Monday, August 19, 2019

ERA & Embryo Transfer Update

After two failed transfers last year I knew that I wanted to have some further testing done before wasting any more money or embryos.  When I spoke at the Infertile AF summit this spring in Rosemont I had the pleasure of listening to Dr. Roohi Jeelani talk about her clinic Vios Fertility and immediately decided that I was going to reach out to her when the time came.  She and I had been Instagram friends for a few months and I got to meet her in person at the summit.  She is so sweet and I just felt right then and there like she could help us.

Fast forward to now—I decided to reach out to her about an ERA.  For those of you who aren't familiar, it's one of the few tests we haven't done yet and it stands for Endometrial Receptivity Assessment or Assay.  Basically what it boils down to is a mock cycle and instead of transferring the embryo, a biopsy of the lining is taken to see if it's either "pre-receptive", "receptive", or "post-receptive".  This past Thursday we had our consultation with Dr. Jeelani and she explained that embryos can implant on day 5, 6, or 7; when you have a natural pregnancy, your body is triggered to start creating enough progesterone to support the embryo no matter what day it implants, but when you're artificially creating a pregnancy, progesterone has to be taken and this test will determine if enough progesterone is given at the right time.  I may need progesterone sooner for instance, if I am pre-receptive.  The biopsy will take place on day 5 and then a potential for a follow up biopsy on day 7 could be possible if the lab performing the tests requires extra specimen.  I may end up having a hysteroscopy at that time as well to check that my uterus is looking ok.

Something else that we would do differently going forward is an antihistamine protocol which adds Claritin and Pepcid into the mix along with Lupron, estrogen patches & pills, and progesterone in oil form, oral form, and vaginal form!  Dr. Jeelani said that immunity issues can be treated with the antihistamine even if we aren't certain there are issues.  I can have my NK cells tested, but it's not necessary.  So for my upcoming ERA I will do the exact protocol that I would do with my next transfer.  Typically the transfer should follow the month after the ERA as well.  The ERA is really best for people who have had multiple implantation failure or like in my case had a chromosomally normal tested baby miscarry—she said this indicates that something is probably wrong inside.  Most of this kind of testing (ERA, immunity, etc.) is very out of the box and has very little research to back it, but I know that the ERA is gaining popularity and it seems to have been a big piece of the puzzle for  a lot of people in the community that I've spoken to about it. 

Dr. Jeelani said she'd be happy to work with our clinic in Georgia as long as they were willing to change up my protocol.  I spoke to my IVF coordinator there & they were willing to adjust as necessary, but a part of me was telling me that we probably needed to consider relocating our embryos closer to home.  Our donor has since moved from Augusta back to her hometown in South Carolina so we wouldn't get to spend as much time with them as we have in the past.  It was a hard decision but I think in our hearts we knew it what was best so we have decided to transport our embryos from Augusta up here to Chicago so that logistically things are less chaotic.  The thought of having 2 different clinics plus a monitoring clinic for 1 cycle really just seemed overwhelming.

Things are moving pretty quickly.  They drew my blood at our appointment Thursday and said as long as I had ovulated already (which I had) I could start Lupron asap.  I was able to track down someone in my tiny home town of 3,000 that actually had some to give and started 10cc on Saturday night.  I will continue with the Lupron until my period starts and then I can call and schedule my baseline and get my protocol.  I've been sooo blessed again by our community with donated meds and appreciate all that everyone has done to help me track down what we need.  I was able to get quite a few estrogen patches and PIO as well but I am still on the hunt for another Lupron kit if anyone has any available.  It's truly unfortunate that we lost our coverage last year.  We were so lucky to have it for a few years and I will never take for granted the fact that we did 3 full fresh retrievals and so many transfers that were all covered.  Now I am feeling the effects of what most people are and that is the financial burden that comes along with this journey.  I priced a Lupron kit with my pharmacy and its $987 for just a two week kit.  It's very much appreciated that this community is so open to sharing! 

So the plan looks like this: Lurpon now, period, baseline, start estrogen, start progesterone, ERA/biopsy, wait for results, and then can begin meds for an October transfer.  Like I said, things are moving VERY quickly but I am excited to see what this new chapter of our journey brings.  It will take about a week for Cryostork to make the arrangements with the clinics once they receive the paperwork from me.  They have 2 levels, Basic and Premium and then they also offer 2 levels of insurance.  We have decided on the Basic package which is slower shipping time (cost is $750) and the level 1 insurance which covers a max of $25,000 for lost or damaged items.  Since we aren't in a huge rush to get them here and have over a month we thought that would be the best option for our pockets. 

Again, just want to thank everyone who continues to ride this roller coaster with us.  It's been over 5 years of blogging about infertility and so many of you have been around from the beginning and continue to support us and be our cheerleaders and it's truly amazing.  If anyone has questions about Vios Fertility Institute or Cryostork or the ERA please email me at

Wednesday, August 07, 2019

Next Steps Towards Expanding Our Family

It took me a lot longer to type this post than I ever expected.  After our two losses last year, one in July and the other in November, I for sure thought we'd have another transfer under our belts come March of this year.  Life kind of threw us (or at least me) for a loop.  Joe decided to start his own drywall business the day after we found out we lost our baby in November.  It was a long time coming but I was definitely surprised.  Then in February Georgia turned 2 and life got a little hectic.  We attempted potty training, we were learning how to run a business of our own, and we had a spirited little toddler in our house that was keeping us on our toes every day.

Eventually I decided to just wait.  I wanted to enjoy our summer season as much as possible with Georgia.  We got her a play set and I knew that we were going to be taking some little trips and just adventuring and exploring as much as possible as a family and I didn't want to take anything away from her and those experiences for a few months.  So I decided that we would just put everything on hold until this fall. 

Fall is truly just around the corner.   For the first time ever in my treatment, I am hesitant to move forward.  I've never ever wanted to wait for anything on this journey.  I always pushed hard to progress quickly through every cycle and every procedure.  Even with our two FET's last year I did them both back to back very quickly, but now that I've taken a break and enjoyed these last several months, I find myself often questioning if one child is all that we really need.  We are so blessed to have her.  There were many times that I doubted if we would ever become parents, but then our donor came into our lives and everything changed.  That is what also reminded me of how important it is to give the other 3 remaining embryos a chance.  We are SOOO lucky to have them and I have to make sure they all get a chance because of the chances we were given by our donor for them to be our children. 

Before we move forward with any transfers I wanted to make sure we covered all of our bases.  After a chemical pregnancy last July and 7w miscarriage in November of a chromosomally normal embryo I wanted some answers.  I know that not all embryos are viable which is what I chalk up our chemical pregnancy to, but our miscarriage was another story.  That embryo actually split in two and maybe that's why it didn't work out, but the test results came back normal so I just felt like we needed to pursue further answers.  I had a second RPL (recurrent pregnancy loss) panel of bloodwork done after our D&C last year which came back normal as I expected it would.  One of the only other tests I could think of that would benefit us that we hadn't done over our years of treatment was an ERA.  An ERA is an Endometrial Receptivity Analysis, it basically evaluates the the endometrial receptivity to prevent implantation failure.  It's often used for people who have had multiple implantation failure or someone like me with a miscarriage of a normal embryo. 

I spoke to my clinic in Georgia and unfortunately they don't do the ERA testing at their clinic.  I decided to reach out to Dr. Roohi Jeelani at Vios Fertility in Chicago, its a relatively newer clinic and I'm only about 2 hours from their offices.  I listened to Dr. Jeelani speak at the Infertile AF Summit in April and she does an amazing job on Instagram of educating her followers as she herself also suffers from infertility.  We spoke through some DM's on Instagram and she helped me get set up at her clinic.  She is amazing and beyond compassionate and I cannot wait to start treatment with her.  

For now the only step we are taking is the ERA.  I've considered moving my embryos back here to Illinois and Dr. Jeelani's clinic will take them, but transfers are a lot cheaper in Georgia and it always gives us and opportunity to see our donor and her family.  I want Georgia to know them and develop a relationship with them as she gets older so it's important to me that we stay close and connected so I'm not sure if we will move them yet.  If we were to move them it would cost us about the same amount (roughly 5k) whether we do the transfer here or in Augusta.  Although the transfer is cheaper at our current clinic ($3025) the cost of travel/accommodations brings it closer to about 5k so it's a decision we will have to think about soon, but at this point in time I'm not quite ready.  I'm definitely taking my time this time around & excited to be checking things off the list little by little and hopefully getting some answers!  We meet with Dr. Jeelani on August 15th for our first consultation! 
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