I Could Really Do Without the Drama April 20, 2005
I called my RE’s office first thing this morning to check on the biopsy result situation. Apparently there was some big brouhaha over my beta 3 integrin results thus the lack of notification.
My results came back negative for the beta 3 integrin. Not a good thing. The report appeared incomplete, however, because of a comment stating “unable to interpret without histological date.” My RE’s office had been trying to get clarification on that from the lab that does the test. They were told that the only person who could help them with that was on vacation until next week.
So, this is what I learned this morning. Needless to say, I was not a happy camper. I was told I would get a call back when they figured everything out, and I set off to scour the internet on the beta 3 subject. It’s not like I hadn’t done any research before the test, but that’s the only thing I could do while waiting for more information. Lack of information drives me insane.
When I hadn’t heard back by early afternoon, I called my RE’s office again. They were finally able to speak to someone at the lab who could explain my results. Before I go into it, there are three possible results for the integrin test:
1. Lining in phase, integrin present
2. Lining in phase, integrin absent
3. Lining out of phase, integrin absent
Option 1 is what you want. I didn’t get that. Option 2 means that your lining has developed how it should, but there’s still no integrin present. That’s the worst case scenario and when you get to break out the 3 month Lupron treatment. Option 3 was me.
Here’s the deal. When the lining is out of sync for whatever reason, there is a very, very good chance that the integrin won’t be present. It’s missing because the lining is out of phase not because of some inherent problem. Thus, there is no result 4 where the lining is out of phase with the integrin present.
Apparently the stroma of my endometrium were maturing way faster than the glandular tissue was, 4 days faster to be exact, resulting in a dyssynchronous endometrium. This, of course, is the most inconclusive result possible. Nothing can be black and white for me apparently.
I did not like hearing this information, but it honestly doesn’t surprise me. This biopsy was done during my first natural cycle since July. It was also done during a 44 day cycle following a chemical pregnancy. Yeah, no wonder my lining was fucked up.
The dyssynchronous lining thing doesn’t bother me so much. The endometrial lining does different things during a medicated vs. natural cycle, so simply doing a medicated cycle could cause everything to sync up. Plus, just because your lining does something one cycle does not mean it will do it the next. The thing that concerns me is that we don’t know if the integrin would be present once my lining gets itself in gear and is in phase. There’s no way to know that without retesting, and even then there’s no guarantee of finding out.
So, now we have to decide what the fuck to do with this information. The way I see it, we basically have two options: do another biopsy to repeat the test or forge ahead with our FET cycle. We haven’t decided yet, but I think I’m leaning in one direction.
I talked to my IVF coordinator about our options, and she said she didn’t feel comfortable giving me advice in this situation. I should hear my RE’s opinion on the matter tomorrow, but quite honestly I doubt her opinion will weigh too heavily in our decision. Not that I don’t want to hear what she has to say on the subject, but it’s quite easy to get someone to say what you want to hear when you know what you’re doing. Plus, she’s really good at being ambiguous. I don’t expect her to have a definitive say on the matter.
I’ve done the research, and I know what I’m dealing with. This is a controversial test with a wide array of opinions as to its applicability. I just don’t know how much weight to give this result. There just hasn’t been enough research done to know how important this whole beta 3 thing is. It’s really hard to make a decision based on scanty information.
This is a tough one. On one hand, I don’t want to waste our embryos on a less than ideal cycle. On the other, I don’t want to waste time and money on something that may not give us any more information or may not even be meaningful to the situation. That’s the problem with dealing with these newfangled tests. Man, I kind of wish we hadn’t done it in the first place.
My other endo biopsy which tests for infection came back fine, so at least there’s some good news. So, it looks like I’ll either be repeating the biopsy this cycle or we’ll be transferring our frozen embryos (assuming they survive the thaw) next week. Anyone want to weigh in?
What a Happy Blogiversary April 19, 2005
I’m pissed. I have been waiting on pins and needles for these damn endometrial biopsy results so I’ll know whether or not this FET is going to happen. Yesterday marked the two week mark, so I really should have heard something.
I finally got antsy enough to call my RE’s office today. I talked to my IVF coordinator this afternoon and was told that neither of the biopsy results were back. She said she would double check with the nurse who handles the incoming lab results and call me if she found out anything. She said that if I didn’t hear back from her to assume that they hadn’t gotten the results.
Well, the phone never rang, so I decided to take things in my own hands and call the lab that does the beta 3 integrin test. I have no idea where the other biopsy sample was sent or I would have been on the phone with them, too. I was told by someone at the lab that my results had been faxed to my RE’s office on Friday. I was also told by the person at the lab that she had actually spoken to two people in my RE’s office today. UGH! I asked if I could get my results over the phone, but that wasn’t happening.
So, now I have to wait until tomorrow to call back my RE’s office to find out the results. Don’t they know how insane I’m going over all of this? This is my information, and I have a right to have it.
After I thought about it a bit, it seemed odd to me that the person at the lab would not only fax the report but also call my RE’s office a few days later. Why would they call? Just to make sure they had received the fax or because my result was abnormal? Plus, why would my IVF coordinator not call me back once she actually got the results? Was it because she was waiting to speak to my RE about them? Shit. I am so freaking paranoid.
At least I know that the result is in. Whether or not I can get my hands on it is another story. So, now I have to keep my fingers crossed that I won’t get bad news tomorrow and also hope that the other biopsy result comes back within the next couple of days.
But please, oh please let that beta 3 biopsy result be normal. Do you know what the treatment for the lack of the beta 3 integrin is? Three whole months of Depo Lupron treatment. Considering my history with Lupron, I don’t think I’d survive 3 months.
Ok, I’m just going to go chill out now. I will know in the morning. Hopefully.
Away We Go Again??? April 10, 2005
My period finally decided to grace me with its presence yesterday on cycle day 44. Boy, that was a freakishly long cycle. So, I’ve started popping Estrace for my maybe FET.
It’s so weird to be possibly starting a cycle. Not because I’m not ready. I’m so ready. It’s just that I honestly don’t know if we’ll make it to transfer this cycle. There’s always a chance of cancellation when it comes to ART cycles. I’m well aware of that. This time, though, there are so many more factors at play that could prevent this cycle from happening.
We’ve got the standard possibilities for cancellation in a FET cycle:
- a stubbornly thin lining
- zero embryos surviving the thaw
Plus some new possibilities thrown into the mix for this cycle:
- ovulation over Estrace
- endo biopsy results not coming back in time
- endo biopsy results coming back showing fucked up results
And we’ve got a couple of new factors at play this time that could increase our chance for cancellation:
- we have slow poke, not so fabulous quality embryos in the deep freeze that have a greater chance of arresting during the thaw
- my body seems to be expelling gray chunks of unknown origin. (don’t even ask. my body is so fucked up.) don’t know if that could affect things, but i’m guessing so.
Add my generally crappy luck to the mix, and I would wager my chance for cancellation is about 72.86%. Ok, I have no idea what the actual chance is, but it’s definitely up there.
So, I’m cycling again I guess. Woo hoo. Sound in the marching band.
Fuck it. This is so not exciting. It’s a maybe cycle. It’s a FET cycle. It’s cycle numero quatro. It’s a cycle with zero chance of ending in happily ever after. This shit sure does get boring after a while.
Happy Day April 4, 2005
Happy days are few and far between, so I’m attempting to savor this one. I survived my big morning of testing. I arrived at my RE’s office, handed over my credit card, and was called to the back. I had to sign some consent form that I didn’t read, because really, would I not have gone through with it because of anything that form could have said? Then I was told to go pee in a cup. I knew what that was for. I literally said, “You’ve got to be kidding me.” Hello, my husband has no sperm. I have a 0% chance of being pregnant. Even if it was possible, a urine pregnancy test at 8 days past ovulation can’t be too accurate. What a waste of pee.
Anyway, I got gowned up and talked to my RE about everything while the anesthesiologist was sticking me with the IV. I went into the procedure room and don’t remember another thing, just the way I like it. Apparently, my RE was able to get the big endo biopsy catheter up through my bitch of a cervix, but it wasn’t easy. Not that anyone expected it to be. She dilated my cervix, messed with the catheter, and finally got it to make its way up to where it was supposed to be. After the biopsy samples were taken the sonohystogram was done. Everything looked good. No fibroids, polyps, etc.
I spoke to my RE about FET protocols. I really don’t want to do the whole BCP/Lupron/Estrace/PIO thing again. Not only does that take freaking forever, but my lining did not do so well last time on that protocol. Plus, there’s the fact that it didn’t work. I really don’t think it’s the best idea to do the exact same thing twice if it didn’t work the first time. So, I told my RE that I wanted to do a Estrace/PIO only protocol. She gave me the “We don’t usually do that protocol, and it may not work” speech, but she’s going to let me do it. I’ve come to learn that my RE is a cookie cutter protocol type gal which is fine if you’re a cookie cutter type patient. I, however, am not. I think it’s about time to start thinking outside the box at least a tad.
So, here’s the plan. Oh, how I love a plan. I’ll be starting Estrace on cycle day 1 which should be soon. Then I’ll cross my fingers that I don’t get canceled. That could happen for any of the three following reasons:
1. I ovulate on Estrace. This only happens about 5% of the time, but we all know my luck.
2. The endo biopsy results aren’t back by CD15, the day I’ll most likely be starting PIO to prepare for transfer.
3. The biopsy results come back but one or both are abnormal, and as a result I have to have further treatment before cycling again.
I see no reason not to go ahead with the prep for the FET cycle, though. If I get canceled for any reason I can just stop the Estrace and either wait for the next cycle or go forward with any treatment with regards to the endo biopsy results. At least this way I’ll be doing something. That always makes me feel better. Who knows, I may get lucky and actually get to transfer at the end of the month. Oh, I crack myself up. I’ll either get canceled or none of the embryos will survive the thaw. That’s more my style.
Anyway, it’s been a good day considering the fact that I had crap shoved up my hoo ha. Just the thought of being able to cycle again has temporarily removed the usual scowl from my face. And knowing that WE’RE FINALLY DONE WITH ALL OF THIS TESTING is enough to make me want to do a little dance. Oh, happy day.
« newer posts