The Game Plan

     My last Depot Lupron injection was May 1st - the last in a series of 3. You can read more about my premature foray into menopause here. While I have been on Lupron injections, I have been working with Dr. Kwak-Kim, a Reproductive Immunologist based out of Chicago, to formulate an immune protocol for my FET. My RE has been out of the country visiting family, and he is now back in action, and together we also came up with a plan. The marriage of this entire preparation is overwhelming.

Here's what we got so far:

5/1 last Depot Lupron injection

5/3 begin Prednisone as part of immune protocol to decrease cytokine level

5/17 blood work for Dr. KK - CBC, metabolic panel, TSH, NK cells and Cytokines (NK and cytokines have to be drawn and then mailed to Dr. KKs lab - a local hospital is willing to do this "courtesy draw" so long as I supply the orders, test tubes, etc - which Dr KKs office supplies me with)

5/23 Baseline u/s for FET...if all goes well I start estrace and Augmentin ( a broad-spectrum antibiotic to r/o endometrial infection)

5/28 Begin Lovenox as part of my immune protocol

5/31 Repeat the blood work panel from 5/17

6/3 Fly to Chicago to have my uterine blood flow checked. I am also due for a lining check for my RE so I plan to have them do it there...if all goes well, I'll start progesterone

6/8-6/10 ****crossing my fingers SO DAMN HARD**** that this will be a transfer of 2 blastocysts.


So many thing are different about this cycle, and these differences bring hope. Hope is a scary thing.

Our prior cycles were antagonist with equal parts Menopur and Gonal F. The only difference between them was the fact that we used estrogen priming for IVF #2. Both yielded 7 usable eggs, of which 4 and 3, respectively, fertilized. Both cycles were 3dts - our first IVF we did an eSET, and our second we transferred two.

This cycle has been a total 180...we did MDLF with estrogen priming, we used a lower total dose of stims, we used a small amount of Menopur instead of equal amounts, we added HGH, we found out that I was heterozygous for MTHFR and began treating that with Methylfolate, we visited the RI who put me on levothyroxine for my thyroid, I took prednisone during stims for my cytokines, I began self-treating cytokines with fish oil and chia seeds, we primed my uterine lining with Depot Lupron for 3 monthly injections, we are doing a FET for the first time, and we have blasts!! Something we have never had before...and, finally, I'll be on lovenox for poor uterine bloodflow and prednisone for my cytokines. If that doesn't work, we will use IVIG, which was somehow, some way, approved by my insurance (but will still be $520/infusion until we hit our OOP max).

Whew...did you keep up with all of that?

These changes excite me, but they also scare the shit out of me because nothing will guarantee that it works. I'm at a point where I feel it is impossible to be pregnant, and I am trying so.damn.hard to keep my chin up, pretend the glass is half-full, keep my eyes on the prize, see the silver lining, and all sorts of other cliché things that people say when you want to crawl in a hole and die over how shitty your life is going.

Time will tell, and for once in this whole shitty journey, I'm really hoping that it is finally MY time.



Well, its been a while...Depot Lupron update...

     Hey there. I have been pretty MIA for the last couple of months. I would love to say that it's been because I've been traveling the world, or [insert super fun thing here], but I haven't. I have been working, going to my clinical rotations, teaching and doing homework for class. Boo. Oh yea, I've also been in a menopausal state, so that's been pretty awesome.

My life has basically been like this:

Depot Lupron hasn't been that bad for me...luckily. The list of side effects would make your head spin...blood in your stool, muscle pains, bone pain, etc. I've just been hot flashing like hell. I would say I get about 1 an hour...sometimes more or less...it's like a furnace is lit in my body. My legs and arms heat up at rapid speed...then it reaches my face and I start to sweat. It's sexy, trust me.

The hot flashes and I were getting along swell until they fucked with my sleep. I'm a great sleeper usually. Despite being anxious and anal retentive, I can fall asleep on a dime. Once the hot flashes came to town, it's been a never-ending cycle  of waking up screaming hot...remove blankets...wake up freezing...put blankets back on...wake up because I am screaming hot again, rinse, wash, repeat.

Needless to say, wearing layers has been my friend.

My brave husband administered my last injection. I'm not sure if I mentioned this before, but the needle is 2" long and made for someone that you would see on TLCs "My 600lb Life," So as of last weekend, there are no more Depot Lupron injections in my foreseeable future which is beyond exciting. I'm ready to have some estrogen back in my life!



My Depot Lupron Conundrum

     I don't want to do 3 months of Depot Lupron injections. There, I said it. I wish the decision was that simple. Today is the one day of the week that I decided to relax and do absolutely nothing. No homework, no housecleaning..I'm refusing to even walk the dog today. So, naturally, because I always need something to occupy my mind and elicit some sort of anxiety, I decided to focus on my upcoming Depot Lupron injections.

     To catch you up, Dr. Wang at SIRM CT recommended that I have the Endometrial Function Test (EFT) performed. You can read more about that here. My results showed that I had a high level of "Glandular Developmental Arrest," or GDA. Basically, this is corrected with three months of Depot Lupron injections.

    This is really fucking bad for several reasons. 1) Apparently Depot Lupron has been pulled from the market in several other countries because of the severity of its side effects. And we aren't talking just about the fact this it puts you into menopause. I mean things like cancer, chronic bone diseases, etc. Sounds fan-fucking-tastic. Of course there are many, many women who are just fine, but still. I don't exactly fall on the upside of odds as evidenced by my current bullshit situation.

    Second, we had our chemical in November. In December I didn't ovulate. In January I did the EFT. This month I cycled and for the next three months I'll be sticking myself with the menopause juice. In total, 6 months on the fucking bench. It's really horrifying to think that I will turn 33 in September. We started trying when I was 30. We still don't have a baby.

     This leads me to my major issue: I kind of want to try on our own for several months. Because of an underlying metabolic disorder, we sought treatment after 6 months of trying. That was fortuitous because I had Celiac and the septum. However, between all of the testing and cycling, we've only managed to try on our own for a total of 10 months. Only 1 month of which was after my big issues were solved. I kind of feel like we could have stuck it out longer. Plus, I am sick of feeling like I am spinning my wheels. The EFT and subsequent treatment is controversial at best. Am I doing the right thing by putting everything on hold for three months? Would I be doing the right thing by trying on our own? Should we do an FET with the embryos from this cycle (that are hopefully still growing) and implement Dr. KKs plan and see how it goes? Will I regret it if it is a BFN or winds up in another chemical? I hate not knowing the right path to take.

    To make matters worse, there is next to no research on this. My RE has quite a bit of ancedotal evidence showing that there is success with this protocol, but where is the scientific evidence to back this up? More specifically, where is the scientific evidence of this that isn't written by Dr. Kliman himself, the founder of the EFT? Along with this line of questioning, the population that actually requires this treatment is so small, and, quite frankly, if you make it to this point in your journey, are you willing to sacrifice potential success by participating in a study where you may wind up with a placebo treatment, or in a control group? Likely not.

     Between this, my emerging anger over my situation, and the fact that I have no damn clue about what course of treatment to take, my therapist will be hearing an earful.

    To quote Vince Vaughn and Wedding Crashers -  "I'm gonna go see Dr. Finklestein and I'm gonna tell him we have a whole new bag of issues. We can forget about mom for a while."