Wednesday, October 09, 2019

ERA Results & FET Delay

On September 16th & 18th I had the biopsies taken for the ERA test.  If you guys recall we moved clinics and decided to proceed with the Endometrial Receptivity Assessment (ERA) before we proceeded with any further transfers.  We had our embryos moved up here to Chicago from Georgia and decided on a September ERA with an October transfer.  Along with the ERA I also had a hysteroscopy at the same time on the 18th and all was good and clear.  My new doctor, Dr. Jeelani wanted to get a clear picture of what my uterus was looking like more in depth.  She wanted to check for polyps and other possible issues but luckily I had none!  Sometimes results like that can actually be a little disappointing because you're secretly hopeful that something is wrong and there's a reason as to why things aren't working out.

On 9/27 I had a follow up with Dr. Jeelani and we discussed my results of the hysteroscopy which she said were perfect.  We also discussed transferring 1 or 2 embryos and we decided on just 1 as we always have.  Dr. Jeelani said I could expect my ERA results on Monday.  When my results were uploaded into my patient portal I quickly logged in to see that they were "receptive" -- basically meaning that the progesterone protocol that we used for the ERA/mock cycle was sufficient for an embryo to be received.  Honestly, I was a little disappointed.  I was hoping that maybe there was an issue with my window of receptivity and the answer to why previous FETs had resulted in miscarriage, but unfortunately that wasn't the case.  I know the results aren't the end of the world and some people may welcome these results but ultimately for us it causes more questions than answers.  

At my follow up on 9/27 we did a baseline but found that my lining was 11mm so they were unable to consider that a "baseline" as my period had not quite started yet (it started the next day) and they wanted my lining to be around 5mm before starting estrogen to rebuild my lining for transfer.  My period started the next day so I scheduled a second baseline for 10/1.  I went in but my lining was still too thick, it was around 7/8mm so Dr. Jeelani told me to go back again.  I went back on Thursday 10/3 to find my lining had only decreased to 6mm.  My doctor knew I  was getting frustrated but reminded me of the importance of a "clean slate" to start rebuilding on.  I scheduled a 4th baseline for Monday 10/7 and kept my fingers crossed that by that time it would go back down.

In the midst of my mock cycle we started to potty train Georgia which went extremely well this time around compared to when we tried the first time back in January.  She did so well and really seemed to grasp the concept this time around which was very rewarding for us.  I noticed that Georgia was beginning to protest going to the bathroom, sometimes for hours upon hours so on Friday 10/4 I had my mom take her to urgent care where they took a sample of her urine.  They told us that it looked like she had elevated white blood cells but wouldn't know til the lab tested the culture so we were to push fluids over the weekend and wait for a follow up call Monday.

Monday rolled around and I had spent Sunday night deathly ill with a fever and vomiting.  I went to work because I basically had to but luckily was feeling well enough to go into work at least for a few hours before I would head to my baseline.  The doctors office called to say that Georgia's results came back consistent with a UTI so when I left work for my baseline I headed to the pharmacy to pick up her antibiotic.  I made the 1.5 hour drive down to Peoria for my baseline where the tech measured my lining at .87cm or almost 9mm, my lining had actually thickened!  I texted my doctor (I do my monitoring in Peoria which is closer for me than my doctor in Chicago) and she was baffled.  She told me that I was somehow getting estrogen through the Lupron which happens in less than 10% of patients.  She told me she'd review the images and results of my bloodwork from baseline & call me back.  I spent the drive home crying and feeling like absolute death.  I couldn't wait to get home & was so discouraged.

A few hours later I received a call from her saying she had found the culprit. A follicle had been growing and producing estrogen which was causing my lining to thicken, exactly as it should be if I wasn't taking Lupron.  My body broke through the Lupron suppression which is extremely rare, but can happen.  She gave me two options--continue with the lining that we had or stop meds, induce a period, and start back over.  I knew what the right and best decision was and that of course was to delay and start fresh giving my embryo the best chance for implantation.  My doctor agreed and said that is what she believes is best even though it's not what we expected.  My coordinator called me shortly after and told me to stop the 10 units of Lupron I had been taking and begin Estrace that night.  Then on Friday I will begin taking 20 units of Lupron this time along with 200mg of Prometrium (progesterone) for 7 days.  Once I stop those on 10/17 I should have a bleed a few days later and hopefully be ready for a successful baseline with a lining at 5mm.  

It's been an exhausting and frustrating process so far at the fault of no one but my uncooperative body.  Everything that has been going on with this cycle plus being sick and dealing with Georgia's UTI and growth spurt she seems to be going through have made for a rough few days.  I know that getting myself and Georgia health and getting my lining where it needs to be is the most important thing right now and I'm at peace with that now.  I really appreciate everyones outpouring of love and encouragement with the news of this delay.  It certainly isn't the end of the world by any means but another hurdle that just seems to accompany every round of IVF that we have gone through.  We are no stranger to bumps in the road and this one isn't the worst we've ever dealt with.  As of right now we don't have a new transfer date but I will do my best to keep this space up to date for those who still come by to read!

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