IVF #5 – Here We Go- The 411

ivf #5 think positive

I am nothing if not determined !

I spoke with my RE, Dr. Robert Kiltz, who owns CNY Fertility Center and Spa yesterday and he called me again today after reviewing my chart in more detail.  He was very receptive to my concerns and took responsibility for the embryo glue not being sent to Albany office for my transfer and we also discussed putting in place a protocol that requires pre-preparation of a medium which will culture immature eggs.  This is not a standard practice, but something he has been exploring and is going to put in place so when patients have immature eggs, the proper culture is there to place them in to give them a fighting chance of maturing.  It is called IVF Maturation…

Long story short, he reviewed my chart and is willing to do another OE IVF using a different protocol and different medications.  I will be doing the Agonist / Antagonist/ EPP protocol.  This is the protocol that Dr. Sher mentions for poor responders and advanced maternal age women.  It is a protocol that CNY has been tweaking and using for women which has shown a lot of promise and success where other protocols have failed.   Dr. Kiltz was very warm and receptive and assured me that we will get this done one way of the other.  He is willing to take risks that a lot of other doctors are afraid to do until they show 100% promise that it works.  Dr. Kiltz believes that if it is not harmful and can be helpful, lets give it a shoot !

I am starting BCPs (Desogen birth control pills) tomorrow as part of the protocol.  The birth control pills are taken for 10 days or so then overlapped with Lupron for 5-10 days.  Once I get my next period (27 days from today), then I start the antagonist and estrogen priming part of protocol, in which I take Ganirelix daily, Neupogen injections daily, Delestrogen injections twice a week (for 2 wks), and then add Follistim (150 units or more) on CD 6 and then we will add Menopur (37.5 to75 units) at the very end for 4 or more days.  Menopur add testosterone to the ovaries, which causes the eggs to not develop properly and then you end up with a cycle with lots of follicles and few eggs and also a lot of immature eggs.  This has happened the last three cycles.

After speaking with Dr. Kiltz, I feel a lot better and am grateful that he listens to patients, takes a look at your chart and does not put patients in a cookie cutter protocol.  He stated they are working hard at revamping the centers so that all of the centers are run the same and seamlessly and they are working on implementing new protocols that are working to improve the live birth rates.

I have referred several advanced maternal age patients lately and I just got word that two of them are pregnant on the 1st time at CNY !!  They had had failed cycles at their other centers.   One of the patients is 44 !!  Woot Woot !  I am so excited !

Now, if we can just get ME pregnant so I can so do some other things LOL.

I did ask if I should consider changing donors, and Dr. Kiltz said I did not have to because it was egg issues and not sperm issues.  I am still thinking about buying the access to the cryobank site and look at the donors they have on there. I am certain that they have added a ton of new donors and some of the ones that were new when I started may be “proven” by now.  It has been a year, so I am leaning towards at least exploring different donors.  I just happen to really be stuck on this one ! 🙂  He is soooo the male version of me and it took me forever to decide on that one…


IVF #4 – Precycle CD3 – The 411

baby - ivf 4

Yesterday, I had my first precycling baseline appointment and bloodwork.  The transvaginal ultrasound shows that I have six follicles on my right ovary and three on the left. My blood work is all normal. I am now scheduled for my hysteroscopy with biopsy on January 9th at Lenox Hill Hospital, which will be my cycle day 20. I am continuing with weekly acupuncture as well.

Last night, Dr. Kiltz returned my call regarding the next steps of my protocol.  I spoke to Dr. Grossman earlier yesterday morning and he said we would defer to Dr. Kiltz’s protocol.  Dr. Kiltz had to look over my chart and figure out what he wanted to tweak for this protocol.  He stated he wanted to shake things up a bit.   Today, I got my precycle instructions for IVF#4.  I will be taking my normal supplements and prenatal vitamins until January 7th.  Starting on the 7th, I am to start taking Estrace tablets twice daily for seven days. Then I am to call with my next period to do a day three monitoring/ baseline appointment and start stims.  I will not be taking Estrace for three weeks and Endometrin the last week and starting Lupron like I did before.

I did discuss with Dr. Kiltz my desire to do a double trigger this next cycle, which is proven to mature eggs.  The hcg trigger shot is taken 36 hours prior to retrieval as normal.  The next morning, I will go in for blood work to test the hcg level and then that night, I will either do a lupron trigger of over 20 units or another hcg trigger.

I will be doing Saizen, 300 Gonal F, 300 Menopur, 5 Lupron (I assume) along with Synthroid and prenatals during stims.  After egg retrieval, I will add neupogen, lovenox, prednisone (20mg) and weekly intralipid infusions. I will be doing a two or three day transfer of all embryos this time instead of waiting until five day.

Merry Christmas to you all !

IVF #4 Upcoming – The 411

baby - ivf egg and sperm

Last night, Dr. Robert Kiltz, who owns CNY Fertility Center and Spa, called me and said he wanted to schedule a phone consult with me for Saturday morning.  He said he was reviewing my file and would call me.  This morning, as promised, he called to discuss my latest failed cycle and to make a plan to move forward.

He wants me to try one more cycle with my own eggs prior to moving on to donor eggs.  He feels that I have good equality and is happy that he sees all my embryos making to blast.  He feels that I need to do a few things:

–  Add Saizen / human growth hormone to my cycle to improve maturation and egg quality

– Use neupogen post transfer

– Do a neupogen wash

–  Do a Hysteroscopy with biopsy

– Do an endometrial scratch on day two of my cycle to improve implantation

– Continue on an estrogen priming protocol

– Use 300 Gonal-F and 300 Menopur with Lupron for stims again

I have decided to give my own eggs one more last shot while I am saving up for a donor egg cycle.  I am going to detox my body first.  All of these hormones have take a toll on my body.   I am going to start a protein train on Monday (protein shakes only, apple sauce, sf popsicles, sf jello, water, diluted apple juice, oatmeal).  I will actually start by drinking only water with lemon, cayenne pepper and grade A maple syrup for two days to detox my body from my sugar habit.  It really does work !  By drinking loads of the lemon cayenne tea, it cuts sugar cravings and helps you follow the Bariatric diet more easily.

For those that did not know, I had gastric bypass surgery March 31, 2004.  When I follow a strict diet for short periods, it helps me refocus and I also drop weight pretty quickly.  I want to get back to my starting weight prior to starting stims.  I should be able to drop the few pounds I have gained due to the hormones.  It can only help with my quest to get pregnant.  Weight loss releases the hormones that are stored in body fat back into the bloodstream.  This is why a lot of women who became infertile due to obesity find themselves pregnant unexpectedly after gastric bypass, lapband, or significant weight loss.

Ironically, one of my friends out of the blue reached out to me late yesterday and said that God had laid on their spirit to relay to me to hold on…. that my bundles of joy were on the way.  I told my friend to go back and relay a message for me…  I will hold on, but can He speed up this timeline ! lol

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 !!

Moving Along In The Process – the 411

I am moving along in my process and will be starting my estrogen priming protocol in a few weeks.  I have to take Estrace for 7 days with the start of my period and go in for baseline and ultrasound.  After this, the next month, I start my injection meds, which are going to be a lot less costly than I thought now that I have been introduced to Freedom Fertility Pharmacy. 

I have selected one donor that I think is somewhat the male version of me LOL.  I am still combing through profiles on two cryobank sites looking for 3-4 more donors and then my siblings, mom, and friends will have a donor selection party to select “HIM”.

I can not wait until March when I go in for my retrieval and transfer.  I am praying that all goes well with my medication protocol and that I produce healthy eggs and enough that I can have twins.  I was speaking to another lady today and she transferred three embryos and is having TRIPLETS !  That I do not think I could handle, but I know I will never do selective reduction either.  I guess I will cross that bridge when I get to it.  I will see where I am after the retrieval and decide then how many embryos to transfer.  The doctor suggested transferring as many as 5.  SAY WHAT?  I can not see that happening, being that they may ALL take !