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)

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.

The title says it all. My suppression check did not go as hoped for and at this point, I really don’t know when I will be traveling for my frozen embryo transfer. Both the ultrasound and blood test were not good. My body is not responding properly to the medication. At this point my body is calling the shots, including what happens next. It all comes down to this weekend. If I don’t respond to the meds within the next few days, my FET could be cancelled.

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

Countdown Until FET: 18 days (as of 6-14-2020)

Suppression Check Disappointment

Pre-Suppression Check Concerns

According to the calendar that my clinic gave me, I should start bleeding 2-5 days after stopping my birth control pill. Well I’m on day 4 and still nothing. I have my suppression check tomorrow and I don’t know what this means if I don’t have any bleeding by then. Does this mean the suppression check will be cancelled? Or can I still proceed? Does this mean my FET timeline will be pushed out further? I decided to email my nurse and ask “What happens if I don’t have any bleeding by tomorrow morning’s suppression check?” Thankfully she responded within the hour and said not to worry, and to continue with the suppression check tomorrow. Phew! I feel better knowing I at least don’t have to make any last minute changes to my suppression check appointment. This appointment is a big deal. It will determine whether my body is responding to the medication and let me know if I have any cysts and that my uterine lining looks okay.

The Suppression Check

I went into my suppression check ultrasound, knowing full well that my body may not be where they want it to be in order to move on with my FET. I’ve learned over these years to hope for the best but prepare for the worst. Well, the ‘worst’ decided to make an appearance at my Suppression Check. The ultrasound tech said everything was looking good so far. It was painful at times as she moved the wand around. Then she asked me, “Do you have endometriosis?” I was kind of surprised by this question because I’ve never been asked this before over my countless number of ultrasound visits over the years. “Not that I’m aware of, no one has ever told me that.” 

As if getting a suppression check isn’t stressful enough, do I also need to be concerned that I’ve developed a completely new diagnosis of endometriosis? “I’ve had scarring and needed surgeries in the past, but those were from miscarriages” I told her. I decided not to ask her whether she thought I had endometriosis because I would prefer hearing this from my doctor. In the past I probably would have questioned my ultrasound tech endlessly about everything they see and what they think that meant, but I’ve learned over time that it’s best to let the doctor view the images and disseminate everything for you. Some ultrasound techs are eerily silent and divulge no inklings of anything to you. It’s strange how some of them have complete poker faces. But other ultrasound techs will be very communicative about what they see and what they think might be going on. They always say that the doctor will be the one to make the determination. 

According to this ultrasound tech, I did in fact have a big cyst at 18mm. I was told by my clinic’s nurse that if I had a cyst that measured over 10mm I would need to go right away to get same-day blood results for my estrogen levels. Right after my disappointing suppression check ultrasound, I drove to the hospital. The receptionist at my regular OBGYN could not guarantee same-day blood results that my out-of-state fertility clinic needs, so they recommended I go to the hospital’s lab for my blood draw. I had called the previous week and asked the hospital’s lab staff if they were able to provide same-day results and they reassured me they would. 

When I got to the hospital they screened me at the front door, due to covid restrictions. They asked me if I had an appointment and I explained that I had a blood draw I needed to do. She redirected me to another building that was several blocks away, because they had recently moved their lab. I had asked several people throughout the other building where the lab was and they did not know for sure. So after meandering around a while I finally found it. Not only was their office full of people (social distancing at least), but also there was a line of people outside the door too. 

I had to take a ticket number and wait outside. I didn’t see any staff at the front desk the multiple times I popped my head in as people filed out. I was nervous wondering if they would call the number and not realize that I was outside the office, because I didn’t see any staff calling numbers outside the office. I ended up waiting about an 1.5 hours. Another lady who was a patient came after me asked everyone what their numbers were who were standing outside the office. She was the unofficial leader of us ‘outside the office people’ and would occasionally pop her head in to ask the staff where they were at with the numbers. She must have went right up to the blood draw rooms to ask the staff because the entire time I was there I never saw anyone at the front desk. It was nice that she did this because I was stressing about when they would call me or if my number would be missed. It was so crowded inside I would have been breaking social distancing if I stood inside the office. 

Finally a staff member came outside and asked me what my number was and said, “You’re up.” Finally, I thought. I had been standing the whole time, because I wasn’t too keen on sitting on the floor like other people were doing. Mostly because I was too nervous to sit down. I was nervous about what these results would end up being. They said they would fax over my results and my doctor’s office would be in touch with me. 

Hours and hours went by, but still no call from my clinic. I emailed my nurse and she said they haven’t faxed the results yet. Then I called the hospital lab and asked them if they faxed it, they said they did. But by the time I messaged my clinic to let them know they should be receiving the fax soon it was already after hours. So much for “same-day” results. I was supposed to get same-day results because it would determine whether I would start my estrace medicine the following morning. I scheduled my ultrasound first thing in the morning to avoid this scenario, but I think because the line was so long at the lab it pushed out the time they were able to get my results. Not to mention the time difference from here to my clinic out of state probably didn’t help matters. My nurse had told me earlier that this might happen and that she would check first thing in the morning for any faxes if it arrived after hours. So for now I have to wait, with no idea what medicine I will be on for tomorrow. 

Suppression Check Results

The morning after my suppression check I had just opened my eyes to reach for my phone and check my emails like I usually do each morning. By sheer coincidence that was the exact moment my nurse called me. I almost didn’t pick it up because it said “Unknown Caller” and I’ve had some scam callers recently that I’ve been screening my calls to avoid. 

A while back I had a funny interaction with a phone scammer. At that time I was expecting a call back from my doctor, so I knew that my doc’s number might show up as “Unknown Caller.” When my phone rang and I answered weirdly enough the guy on the phone sounded just like my doctor. Here’s how it played out:

“Hi how are you?” He had the same sing-songy greeting just like my doctor normally does. 

“I’m doing good. How are my results?” I said.

“Good, well I’m happy to announce you won the Publisher’s Clearing House prize!”

“What?” At this point I was thoroughly confused.

“That’s right you won!” he laughed excitedly, probably thinking he hooked a sucker.

“Oh, I thought you were someone else” I said disappointed.

When I realized he was a scammer I didn’t yell at him or say anything rude, I just kind of sat there with the phone to my ear curious to hear what he would say next, especially considering the fact that I did not enter a Publisher Clearing House sweepstakes. After a long pause he decided to hang up on me. He’s probably thinking, “Who gets disappointed when Publisher’s Clearing House calls?” This girl does apparently.

Anyway, so let’s get back to my early morning phone call from my nurse with my suppression check results. She let me know that my estrogen level was at 130 and that it should be no more than 60-something, I didn’t retain the exact number because I just woke up. She asked if my period started yet. Nope, nadda. She then asked me how I feel about changing my travel plans and I let her know I could probably get a credit on my plane ticket for future travel, since I already had to do this with Kurtis’ ticket. She let me know if I don’t get my period by Monday I may need to adjust my travel plans. 

“In the meantime keep taking your Lupron at 10 units and hold off on starting the Estrace. I’ll need to redo your calendar on Monday.” None of these last minute changes took me by surprise. With both of my egg retrievals I had to adjust my schedule because I was a “poor responder” to the medication. I was staying out-of-state near my clinic in Seattle for almost an entire month with my second egg retrieval because my eggs were growing at a painstakingly slow speed. So for my current FET procedure to be delayed, not too surprising for me. One possibility is I will need to cancel this FET and reorder all my medicine, which cost almost $1,000. 

Later in the day my nurse messaged me and asked if I could arrange a follow-up suppression check on Monday. I called and scheduled it for their earliest slot in the morning at 8:45am. According to my order from my clinic, if my cyst is still over 10mm I will need to do a blood test for my estrogen level. At least now I have a plan for what to do next. 

Part of me wondered if I could eat certain foods or something to get my menstrual cycle to start sooner so I can get rid of this cyst. After Googling this question it’s easy to fall down the rabbit hole of an assortment of old-wives tales on how to jump start a period. Everything from ginger, orange juice, coffee to sex. Why is it that each website has different suggestions for this? Probably because they are just as clueless as the rest of us. I think this is something that is largely out of anyone’s control and people are just grasping at straws for solutions. For now I will pray to the fertility gods for my period, doesn’t that sound confusing? Oddly enough, in my current situation it makes sense.

The Downsides of Fertility Meds

This week sucked, a lot. Although my anxiety has gone down these past few weeks, my irritability is in full swing. I don’t like feeling this way at all. It’s as if someone entirely different has taken my body over and I am just a witness to the emotions that bubble over. I have to get a lid on this. I got irritated with Kurtis over something minor, we were fine the next day after I explained that I thought I was being hormonal. After we patched things up the next day, I joked with him that I feel like I need to be in seclusion in a cabin or something for the remainder of my hormone treatments. He thought that was funny. I said it half jokingly but also half serious because I’m sure I’m not a joy to be living with at the moment. 

On top of feeling irritable, I was in bed most of the day yesterday with a horrible migraine and feeling super nauseous. Although I was on this same medication for my egg retrievals in the past, it seems like this is affecting me more this time. Maybe I’m on a higher dosage or something, I can’t remember my past dosage. I decided to Google “Lupron side effects” and learned that Lupron is also used as chemotherapy. Wow, that explains why I feel like I want to puke 90% of the day. In hindsight I think I vaguely remember talking with my insurance company years ago about whether they cover the drug. They asked me if I was going to be taking it for oncological reasons or for infertility. I don’t think I understood the term oncological at the time, so I simply answered “for infertility.” 

I had a sarcastic thought earlier today in regards to fertility treatments. If I were to write a Yelp review about it, the title would be “Would Not Recommend to Friends.” I know I would be saying the exact opposite if this works out and we finally have our precious little baby, but the process of getting to the baby really, truly sucks. It sucks emotionally, physically, and financially. Without a doubt it takes a toll on relationships. Both my husband and I have been through a lot, and I mean a lot, with this journey to have a baby. 

Occasionally I will watch YouTube videos of other couples, sharing their infertility journey. Sometimes the ones that are overly enthusiastic and endlessly happy leave me scratching my head. Are they new to this or something? Because no one in those videos seem to be talking about the strain this puts on their relationship. It’s not all rainbows and sunshine, come on now. Kurtis mentioned to me in the past that maybe those couples are doing that for the camera, and not talking about how they really feel to the world or even to each other. I tend to see more authenticity from other infertility bloggers compared to YouTube. Every once in a while I’ll come across a YouTuber who is telling it like it is. I always appreciate hearing their stories.

Found a creek on our recent hike near South Bivouac trail in Anchorage.

The way I physically feel right now has me questioning whether I will have the strength to do this again in the future. This process is not for the faint of heart. There’s a chance this FET will not work out. It could be a cancelled FET cycle (due to body not responding to meds), or implantation failure, or miscarriage. I need to be realistic, and mentally prepare myself for those possibilities and understand that I absolutely must take care of myself if it doesn’t work out. If this happens, I will grieve the loss and really focus on ways to build myself up and heal. Self-care would be so important then, like taking a nap, reading, listening to calming music, going for a walk, and talking to those in my local infertility group. I don’t see it as a negative thing to think of that possibility, I see it as planning ahead to take care of myself. 

I would be shocked if this FET works and I become pregnant. I would be even more shocked if I made it to having a live-birth. That would be so surreal and incredibly amazing. The odds are certainly stacked against me, but at least I will know that I did everything I could. All I can do for now is just wait to hear back from my nurse on Monday on what my newly adjusted medication calendar will look like. Then I’ll need to change my flight and hotel dates around most likely. One step at a time is all anyone can do when they face obstacles.