ROUND 5!!!

Got my first BFP yesterday!!!!!!!!! I took the test early that morning, and it was negative as can be. I officially gave up - and even didn't take a progesterone that morning because I was certain it was over for me. 2 hours later I had to go to the bathroom so as I went, I looked at the test in the trash. Took it out just to give it one more glare and couldn't believe my eyes when I saw another line!!! Are you joking?! I instantly took another progesterone pill and followed my normal medicine plan that night. (lovenox, progesterone).

  I didn't want to get too excited because you hear so much about "Evaporation lines" after 10 mins of the test so they usually are void after that. So this morning I ran to target cause I was out of tests, and went to work. At work I went to the bathroom and took another. BOOM. Right away, no doubts about it...no squinting, no flashlights, instant positive!!!! 

FINALLY!!! I am trying not to get too excited, this is my 5th attempt at pregnancy and I understand the risks. I have to remain calm and understand that I am far from out of the woods. These next couple of days/weeks will be the most critical. I am going to remain positive, but also understand that I am doing all I can to keep this one. But if things happen, they happen. It's out of my control and I understand that. And will just face things day by day. Like the words I live by now:

"Don't stress over things that may be....because they may never be...and you've wasted all of that time and energy stressing over nothing. Cross bridges as they come, live for the day" 

So today...I'm so excited!!! 

POSA

I have entered the "pee on a stick addiction" portion of the month, where I test everyday and then strain my eyeballs trying to see any hint of a line. This month was odd. I never could determine if or when I ovulated because my temps never shifted to much. It raised about .17 degrees and then stayed put like that for days! Usually I have about a pretty significant temp shift but not this month. Fertility Friend can't even detect if I O'ed or not. So I just had to guess when it *may* have happened and based my meds off of that. Very frustrating I tell ya!!

  It's so irritating that I was so solid at predicting and achieving when to DTD to conceive. I succeeded at every try before I realized what might be going on with me. Now that I could potentially have a fix, it's just not happening. It's like the Gods above are playing some sort of evil trick out on me. Depeche Mode has a lyric that rings true for me with this whole mess I've been going through. It goes "I don't want to start any blasphemous rumors but I think that God has a sick sense of humor and when I die, I expect to find him laughing". Yep. Pretty much.

  But I have good news to report!! My doctor agreed to prescribe me 100mg of Progesterone! So I took my first dose last friday, scared shitless that it was going to make my heart start racing again....and then.......nothing!!! I felt fine!!! The entire night I slept fine and didn't wake up at all! So the next morning, I decided to play with fate and took a morning dose as well (since I would like to up the ante a bit more than just 100mg a day). And again....felt fine!!! I could take 200 mg, 100 in the morning and 100 at night and not be bothered by evil side effects other than feeling a bit groggy. Which is normal!! So yesterday, I really decided to play with fire by adding a mid day dose. 300mg a day. 100 in the morning, 100 in the middle of the day, and 100 at night. I sat on this idea for a few and said, F it. If it bothers me, I will cut it back to just 200mg. So I went for it, and again.....felt fine!!!! So now I can take 300mg with no issues!! Yay! Guess my body just handles it better in small doses!

   I'm really excited about that because I simply don't know if I have a progesterone issue, but it can be a huge reason why people miscarry. My temps never shifted up much this month and my AF came on day 25 last month which was odd for me. Those can be indicators of low progesterone. So now you understand my excitement that if that truly is the case, then I can take these pills to help fix the problem with no issues!! :) After I started the pills, my temps are now where they are suppose to be at this stage, and my boobs are KILLING me. SUPER sore. So that proves the medicine is doing it's job! :)

   Anyway, well I will keep this updated as the week progresses to let you know if I succeeded or if it's back to the ol' drawing board. In the meantime, I am still preparing for Christmas and getting this in order for that. Only 1 more day of this work week and then it's a lovely 4 day weekend! Can't wait!

Dropping by

Dropping in today just to write a few things down. I have been pretty busy these past couple of weeks with the holidays, Christmas shopping, my 37th birthday..etc..etc. This time of year is always so exciting, but suppperrrr busy. I am really looking forward to next weekend because it's the first weekend I will have to myself in WEEKS. We aren't going anywhere, have nothing planned...it's going to be awesome! 

  On Dec 4th, I turned 37. We went to New york to go see Saturday night live which was AMAZING! Ryan Gosling was the host and Mike Myers also came out for a quick cameo. As the band was playing, Justin Timberlake was right below us just chatting with Lorne Michaels! It was really surreal! Afterwards, we got to tour the entire studio, backstage, stand ON the stage, and then tour Jimmy Fallons and Seth Myers studios as well!! My moms friend works for SNL and gave us the royal VIP treatment! It was beyond amazing!! 

  So needless to say, I had an amazing birthday. And although I am NOT happy about turning 37, it definitely took the sting out of it all! ;)

  On a TTC update, well not much really to report there. We are in the TTC phase and I am expecting to ovulate any day now. It's being a little delayed this month for some reason. I'm on cycle day 16 and nothing as of yet. Also, my last period came early on day 25. So I don't know what is going on with me. I hope my system isn't starting to get all wonky on me now!! I need it to stay relatively stable so I can predict things easier, but of course..that would be TOO easy...and nothing comes easy for me!

  So I sit here and I wait. We are DTD every night until I can confirm it has happened. The husband is being a good sport, but it sucks because I would like to get this show on the road!! Today I felt some twinges in my ovaries so hopefully things are finally progressing! 

In other news, I spoke with my nurse and since my dumb insurance won't cover the new progesterone I wanted to try, we are going to give the prometrium one last ditch effort. Only this time we are going to minimize the dosage to 2 100mg pills a day. So one in the morning and one at night. That will hopefully be a low enough dosage to where I won't have such side effects from it. I am crossing my fingers, especially after my period came early last month. That could hint at a progesterone issue and I don't even want to deal with the thought of not doing anything I can to prevent another disaster. So if I can take these pills to ensure I am good in that dept...bring it. I just pray my body will react better to the lower dosage. Will keep ya posted! 

Strike two

Well, haven't updated in a few weeks and it's just because there really hasn't been much going on. I TTC again 2 weeks ago and unfortunately AF arrived yesterday, so clearly I'm out again. It's pretty frustrating. It's like, this past year whenever I have tried, we succeeded no problem! But now that I actually have a remedy to try to hopefully make the pregnancy last...I cannot even get pregnant now! I can't win!

 I'm wondering if the Lovenox is just making things a little too thin for conception. Like, what if my blood is just too thin to build a decent uterine lining. I have read that this could be an issue, which is why many doctors like to wait until after you get a positive pregnancy test. My only issue is that my losses are so early. Like a couple of days after my missed period. Which is why I was told to start after ovulation, to help prevent any microclots from forming beforehand.

 However, I am also taking baby aspirin as well. So, this next time around - I think I am going to continue the baby aspirin all throughout my cycle. But I am going to hold off taking the Lovenox until after I get a bfp. That way maybe things can develop naturally for a bit. I am hoping the baby aspirin will be enough to prevent any tiny clots from forming and then the Lovenox can seal the deal after the BFP. This is all my non-scientific, non medical opinion. I have no idea if it will work or not. I might be setting myself up for another loss. But I have got to try something different since clearly this isn't working. And ironically it stopped working once I started the blood thinners. So I am sort of linking them together here.

 Anyway, I'm on day 2 of my AF. Hopefully it will pack up and get the f$%k out of here by the weekeend. My 37th birthday is on friday and my mom managed to miraculously get a hold of 2 tickets to go see Saturday Night Live in NYC!!! Unreal!! So my husband and I will be heading north for the weekend for that! Very exciting! It will help take my mind off of things as well. Then the next week we will be back to trying again. Maybe we will get some Christmas magic sprinkled upon us this time around. We shall see...

Mentally preparing myself

I often sit back and think about everything that I have gone through til this point and it still amazes me. I am at the point where I don't really know where to go from here if God forbid this doesn't work and I suffer through yet another loss. I want to be strong for myself and my husband...but I have taken my lashings and I just want to be done. I understand the reality that the possibility of losing another is very high. So I have to mentally prepare myself.

   I don't want to be a "debbie downer" and I know having a positive mental attitude is very important. And believe me, I am trying. But I am also the type of person that kinda goes by the "hope for the best but expect the worst" kind of attitude. Many don't like this rational....but it's the way I am programmed. It's how I deal. Maybe it's a bit negative. But it's just how I think.

  Anyway, we try again next month. In like 3 weeks I have to go back to the doctor for an ultrasound to make sure I am going to ovulate next month. It's important to time this ovulation precisely because I have to take these injections literally right after. So I can't be off on my days. Timing is everything with this one.

  It makes me a bit sad. It's all so calculated. The fun has been stripped away. The excitement is gone. It's very scientific now more than anything. I feel like a guinea pig. I will always remember the excitement I had with the first positive. I will always miss that feeling. Now I am just petrified, curious, anxious and angry that it has even come to this. But as my nurse said - if this all works out - every single thing I did to get there will all be worth it. I hold on to that very hard. Every time I will have to prick myself with daily injections...I will think of that.

  If this doesn't work out...and I do miscarry again. They will test the embryo and find out what is going on. I read a blog where the woman who was literally going through the same thing. She had another miscarriage after everything. 4 losses, same medications, I literally could have written her blog. But she went on to have her "rainbow baby" as they call it. Her blog gave me hope. That even if God forbid my long road isn't over...that one day it will be. Hopefully with a happy ending as well. But regardless the outcome, I just hope someone who is going through what I am going through will stumble upon this blog and find some inspiration...or at the very least, someone to relate to.

The Gameplan

Looks like I am all caught up now! I started this blog after all of this had happened, and wanted to move forward sharing my experiences as they come from here on out. So this is the most recent and up to date entry. Last week, Sept 22. we had our followup with the doctor to go over the gameplan. My doctor believes that the issues are stemming from my blood clotting disorders, so she is going to put me on a cocktail of medications for the next time (which will be after this cycle).

  Basically, the recipe is going to consist of:

- Daily Lovenox (a blood thinner) injections. Yes I have to take a needle and inject this medication into my stomach for the next God willing 36 weeks. If I make it that far, after 36 weeks I will switch to Heparin (another blood thinner) and will up the dosage to 2 shots in the belly a day until the baby is born. Then I will be put back on Lovenox for a good 6 weeks post labor. This will help prevent and/or breakdown any clots from forming while pregnant. I will get started on this medication on day 3 after ovulation (even before I even get a positive pregnancy test) to be sure no clots form during implantation.

- Baby Aspirin. Another blood thinner. Lovenox basically protects me from blood clots - baby aspirin protects the baby. Lovenox does not cross the placenta...baby aspirin does. That's the difference between the two. With my conditions, I will have to take baby aspirin every day for the rest of my life.

- Metanx - it's a non synthetic form of Folic Acid since my body has a hard time breaking it down due to the MTHFR. It also contains B6 and B12.

- Progesterone - Have to take this the entire 1st trimester to help keep my uterine lining nice and thick for baby.

- Calcium - Lovenox really takes a toll on your bones so I have to keep them strong with calcium tablets

- MultiVitamins - to go along with the Metanx

- Prenatal DHA - to help avoid neural defects

- Vitamin D3 - since I was low and it plays an important roll in pregnancy

And there you have it. Blah.

Give it to me straight, doc

Well, the results are in. And from what it seems...the issue lies solely within me. My husbands results came back perfect! More than perfect actually! I knew his results would. I mean, he's batted home runs 4 times in a row now! He's a champ! Me on the other hand.. well for starters, my HSG results came back great! Uterus showed no abnormalities and fallopian tubes are wide open! No blockages! So that was refreshing to hear! Also my FSH and AMH results came back, which basically gives you an idea of how your ovarian reserve (eggs) are....and my numbers looked great! Lots of little eggs left so definitely not going through menopause anytime soon! Yay! Now for the bigger issues. 

Here are my results: 
 - Heterozygous for 1 copy of the MTHFR C677T Mutation
 - Homozygous for 2 copies of the PAI-1 Serpine 4G/4G Variant 
 - Chromosome 9 inversion. 

 And there ya have it. Here is a brief rundown of what each one is:

What is MTHFR? 

MTHFR - (Methylene-tetra-hydro-folate-reductase) is an enzyme found in the cells of our body. It is needed to metabolize (break down) homocysteine, an amino acid found in the proteins you eat. Elevated homocysteine levels have been associated with fetal neural tube defects (i.e., spinal Bifida) and miscarriage. An elevated homocysteine level can also indicate a increased risk factor for blood clots, arteriosclerosis (hardening of arteries) and strokes in both men and women. The metabolism of homocysteine depends on several enzymes, one of which is MTHFR, along with B vitamins and folic acid. In other words, B vitamins, folic acid and MTHFR are necessary to keep homocysteine levels within normal limits.

Sometimes your MTHFR has a genetic defect. These defects are fairly common and its estimated by some studies that up to 60% of the population have one MTHFR mutation or another.

There are two common genetic MTHFR mutations. If you have one mutation only, you are heterozygous. It is reported that nearly half the population is MTHFR heterozygous. - it is nothing abnormal. If you have two copies of the same mutation, you are homozygous. Homozygotes can have elevated homocysteine levels in maternal blood and amniotic fluid. If you have one copy each of the two different mutations, you are compound heterozygotes. Compound heterozygotes have the same treatment and risk level as homozygotes. If you have neither mutation, you are negative and don't need to worry about MTHFR.

There is NO CURE for MTHFR mutation. If you have the mutation, that's the way your body is made. You can, however, lessen any risk factors you have by taking B vitamins, Folic acid and baby aspirin in doses prescribed by your doctor. By taking these agents, you can lower your homocysteine levels and therefor your risk for the conditions above.

MTHFR mutations are hereditary. Families with significant early cardiovascular disease or recurrent pregnancy loss might benefit from clinical investigation.

PAI-1 4G/4G

      PAI-1 4G/4G has to do with the blood clotting system. Everyone has a plasminogen activator inhibitor that is responsible for helping to breakdown blood clots. A person can have PAI-1 5G/5G, PAI-1 4G/5G, or PAI-1 4G/4G mutation (4G/4G being the worst- the one I have). When the PAI is “broken” or “mutated” blood clots that form are not broken down as they should. With pregnant women, this can cause clots in the placenta, cord, or uterine wall, inhibiting effective implantation. MTHFR and PAI 1 4G/4G are a bad combo. MTHFR can be responsible for forming clots - and the PAI 1 4/G/4/G cannot break them down once they are formed. 

Pericentric Chromosome 9 Inversion

Pericentric inversion in heterochromatic region of chromosome 9 (inv[9]) is a common (1–3%) heteromorphism in the general population. Chromosome inversions are a relatively common structural alteration. There are 2 types of inversions. If both breakpoints are on the same side of the centromere, the inversion is paracentric; if they are on both sides of the centromere, then it is pericentric inversion. Pericentric inversion in the heterochromatic region of chromosome 9 has been recognized as a normal variant, generally without phenotypic effect. 




Pretty overwhelming stuff. My doctors and the lab tech, both agreed that they do not think the Chromosome 9 Inversion plays any issue in this. The lab tech stated that they are so common, he see's at least several a day. He also said it's considered a normal variant because the genetic codes are all there and the break point is in the center which leads to no issues. So I am just going to take their word on that and focus more on the blood clotting issues. Man oh man. Now time to figure out a gameplan...