"Now and then it's good to pause in our pursuit of happiness and just be happy. "

14 August 2010

Plans A, B & C

Can you still call it a plan A if you've already tried and failed at other attempts? If you have already exhausted plan A, B and C? Ok, so maybe its plan D, E and F... Whatever it is, we've got PLANS!!!

Over the past month or so, we've poured (ok, I... who am I kidding.. I've poured) over test results and research and second and third opinions. I've had countless vials of blood drawn. I've schemed to get as many of the tests covered as I possibly can by my insurance and I've spent way too many hours on the internet consulting Dr. Google. With all this information, I've even created a spreadsheet of possible causes, issues and next steps (maybe I'll add it to this post later...) And from this, a path, not necessarily clear, but a path nonetheless has formed. And I'm very excited to get back on the trail.

So here's the plan(s)....

Plan A: Metformin. One additional thing that came out of all of these blood tests other than the immune results, is that it seems as though I'm insulin resistant, which simply means that my body's cells do not process the signals from insulin properly and it needs more than the average person to get the point. Because of this, many things can happen in women, including PCOS, weight gain, among others... luckily I don't have those, but I do have hormone imbalances that are shown by adult acne (yuck) and oilier than average skin along with spotting before my period and throw in some anxiety for good measure. All of these things are signs that my hormones aren't working quite right. So Metformin, along with exercise and a low gylcemic index diet, helps your body re-sensitize itself to insulin. Then, the hope  is that the female hormone system should go back into balance. There's also lots of evidence showing insulin resistance is highly correlated with inflammation (not sure which causes which, but they occur very often together) and thus an explanation for implantation failure. So I started Metformin yesterday, as a pill at mealtimes, and I'l be on that indefinitely.

Plan B: I'm pre-screened to be in a FREE IVF study!!! Yippee! Its not the ideal protocol for me (too technical to get into here), but its a FREE cycle. So I'm going to attempt to make it through to transfer. Because it is a study being sponsored by a pharmaceutical company, I have to quite a few different hoops to jump through, the first of which is a final screening consultation with one of the REs running the study, which is occurring on August 27th. After that, if I pass certain blood tests, I will then be able to start taking meds and growing eggs and hopefully if I grow enough, I will make it to retrieval and we can try another transfer!!!

While I am excited about this study, I'm also cautious because 1) the FSH dose is lower than I've been on with my other two IVF cycles, so I won't make as many eggs and 2) there will not be anything else allowed into my body for help with the potential immune issues that I have. But its a free cycle and I might as well give it a shot, right?

Then, if neither of those work,... Plan C: We're going to try (and have to pay for :-( ) one last IVF cycle here with my local RE... with 2 twists...1) We'll add in some meds to help with the potential immune issues to aid implantation, and 2) we're hoping that we make enough good quality embryos to transfer into both me AND a gestational carrier (more on this in a later post)... AT THE SAME TIME!!! eep!

My thoughts behind this double transfer are as follows: We don't have endless amounts of money to continue with IVF cycle after IVF cycle. We're fortunate to be able to think about affording one more, however, we have to draw the line somewhere. Also, if we do use a GC, I'd like to be able to transfer a fresh embryo, rather than frozen, because the odds of implantation and a successful pregnancy are increased, thus being more cost effective. And finally, I want to at try some of the immune interventions at least once for me, but we simply can't afford to do 2 more IVF cycles, especially if we are going to pay more for a surrogate in the end... So I think that this double transfer is the most cost effective and highest probability of success in one shot. And yes, we would be THRILLED to have "twins"

I'm so excited to have a plan back in place. I feel at peace again and am more hopeful that I've been in a while. It worries me of course that the peace is really just a false sense of hope, because I'm putting up another wall or two in front of my future. But I find comfort in these walls.

And I'm going to need that comfort because this fall is going to be a wild ride! Get ready....


  1. I just got caught up on your journey since your last round of testing. SO glad you finally got some answers. When we found out about our chromosome issues, I remember feeling so relieved because we knew WHY things weren't working, but shortly thereafter, the relief went away and we had to deal with this new reality and what we were going to do to combat these new issues. The good news is you have information and you have a gameplan!! AND you feel good about that plan! Can't wait to hear how everything goes! Wishing you the best!!

  2. How wonderful to have plans. :-) I'hope you can get into the free trial though; a free cycle would be great!

  3. I took Metformin too - hope it helps you! If you are insulin-resistant you are more likely to develop gestational diabetes so make sure to get tested early when you do get pregnant. I have it and there is some effort that goes into managing it. I may go back on Metformin afterwards also, and I believe it helped me.

  4. Wonderful plan! It makes absolute sense to me and I know the relief of FINALLY having a plan and feeling excited or at least at peace about it.