Houston, we have a protocol!

In the last 3 years, I don’t think I have ever been so excited to get my period.

In fact, I don’t think I’ve been excited at all. As mentioned in a previous post, it usually resulted in mental anguish followed by the drinking of copious amounts of wine. But I am 3 months out from my treatment (that sounds so “Dollhouse”), and things are starting to roll along. I can’t wait for my next two periods to get here!

I heard from Mag this week, and have been given my protocol. I’ve synced my birth control pills to fit. The breakdown is as such:

  • Some time in early December (exact date to be determined at my October 6 appointment): Endometrial biopsy (more on that later).
  • December 14: I get a Diphereline Depot shot in the ass to down reg and shut down ovarian function.
  • December 19: Last active birth control pill (Day 21 of the pill pack).
  • December 24: CD 1 (1st day of estrogen supplementation)
  • Estradiol/Oestradiol:
    • CD 1-4: 2mg (1 tab) in the am.
    • CD 5-7: 2mg in the am and pm.
    • CD 8-whenever the docs tell me to stop (hopefully, 12 weeks of pregnancy. Not even going to list the alternative. Positive thinking.): 2mg am, lunch, and pm.
  • Progesterone:
    • CD 15-whenever the docs tell me to stop (12 weeks!): After discussing the different forms of progesterone supps, I’ve decided to go with progesterone in oil (PIO). Which means I will get a daily shot (usually 100mg) for about 12 weeks. Yikes. Hubby has agreed to take this on, as I will need to get the shot IM (just like the diphereline…in the ass). My reasoning for choosing this route: I’ve heard that women have had problems with absorbtion using utrogestan (Prometrium in the US); even my RE stateside said he didn’t like it when I was doing IUI’s and asked for progesterone support. Crinone 8% (2x daily vaginal gel) is supposed to have similar outcome to PIO with regard to implantation, clinical pregnancy, and live birth rates, but it can’t be monitored by a blood test (it absorbs directly to the uterus). I know of a friend who was taking PIO and having blood levels monitored; her OB was able to track when her progesterone dipped and up her dosage in order to protect the pregnancy. There is no such tracking with Crinone (or other suppositories, for that matter). This alone was enough to convince me. Plus, Crinone is prone to clumping up and clogging up your vag. It’s recommended to….TMI here….use a finger to “clean things out” in the shower every couple of days. But, that’s perfectly okay if you’re truly averse to shots, if you have an adverse reaction to the shots, or your ass just can’t take it any more. The things we do for pregnancy.
  • Day of fertilization: January 7.
  • Estimated date of embryo transfer: January 12 (5 day blast).
  • Estimated test date: January 26.

Mag also let me know that the clinic has appointments for donor women with my blood type to come in and have eggs frozen in November. They are going to screen for my characteristics, and Mag will let me know when she gets more information.

Speaking of Mag, she has been invaluable with regard to helping me with medications. My insurance would cover the estradiol, but won’t cover the diphereline (or lupron, or anything similar) and they won’t cover the PIO. I don’t know what it is, but Aetna hates anything injectable. Anyway, Mag is coordinating with the clinic for me to get the meds shipped here from Czech, where they are ridiculously cheap. She also did a search stateside for cheaper (though not as cheap as Czech) meds, if that was the route I wanted to go or found myself in a pinch for PIO half way through the cycle.

As far as other updates…I’ve been to the psychiatrist and she gave me two meds. I’m taking Zoloft (sertaline) for long term management of the anxiety/mild depression. It takes a few weeks to kick in, so in the interim I’m using Ativan (lorazepam) for panic attacks. I’ve been warned by both a pharmacist friend and my counselor friend to take it easy on the Ativan; it’s a temporary band-aid on symptoms but doesn’t really treat the underlying cause. I’ve headed their advice, though I think I would have taken it sparingly anyway. A took a full dose during an attack and felt very out of it for a bit until the “rush” wore off. I don’t like that feeling at all! I want to be calm, but I also want very much to be present and alert.

I have another appointment (also on the 6th) to get a baseline for how I’m tolerating the Zoloft. Sidebar…it’s tough on the stomach for the first week or two. It’s an SSRI (selective seratonin reuptake inhibitor) and I guess we have receptors for seratonin in our stomachs as well as our brains. The overload temporarily causes upset stomach and nausea. It was recommended that I 1) take it right before bed and 2) take ginger capsules with it to ease the nausea (1 in the morning, 1 in the evening). I picked some of those up at my local Sprouts store, but I’m sure they’re at any healthy food store or online at Amazon. I’ve also been taking an OTC Zantac about an hour before the Zoloft, as well as sleeping with my head/torso slightly raised on a couple of pillows (learned that from a history with acid reflux). All have helped immensely, and tummy upset has been there, but very minimal.

I think that’s it for now…more to come after my appointments.

One thought on “Houston, we have a protocol!

  1. lookingforhope says:

    Just found your blog! Best of luck with treatment! It’s crazy how excited we can get about getting our period when we are going through treatments!

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