Time to cross the fingers.
Took the last Provera pill yesterday and so we’re now waiting for my period to begin, hoping that did the trick so that I can finally get crackin’. By Monday I should be starting the mock cycle of delestrogen injections every 3rd day, getting my Endometrial Receptivity biopsy (ERA) scheduled – nothing like working injections around doctor’s office schedules around the holidays, eh? – and thereby knowing when to start PIO injections as well.
Here’s a few interesting things I have come to realize after so many cycles when it comes to failed implantation:
- Traditional protocol is to take progesterone for 5 days preceding one’s embryo transfer. Looking back at my online calendars, transfer day was on that 6th day, BUT I was doing my PIO shots in the morning as per my RE’s instruction, and that means I actually had 6 progesterone shots before transfer. Does this mean we may have technically been doing the transfer a day late for the average uterus?
- Along with the above, three out of the four unsuccessful transfers were done late in the day on that 6th day (usually 4-5pm), giving that 6th PIO shot many more hours to absorb. The first transfer and the 4th “successful” (miscarriage @ 9 weeks) transfer were done in the morning. Knowing there is only a 12 hour window for implantation, could this have made the difference? Could I have gotten pregnant on cycle 4 only because it was in the final minutes of the 12 hour window? Could my transfers have occurred when I was post-receptive?
- And it seems knowledge of the Matris Ultrasound, a non-biopsy version of the ERA (i.e., totally painless), is few and far between beyond a couple of bloggers and forum participants. My own RE had never heard of it and the website sadly doesn’t say who uses it (grrr). What a bummer – fertility clinics could make a killing off this test (not to mention increase their success rates), right? Or I suppose they’re profiting more off of multiple failed IVFs, ugh…
Food for thought, for sure. I chatted with my RE yesterday and while I didn’t mention the above, I did ask him if I could do PIO shots at night like I do with Delestrogen, and he said that would be fine. I primarily wanted that to happen because it’s more convenient with my husband’s schedule (hey, I’d rather go into his work and have the shot in the back room at 8pm when he has late shifts compared to getting up at 5am before his early shifts), but thinking about the finer points of my cycles and medication timing, this would mean on the biopsy day I’ll only have had 5 PIO shots injcted into me, rather than 6.
Who knows, with this and – fina-fucking-ly – a perfect thyroid TSH (and hopefully improved antibodies numbers, which we’ll test again in a few weeks), perhaps this final attempt will give us what we have longed for for so long. It’s hard to be optimistic, but I’ll be giving this last cycle my pure, honest and positive attention. I have researched everything. I have gotten my thyroid down to normal levels. I have gotten second opinions, I have changed some of my providers, I have returned to others. I have gone down every avenue, from IUI two ways to donor egg IVF five times which led to the loss of our baby in August at the fourth attempt, to foster/adopt to international adoption to domestic adoption.
This final round? I need to do this for me. And then, no matter what, the chapter of bringing life into my womb? It will be whatever it is meant to be.