Back in the Stirrups

Well, it's official - after three years of frolicking around happily in the land of the Fertile, we are patients of a reproductive endocrinologist once more. We had an appointment with our RE yesterday to discuss our options for Baby #2 (as he or she will known on the records of the Church - just kidding.) We are very (VERY) lucky to have three embryos which were frozen after the IVF that got us Sawyer. That means we don't have to go through the whole (horrible, expensive, painful, and did I mention horrible?) process of a full IVF again, we just have to transfer the embryos into me and hope they take. Our RE gives us about a 30% chance that it will work. With a fresh cycle it's about 40-50% - the thawing process can damage the embryos, so a frozen cycle is always riskier than fresh. As with last time, our chances are better than most people's because we are young and because our diagnosis is male factor (as far as we know, all my stuff is working.)

Here's the protocol, for those who are interested in the gory technical details.*

Beginning with my next cycle:

Diagnostic Tests

Day 3 - Sonohysterogram. This is where they fill your uterus with saline and do an ultrasound (the "fun" kind.) This allows the doctor to do some measurements and check the general shape of things.
I'll also have some blood work done to check my hormone levels.

A few days later - Hysteroscopy. Another diagnostic test where they feed a thin telescopic camera through the cervix to have a look around. Here they're looking for fibroids and polyps and anything that's not supposed to be in there. As you can imagine, this one isn't very pleasant to go through, but thankfully it's pretty quick, and it's actually kind of cool to be able to see inside your own uterus up on the screen during the procedure. While they're in there they'll do a trial transfer - measuring to find the best place to deposit the embryos on the big day.

The best part of my diagnostic protocol is ... NO HSG! And no laparoscopy! Those were the most painful procedures for me last time (apart from the ovary stimulation and egg retrieval) so I am thrilled not to have to go through those again this time.


Medications

The normal protocol is to go on birth control pills for the first 14 days, but since I have the Factor V Leiden gene, our Dr. wants to avoid this. What I'll do instead is use another form of birth control (oh, the irony) and use ovulation predictor kits. When I get a positive (meaning I'm about to ovulate) I'll call the office so they can schedule me for the next step - medications.

I'll have some more blood tests, then I'll start taking:

Lupron (20 units) - subcutaneous injections, once a day. This suppresses the ovaries.

Estrace - Estrogen, taken vaginally or orally (woohoo, no needles!)

Progesterone - the Big Ones. Eric will once again have the joyful experience of stabbing a 1.5" needle into my hiney. The RE did say that if the injections are painful for me I could switch to vaginal capsules instead, for which I will forever bless his name.

Somewhere around 6 weeks after my cycle begins (end of December or start of January), we'll do the actual transfer. We're transferring all three embryos (two blastocysts and one morula). This sounds scary, but with a frozen cycle the chances of ending up with triplets are almost zero. And they're only slightly higher for twins. So we're hoping and praying for one healthy, adorable baby.



*If you're wondering what Eric has to do for this cycle, here it is: he has to get bloodwork done to screen for infectious diseases. Which he did yesterday. So yeah, he better be nice to me for a long, long time.