FET Prep Week 24: Good to Go! | Starting PIO Shots | Ways to Thicken Uterine Lining for Embryo Transfer

FET Prep Week 24: Good to Go! | Starting PIO Shots | Ways to Thicken Uterine Lining for Embryo Transfer

Last week I talked about how my lining was too thin. Last week my lining was 5mm, and this week it went up to 5.3mm. Not much of a difference in my opinion. I’ve read there is a range of acceptable lining measurements. Anywhere from 6mm to 10mm seems to be the general consensus for acceptable lining measurements. I was certain that my doctor was going to either postpone my transfer again or cancel it all together. 


Entry written prior to posted date.


Catch-up on Previous FET Prep Posts

FET Prep Week 1: 3.5 months until FET

FET Prep Week 2: Supplements, WTF Email, & Increased AMH Level

FET Prep Week 3: You say Future Tripping, I say Future Planning

FET Prep Week 4: Bad News from SIS Test

FET Prep Week 5: Surgery, Depression & Trip to Nevada

FET Prep Week 6: Relax! You’re on Vacation.

FET Prep Week 7: Food Plan, Medical Debt,  Post-op Follow-up, & Imagining Motherhood

FET Prep Week 8: Migraines & Some Good News

FET Prep Week 9: A Tough Decision

FET Prep Week 10: Down-Regulation Started, Infertility Group, Coronavirus Concerns

FET Prep Week 11: Possible COVID-19 Travel Restrictions, Postpone Fertility Treatment?, & The Skyrocketing Cost of Leuprolide

FET Prep Week 12: Clinic Says “No FET” due to COVID-19 Pandemic, Digital Roundtable on COVID-19

FET Prep Week 13: FET Scheduled After Clinic Partially Reopened

FET Prep Week 14: Plans Changed, Flying Solo, & Confusing Med Instructions

FET Prep Week 15: Should This be Happening? | To Lovenox, or Not to Lovenox, that is the question. | High Anxiety from Methylfolate

FET Prep Week 16: Injections Started | Approved for Lovenox | New Vitamins to Reduce Anxiety

FET Prep Week 17: Suppression Check Disappointment | The Downsides of Fertility Meds

FET Prep Week 18: Altered Plans Due to Cyst | On Different Pages with Spouse

FET Prep Week 19: Facepalm and Panic Moment | Treatment During COVID & Seattle’s ‘CHOP’ Protests | 3rd Monitoring Appointment Results

FET Prep Week 20: Clinic Cancels My FET 

FET Prep Week 21: Starting All Over | Scary Side Effect? | Not Enough Syringes | Move or Travel Abroad for Treatment?

FET Prep Week 22: Hormonal Hot Mess 

FET Prep Week 23: Transfer Date Postponed Due to Thin Lining

Countdown Until FET: 1 day (as of 8-2-2020)


FET Prep (9)


Good to Go!

I had my ultrasound and blood draw to test my progesterone and estrogen levels on July 28th. Over the years I’ve gone to so many ultrasound appointments I know practically exactly what to look for on the screen. Even before the ultrasound tech can tell me any bad news, I can already see it. During my egg retrievals I could spot almost every follicle, with the occasional exception of a few super tiny ones. I can also recognize a dreaded cyst on the screen. More recently, I’ve been able to see how long my endometrium is, even when they quickly dart from one measurement to the next. I saw 5.3mm flash across the screen. Damn I thought. That was the longest my lining measured out of the three different ones she took of it. 



Different shots of my uterine lining thickness from my appointment on July 28th.


I left feeling somewhat defeated but I knew everything would depend on what my doctor says next. I had already done my blood draw before my ultrasound. So now I just have to wait. I got a call that afternoon that both my estrogen and progesterone levels were good and that I was approved for my embryo transfer.

“Oh, I thought for sure my transfer would be postponed or cancelled since my lining is only 5.3mm” I said to my nurse.

“Well it is slightly on the low end but by the time we do your transfer next week it should be right where we want it to be. Your progesterone and estrogen levels are perfect and right where we want them to be, so we think that your lining will thicken up in time” my nurse said.

So my embryo transfer has been officially scheduled for August 3rd. Finally! It’s been a long road, that’s for sure. I am now on a new medicine routine. No more Lupron (thank you Jesus!), no more vaginal estrace. Instead I am on oral Estrace 3 times daily, Endometrin in the morning and evening, and 1mL of the PIO (progesterone in oil) booty shot in the evening. 



Showing my arm from my blood draw and my dog starts licking my hand. I think he thought I had a treat for him.  🙂


Starting PIO Shots

I’ve decided to have my husband help me with the PIO shots, and when he is not around the plan is for me to do it on my own. So I will need to do it on my own when I go to Seattle. I’m kind of afraid, because I’ve heard stories about women passing out when they try to do it themselves. This one poor girl passed out in the bathroom and fell on the ground. When she came to, she still felt super dizzy and crawled out slowly to the living room where her husband was. As she crawled out, the shot was still sticking in her butt as she asked for her husband’s help. That poor girl.

I don’t want to be that girl, so I need to figure out how to do this shot on my own without passing out. Sure I’ve done lots of stomach shots, but they are a fraction of the size of the PIO shot. Plus there are extra steps to the PIO shot, like pulling back the plunger to make sure there’s no blood, for example. Got blood? Start all over. Thankfully my husband seems fine with giving me the shot. One less stress, plus I told him “You are a part of the process now, and helping to hopefully create a little baby.” I wanted him to feel included and that he is contributing in some way. I’ve heard that some men feel really out of the loop and helpless. Well my boys, offer to help your wife with her PIO shots. I’m telling you, as long as you follow the instructions and help her relax during the shot, you truly are doing a lot to help her. 



About to do my first PIO (Progesterone in Oil) shot. That needle is scary long.


Ways to Thicken Uterine Lining for Embryo Transfer

I will probably create an article specifically on this subject in the future. But for now I wanted to talk briefly about some of the things I’ve done recently to try to get my uterine lining thicker. Obviously it isn’t quite where my doctor wants it just yet (currently at 5.3mm), but I thought I would try some of the ideas that are often suggested and tend to be widely accepted as being helpful for increasing uterine lining thickness. Talk with your doctor before trying some of these suggestions. 

I decided to increase the L-Arganine I was taking to 6g daily. I was hesitant to take this in the past because I’ve heard it can affect egg quality, which can impact future IVF cycles. But in the case of FET cycles, it seems to be fairly helpful for some women. I was taking a much lower dose before and not on a regular basis, but this week it was 6g for me. Where did I get the 6g dose from? If you read It Starts with the Egg by Rebecca Fett, she goes into a lot of detail about various supplements to take depending on where you are at with your treatment. According to Fett, taking L-Arganine in conjunction with Vitamin E can help thicken uterine lining but is only recommended for frozen embryo transfers and not fresh transfers.

I also ate more vegetables this week than I normally do. Eating fresh fruits, veggies, beans, legumes, nuts, and basically a medetarrian diet, while also avoiding processed food as much as possible seems to be a widely accepted way to improve fertility odds. I can hear my Keto friends yelling at me. No worries though, you do you. If you are following your doctors recommendations and you are seeing the results you want, more power to you.

It just so happened I had a lot of walnuts on hand, which I’ve learned nuts can help thicken the uterine lining and make it more receptive for an embryo. My eyes kind of bugged out of my head when I saw my walnuts were about 200 calories for ¼ cup. But if it helps my lining thicken up, I will do what I gotta do. Doing an embryo transfer is usually not a good time to lose weight, and the focus should be on nutrition. Trying to lose weight while also doing a transfer I’ve heard adds extra stress to the body. Extra stress is no bueno during embryo transfers. I’m not going to stress too much about my extra five-ish pounds (emphasis on the “ish”)  I’ve gained if I know I’m also eating healthily. 

I decided to also seek out advice from my Instagram followers about what they did to help increase their lining and I received some good ideas. I’ve heard that acupuncture can be helpful and this too was being echoed by some of my followers. After looking into it more, from what I understand acupuncture tends to be more helpful doing it a series of times leading up to the transfer, and there were not as significant results from just one session prior to transfer. Also, if the added expense and the idea of acupuncture seems stressful, you don’t have to do it. Remember, you can reduce stress in other ways. I opted not to do acupuncture for this FET because of the expense as well potentially being exposed to COVID in the acupuncture office. Being in close contact with someone who sees multiple people all day did not seem worth doing acupuncture, but that’s a personal decision. 

It was quite serendipitous that I received about half a dozen suggestions across different social media accounts (at the same time) for something I had never heard of.  I decided to check in with my MTHFR facebook groups I’m a member of and I asked if they had any suggestions on improving my lining, as well as any other ideas the had to help increase my odds of my embryo implanting. Everyone was suggesting Estrogen patches. I’ve never heard of this, and it could potentially be a game changer for me. Although it’s kind of late in the game to do anything now, since I am so close to my transfer date, this could definitely help me in the future.  Perhaps it could help me during my pregnancy, if I am lucky enough to become pregnant. I will definitely ask about it. 

Having proper estrogen levels can help thicken your lining, and if you have a MTHFR gene mutation your body may not be absorbing the oral Estrace pill as well as a patch of estrogen could. This blew my mind. First of all, why had no doctor told me this before, despite me telling them about my gene mutation? Even without the mutation, wouldn’t you as a doctor consider alternative methods such as the estrogen patch if your patient’s lining and estrogen levels have been consistently off. What gives? Why not mention this? I’m thankful I learned about this from other patients online, perhaps this will help me later on. Although social media isn’t the be-all and end-all for treatment, it has proven to be a good tool to help me advocate for myself to try different approaches.



Got out to Hatcher Pass in Palmer, Alaska. It was nice to get out.



Mom was able to go with us too, she brought her little Yorkie. Nothing like mountain-fresh air.

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