Damn You Endometrin !! – The 411

I am on my 3rd week of taking Estrace and had to add Endometrin progesterone support today.  The last time I took it after my transfer, I had yeast infection type symptoms and little bumps in my bum.  Well, guess what?  IT IS NOT YEAST !  Women develop the equivalent of JOCK ITCH !

baby - hydrocortisone baby - lamisil

Not long after I took the first dose did the burning and itching start !  I tried applying Aquaphor, and it did not help.  I reached out to my nurse on Facebook and told her what was going on.

So, I was told by my nurse to apply hydrocortisone cream and Lamisil or Lotrimin twice a day and to also use a hand held blow dryer to dry out my hoo-haa after showers.  The goal is to keep it as dry as possible down there.  At night, I am to remove panties and sleep with a towel under me to allow things to “air out !”

The things we go through all to have babies !  #embarassing

Progesterone – The 411


Progesterone is a hormone produced principally by the ovary after ovulation. One of its major roles is to prepare the lining of the uterus (the endometrium) to allow the embryo to implant and grow.
In some of the treatment protocols progesterone is not produced by the ovary in adequate amounts, or its effect on the lining of the uterus is inadequate. This problem is called luteal deficiency. It is more common in older women and in women with abnormal ovulation.

There are different forms of progesterone to choose from.
• Daily oral progesterone
• Daily intamuscular injections e.g. gemstone
• Daily vaginal pessaries e.g. cyclogest. These are mounted in wax, which melts as progesterone is absorbed causing discharge. It may be necessary to wear a panty liner.
• Daily vaginal tablets e.g. Utrogestan
• Daily vaginal gel e.g. crinone 8%

Injectable progesterone (Progestrone given intramuscular [IM])
Injection of progesterone produces the highest blood levels.
Natural progesterone is dissolved in an oil for injection.
Because of the body’s rapid metabolism of progesterone, the injection should be given daily to maintain adequate blood progesterone levels.

Progesterone suppositories or creams
The absorption of progesterone through the vagina is more variable.
Blood levels are less predictable but progesterone may exert a direct local effect when absorbed through genital tissue.

Oral progesterone
The oral progesterone capsule is a relatively new way to take progesterone. This avoids the possible complications of pain and abscess formation associated with injections.
Oral progesterone is rapidly absorbed into the circulation.
For best blood levels, this should be taken twice a day.
On a theoretical basis, the metabolism of progesterone given orally could be different from the way progesterone is broken down when it is given either vaginally or intramuscularly.
The oral progesterone is well tolerated with side-effects in some women of dizziness or sleepiness. This can be minimized by taking the highest dose of progesterone at night. Care must nevertheless be exercised when taking oral progesterone, especially for the first three days, to avoid complications related to drowsiness.

Injectable progesterone – Progesterone given intra-muscular (IM)
Preparing Progesterone
Progesterone comes in a multi-dose vial. Because progesterone in suspended in an oil base, the mixture is thick, making the injection more difficult. However, the medication can be warm once it is drawn into the syringe, to make the injection easier
Please follow these steps:
1. Always wash your hands.
2. Take out the vial of medication; check the name and expiration date before removing the protective cap. Do not remove the rubber stopper.
3. Unwrap a 3cc, 22 gauge syringe with the 11/2″ needle; keeping the cap on the needle, unscrew it from syringe and place it aside as you will need to re-attach it for the injection. Replace the 22-gauge needle with the 18-gauge (pink) one.
4. Wipe the rubber stopper with alcohol.
5. Pull back halfway on the plunger to fill the syringe with air. Push the needle through the rubber stopper and push on the plunger to inject air into the vial.
6. Keeping the needle in the vial, turn it upside down and make sure that the needle tip is below the level of the medication.
7. Draw back on the plunger to fill the syringe halfway with progesterone; push the plunger up to the instructed dosage level of 1/2 cc or 1cc, expelling excess medication, air and bubbles back into the vial.
8. Remove the syringe from the bottle and draw the progesterone back into the syringe.
9. At this point, you may put the filled syringe in warm tap water to thin the medication and make administration easier.
10. Place the cap back on the 18-gauge needle, twist it off and replace it with the 22-gauge needle for the injection.
11. Push the plunger forward to expel air, being careful not to lose any medication.


Injecting the medication
• Cleanse the injection site with alcohol. Wait a few seconds until alcohol has dried on skin. Remove cap from needle.
• Insert needle quickly in a dart-like motion 90-degrees to the skin as far as it will go.
• Anchor syringe with your free hand. Pull back slightly on the plunger, if you see blood return, remove the needle and re-inject in an alternate site.
• If there is no blood return, inject medication slowly.
• Withdraw the needle at the same angle at which it was inserted. Apply pressure at the injection site with gauze or tissue.
• Dispose of used needle and syringes carefully in an approved sharps container.
• Alternate sides with each injection.

Note: If the uncovered needle touches any surface other that the inside of the medication vial prior to injection, it is contaminated. Twist off needle and replace with a sterile needle. Use all needles and syringes for 1 injection only.

Injection sites for intramuscular injections (IM)
The upper-outer quadrant of the buttock (right or left) is the recommended site for intramuscular injections. As an alternative only, injections may be given to the upper front quadrant muscle of the thigh.

Vaginal application
CRINONE® 8% (Progesterone Vaginal Gel)
Progesterone  90 mg/dose, 8.0 % w/w. Each applicator contains 1.45 g of gel and delivers 1.125g 8% gel.
The progesterone vaginal gel is based on a polycarbophil delivery system which attaches to the vaginal mucosa and provides a prolonged release of progesterone for at least three days.
List of inactive substance used as a carrier for the active ingredients:
Light Liquid Paraffin,
Hydrogenated Palm Oil Glyceride,
Carbopol 974P,
Sorbic acid,
Sodium hydroxide,

Shelf life: 36 months.


How does Crinone 8% work?
Crinone 8% comes in the form of a bioadhesive gel. This gel is squeezed from an applicator into the vagina. Once in the vagina, the gel attaches to the vaginal wall, enabling patients to stand and go about their normal routine immediately after application,  where progesterone is absorbed and transported to the uterus. Even if the applicator is not inserted all the way to the cervix, gently squeezing the bulb will direct the gel towards the cervix. The applicator is designed to deliver the correct amount of gel with a gentle squeeze. A small amount of gel will be left in the applicator after administration. This is normal. In addition, normal movement between the vaginal walls will spread the gel.

Crinone 8% should not be applied at the same time as other local vaginal treatments. If other local intravaginal therapy is to be used, it should be administered at least 6 hours before or after Crinone 8% administration.
Regular sexual activity has not been found to lessen the effectiveness of the drug.

Crinone 8% should not be used by women who have:
• Allergies to progesterone, progesterone-like drugs, or any of the inactive ingredients in the gel
• Undiagnosed vaginal bleeding
• Liver dysfunction or disease
• Known or suspected cancer of the breast or genital organs
• Had a missed abortion (i.e. a miscarriage in which the gestational tissue remains in the uterus)
• A history of or active thrombophlebitis or thromboembolic disorders
Before using Crinone Gel inform your physicians about:
If you are pregnant, planning to become pregnant, or are breast-feeding
If you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
If you have allergies to medicines, foods, or other substances
If you have heart or blood vessel problems, bleeding problems, high blood pressure, high cholesterol or lipid levels, diabetes, kidney problems, asthma, migraine headaches, or lupus
If you have a history of seizures, depression or other mental/mood problems, cancer, or tobacco use
If you have a family history of blood clots
If you are very overweight

Medication interaction with Crinone Gel.
Tell your health care provider if you are taking any other medicines, especially any of the following:
Rifampin because it may decrease Crinone Gel’s effectiveness

Storage or handling care
Crinone 8% should be stored between 59° and 86°F (15° and 30°C).
Do not expose Crinone 8% to extreme cold or heat.
Crinone 8% does not require refrigeration or other special care.

Important Safety Information
The most common side effects of Crinone 8% include:
Breast enlargement,
Constipation, somnolence,
Nausea, headache,
Perineal pain.

Crinone 8% is contraindicated in patients with active thrombophlebitis or thromboembolic disorders, or a history of hormone-associated thrombophlebitis or thromboembolic disorders, missed abortion, undiagnosed vaginal bleeding, liver dysfunction or disease, and known or suspected malignancy of the breast or genital organs.

How to use Crinone
Crinone comes in a slim, rounded vaginal applicator that is similar to a tampon applicator. Some gel will be left over in the applicator after use.




Here are step-by-step instructions for taking Crinone 8%:
Wash your hands thoroughly and make sure that the surface you work on is clean.

progesterone7Each prefilled applicator of Crinone comes individually wrapped within the Crinone box.

progesterone8Carefully remove the wrapper from the prefilled applicator.

progesterone9Identify the thick end of the applicator. Grasp the applicator by the thick end but do not squeeze yet.

progesterone10With your other hand, grasp and bend the tab located at the opposite end of the applicator. Bend and twist the tab until it breaks away from the applicator.

progesterone11Choose a comfortable position for inserting the applicator. You may lay on your back

progesterone12You may stand

progesterone13Insert the applicator into the vagina as far as it will comfortably go or when one half of the applicator has been inserted whichever is less.

progesterone14Squeeze the bubble and the thick end completely. An amount of gel about the size of a dime will be dispensed into the vagina.

progesterone15Remove the applicator. The gel will remain in the vaigna. Dispose of the used applicator. Do not reuse the applicator. If you wish, you may remove the residual gel by inserting your finger into the vagina and clearing the gel manually.

Progesterone in capsules –  Utrogestan (Prometrium)

Each capsule contains 200mg micronised progesterone as the active substance.

Other ingredients
Capsule contents: Arachis (peanut) oil, soybean lecithin.
Capsule shell: Gelatin, glycerol, titanium dioxide

UTROGESTAN 200mg capsules can be taken orally (should not be taken with food), and can be inserted into the vagina.


Do not take Utrogestan 200mg Capsules if:
• You are allergic to progesterone or any of the other ingredients in this product
• If you are allergic to peanut or soya as Utrogestan 200mg Capsules contain arachis oil (peanut oil)
• You have severe liver disease
• You have, or have had, breast cancer
• You have porphyria (a metabolic disease resulting in abnormal colouring in the urine and the skin)
• You have had blood clots, bleeding of the brain, or a stroke.

Take special care with Utrogestan 200mg Capsules if:
• You have high blood pressure, a heart, kidney or liver disease
• You suffer from epilepsy, diabetes, migraine or asthma
• You suffer from depression, or have had depression in the past
• Your skin is sensitive to light (photosensitivity)
• You are taking medicines containing bromocriptine, cyclosporin, rifamycin or ketoconazole. If you are not sure check with your doctor.
• If unexplained, sudden or gradual, partial or complete loss of vision, proptosis or diplopia, papilloedema, retinal vascular lesions or migraine occur during therapy, the drug should be discontinued and appropriate diagnostic and therapeutic measures instituted.
• Utrogestan 200mg Capsules should be used cautiously in patients with conditions that might be aggravated by fluid retention (e.g. hypertension, cardiac disease, renal disease, epilepsy, migraine, asthma); in patients with a history of depression, diabetes, mild to moderate hepatic dysfunction, migraine or photosensitivity and in breast-feeding mothers.

Symptoms of overdosage may include:
Euphoria or dysmenorrhoea.

Micronised progesterone is absorbed by the digestive tract. Pharmacokinetic studies conducted in healthy volunteers have shown that after oral administration of 2 capsules (200mg), plasma progesterone levels increased to reach the Cmax of 13.8ng/ml +/- 2.9ng/ml in 2.2 +/- 1.4 hours. The elimination half-life observed was 16.8+/- 2.3 hours.

Progesterone is approximately 96%-99% bound to serum proteins, primarily to serum albumin (50%-54%) and transcortin (43%-48%).

Urinary elimination is observed for 95% in the form of glycuroconjugated metabolites, mainly 3 α, 5 β–pregnanediol (pregnandiol).

Progesterone is metabolised primarily by the liver. The main plasma metabolites are 20 α hydroxy- Δ 4 α- prenolone and 5 α-dihydroprogesterone. Some progesterone metabolites are excreted in the bile and these may be deconjugated and further metabolised in the gut via reduction, dehydroxylation and epimerisation. The main plasma and urinary metabolites are similar to those found during the physiological secretion of the corpus luteum
Shelf life: 3 years
Storage: No special precautions for storage.

Endometrin (progesterone) Vaginal Insert 100 Mg is a brand of micronized progesterone inserts, supplied with polyethylene vaginal applicators.

The chemical name for progesterone is pregn-4-ene-3,20-dione. It has an empirical formula of C21H30O2 and a molecular weight of 314.5. Progesterone exists in two polymorphic forms. The form used in Endometrin, the alpha-form, has a melting point of 127-131°C.

Inactive Ingredients include:
Lactose Monohydrate
Adipic Acid
Sodium Bicarbonate
Sodium lauryl sulfate
Magnesium stearate
Pregelatinized starch
Collodial silicone dioxide.


Dosage and administration
The dose of Endometrin is 100 mg administered vaginally two or three times daily
Do not take if:
• Previous allergic reactions to progesterone or any of the ingredients of Endometrin Vaginal Insert
• Known missed abortion or ectopic pregnancy
• Liver disease
• Known or suspected breast cancer
• Active arterial or venous thromboembolism or severe thrombophlebitis, or a history of these events
Adverse reaction:
The most common adverse reactions reported (greater than 2 %) were:
• Post-oocyte retrieval pain
• Abdominal pain
• Nausea

Drug interaction:
No formal drug-drug interaction studies have been conducted for Endometrin
Endometrin is not recommended for use with other vaginal products (such as antifungal products) as this may alter progesterone release and absorption from the vaginal insert

Storage or handling care
Endometrin should be stored between 59° and 86°F (15° and 30°C).
How to use the drug:
Follow the steps below:
Unwrap the applicator.
Put one insert in the space provided at the end of the applicator. The insert should fit snugly and not fall out.
Place applicator with the insert into the vagina while you are standing, sitting, or when lying on your back with your knees bent. Gently place the thin end of the applicator well into the vagina.
Push the plunger to release the insert.
Remove the applicator and throw it away in the trash.
Other information for using Endometrin
• If you forget a dose of Endometrin, take the dose as soon as you remember, but do not use more than your daily dose.
• Call your doctor if you use too much Endometrin.
• Do not use any other vaginal products when you are using Endometrin.
• Progesterone can increase your chance of getting blood clots. Blood clots can be serious and lead to death.

Serious blood clots include those in the:
Legs (thrombophlebitis)
Lungs (pulmonary embolus)
Eyes (blindness)
Heart (heart attack)
Brain (stroke)

Call your doctor or get medical help right away if you have:
Persistent pain in the lower leg (calf)
Sudden shortness of breath
Coughing up blood
Sudden blindness, partial or complete
Severe chest pain
Sudden, severe headache, vomiting, dizziness, or fainting
Weakness in an arm or leg, or trouble speaking
Yellowing of the skin and/or white of the eyes indicating possible liver problem

Other risks of progesterone use include:
Breast tenderness
Bloating or fluid retention
Mood swings and depression

Energetic !- The 411

baby - energetic

With all of the supplements and herbs I have been taking, coupled with the Daniel Fast I am on, my energy level is ridiculous !  I feel like an energizer bunny with nothing to do !

My mom had her PETscan on Monday and thank God, the cancer has not spread to any other place on or in her body !  It is just on the right breast that was removed.  They are going to do surgery to remove some of the breast tissue and the implant and put a temporary implant in.  She will go back in a few months and have the permanent implant put in.  While she is under, they are going to do augmentation and reduce the left breast since she has gained and lost weight in the past 8 years and the right breast sits higher than the left.  She will once again have perkier boobs than me !  😦   We tell her all the time she makes us sick !  lol

My mom’s cancer is a stage 2.  The same stage as it was 8 years ago.  She found her mamography report from a few months ago where they told her it was all clear.  I will be calling Willie E. Gary’s office next week to file a lawsuit. When a patient tells you something is wrong and there is a knot, you check it and say it is fine and do a sonogram AND a mammogram and STILL put in writing that there is no cancer, someone did not do their job !

In other news, I am still taking estrogen twice a day along with a laundry list of other supplements, meds and herbs.  I feel like a pill factory and like I am on a medication schedule ALL DAY LONG !   I am taking pills from 4:30 am until 8:00pm every day.  It will be worth it in the end.

I am enjoying my little vacation and am spending time with my mom and going to her multiple appointments.  My film crew will be back tomorrow so they will film me going about my daily business.  So much for not having to wake up and look cute right away !  I get up, hop in the shower and put on a tad bit of make up and lip gloss.  I have to dress up.  Not my idea of fun !

I joined a dating site at the urging of two of my friends and so far NOTHING !  None of these guys, that I like, look like the guys I would date.  If they do fit the bill in the looks department, they are not into interracial dating or their profile seems to make them appear buttholes ! Arrogance is NOT a cute quality to possess.  Then there are some guys who seem to have it together, but their profile is full of half naked pictures !  I am NOT looking for a booty call !

I have had a ton of older guys send me winks or inboxes, but I am so not into older guys. I do not have a “daddy complex” at all.  The thought of marrying a man much older than me is not appealing !  I love young energetic guys. I need someone who can match my energy.  I am not ready to sit on the porch and rock just yet ! lol

If you are following my blog and have ever had success with online dating PLEASE share some tips ! 🙂

Anyway, I am heading out for family date night!  My mom, grandmom and I normally go see the preview of a new movie on Thursday nights if something good is coming out.  I love that new movies preview the night before “opening.”

I hope all is going well with everyone else !

One Lovely Blog Award – The 411

baby - one lovely blog award

I have been nominated for the One Lovely Blog Award by the sweetheart, http://spiritbabycomehome.wordpress.com/.  Thank you so much for the nomination and kind sentiments.

The criteria for accepting a One Lovely Blog Award are:

  1. Thank the blogger who nominated you
  2. List the rules.  I prefer to call them guidelines.
  3. List seven (7) facts about yourself.
  4. Nominate 15 other bloggers and let them know you did.
  5. Display the award logo and follow your nominator.


    1.  I am embarking on IVF Cycle #3 !  I truly thought I would be ONE AND DONE !  I guess God and Life had other plans…

    2.  I am addicted to my cellphone and my laptop.

    3.  After being harassed by friends about the lack of love in my life, I finally set up a profile on an online dating site, since I have not dated but once since my wedding was called off.

    4.  I love to cook and bake and it is my form of therapy at times.

    5.  I just started a new travel agency to book travel for my friends, family and to book travel for the film industry and other groups. It is called Crimson Hill Travel !!

    6.  I am currently working on a comedy feature film that we are completing the script for and will be shooting in NYC, Philly, and DC.

    7.  I am looking forward to taking a quick, impromtu 5 day vacation with my mom, sister, and camera crew to Grand Bahamas Island in 2 weeks.

















IVF # 3 – Supplements And The Start of Stims – The 411

baby - ivf 3 supplements

This morning, I started my new supplement regimen for IVF #3 full force !

I had my morning acupuncture session and Dr. Fan started me on two different herbal supplements in addition to the ones my RE has me on.

My new supplement regimen for the next 3 wks is as follows:

Synthroid (150mg)

Prenatal Plus (prescription prenatal) (am only)

4g per day Inositol

600 mg per day Co Q 10 (200mg 3xs a day)

4 mg per day Estrace (2mg 2 xs a day)

Biotin (5000mcg)


Folic Acid (8mg a day)

Vitamin D (1200mg a day – prescription)

Innate Whole Food Prenatal Vitamin (pm only)

Bu Gu Zhi Fang (2 tablets 3xs a day)

Ba Zhen Pian (10 tablets 3xs a day)

During week three, I will take progesterone supplements vaginally twice a day (Endometrin 100mg tablets).

I will begin Lupron injections (10mg) the week after the progesterone.  After I start the other stim meds (300 Gonal F and 300 Menopur), I will also be doing Neupogen injections every day.

Here’s to a bunch of pills, hooo haaa tabs and rigid ingestion schedule to get some healthy babies in July ! 🙂



IVF #3 Day One- Starting Anew & The Cancer Diagnosis – The 411

breast cancer - ribbon

This has been the week from HELL ! –  and it is just Tuesday !  My mom had her biopsy today and the doctor could tell by the look of the mass that it is definitely cancer.  My mom told her oncologist, Dr. Robert Reid, LAST YEAR that there was a suspicious place on her right breast.  He ordered an ultrasound of it and he never followed up with her to say that it was a problem or to order further test.  In that regard, I fault my mom because she should stay on top of her own health and healthcare.  Depending on the stage and whether this cancer has spread elsewhere, that oncology center can expect a malpractice and medical negligence suit coming their way !  I do not play when it comes to my family and will fight to the death to make sure they are well.

My mom, sisters and I are all very down about this.  We will know more on Friday after the biopsy results are in.  A petscan is being ordered as well.  I would dare to pray that this mass is benign, but the way things have been going lately with prayers and hoping, I am scared to even venture there… just being brutally honest !   I have no choice BUT to trust that God has this all in His plan and satan IS a liar and this is already worked out.

In other news, I spoke with my clinic today and we reviewed my last cycle and agree that it did not go well.  The RE who owns the clinic is aware that my RE was on vacation while I was stimming and that I was not at all happy with the response my body had with this past cycle and had major concerns regarding autoimmune issues I seem to be having. 

Dr. Kiltz was very understanding and reviewed my chart and last two cycles while I was speaking with him and he was very receptive to the autoimmune protocol Dr. Braveman suggests, as he is big proponent of autoimmune protocols and how they benefit patients.  He revamped my protocol and I started today with an estrogen priming protocol which involves taking Estrace 2mg twice a day for 3 weeks and on week 3 adding Edometrin progesterone suppositories.  I am also to take Lupron prior to starting stims.   My med doses have been changed to 300 gonal-f and 300 menopur and I will be taking Lovenox and baby aspin after retrieval, my prednisone will be upped to 20mg a day and I will be doing neupogen injections daily starting at stims and my intralipids will done weekly as opposed to every 28 days.   I am very happy with the care and concern the doctors at CNY are giving to my case and Dr. Kiltz assured me that CNY is only here to help patients and he very much feels that we will get this right and get me to the end zone ! 

I am feeling very good about my upcoming cycle and am elated that Dr. Kiltz, Dr. Grossman and Dr. Ditkoff are equally as caring and concerned about me as a patient and a person.  It means EVERYTHING when your doctors HEAR you and come up with a game plan to get you to where you need to be and are no afraid to shake things up at all if it means the patient wins !!  

I have referred about 12 people to CNY in Albany who have either already started treatment or will be starting soon and I have a renewed faith in why I referred patients there to begin with.  They are really showing themselves to be a class act and a center not driven by making money, but actually by making babies and patients happy.  Custom service oriented businesses ALWAYS go to the top of the list in my book !

NOW, to get my mom well AND put another grandchild in her arms !   Oddly enough, with this next cycle, should I get to the finish line, my baby(ies) will be born in July (my birth month AND my mom and newest niece’s)-  How incredibly kewl is that?  🙂 

 I will keep you updated as I go through this cycle.   I am truly grateful for all the kind sentiments and words of encouragement I have received from you all !  You have NO idea how much this has meant to me as I struggle along this journey to motherhood.  You all GET IT!  That makes all the difference in the world ! SMOOCHES !!

BFN and The Quest to Replace This Cycle – The 411

baby - BFN 2

As I suspected, this cycle was a complete bust !   I wasn’t going to go in for beta yesterday but one of the nurses called and said I should go in because the HPT could be wrong.  I went after lunch, knowing that it would still be >1. 

This morning, the nurse called and left a message to tell me that the beta was negative, she was so sorry and to call with my period. 

I spoke with some other patients and asked additional questions I had about the fact that my E2 peaked at 148 this cycle and it was not posted until after my retrieval.  My first cycle the E2 peaked at 1430.  This cycle, I only had 3 follicles on right and 1 on left at baseline and I wanted to stop the cycle.  I had questions about the autoimmune protocol and many concerns about beefing it up and the only change made was an increase in the intralipids and a decrease in my prednisone.  I wanted my prednisone increased to 20 mg because it worked for others.  I also wanted neupogen and was talked out of it saying it has not been shown to be effective. I also wanted to try HCG injected into the uterus before transfer and that was brushed off as well.  My RE was on vacation while I was on stims, so I was not able to adequately address this transfer stuff prior to retrieval and had to as at procedure. At retrieval, out of 12 follicles counted at baseline, only 4 IMMATURE eggs were retrieved.  That is indicative of too high dosage of meds (which damage eggs) and too soon a trigger.

I am very disappointed in how this cycle went and I am going to talk to the owner of CNY about replacing this cycle.  I do not feel it fair to make me lose a cycle because someone decided it was okay to continue with a peak E2 of 148.  I knew when I saw that that something was wrong and this cycle would yield nothing.  The fact that all eggs were immature and the next day they miraculously they matured but did not seem to want to fertilize all pointed to a terrible cycle.

This morning, I called and left a message on Dr. Kiltz’s cell phone to give me a call regarding my failed cycle.   I am hoping that he will replace this cycle.  If he will, then I am told I have to pay the$450 anesthesiologist’s fee. 

I am seeing my acupuncturist again, Dr. Arthur Fan, who is a fertility specialist.  I will start herbs again and continue to pay $299 a week for acupuncture treatment, which proved effective the first cycle.  I didn’t do acupuncture until the day of transfer this time and then went last Wednesday.  Dr. Fan said my tongue looked terrible.  I need to work on my blood circulation and kidney function.

Today, I am starting my regimen of 600mg a day of CoQ10, 4g Inositol, baby asprin, Prenatal Plus, folic acid, B6, B12, biotin and the Innate whole food prenatal vitamins.

Today, my sister and I do with my mom for her biopsy.  I am praying that the mass is benign or just scar tissue.  I can not fathom NOT having a baby and also NOT having my best friend / Mom !  Life can NOT be that cruel…




Feeling Like A Loser – The 411

baby - loser

So….. I took another HPT this morning (8DP5DT) and…. BF effin N !  How do you transfer THREE embryos and NONE of them take?  NONE… NOT ONE !

I am supposed to go in for beta in the morning, but I am not going to.  No point…  I feel like my period is trying to come on.  It is due to come on on the 8th or 9th.  

My mom has her biopsy on the 9th so beta will have to wait until after that. I do not want to go for beta to get a call tomorrow afternoon with the “so sorry… better luck next time!”  “We were so sure this cycle would work!”

How do you get a BFP 1st time out the gate then absolutely NOTHING the next?  I am so disappointed and disgusted !

I do not know what to do next.  I really do not want to do donor eggs.  Bad enough I will have to tell my children that their father was a donor… then to explain that biologically, with the exception of epigenetics, I am not related to you either.  I just made ya in a little lab and pushed ya out… 

I have one frozen embryo still at CNY, but I am not sure I want to transfer just one embryo. Transfer one for it to just die off too?  I want twins and done !  Is that too much to ask for?  Really?

I think what infuriates me the most is every day lately when I turn on the news, look on FB or other social media, there are reports of people leaving their infants in the car, abusing their children, selling their children, etc…  All I want is to give birth to two healthy children that share my DNA and to nurture and guide them through life.  And GOD gives children to vermin who hurt and kill their kids?   That is one discussion He and I will be having face to face one day.  I just want to understand how and why that is even a remote possibility.  What what the PLAN in that? 

I just do not know what to do now.  How do I figure out which clinic to use next?  Do I use donor eggs?  So many women are using donor eggs and STILL having miscarriages or not getting pregnant at all.  My embryos are genetically normal at 5 day blast-  the ones that make it-  so what is going on with my body that they are not implanting?  Why are the doctors not doing more to ensure that implantation occurs?  Every med you mention, the song is “we do not have enough evidence to show that it is truly effective”….   This time we even increased my intralipids to two bags and still nothing !

This is so confusing and painful.  I went into this with all the hope and faith in the world.  I am trusting that God will bring clarity and instruction on where to turn next.  I have the sneaky suspicion that I am taking too high a dose of meds and should be taking 1/2 the gonal f I have been taking and should slow down the stimming process then trigger.  The fact that I only had 4 eggs with 10-12 follicles and none of them were mature shows that I was triggered too soon and the meds were not effective on the eggs this cycle.

I am not willing to pay more money to CNY for more cycles to “fish around” for the right protocol. I need to find a clinic that can get me where I need to be right off the bat and sustain the pregnancy through the right autoimmune protocol.  I refuse to believe that all RE’s believe that there is not much out there which can help an autoimmune problem.  I have got to figure out what to do next…  Money does not grow on trees and I have already spent over $20,000 with meds, procedures and the travel expenses for these 2 cycles.  So confused….

baby - hpt

Worry Worry and More Worry- The 411

baby - worry

Today is officially SIX days past five day transfer.  I do not really have any symptoms indicating pregnancy is transpiring. I try to keep in mind that implantation occurs during days 4-9 after the transfer. HCG does not begin to show up in the bloodstream until day 6 and by day 8 or 9 is when the HCG is more concentrated in the bloodstream. 

Like a little dummy, I started testing on day 4 to rule out the trigger still being in my system.  

Last time, I had some symptoms by now.  I was at least feeling twinges and more “digging” or “rooting” of the embryos into my uterine wall.   I felt some digging on day 4 but nothing since.  I also had shortness of breath and sore breasts last time as well, but not sure if it was this early.  I did not realize that Crinone Gel 8% causes pregnancy type symptoms and I used Crinone last cycle.  This cycle, I am using Endometrin.  The only symptom I have had from Endometrin was initial irritation.  I also forgot to eat tons of yogurt after my retrieval as well while taking the antibiotics and I ended up developing a yeast infection.  I sent an email to Dr. Grossman and asked if I could take something OTC since applying topical yogurt with live cultures was not clearing it up.  He ok’d Monistat 1 and I took it and it worked.  I feel much better.

I have decided not to take another HPT until Monday which is day 9 after transfer.  I am supposed to go for beta on Monday as well.  I tested days 4, 5, and 6 and there is only one line showing up.  Granted, the tests I am taking are the cheap dollar store tests.  I purchased Clear Blue Easy tests for Monday.

I am going to be really blown if none of these embryos stick.  I do have one frozen embryo to transfer later if need be from my first cycle.  How ironic and cruel would it be for my first cycle to be a BFP, although I lost her, and my second be a complete bust?  UGH!  This is so nerve wrecking.

On top of all of this stuff going on, my mom noticed a bump/lump/growth on her breast.  It is the same breast a mastectomy was done on 7 years ago.  She has been cancer free for 7 years.  The MRI results showed a mass growing on the skin, but they have to do a biopsy to determine is it is benign or malignant.  We are praying that is scar tissue or a benign growth and not a return of the cancer.  The fact that she has been so cranky, irritable, and overly exhausted these past few months, is not a good sign.   When it rains, it pours !

Okay God…. balls in your court… Your battle !  I will sit over here patiently and pray while YOU work all this out.



OHSS Explained – The 411

baby - OHSS


There are many different regimens for prevention/reduction of OHSS because the condition is poorly understood even by many REI doctors. Case in point is the wife of a prominent REI that nearly died after her husband fluid restricted her to prevent OHSS. OHSS, at its root, is a cluster of symptoms that result from leaky capillaries in the ovarian follicles. After ovulation, even in natural cycles, new and temporary capillaries are made in response to LH/hCG. These capillaries invade the granulosa cells of the follicles, delivering cholesterol to these cells so that the granulosa cells can produce progesterone (which is made from cholesterol). These capillaries, made in haste, are leaky. The fluid portion of the blood leaks through the capillary wall but the cellular part of the blood stays in the capillary. This is not a big deal in a spontaneous cycle as there is only a single follicle in most cases. In typical cases of OHSS, there are many, many follicles and therefor a lot of leaky capillaries. The fluid that exudes from the capillaries accumulates in the abdominal cavity as ascites. In an IVF cycle this can occur at two different points. The first point is after hCg administration and the second point is when hCG levels start to rise after pregnancy has been established. In severe OHSS, the ascites can accumulate to the point that the abdominal cavity is so full of fluid that it interferes with the diaphragm’s ability to move and makes breathing labored (‘respiratory embarrassment’ in medical jargon). the pressure from the fluid also puts pressure on the stomach causing a sense of fullness and decreased appetite as well as pressure on the vessels perfusing the kidneys. To understand the rationale for my recommendations, you must first look at the principal symptoms of OHSS and their causes. One also has to keep in mind that OHSS is a self-limiting condition and will get better on its own with time in nearly every case. I will list the common symptoms in ascending order of seriousness. Please understand that only in very unusual or neglected cases do these things result serious threat to the patient’s health. OHSS is always a matter of temporizing treatment designed to reduce symptoms and buy time while the OHSS resolves on its own.

1. Decreased urine output. This is defined as less than 30 mL of urine per hour. It is caused by a combination of factors that lead to decreased renal perfusion. These factors include: decreased blood volume due to the leaking of fluid from the capillaries in the follicles to the abdominal space as ascites; increased intra-abdominal pressure due to tense ascites causing a.) decreased blood flow to the kidneys. b.) decreased fluid intake because the patient feels full; alterations in the renin-angiotensin system that controls salt balance. This is poorly understood and may be genetic.

2. Increased blood viscosity. This is the result of the fluid portion of the blood leaking through the capillaries leaving the cellular portion of the blood highly concentrated within the vascular system. This can put patient at risk for thrombus formation (blood clot).

3. Low sodium (hyponatremia). The combination of low sodium and low intravascular volume is somewhat of a paradox and is also accompanied by low potassium (hypokalemia). This is due possibly to the follicles functioning as faulty glomerulii (the glomerulus is the filtering apparatus of the kidney and usually retains sodium and potassium) as well as the alterations in the renin-angiotensin system which I alluded to above.

4. Ovarian enlargement and pain. This is due to the stretching of the capsule of the ovaries. This occurs as the ovaries increase in size due to the ‘lutienization’ that occurs in response to hCG. This is typically the most common symptom, occurring in moderate as well as severe OHSS, as well as the most bothersome symptom for patients.

My recommendations:

1. Drink at least two protein supplements per day each containing 30 grams of protein. Try to eat protein rich foods like meats and legumes. Rationale: the protein will serve two purposes. It will possibly help provide substrate so that the capillaries formed are more substantial and less leaky. Protein will also provide substrate for the production of albumin. Albumin is a component of blood that is integral in keeping the fluid part of the blood from leaking out of the vascular system. The albumin is too large to leak out of the capillaries and will (hopefully) provide oncotic pressure and keep more of the liquid part of the blood in the vascular system, thereby reducing ascites. Failure to get adequate nutrients will quickly lead to a reduction of albumin production and is part of the reason that patients often rapidly deteriorate with OHSS when the get tense ascites and lose their appetites.

2. Drink electrolyte balanced fluids rather than water. Gatorade or like electrolyte drinks will provide sodium and potassium, which is being lost in the ascitic fluid. Maintaining adequate hydration is key to maintaining adequate renal perfusion. When you are thirsty or notice dry mouth and lips, chug Gatorade. If you have concentrated urine or dry mucus membranes, you are not getting enough fluid, drink Gatorade until it improves. Coconut water is another popular electrolyte rich fluid but is not as good as Gatorade in my opinion.

3. Put extra salt on your food and eat salty snacks. See number 2 above. You need sodium and potassium. Low sodium and potassium contribute to the feeling of lethargy and decreased appetite that often accompany severe OHSS. You are losing sodium through the capillaries and need to replace it.

4. Stay off your feet as much as possible. Walking excessively results in increased ovarian pain and may also increase leaking from the new capillaries. Often the pain is most noticeable at night. Staying off your feet may also aid in the reabsorption of the ascitic fluid.

5. Take a baby aspirin per day. All of my patients are already doing this OHSS or not. The 81 mg of aspirin helps to prevent clotting of the concentrated blood. In certain severe cases, lovinox may be added to prevent thrombus formation.

6. Take narcotic pain medication as needed for pain. We usually prescribe Vicodin. You do not get extra credit for being a hero.

Things your doctor should keep in mind:

1. IV hydration can be provided as needed in an outpatient setting and should be provided liberally to maintain renal perfusion in patients having a hard time getting enough fluids in.

2. Ultrasound guided transvaginal paracentesis can be used in an outpatient setting to relieve tense ascites. This relieves respiratory embarrassment and improves renal perfusion through the reduction of intra-abdominal pressure.

In most severe cases, giving fluid and draining fluid in an out patient setting to maintain renal perfusion is usually all that is needed to temporize until the OHSS begins to resolve on its own.

For patients:
When you have you first day where you do not feel worse than the day before, you are usually about to begin improving.

Once you are on the mend, you will begin to notice a high rate of urine output as your body reabsorbs the ascites and get rid of it through your urine.