are the odds? They were ridiculously overpriced but I got them anyway. According to the internet, pineapple helps make babies so I got them them for transfer day :)

Cute!! It makes me happy so it was worth it!

I'm dreading the 2WW. It was so stressful last year. I remember the worst part was that even after I "knew" it didn't work -- I guessed based on the HPTs and lack of symptoms -- we still had to continue with the PIOs until it was confirmed by the bloodtest. It was hard to keep doing the painful shots and trying to keep being hopeful even though I knew it didn't work. I don't know how to make it better. I don't know if there is a way to make it better. But there's no way to skip that part and even if it works, it would be the first of many milestones that require patience.

I already calculated and if this transfer sticks then we would be at 3 months around the end of summer, just in time for baggy fall clothing! This is only one of a million random thoughts that have been going through my mind in prep for this transfer. 

In terms of telling people, I decided I'm not going to argue about who he wants to tell. I'll make my case one last time of why I prefer not to and if he still decides that he wants to tell, then I won't be mad. It's such a tiny cog in the grand scheme of things. It's very possible I'm trying to hold on some form of control because the rest of the situation is so out of my control. I'm telling the internet so who am I to stop him from telling the people he chooses? I know there's a difference but I can see how he may view it as a double standard from his perspective. In a perfect world I'd rather not tell anyone until 6 weeks when we hear a heartbeat, but if that's not feasible then at least until we get a positive beta. Again, I'm getting ahead of myself and worrying about a lot of irrelevant things right now. Let's first get to a successful transfer. 

Looking forward to a restful weekend!!!

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. 

FET #3: Baseline

It happened and we're all ok! I was so anxious about the appointment this morning but of course it was fine. And I'm fine now that it's over and we've officially started the cycle. I don't even know why I was so anxious. Everything looked good according to the ultrasound, and bloodwork came back ok so we're good to start. First del estrogen shot tonight and again every third day until further notice. I'm ok with it. It is what it is.

The appointment this morning went well. I arrived at a great time so there was no wait. I got taken back right away, quick ultrasound, painless bloodwork. (My official recorded weight today was four pounds less than what they had for me at my last retrieval which was about a month ago. Weee!) Quick and simple. I was out the door so fast that I got to work earlier than I do on regular days.

There was a little drama last night when we realized the paperwork never got signed. I had gotten it from the nurse electronically, signed it, and it was supposed to be sent to my husband for signature but he never got it. So the nurse resent it to me and said "try again." I thought she had meant for him to try again and I forwarded that email to him. He kept pushing it off because he wanted to read the document in its entirety, so it kept getting procrastinated until I said last night that it needed to be signed. So he sits down to read and sign but he never got it still from the clinic and all he had was that email I had sent. There was no one to call in the clinic and I was so upset because I knew they would delay a start without signed paperwork and having him go down there was such a waste of time. Our plan was for me to go to the clinic earlier than my scheduled appointment, have them send it to him as I'm standing there, and I would text it to him letting him know to do it now so that I could move on with the rest of the appointment.

This morning I woke up and had a thought: what if the nurse meant to tell me that I'm supposed to sign first and then a copy gets automatically sent to him? I figured it can't hurt to try so I dig up her email saying to try again, signed electronically, and a second letter he get an email. Success! I can't believe it took that much drama to figure it out. So yeah, it was technically my fault he didn't get it but had he not waited until the last minute it wouldn't have been a big deal figuring it out. All's well and that ends well.

My next appointment is in June. She told me the date to come in and I asked if it was at all possible to move it up a day since I have a huge work project happening at the same time. She said she wanted a specific number of doses first so I said no problem, we'll make it work. Obviously. I'm not postponing it. So June will be a little hectic, that's fine.

The weather is being so ridiculous. I was in a sweatshirt outside nearly the entire last week. In May! Winter: you had your turn and you didn't take it!! If we're having no Spring I demand extra days be added to fall! But it is technically almost summer and I have plans for Summer 2016.  We're looking to buy a new car in June. I also want to plan a beach vacation or maybe something to a nearby lake. I put bedroom redecorating on hold while I'm busy with work. 

 I stopped thinking about zika because it's out of my control. I got my yard sprayed and bought tons of repellent. It's been too cold to wear repellent, but I have it and will wear it daily once it gets warmer, and that's as much as I can do. It won't do me any good to agonize over it.

I'm determined to try not to take any HPTs after the transfer. I hope I stick to that. I remember how agonizing it was testing daily, sometimes multiple times. The 2ww is such a stressful time for me and I know I need to prepare in order to avoid going bonkers. I'll have to work on that.

I'm excited for the weekend just to be home and veg out!!! Yay TV and sleep!