But Wait, There’s More Testing!

To pick up where I left off after our IVF Consultation, we had a list of things to take care of. Here’s what was on the docket:

  1. Standard repeat labs for me
  2. Blood pressure issues for me
  3. Genetic testing for both of us
  4. Birth control on CD1 for me

Yes, you read that right – birth control. I’ll explain more in just a bit. 

I want to give a little background on why we did genetic testing as it isn’t always mandatory. It was an easy decision for us though as Dr. F recommended it as we had five failed IUIs and because we wanted to know what we would be up against. Sweet Jeremy took one for the team during our IVF Consultation and said, with a smile, “She’s going to go through a lot so I’ll go first for the genetic testing!” Uhhh…thanks? The genetic test we did was the Myriad Foresight Carrier Screen which looks for over 175 diseases. To break it down, we wanted our results to come back showing we didn’t overlap on any diseases. If we did match, we would have a 25% chance of passing it onto our child(ren). 

Anyway, Jeremy went first and arrived at the clinic on the morning of November 4th while I was at having my standard labs retested at LabCorp, my favorite thing to do on a Monday morning at 7am. A few days later, my phone rang and it was Dr. F. It’s totally normal for him to call so I wasn’t suspecting anything other than a reminder that it was my turn to do the genetic screening. Nope. “I’m a little concerned about your thyroid levels so I’m going to have Crystal draw for those as well when you’re in for your screening.” Okay…. cool, something else to worry about. So, my turn rolled around on November 14, shaking like a leaf, I nervously walked in as I had never had Crystal draw by blood before but how bad could it be, right? One quick stick and I was done, I didn’t feel a thing, and I officially casted my vote for Crystal as the world’s best phlebotomist! 

Once all of our blood tests were done, I was headed to my primary care doctor to discuss my blood pressure issues. This shouldn’t come as a shock knowing how nervous I get at every single doctor’s appointment. Dr. F had expressed his concerns oh my high blood pressure and anesthesia for our IVF retrieval. To prepare for this appointment, I purchased a blood pressure cuff and took my BP three times a day for a week so I had plenty of back-up to defend myself that I don’t have high blood pressure all the time. Long appointment made short, my PCP put me on Methyldopa to take before appointments. Easy enough, I could live with that! *Methyldopa is safe for pregnancy.

Back to yet another brutal waiting period for our test results (which didn’t help my blood pressure issues), we knew just how to celebrate – with birth control! (Did you sense my sarcasm there?) We were out of town for our nephew’s 4th birthday party so we stayed overnight in a hotel with my mom (separate rooms, of course). And on Sunday, November 18 I woke up to CD1. But this time was different, CD1 really hit me (emotionally and physically). I, yet again, was holding onto the tiniest bit of hope that I would magically be pregnant on our own. Everything was so scary and real all of a sudden. Crying my eyes out in our hotel bathroom at 7 am knowing that after two years and five months, I was going back on birth control the next night. Fast forward to the next night: maybe it was because a few years had passed or I was just in a totally different headspace and having been through so much else already, but I felt no side effects to the pill I was put on. Which was a good thing because little did I know, I would be on it longer than anticipated.

To make this wait even worse, I received another phone call from Dr. F in the middle of the day on November 19 and it went like this.

Dr. F: Kate?
Me: Dr. F?
Dr. F: How are. You?
Me: Fine. Did you call to wish us a happy one year anniversary of becoming your patients?
Dr. F: Well, happy anniversary but no, I received your thyroid results and called to let you know I’m diagnosing you with Hashimoto’s Thyroiditis.
Me: Mmmmmkay. (insert eye roll)

Dr. F let me that all would be okay but I did need to lower my number substantially to be considered safe for pregnancy. *Backtracking for a moment, when I had my standard labs repeated on November 4, my TSH was 3.880, pretty elevated. Then 10 days later, my TSH was even higher at 4.52 – whoa! For context, “safe for pregnancy” meant anywhere between 1 and 2, so I had quite a ways to go. The gist of our call was that I was being prescribed Synthroid in 0.05mg to take nightly.

After a few anxious weeks, we finally received our genetic screening results and we didn’t match on anything, which was great news! We learned that I am a carrier of Congenital Adrenal Hyperplasia which was no surprise because of my PCOS. Being that CAH affects the body’s adrenal glands, my body is unable to produce cortisol and aldosterone, causing a hormonal imbalance. (CAH is also known as 21-Hydroxylase-Deficient.) The side effects are pretty on-par with PCOS: abnormal cycles, acne, facial hair and yep, you guessed it… infertility. Jeremy is a carrier of Primary Hyperoxaluria Type 3, making him more at risk for kidney stones, and Autoimmune Polyglandular Syndrome, an inherited disease where the body’s immune system attacks healthy cells mainly of the glands that produce hormones.

With that good news, it was time to move onto the final test on our list (for now), one I was way more worried about. This time I was up for a SIS, saline infusion sonography, (or SHG, sonohysterogram) is a transvaginal ultrasound where saline is injected into the uterine cavity to look for abnormalities.

SIS tools from left to right: plunger for saline inserted into the catheter; catheter; betadine antiseptic solution; world’s largest cotton swabs

This is different from the HSG I had done last May, as the HSG looks at the fallopian tubes and the SIS looks at the uterine cavity. Of course, I questioned how painful this would be. Dr. F reassured me it would be similar to an IUI and nowhere near as painful as my HSG. I was really trusting him on this one but I had to take to this question to the trusty infertility community on social media as I knew they could reassure me further (or freak me out, which is always a strong possibility).You’ll often hear a SIS referred to as a mock transfer, more about that in a minute. 

The excitement of the holiday season and Thanksgiving just a few days away was put on the back burner because we were headed to the clinic on the morning of November 26 for my SIS followed by an appointment with our IVF Coordinator, Susan, to go over everything you can imagine. But first, we greeted the girls and Dr. F with donuts from our favorite local place, Donnie’s Donuts! (The maple bacon is always a huge hit!) To begin our appointment, I refused to get on the scale as I woke up that morning at my lowest weight in years, and luckily Crystal took my word for it! I’ll take any small victory. *side note: I saved my donut until after our appointment to not alter the scale at all.* You know the drill: vitals, empty my bladder, undress from the waist down, put on my Happy Ovary socks, anxiously await Dr. F and immediately start questioning everything when he walks in the room. After a quick explanation of the steps and seeing everything laid out, I assumed the position without having to be told to scoot down any further. Was this another small victory for the day? I fully expected my SIS to be at least a 9/10 on the pain scale as everyone said it was nowhere near as bad as an HSG and we all know that was a precise 142/10. But this was simply a tiny pinch from the catheter and a rush of saline and about 60 seconds later, I was done! That was it – I lived. As he was disassembling all of his tools, Dr. F said “Now when it’s time for the real thing, you’ll do great!” Uhhh…..“What real thing? What was this fake thing you just did?” He explained that a SIS is commonly referred to as a mock transfer as it is done the same way, just with an embryo in the tube. So, to put it simply, I was paranoid for no reason and I’ll live through an embryo transfer! A few more questions later and it was time to meet Susan in her office to go over the nitty-gritty.

Walking into her office we were faced with a massive IVF folder. 96 pages to be exact. While we went over everything that day from the basics of IVF to medication mixing and administering, pricing and contracts, it was clear that we would need to do more reading and took our packet home with us. We were also able to practice drawing up and injecting medications (on a stress ball) which was super helpful although we knew we had a few weeks to go.

At the end of our appointment, Susan gave us a calendar with our start date on December 19! HOLY COW, it was really happening and in less than a month. I knew going into this appointment that 9 days is the average length of time a woman in on stimulation shots, which put my retrieval date right around December 30th, but if you’ve realized anything about our journey it’s that I get way too ahead of myself. So for the time being, we (*I) left with some homework: remain on birth control with my last pill being on December 15 and pray that CD1 was on the 18th so that CD2 lined up perfectly with my first lining check and next appointment on December 19, and order my medications. Here’s a post dedicated to my medications and the pharmacy I used.

Just as we were headed out the door, Susan stopped us and said “Jeremy, we need to repeat your Hepatitis labs. Can we get that real quick?” I don’t think I’ve EVER smiled so big or answered “YES” so quickly for a question that was directed towards me. Jeremy prides himself on not being afraid of anything medical, so this was his time to prove it. I covered my eyes (after grabbing a quick photo to document his bravery) and just a few seconds later, Crystal said he was done. But here’s the real kicker – as we walked to the car, he asked me to drive home as “the bandage was in his way and he couldn’t bend his arm.” He had to be joking, right? Nope, he got in the passenger seat before I could even laugh at the question!

And just like that it was time to celebrate Thanksgiving and to dive deep into our IVF packet, but the very first thing on my list was to eat my salted caramel donut (the Seabreeze) followed by a nice long nap!