Wednesday, May 29, 2013

Proof of Heaven

Why do bad things happen to good people? Why is there evil in this world? Is there really even a God??

I've never been shy about struggles in my life. It hasn't been a walk in the park by any stretch of the imagination. But then again, who's life is? My father was an absent alcoholic for most of my life. He was an addict with an uncontrollable temper when he drank. My first significant memories around age 3 & 4 were of my dad beating my mom during heated late night arguments. She used to climb into bed with my sister and I afterwards, because she knew he wouldn't come after her there.

When there was an argument downstairs which escalated into violence, my sister and I would watch him beat her from the top of the staircase through the rungs on the banister, frightened for my mom's life. I will never forget the time he was in a complete rage, ripped the downstairs toilet right out of the floor and hurled it across the living room at her. I remember my mom calling the police, who proceeded to arrest him. I cried the whole time pleading with them "Don't take my daddy!" As much as he hurt my mom, I didn't want my dad to be taken away.

Needless to say, the upstairs bathroom was off limits, because he grew pot in there, and now no toilet downstairs either. Fun stuff. I was witness to more drug deals (pot & cocaine), smoke sessions, beer runs and nights at the bar by the age of 4 than some people experience in their college years. Eventually, my mom had enough and divorced my dad. I would not see my father again until age 9, and didn't even know where he lived. He later told me he became homeless during this time.

At age 6, my mom remarried; She was a bartender (going to college at the time) and married one of her customers. He was a much better provider, a Chief Master Sargeant Air Force, and basically whisked us away to live in Florida where things were less chaotic. However, he was also an alcoholic. As the first couple years went by, the honeymoon period dwindled and the arguments became more regular. Once again, the black cloud of fear was back and seemed never to leave. I will never forget the time my step-dad threw a chair right through our giant kitchen window and shattered it into a million pieces. Rules were a plenty and I was constantly walking on eggshells, scared of making one false move in that house, or asking for anything that required $$. I didn't want to be the cause of a fight about credit cards.

By age 13, I was so miserable at home, that my sister and I tried living with my real father back in St. Louis. At the time, he and his new wife had one toddler and announced a couple months after we had moved in that they were expecting #2. I should add that it was already 5 of us living in a converted apartment with 1 bathroom, built on top of an old barn. Yes, a barn! My sister and I shared a "bedroom", which was basically drywall with tape and mud (no paint) and no ceiling. Let's just say I never felt completely welcome and it lasted less than 1 year before I moved back to FL with my mom and step-dad.

During HS, my real father was diagnosed with MDS (myelodisplastic syndrome) and cancer. He underwent treatment for 7 years and passed away in 2001, 1 semester before I graduated college. By then my mom had been diagnosed with stage 4 ovarian cancer and was battling cancer as well. She also fought it for seven years before losing her battle. Unbelievably, my step-father was also diagnosed with colon cancer during the last year of my mom's life and never recovered fully from surgery to remove it (his liver and bodily systems were totally diseased from so much alcohol and poor lifestyle habits). My step-father passed first and then my mom 6 months later in 2005.

Of course I did have plenty of happy memories. There were A LOT of things my mom did for us as kids that proved what a spirited, creative, caring, and loving mom she truly was. I think she just had a knack for picking bad mates and might have had an undiagnosed mental issue, but besides that she was a great mom. She didn't have the easiest start to life either, but more on that later.

If you are still reading GOD BLESS YOU! I wasn't intending to pour out the condensed biography of Emily, but I warned you early on my blog is my free form of therapy!  Things got much better once the grief of losing my mom subsided slightly. I married the most amazing man in the world, and we started a new life together. It really has been the best time of my life since then, up until the point I was diagnosed with infertility about 2 years ago and this whole ridiculous TTC journey started.

One of the reasons I so desperately want to start a family is that I don't have much family left. The other is that I want a chance to raise my own children the way they are supposed to be raised, in a safe, loving, open and fun environment. I want to feel the joy of a having my own children and give them the love they deserve in a family they are proud to be part of. Of course, there is also that innate desire to have children that billions of people over the past countless number of centuries have been born with... I guess I was just born with the desire to have children like everyone else.

Why then must it be so damn hard? Through each pregnancy loss, I have begged the question of God "WHY???" Through every invasive appointment, every painful shot, and every hard earned dollar spent, I've asked "WHY???" And when I don't seem to get an answer my questions turn into, "Is there really a God at all? Do I even believe in God (as described in the Bible) anymore?" Some days I seriously doubt my faith.

I mean, I have come to terms with the fact that I had a shitty family life growing up, but will it ever truly be "happily ever after?" Ok, forget happily ever after. I don't even believe in that, but how about just NORMAL?  I would give anything for normal, average, or anything not involving medical treatments. It just feels like STRUGGLE has been such a common theme for way too long. When you feel like you are doing everything right, yet you're being punished or tested for no reason day in and day out...when you can't seem to be blessed with the one thing in life you want and everyone else has, WHY???

As you know, I've been doing my best not to be soooo focused on fertility things recently. I haven't been on infertility forums for days and I'm trying to make it more than 24 hours without discussing treatment with my husband. Yes, that is actually progress. Yesterday, I was in search of a book to distract me and to give me some hope that I AM still in God's hands and that He hasn't totally forsaken me...or at minimum that He really exists. Sorry, but I was just needing something other than reading a bunch of Bible verses.

I came upon Proof of Heaven and am so glad I did...



It moved me in a way I needed to be moved...just a tiny bit closer to God. It's not a religious book, but more of an account; A true story of one man's near death experience and journey into the afterlife. He was in a coma for a full 7 days with a rare form of bacterial meningitis. Ironically, he is a neurosurgeon himself, and prior to experiencing this, was the biggest skeptic on near death experiences out there, not to mention a skeptic of God's existence and spirituality altogether.

Dr. Alexander gives one of the most unique perspectives I have ever read, outlining the most descriptive account of what Heaven really looks and feels like from someone who's actually been there, along with plenty of evidence for why this couldn't just be his brain playing tricks on him while he was "asleep." He should not have survived the coma at all, and telling this story became his life's mission after his recovery.

He speaks of the opportunity to actually ask God himself why there is evil in the world. God's response?

That Evil is necessary because without it free will is impossible, and without free will there could be no growth-no forward movement, no chance for us to become what God longs for us to be. Horrible and all powerful as evil sometimes seems to be in a world like ours, in the larger picture love is overwhelmingly dominant, and it would ultimately be triumphant.

I know a few people might be rolling their eyes out there. For me though, there were just a lot of messages like this I needed to hear. Some messages I've heard before, but hearing them in a different way was helpful...as a reminder if nothing else that God is real and that struggle happens for a reason. That life does exist after our life here on Earth. That our loved ones are watching from above and helping to protect us. That everything we are going through here on Earth is for a reason, even if we don't understand it at the time. It's part of the growing process. It makes us who we are and what we're meant to become.

Friday, May 24, 2013

Diamond Digging for Dumbasses

Nothing like dropping a diamond earring down your bathroom sink to start your Friday morning off right! Yep, that is what happens when you clean jewelry over the bathroom sink (without the sink plugged like a dumb ass) two minutes before you need to be out the door.  I even caught it for a quick second...had that sucker pinned between my finger and the side of the drain scooting it up slowly and out of harm's way. Nope, no cigar. It slid right through my fingers into the abyss of the gooiest sink in the whole house, full of make-up, hair and God knows what.


All I could do was laugh. I mean really? Immediately, the thought pops into my mind, "That earring was equal to one FET!" Yes, this is how I now place value on all items. Need a new car? That's about one IVF. Weekend in Vegas? That's one IUI. Need a new mattress? Why have that when you could have one full year of embryo cryopreservation!?

Someone please tell me I'm not the only one who actually thinks about finances in terms of fertility treatments. What you say? I am? Oh well, at least I admit I'm left brain bat shit crazy. BTW, you'll be happy to know that we were able to disassemble the plumbing ourselves and retrieve the sacred earring from the pea trap underneath the sink ourselves. I was not about to hire a plumber. That is one transvaginal ultrasound!

It's been a full week since my last Provera pill (now Cycle Day 37) and STILL NO SIGN of a new cycle starting. Yes, cycle day THIRTY SEVEN and nada. It usually only takes a few days after stopping Provera for a brand new cycle to start, but it can take up to two weeks apparently? I learned something new on that one. Hooray. Lucky me, I seem to be the exception to the rule yet again.

I have tried everything in my power to get a new cycle to start. I've huffed eucalyptus essential oils until I'm blue in the face, have used warm castor oil packs on my abdomen, drank tea with dandelion root and ginger, the works. I haven't left the house wearing white pants without any tampons in my purse yet however. I almost tried that today, but chickened out.

Diamond digging and cycle voodoo aside, I think it's clear from recent posts that I can use a mental break. It's Memorial Day weekend, and I'm going to do my best to NOT focus on anything fertility related. I will still support my fellow blogger friends in my downtime, but no infertility chat rooms. No emotional breakdowns and unexpected tears (hopefully). No planning, wondering, or worrying what the heck is going on with my body right now. I give up. I can't control what it wants to do at this moment. 

I need a few days to just be me, to just be us, like it was recently on our weekend getaway in Cancun, except right here at home in the heart of Texas. As long as my body is going to take it's good ole time getting started with a new cycle, I'm going to take my good ole time with a drink in hand lounging by the pool. If anyone needs me, that's where I'll be. Hope you all have a great Memorial Day weekend free from worries and full of love!

Monday, May 20, 2013

Wonderful World of Hormones

Oh, the wonderful world of hormones. Most of the past week and weekend I was happier than a slinky on an escalator. I was feeling pretty damn good! Then, on Sunday out of nowhere, it was like a Hollywood director shouted, "Cue the waterworks!" My poor husband. Seriously though, when you are taking so many hormones on and off like this, there are just times when even the most controlled of individuals lose their faculties and need to have an emotional breakdown in public.

Not to detract from our good time though, we really did have a great weekend for the most part. There was a "Tour of Homes" taking place in Austin, where you can visit open houses from various home builders in the area. Since I am admittedly interior design challenged, and we obtained wristbands for free, this was the perfect opportunity to snoop around for ideas.  We spent Friday evening and Saturday perusing the most expensive homes we could find on the list to get inspired and make ourselves green with envy. Here is one of my favorites along the way...

@ Lake Travis, TX

I don't know about you, but I could totally see myself living here! I swear I wouldn't mind cleaning it! Surprisingly enough, touring the homes actually just made us even more thankful for our own home...that is how much we truly love our home. Plus, I think some of the interior designers for the more expensive $1-2M homes were smokin' crack. Apparently they did not get the memo that leopard print should be used in moderation and "institution green" should be reserved for insane asylums in horror movies. Even I know that! It definitely kept our tour entertaining though. haha!

Even though we've lived in our house 4.5 yrs. already, we still have a lot of undecorated space. In fact, I had been eyeing these Shrek sized stainless steel utensils at Pier One for a few years but was too cheap to break down and buy them previously. It was just our luck that they were on sale 40% off this weekend, so they are now hanged happily beside the oven. These are so fun!



Of course, I am just waiting for someone who's had too much to drink to do something crazy at some point. Realistically, you can't have a fork that big on your wall and expect it to be left alone forever. Don't be surprised if our next Christmas card ends up being a modern day remake of American Gothic!


Speaking of American Gothic, I'm beginning to feel like we may be that old before we ever have kids. I'm entering what I will call another "impatient phase" right now. Maybe it's because I turn 35 in 2 weeks. Maybe it's because there were families with babies and children around EVERY turn ALL weekend long. 

There have been A LOT of pregnant women everywhere the past week, so much so that I am starting to wonder if God is punishing me or toying with my emotions on purpose. I could be standing in a 50,000 square foot gym, and the one pregnant woman in the whole entire place will plant herself in conversation right next to me talking about her pregnancy for 30 minutes straight with her neighbor. Or, I could walk into Bed Bath & Beyond on a mission for something very specific, and the one section I seek out has a pregnant woman blocking the one shelf I'm trying to browse. It's extra hard to see pregnant women and families right now, because the weather is gorgeous and the preggos are all wearing their cute little sundresses, toting toddlers, and enjoying a blissfully perfect stroll with their cute round bellies, on the arm of their oh-so-proud husbands.

I realize we live in a small town in Texas and it's expected to have families everywhere, but sometimes nothing prepares me for the onslaught of Brady Bunch I must maneuver around.  Sunday it just became too much for me. The Bed Bath & Beyond encounter did me in. We left there and headed to World Market, and before I could even get to the front door, I just stopped in my tracks and stood there sobbing beneath my sunglasses. It came out of nowhere, but I could NOT help it. It was a completely involuntary reaction. I scooted to the side and turned so no one could see me, and my husband just put my head on his shoulder and held me in his arms to let me cry it out. I wiped my tears and proceeded to enter the store to hunt down this God forsaken giant pillar candle that we were hunting for with no success.

Ugh, I hate those moments. In a matter of seconds, I can go from being OK to feeling like I'm standing on a platform in a carnival dunking booth and someone has just thrown the perfect shot to knock me down. Not only am I soaking wet and struggling for air, the person who threw the shot could care less and certainly doesn't offer me a towel. They are just oblivious as they get to excitedly collect their prize. I wipe the hair out of my eyes, situate myself back on the platform, and raise myself back up, just waiting for the next contestant to knock me down again. I can't speak for everyone, but for many women dealing with infertility and pregnancy loss, this is how it feels to witness the endless stream of pregnancies and families on a daily basis as you remain barren and unfulfilled. 

I'm pretty sure most women going through this are more of an emotional mess than their husbands. However, it's very hard on the husbands too. Even though they aren't crying in front of World Market, they are watching their wife become depressed at the flip of a switch, and it's got to feel a little helpless to experience this for months or years on end.  I'm sure this is even how friends of infertile people feel many times. It's hard finding the "right words" to make it all better, but it's those tough times that we just need someone to listen and be there when there are no words.

I am completely addicted to Hunter Hayes' new album,  and one of his songs "Cry With You" is about wanting to be there for someone in their difficult time. It's about being that friend or family member or spouse, watching someone go through something hard or going through it with them and just not having the words. To me, I have a select few people who have really been there for me the past couple years, and I couldn't help but think of them when I heard this song....and proceed to bawl my eyes out of course. I cannot listen to this song without crying.

Warning: GRAB YOUR TISSUES...




I think my husband could have written this song and dedicated it to me. He is just the most amazing husband I could have ever dreamed for....always seated right next to me on this crazy roller coaster, telling me it's going to be OK.

Needless to say, I cried again on the drive home yesterday. That's when I realized that this was partly a biological thing. Saturday was my last day of taking Provera and it had been more than 24 hours since my last pill. I'm guessing that my body was experiencing a drastic drop in progesterone, which is exactly what is supposed to be happening right now. Is this how PMS feels? I never had this before fertility treatments, but then again I never really had PMS either. I assume Aunt Flo will be making a visit in the next day or two.  Let's hope she does, so we can get this show on the road for our FET (frozen embryo transfer)!

I have an appointment with a rheumatologist this Wednesday, so I can ask questions about autoiummunity, blood clotting factors, pregnancy/loss and their relation to one another. I'm not sure he'll be well-versed on infertility or pregnancy related issues, but perhaps I can at least find out what my true risks are in relation to the "autoimmune issue" my hematologist says I have. Can we call it something? Can he test for Natural Killer cells or anti-thyroid antibodies? I mean what it this "issue" I'm dealing with anyways?

Assuming that Aunt Flo comes this week, I'll also be having my baseline ultrasound with Dr. Vaughn. As long as there are no ovarian cysts present (fingers crossed), we should be good to start our FET cycle, and I can begin taking YOU GUESSED IT... More hormones! lol

Lord, please let this cycle begin uneventfully and continue without any major hiccups. We've paid our dues. We have been faithful and as patient as possible. We're doing everything we can. We just really need this to work. I don't think I can endure another summer without good news.

Saturday, May 11, 2013

Wash, Rinse, Repeat.... Aaaaand start all over again.

Sometimes TTC feels like following instructions on a shampoo bottle. We were so well intentioned this month. It was supposed to be our little "break" leading up to a FET (frozen embryo transfer), but we were determined to take advantage of TTC on our own (without science). Time is a tickin' and neither of us is interested in taking months off completely when all we want is a baby.

We were busily babydancing away, and I got all pumped when a second line appeared on my Wondo OPK. Then, next day line disappears. Then it reappears, then disappears, and reappears and....well you get it. No smiley face making an appearance on the digital OPK either, even though the Wondfo looked pretty dark one of the days (I always test with both brands to confirm for this very reason). WTH? I had never seen this type of activity EVER before and I knew something was off kilter.

So, on CD21 I requested to take a P4 (progesterone test) to see if there was any chance I had ovulated days after a fairly dark test line. P4 came back at 0.2, so no way I had ovulated. I then requested an ultrasound the following day, because I had already been testing with OPK's for 10 days, twice a day, and was about to pull my hair out from seeing the wonky results and no signs of a real ovulation impending. I needed to know where the heck I was at in this crazy cycle.

At the ultrasound appointment Dr. Vaughn says, "Well looks like you aren't going to ovulate this month."  Lining was only 4.5 mm and I had one 9 mm follie. So yeah, no where near an ovulation on CD22. Well this hasn't happened in a loooong time, but I'm guessing my body is all whacked out from being poked, prodded and pumped full of meds the month prior. Hubby made a good point too, that my body just gave up 17 eggs during IVF and it's probably being stingy this month.

Obviously, there is no trying on our own this month anymore. You've gotta have an egg to make a baby! Dr. V gives me two options...

A) Wait for anovulatory bleeding (spotting) to occur God knows when, which would be considered the start of a new cycle. Could be 2 weeks or 100 days or longer...no predicting how long an anovulatory cycle can drag on.

B) Take something to reset my body's clock (progesterone pills or BCP's) which will induce a period and give us control over when I start a new cycle.


Being the control freak that I am, of course I picked option B. I was actually anovulatory for almost 3 YEARS at one point (see timeline on the right >>>), which I think scarred me for life.  I'm not about to sit around and wait for days or months on end for a new cycle to start all. over. again. We are just ready to get the show on the road with our FET if I'm not going to release an egg naturally this month.

I filled the script and began taking Provera (progesterone pills) that day.  Today is day 3 taking the pills. l'll take Provera for 10 days (which will artificially give me the hormones typically released post-ovulation). Then, when I stop those, a new cycle will start within 2 or 3 days and this will be the start of our FET cycle. This is how the FET will play out basically...

Once a new cycle starts, I'll begin taking Estrace (estrogen pills) on CD2 and take those for 10 days. This will help ensure that my endometrial lining gets nice and healthy for an implanted embryo to attach to. It will also prevent my body from ovulating naturally. Obviously, I don't need my body to ovulate because we're implanting an already fertilized embryo.

I will also begin supplementing with Crinone (progesterone suppositories) during this time, but not sure when that starts. This will also help with my lining.

Additionally, I'll begin taking daily Lovenox injections right around transfer time. This was not part of my protocol with our first IVF attempt. Because I have blood clotting factors present, using this blood thinner will hopefully increase blood flow to the uterus and assist with successful implantation. My RE says that as long as I begin them prior to implantation, the medicine will do it's job before an embryo ever tries to implant. Although, just for the record, he's NOT convinced that Lovenox increases success rates for those with clotting factors whatsoever. After much discussion, we have agreed to disagree on this theory. However, he said it can't hurt anything, and I was given clearance to go for it with the Lovenox.

I tried them out this cycle. Hands down these are the
WORST shots I have EVER done IN MY LIFE!

These fockers hurt like a SONOFABITCH, so they better help combat my body's stupid blood clotting issues! I'll be taking baby aspirin daily for it's anticoagulant properties the entire cycle as well.

Then, a beauty contest will be held and one lucky embryo will be chosen for transfer. Take a sneak peak at the contenders for Miss/Mr. June FET...

Day 5 blastocysts: Both roughly BC quality (150-200+ cells)
Day 6 blastocysts: 2 Grade BB + 1 Grade CB (all 150-200+ cells)

I'm guessing we will choose one of the Day 6 grade BB blasts. The lucky winner will be thawed, given a shiny sash with a glittery title, and will be implanted through a simple ultrasound guided insemination, which does not require anesthesia. We had a discussion with Dr. V on number of embryos to transfer and all parties agreed on doing an eSET (elective single embryo transfer).

For one thing, I've already been vocal about the fact that I don't want to waste all of our embryos if the addition of Lovenox will not help and/or our next one or two FET's don't produce a pregnancy.
It seems MUCH harder emotionally to have a negative pregnancy result if you've implanted two embryos vs. one. Logistically, we're trying to conserve them while also trying to see if it's really a "bad embryo" problem or if there is something more underlying our issues.

For two, we would rather not have twins. The goal this whole time has been one baby. Sure twins are so cute! However, there are real risks to the babies, mostly surrounding premature birth. We haven't come this far only to have a difficult pregnancy we could have avoided by being prudent and just transferring one embryo at a time. Nor do we want to have a child with issues stemming from premature birth...less likely with a singleton.

We did decide to transfer two embryos at the time of our fresh IVF cycle, but at that time we had no idea if we'd even have extra embryos survive long enough to freeze. In our minds, we wanted the best shot possible and thought we should maximize our only chance at using fresh embryos. Now that we know we actually have 5 frozen embryos, we feel like we have more flexibility in choosing the # to transfer and know how many will be left. This changes our approach slightly.

Many RE's will actually suggest transferring two vs. one because it does increase the pregnancy rate slightly. Of course RE's want their pregnancy rates high right? They are required to publish them through the CDC. Well, as Dr. Vaughn pointed out, using two embryos does also increase the risk of multiples and the risks that accompany them. He is actually a proponent of always electing to transfer one embryo when possible. I like that about him. He's genuinely more concerned about the risks to the future babies rather than his SART data. He agreed that we didn't come all this way, only to have a risky pregnancy or childbirth.

He also pointed out that it's a financial thing for most people, who don't want to keep throwing $2200+ at each FET. All of the little charges do add up...

Does not include Crinone ($196) or Lovenox ($150)

Most people figure transferring more embryos will increase their odds while reducing the amount of money they spend in the long run (since there will be less FET's done). While this is true, we feel it's worth it to us to take it a little slower, conserve our embryos, and reduce our risk for multiples.

Then, after the transfer we shall wait. We are getting pretty good at this part by now. Well not really, but you know what I mean. We have practice.

No matter how many times I read this quote, it makes me tear up. Sniff sniff

Oh, and NO home pregnancy testing this time around. I will already be taking Lovenox, so I'm not concerned with my start date for that if I am indeed pregnant. I won't be driving myself crazy with that whole mess again. Nuh uh. Not gonna do it!

Now that I've told you guys all about it, I'm getting excited! Wish us luck and pray for us please!

Saturday, May 4, 2013

Is Your Body Baby Friendly?

A few months ago (Nov. 2012) when I found out pregnancy #2 was not going to be viable, I requested an RPL (repeated pregnancy loss) panel of bloodwork. It's very common for doctor's to omit telling women about this testing until at least 3+ pregnancy losses. In some cases, there are women who have had 5, 10 or more miscarriages, and have NEVER had this testing done. This just baffles me that we have doctors out there who don't even consider this testing at all and instead just keep telling women, "Just try again. It was bad luck. It was a just a bad embryo."

The reality is that there ARE other factors that could exist causing problems other than just "old eggs" or "bad embryos."
Luckily my RE is receptive to any requests I make and allows me to visit things I have questions about, but he isn't the one who even brought up having this testing done. It was me and my own research that led me to want to investigate blood clotting factors as a possible cause for my pregnancy losses and issues becoming pregnant in the first place. So, I consulted with one of the most knowledgeable resources I know of (my online infertility support group) and compiled a comprehensive list of things which are commonly tested for in an RPL. I printed the list out, took it to a hematologist, and had a full workup done. In case you have ever wondered what is typically tested for in an RPL, this is the list I took to the hematologist...

Prothrombin Time (PT)

Protein S-Functional

Protein C-Functional

MTHFR

Lupus Anticoagulant Panel

Homocyst(e)ine, Plasma

Fibrinogen Antigen

Factor V Leiden Mutation

Factor II, DNA Analysis

Chromosome, Blood, Routine

Beta-2 Glycoprotein l Ab,G,A,M

Anticardiolip Ab, IgA/G/M, Qn

Antibody Screen

ANA w/Reflex if Positive

Activated Protein C Resistance

Prolactin

15 vials of blood later, I was glad I had the testing done, because it turns out I have 4 significant blood clotting factors...

Antinuclear Antibody
Anticardiolipin Antibody
Protein S deficiency
MTHFR


The hematologist tells me that these things are associated with miscarriage (especially when there are multiple factors) as well as autoimmune issues (especially lupus-based on the combination of the first two antibodies listed) and Rx's me daily Lovenox injections and baby aspirin for my next pregnancy as soon as a pregnancy is confirmed. He tells me, "I'm not going to tell you that you have lupus at this time. What you do have is some sort of autoimmune issue going on and your blood vessels are basically attacking themselves."  He tells me this stuff is typically hereditary as well and to do some digging and see if anyone else in my family has had similar issues.

Come to find out my sister was hospitalized for a DVT (deep vein thrombosis) is Rh- (autoimmune related blood disorder) and my mom's first cousin was diagnosed with lupus in her childbearing years and struggles pretty badly with it currently. Additionally, my sister and I are almost positive my mom had an undiagnosed autoimmune/neurological issue. She had very strange uncontrollable twitching in her hands for as long as I can remember, very similar to what you'd see in someone with MS or Parkinson's. I used to tell my mom to see a dr. all the time for it, and it definitely wasn't normal. Because my mom was adopted and is now passed away, this is the extent of my family history on that topic, but who knows if there is more autoimmune stuff I just don't know about? For me, the things I have found so far are enough to warrant more investigation.

I am no doctor obviously, but the inquisitive nerd with a laser sharp intuition that lives inside of me is. haha! Seriously though, ever since I received the news of having 4 blood clotting disorders and an "autoimmune issue" whatever that might be, I have had these voices in my head telling me there might be something there more strongly related to our inability to conceive, our pregnancy losses, and now our failed IVF (despite the fact that we transferred two perfect looking embryos and all other conditions were perfect).

I am also realistic and am not expecting some silver bullet answer to WHY this keeps happening to us. Most RE's and people out there know that miscarriage does just happen sometimes and that IVF is not always successful on the first try. We've all heard stories of people who tried 4+ IVF cycles before magically being successful. But what about those women who try and try and try and it never happens? They either never get pregnant or if they do, they just miscarry. There has to be some other answer besides, "The embryos just weren't as good as we thought they were."

I, for one, am not going to ignore the voices inside my head that are pleading with me to investigate more before I go throwing our 5 remaining frozen embryos into my body haphazardly.
These are our babies, and I am going to protect them the best way I know how, even if they are only microscopic. Our frozen embryos are the only chance for a family we have left at this point. So, I've been researching my brains out, asking other women about their stories, and came upon a recommendation for the book Is Your Body Baby Friendly? by Dr. Alan Beer. As soon as I opened this book I could not put it down!



FASCINATING read if you have experienced...
-pregnancy loss
-unexplained infertility
-IVF failure
-blood clotting disorders
-endometrial lining issues (including endometriosis or thin lining)
-autoimmune issues or family history of them


Reproductive Immunology is still a fairly new field of science and the practice of using in-depth testing and protocols aimed to help those with immunological problems affecting their ability to become mothers is still quite limited. There are very few doctors who specialize in this field, and none that I have found yet in Austin, where I live. Additionally, some of the protocols they practice are controversial and not widely accepted in the medical community. However, I've got to say that after reading this book, I feel like there could be something going on with my body that has just been missed along the way.

Dr. Beer (who passed away in 2006) did not believe that "miscarriages or infertility just happen." He believed the body was designed to become pregnant and carry to term against all odds and in any circumstances, and if it isn't able to do that there is some issue preventing it from doing so. There is a REASON that some women have umpteen miscarriages or IVF failures and it's not just due to "bad eggs" in all cases.  Furthermore, for women who have multiple failed IVF's and turn to using donor eggs as their last hope, they may only experience more heartache if there is an untreated immunity issue present that is actually the underlying cause of their troubles.

According to Dr. Beer's findings, in some cases ectopic pregnancies can even occur due to factors completely unrelated to the integrity of the fallopian tube itself, but can instead be caused simply by high amounts of autoimmune activity occurring in the uterus, like high levels of natural killer cells which are produced by women with autoimmune issues (basically these cells think the embryo is foreign and attack it or cause it to "run away" to a safe place to implant....possibly a fallopian tube).

One of the biggest takeaways I learned in this book that I can apply easily, is that for women like me with blood clotting disorders, Lovenox is needed much earlier than the time of a confirmed pregnancy for successful implantation to even occur. He recommends beginning it on CD6 of the cycle of conception, along with baby aspirin daily from CD1. Many times taking a steroid like dexamethasone or prednisone can also work jointly with the Lovenox to reduce inflammation and improve receptivitiy of the uterus in women like myself, who may have autoimmune activity present. The book gets even more in-depth with various protocols used for specific issues (like Ivig therapy), but I'm not delving too deeply into those very complex and expensive protocols quite yet. I'm taking baby steps to learning more, and I'm not ready to go there at this point.

The early administration of Lovenox and dexamethasone are two things alone that are low risk which could benefit someone in my situation.
I was on dexamethasone during my IVF protocol, but it was discontinued before my egg retrieval. Why?? To me, this makes no sense and I will be asking to continue it post-transfer with our FET (frozen embryo transfer). Many times stopping or starting meds like steroids and even baby aspirin can cause an inflammatory response in the body of people who are hypersensitive, and that is something that should be minimized when transferring an embryo. Makes sense!

During our recent phone convo, my RE has already agreed that it's ok to start Lovenox earlier with our FET to help with blood flow and implantation.
Because there is no egg retrieval (needles going into the ovaries) taking place, there is no risk for bleeding and blood thinners can be started earlier with FET's. There are zero risks to using Lovenox earlier on, so why wouldn't I want to do that to help? I will also be able to continue baby aspirin without starting and stopping this time around.

Given the fact that I have not 1, not 2, but 4 blood clotting factors in addition to some family history of autoimmune issues, I really feel it's worth investigating more. I am not looking to add another "problem" to my laundry list of issues already, but I think it would be totally irresponsible of me to ignore these red flags and keep throwing perfectly healthy embryos in my uterus to no avail, and then be forced to ask myself these hard questions anyways. I am all about being proactive. After all, if I hadn't basically demanded the RPL testing before, I still wouldn't even know I had those, and that is a majorly important piece of info!

Although there are no reproductive immunologists in my area, I have an apt. with a highly recommended rheumatologist on 5/22. This is the closest thing I could find to get more answers and at least he will be able to answer my questions about lupus or anything else that is strongly correlated with these pesky blood clotting factors. Perhaps he can offer insight into safety and efficacy of using low dose steroids to improve pregnancy rates and/or reduce miscarriage in those who experience repeated losses. Either way, I'm glad that I read this book. It basically confirmed the possibility of what my intuition has already been telling me, and I am now armed with a body of evidence to discuss with my doctors and ask the questions I need to have answered.