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10/19

 It's been a long time. I have a lot to update on. 

A couple weeks ago, we had another consult with the RE. Basically, we determined that we wanted to move forward with IVF. With my history of miscarriages, one being confirmed to be a chromosomal issue and another likely was, we determined we would rather use IVF than continue trying on our own. 

She briefly went over what would come - I would start an estrogen priming cycle first, with estrogen patches after monitoring ovulation. Then, I would start stimulation medications in my next cycle, then move on to the egg retrieval, PGT-A testing, and hopefully transfer. It was a lot, but it felt good to have a plan besides "wait and see" and "keep trying" and "it's normal."

I also found out that my biopsy result from the hysteroscopy came back, with some rare plasma cells. I started being treated for chronic endometritis with an antibiotic. Thankfully I was reassured this won't affect anything with my IVF plan moving forward.

My husband also had his bloodwork done, as well as a sperm DNA fragmentation test. The results shouldn't impact my plan, but my doctor said they may make adjustments if they learn there is a large amount of fragmentation. But, I believe we should get the results relatively soon. 

About a week ago, I also had a virtual zoom meeting with a nurse practitioner. I wasn't sure what to expect, but it was actually very helpful. She went over all my plan details with me and explained everything to me. 

Basically, I went in the next day after the consult because I had started my period, and I needed a baseline ultrasound and bloodwork to make sure my body is starting off correctly with everything. I also started monitoring my ovulation and need to let them know when I ovulate. The doctor will then want to see me to confirm it, and then let me know when to start using the estrogen patches. I was stressed because initially my insurance wouldn't cover them, but the pharmacy was able to fix it. 

Then, she said when I get my next period in early November, my doctor will want to see me for another baseline ultrasound and bloodwork. After that appointment, they will direct me on when to start my injections. She said it will likely be 2 a day as well as oral medication Clomid. She said I will choose an evening time to take these for 8-14 days, and I will have bloodwork and ultrasounds about every other day to monitor the progress and make any adjustments needed. I need to come in between 7 and 9:45 in the morning. 

My egg retrieval will likely be in mid November. I will only know about 2 days in advance when it will be. Before the egg retrieval, I will have to give probably 2 trigger shots at a specific time. The procedure will be IV anesthesia, and I will go home knowing how many eggs they got. My husband will have to provide a fresh sperm sample, and I won't be able to work that day. 

The lab will see which eggs are mature enough to try and fertilize, and we will get fertilization results the next day. Then, we wait for eggs to mature before biopsying them and PGT-A testing them for chromosomal issues. The eggs will have to be frozen after the biopsy. The testing will take 2-3 weeks. 

My medications will be ordered from a specialty pharmacy to be delivered at home which seems wild.

She warned me of some risks like OHSS, told me to stop sex once I started the injections, limit lifting and stop alcohol as well. 

I appreciated her going over everything for me so clearly.

My ultrasound and bloodwork looked good, and everything began after that. I am currently ovulation testing, and haven't ovulated yet. I also set up a meeting with my superintendent to let her know what is going on. I am hoping she will be understanding. and accommodating especially with the amount of appointments I will need. However, after doing a test one the other day and taking off work, I think I would be able to get an appointment at 7:45, and get to work around 8:30 (8:45 or 9:00 at the latest). I am hoping I won't need to take off the full morning for those. 

I am just nervous because the odds have not been in my favor on any of this so far. 1 in 4 pregnancies end in miscarriage - 3 of my 4 have. 1 in 6 couples experience infertility. and 1 in 100 experience recurrent miscarriages. I am ALL of these. I am hopeful, but it makes me feel very hesitant. 

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