Refreshed and ready to go

It’s been about 4 months since I last wrote a post. This time has been taken for my husband and I to just live life. Breathe, heal, enjoy the summer heat. Once summer was over, we continued enjoying the frazzle-free life of not TTC. And then, we both felt we were ready.

I had an appointment with my RE in September to assess how we should move forward, and got some surprising news (both good and bad). The good…Dr. Albrecht from Albrecht Women’s Care (they specialize in treating women with low ovarian reserve) had Day 3 labs drawn and they came back GREAT. So great, in fact, that he believes he can get me pregnant with my own eggs. Holy shit.

FSH: 5

AMH: 1.4

E2: 31

LH: 5

TSH: 1.53

Prolactin: 13

Vitamin D: (The nurse didn’t give me a value, but she said it was great, and they normally don’t see that.)

Did you see that AMH?! That’s up from 0.28 about two years (or so) ago, and up from 0.7 almost 4 years ago. The supplements I’ve been taking (I’ll post them again at the end so you don’t have to dig through my old posts to find that info.) have really worked!

And now for the bad…he also did a saline sonohysterogram to assess uterine architecture, since I hadn’t had an eyes-on exam in a few years. He found what he believed to be a fairly large submucosal fibroid (the kind MOST likely to affect fertility) pushing into my uterus, taking up rent-free space in the majority of my uterine cavity. It was large enough that he recommended surgery over management with medication. He also said he believed that rat-bastard lump of tissue (my words, not his) may have been partially responsible for my recent miscarriages.

Mayo uterine fibroid

So, we scheduled me for a hysteroscopy. I had that done the first week of October. The surgery actually wasn’t bad at all. I went under general anesthesia, woke with a bit of pain, but that was taken care of immediately (my recovery RN accidentally double teamed me with an oxycodone pill and dilaudid in my IV before I was conscious enough to tell her she had the wrong patient information sheet and I wasn’t, in fact, prescribed oxy. I pretty much slept the rest of the day. It was actually quite nice. But…ahem…don’t do drugs, kids.). I had light pink spotting for the first day or two, then I was in the clear. My period came about a week later, a week early. My cycles have been normal since.

When the pathology report came in, we learned that it wasn’t a fibroid invading my space, but an adenomyoma. Adenomyosis occurs when cells from the uterine lining grow into the the uterine wall (think endometriosis, but inside the uterus.). The site referenced with the above link lists the following:

The evidence that adenomyosis causes infertility includes:

  1. In women with adenomyosis, the muscles cells in the uterine wall swell and they function differently than normal uterine muscle cells.
  2. In women with adenomyosis, the lining cells of the uterus do not go through normal changes during the menstrual cycle.
  3. In women with adenomyosis, the uterine lining cells cause inflammation in the muscle wall which interferes with the movement of the fertilized egg inside the uterus.
  4. In women with adenomyosis, there are changes in the uterine lining cells that interfere with implantation of the fertilized embryo.
  5. Surgical removal of adenomyosis or medical treatment with GnRH agonists (Lupron) increases the chance of pregnancy.

Well, fuck.

I’m just starting to feel like a walking fertility train wreck. How many things can go wrong with one fucking person??

That sentiment aside…I just had a second post-surgery check up with Dr. Albrecht yesterday; another saline SHG. He gave us the green light for moving ahead, saying my uterine cavity now looks perfect. He’s also decided to go aggressive with me. Given the fact that I’m 38 with a fragile-X premutation and a history of low reserve, he told us that he wants to shoot for 5-6 follicles for an IUI cycle (we still can’t afford IVF in the states, and I love, love, love my RE right now.), with the understanding that at least a couple of them will be duds. We also discussed the possibility of selective reduction (I’m no Octomom or Kate + 8), but the Doc doesn’t think this will be an issue. He said in cases like mine, he’s had one set of triplets born over the last 30 years, with no selective reductions performed. Hubby and I are comfortable with this, and with Dr. A.

I will be using Femara, Gonal-F, Cetrotide, Micro HCG, and Heparin (he chose Heparin instead of Lovenox for the first trimester and prep as his research has indicated it has a better outcome with clinical pregnancy with regard to autoimmune and inflammation issues) during this cycle. That’s a LOT of daily shots. But very much worth it if we bring home a baby.

I’ll post more once we figure out when this will happen, to include protocol, dosages, medication information, timing, etc.

In the meantime, my supp list, reposted (and confirmed with Dr. A.):

  • 1200mg Fish Oil (600 A.M., 600 P.M. / Spectrum and Nordic Naturals are good brands) **Make sure to consult with your physician before taking a dosage this high. It has an anti-coagulant effect.**
  • 400mg Ubiquinol CoQ10 (Jarrow) in the A.M.
  • 4000 IU Vitamin D3
  • 1000mg Calcium Citrate (500 A.M., 500 P.M.)
  • Fairhaven Health OvaBoost ( 4 pills P.M. / contains CoQ10, 2000 mg Myo-Inositol, melatonin, 100 IU Vitamin E, Alpha Lipoic Acid, Grapeseed Extract, and 400 mcg Folate (there is a difference between Folic Acid and Folate!! Additionally, there is a difference betweenvarious types of Folate.)
  • Neevo DHA Prenatal Vitamin (1 A.M. / prescribed by Dr. A. This is his preferred brand of prenatal for those with MTHFR.)
  • Seeking Health Iron Plus Cofactors (1 pill at lunch)
  • 100 mg Natrol Pycnogenol
  • 81 mg Baby (low-dose) aspirin
  • **New** Added per Dr. A.: 40 mg PQQ (20 A.M., 20 P.M.)
  • **New** Added per Dr. A.: 1000 mg Acai Berry Extract (500 A.M., 500 P.M.)

Dr. A. also told me that if my AMH had been below 1.0, he would have had me on 75 mg micronized DHEA (25 mg 3x daily) from a compound pharmacy.

Well, I think that’s enough info for now. This post has inadvertently turned into a monster. Until later…

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