Saline Infusion Sonohysterography (SHG)

My last RE ordered a SHG back in November.  An SHG is checking for adhesions, polyps, fibroids and any other abnormalities in the uterus.   It came back 100% unremarkable meaning there were no issues.  My current RE ordered another one just to make sure nothing had grown and again the test came back unremarkable.  You would think that when a test come back perfect they would have a better term than unremarkable, it makes my uterus sound so boring.  

My unremarkable uterus (it's the black oval in the middle)

I am writing this post mainly out of frustration of my very first RE who I spent 2 year with and three IUIs and three IVFs all of which were BFN!   When I was first diagnosed as infertile, it was such a shock.  You are thrown into this world of unknown and you hear works and phrases you just don't understand.  My RE came highly recommended and I just followed him blindly.  The only thing he tested was my Vitamin D, AMH and FSH and STDs on both of us.  They then sent me in for the dreaded HSG test and after that came back fine, we jumped right into the IUIs.  After those failed, we were pushed into IVF before we knew what hit us.  At that point, the tested Ryan's sperm and then it was full speed ahead with failed back to back to back IVFs.  Even though my SHG came back unremarkable, I find it crazy that a simple and pretty much painless test wasn't performed before any infertility treatments.  I have many friends in the IF world where they did find something on that test and usually it needs to be dealt with before you can move forward.  There are several other tests that can be run before jumping into treatment and I suggest doing them all.  Not only are almost every single test cheaper than one failed IUI, the heartbreak you receive after hearing the news of a BFN is devastating.  If you can ward those off by some simple tests, do them.  Other important, but usually overlooked tests are: MTHFR (tests for a gene mutation in which you can't process folic acid), Iron (if you are anemic, the chances of implantation failure is extremely high)and thyroid.  Insurance covered all these tests for me including SHG because that is a diagnostic test and not fertility related.  

So back to the SHG.  This test is relatively quick and relatively painless.  The first time it took about 5 mins and the second time it took longer only because they had to insert the catheter twice and by longer it was about 10 minutes. The picture to te left is all that is needed for this test.  The container on the right in the saline and they don't even use all of that.  The container in the middle is the iodine for cleaning.  Below that is the catheter and the syringe is to fill the saline into the catheter.  

Here's hoping that everyone out there is unremarkable as well :) 

Thanks for reading,

HEATHER

Follow Up Lab Results

Yesterday we met with the two naturopathic doctors that we have been working with.  Ryan had the day off so he went with me to get my results.  The doctors work in the same office (they are actually married) and I have worked with both so we had the appointment with both of them.  It was nice to get both of their opinions on my lab results and what to do going forward.

The reason for the recent lab work was twofold.  First, we wanted to recheck that all my critical vitamin levels were where the needed to be.  Since I am a vegetarian, I am always worried that my levels aren't where they need to be.  Last year my results came back severely anemic at 12.  I have been working really hard to get that where it needs to be.  Secondly, we did some autoimmune testing and some blood clot testing.  This is more commonly referred to as a miscarriage panel.  Usually if you have 3 miscarriages, your doctor will run it.  Since that is absolutely the last thing we want to happen, we just paid out of pocket for this lab panel.  It cost is about $700.

Our results were great, or maybe I should say par for the course, they didn't show anything wrong with me or anything the doctor would be concerned about.  This also means we have no idea why this isn't working.  By default we are again, undiagnosed and by default that points to egg quality.  But looking at the glass as half full, there is no reason not to hope that it will work this time.  Especially since we have two normal embryos to work with that are waiting for us.

The vitamin/supplements that I looked at were Iron, B12, Vitamin D and looked at my thyroid again.  Everything came back where it should be at except my Vitamin D came back low for the second time in a row.  I was taking 5,000 units, then upped it to 7,000 and now I am going to try taking 10,000.

The most exciting news is that I can start to cut back on the obscene amount of pills that I take.  As I finish off bottles, there will be no reordering for most of them.  Here is what my FET protocol looks like so far:
Medicine
Levothyroxine 75mcg 1 x day  - (I have to run this by my RE to get his approval and for the prescription)
Dexamethasone .75mg per day - I start this steroid once I start the interlipids

Supplements:
B12/B complex
Vitamin D3
Selenium
Probiotics
DHA
Iron
Vitamin C
CoQ10
Vitamin E

And that's it!!  Compared to my prep for ER this is so much more manageable.

Ryan and I are feeling both anxious and nervous.  Ryan is more hopeful than I am.  I am scared for another bout of depression if this fails.  The last BFN did a number on me so it is very hard for me to get too excited.  I'm glad that I have Ryan to think the positive thoughts for both of us.

Thanks for reading,
HEATHER

PS If anyone out there is looking for a naturopathic doctor, I can't recommend these two enough.  They both are very kind and compassionate doctors which is so very important in dealing with infertility.  They also look at things that your RE doesn't even consider.  I just like that they are looking at my whole body and not just my ovaries in order to get EVERYTHING in working order.  Here is their info: http://sandiegonaturalhealth.com/

Aerial Yoga

As I mentioned in my Next Steps post, I am back on track and going to yoga again.  I really missed my practice and I am beyond excited to be back.  My RE in Los Angeles suggested that I start doing yoga on a regular basis to help with blood flow as well as all the stress I was dealing with.  Sadly during my stims I had to cancel my membership.  With my bloated stomach full of bruising and my headaches, aerial was out of the question.  Now I am back to normal and back regularly practicing at Trilogy.  I have about 2 months before my FET so my focus in on mind, body and soul and yoga touches on all three things for me.

After I quit my job and moved to San Diego I discovered Trilogy Sanctuary and aerial yoga.  Trilogy is a rooftop studio and the views are amazing.  It is literally the most amazing yoga I have ever done.  I have been practicing there since September.  I do aerial yoga but they also have some amazing restorative classes.  I love the balance between the two classes.  There is a Balance and Restore class as well as Yinki and I take both.  Just walking in there, I feel the stress of all this just melting away.  It is short lived, but I will take any relief I can get.

chandelier pose

  I absolutely love this photo.  This pose is called shoulder stand.  When I first started I couldn't do this pose.  My teacher stood behind me and helped me get into the fabric.  I also would have my feet locked in to be able to balance.  Today I am able to do the pose and free my feet.  It is an amazing feeling especially when I live in a world without progress and without being able to reach certain goals, it helps to remind me that I AM able to conquer and attain.  Hoping that this feeling of growth and achievement helps take away all the hopelessness that I have felt for so long.

This is my beautiful teacher Olivia.  She is absolutely amazing and so supportive.  I love having her as a guide in this part of my journey.  Anyone in San Diego, come on down and join me in a class.

Thank you for reading,
HEATHER

Regroup

We had our regroup yesterday with our doctor and came up with a FET protocol and strategy.  We have a few things that are up to us to decide before we move forward.  Our doctor wants to do another test to make sure my uterus is still normal.  We are also doing a few blood tests with our naturopathic doctor just to make sure that we are checking everything we possibly can.

The most exciting news we received  yesterday was  that we found out the gender of our two embryos.  We have decided at this time that we are going to keep that news to ourselves.  We want to keep some part of our reproductive life to ourselves :)  If we actually get a BFP, then we will share.

The first thing we need to do is another sonohysterogram (SHG).  This is a test to make sure there is nothing in my uterus that would interfere with the embryo implanting such as polyps, adhesions or fibroids.  I had this done last year and there were no issues.  My doctor wants to do another one to make sure there hasn't been any changes.  This is a painless test that only take a few minutes in the doctors office.

The first big decision we have is how many embryos to implant.  If we implant both we have a 65% chance and if we implant only one, we have a 50% chance.  Obviously if we implant both then we also have a higher chance of twins which we would be totally fine with.  But if it doesn't work, we would have nothing left to try again.  Or if it does work and only one takes, then we don't have another chance for a sibling.  We have up until the day before the transfer to decide.  Knowing us we will go back and forth a million times before we make up our minds.

Thanks for reading,
HEATHER