Friday, June 24, 2016

Catching Up: The Post- Depot Lupron FET

Hi!

Sorry it's been a while. Life has been absolutely nuts.

Here is how things went down for this long-awaited transfer, 7 months in the making.

Like planned, I had my last DL injection on 5/1. Per Dr. KKs protocol, I started 10mg Prednisone daily on 5/3 (21 days before CD1, or the first day of FET meds). So far, so good.

I was instructed to send in blood work two weeks later. This involved some pretty easy blood panels, like metabolic panels and CBC, but also the Kwak-Kim specific panels like NK cells and Cytokines. So, they needed to be mailed to the Rosalind Franklin University lab. To do this, I called local hospitals to see if they would do what's called a "courtesy draw" for me, where I provide the orders and the vials of blood (which KKs office mails me), they draw the blood and then they mail it for me. Dr KKs office also provides me with a FedEx clinical pak to package the vials and all I have to do is print an overnight shipping label. The phlebotomist then puts my pack o' blood with their FedEx pickup and it arrives in Chicago the next day.

My first results showed that my cytokines, which had been slightly elevated at 35 (normal is less than 30.6) were now very elevated at around 49. My NKs, which had been 4.5%, were now around 16% (anything above 15% is elevated). This led me to the great IVIG debate, which I will write about later.

From there, my Prednisone was increased to 15mg daily. Fine. Other than that, I just kept taking my Synthroid.

On 5/23, I had my baseline. They had a hard time "finding my lining" which I guess was to be expected coming off of the DL - after all, it was supposed to strip my lining and bring back a new, shinier version.

From there, I started my FET prep - this involved 2mg Estradiol three times daily, Augmentin to make sure I didn't have an infection, and Letrozole (Femara) once daily. So far, so good.

On 5/28 (CD 6 of meds), I began a daily lovenox injection (40mg) per Dr. KK for my poor uterine blood flow.

On 5/31, my husband surprised me with a puppy!! Chaos ensues :-)

On 6/2, I flew out to Chicago for a Friday 6/3 appointment at Dr. KKs office to check my uterine blood flow, run some blood levels and meet with Michell, the NP, regarding my plan going forward. I had been super anxious that whole week because I decided not to do IVIG despite having it covered by insurance, but was happy to find out that my uterine blood flow was awesome, my lining looked amazing (in fact, Michelle said it was rare that they see a lining looking this good!), and while my NKs had gone up slightly to 17%, my Cytokines were way down at around 36 I think. I was super excited!!! I was officially cleared to start Progesterone per my RE the next day.

My transfer was scheduled for the 6th day of Prednsone on Thursday 6/9. I scheduled pre/post acupuncture on transfer day and we headed to see Dr. Wang. Luckily, both embryos thawed and continued to expand! I didn't ask about grading because honestly, it wasn't going to matter. Good embryos don't always implant and crappy embryos sometimes make babies.

I was also instructed to stop lovenox 24 hours before transfer and begin it 12 hours after, and starte 200mg prometrium twice daily beginning 48 hours after transfer.

I had a really challenging TWW. My chemical in October had produced pinching sensations and cramps and slight nausea. This time, I didn't feel much of that - some twinges here and there, and some slight dizziness towards beta, but that was it. I always go beta or bust.

At 8dp5dt, I had my first beta. I was a nervous wreck all day and had them call my husband. After a delay in getting the beta (thanks, Quest), it came back at 78! I was elated....and also ridiculously anxious! Beta at 12dp5dt came back at 634 and today, at 14dp5dt came back at 1945! Holy crap!

My symptoms come and go...anything from twinges to cramping to back aching to very very slight nausea. I'm praying that on Monday, my next beta (per Dr KK, who wants betas up until you see a HB), keeps heading in the right direction!