Wednesday, August 5, 2009

WWYD??

So, I am nearing the end of my first Lovenox cycle.

Just as a quick update for any new readers (welcome, new readers!), I was diagnosed in March with the MTHFR compound heterozygous gene mutations, and then with some further testing in May, discovered a handful of other blood clotting factors including PAI-1 4G heterozygous, and a couple of APAs, etc. (I still don't completely understand it all.) What I do understand is that blood clotting factors are usually only tested for in women with recurrent miscarriages, to see if this is the cause of their losses. When someone has a blood clotting factor (or several, because they tend to go hand-in-hand), the blood flow from the uterus to the developing embryo is compromised, and implantation is weak or impossible.

Well, it is the theory of some of the top Reproductive Immunologists out there that these clotting factors can also wreak havoc for women with infertility- women who have never had a miscarriage (that they know of). By forming clots very early on, the embryo has nowhere TO implant, and is then just washed out with the monthly period. Of course, there is no way to prove this theory, since you can't prove that a woman is conceiving and just not implanting. BUT, their treatment success speaks for itself, in my opinion.

Because I do tend toward clotty periods, and I had a hard time believing that I have never conceived in 36 months of TTC, I went ahead and started trying a treatment protocol used by these RIs for women in whom they suspect implantation failure. I began taking 40 mgs of Lovenox injections (a blood thinner) every day, starting on CD 6. This is along with daily baby aspirin, fish oil, and a prenatal vitamin which helps my body absorb more methylfolate (another side effect to MTHFR).

And now, I am on P+12, or 12dpo, in that first Lovenox cycle.

I have not taken an hpt in a very long time. I usually don't/won't test unless I am late or spotting (premenstrual spotting isn't normal for me).

But if I suspect early implantation failure, I'm thinking it would behoove me to test BEFORE I expect my next period. Like, 13dpo or so.

I am scared. to. death.

The last thing I need right now, after the news of my SIL is to see a stark white NEGATIVE hpt. A BFN is much more offensive, in my opinion, than AF.

So here's my question. What would you do? (I would ask, "What would Jesus do?" except I really don't think He ever found Himself in this kind of situation...)

Oh, and in case you were wondering, I have zero symptoms. Just the same sore bbs and fatigue I get every cycle.

This sucks.

16 comments:

Just Another Day In Paradise said...

I think you should get a beta done as soon as your doctor would allow. If you are having implantation failure, that is importnat knowledge to have. Have you ever asked your RE about intralipids? Check out www.haveababy.com or check out my blog for some info.

Praying for Hope said...

Wait a cycle? If you're still feeling a little raw from your SIL's announcement, don't test until the next cycle. Give yourself a little time to work yourself up to a potential BFN. A BFN certainly isn't guaranteed, of course, but you know what I mean. That's probably what I'd do.

This_Cross_I_Embrace said...

Thank you for your advice. JADIP, I think Intralipids will be my next step if Lovenox alone doesn't cut it. (I will need to get this from the Sher Institute, tho, since Dr. Kwak-Kim doesn't Rx Intralipids. I just can't afford IVIG, right now. Sher is where I got all my immune testing done, and surprisingly, they told me I was "fine" and that my clotting factors (found elsewhere) were no big deal. Probably b/c I wasn't going to do IVF and give them a crapload of $$. So, while I don't think they are the best Drs for me, I will absolutely "use" them for what I need them for when/if the time comes!)

Sew said...

I guess I am a glutton for punishment. But I say go and pee on a stick. How long are your luteal phases usually.

It wasn't until P+14ish that I started having symptoms. Except for the exhaustion a couple of days after my last HCG shot.

Are you cramping?

Just Another Day In Paradise said...

I "use" them as well :) If you happen to be in the chicago area, or even if not, you could check out dr. coulam, i didnt like her staff but i have heard good things about her

inallthingsgood said...

I totally understand you on the pain of the BFN. I feel like the darn test is mocking me; I prefer to wait and get my period like normal.
But if it could help you diagnose, that would be fantastic!
But I wonder, could it really help you diagnose? I thought HPTs detected the hormone that surges during implantation... is that right? So if implantation is the problem, would it even detect? I don't know.

Mrs. Mike said...

I'm a little dense and not sure I understand. If you do get a +HPT now, is there anything they can do if they suspect an implantation failure? Or would testing for the possibility of a +HPT be chiefly for the purpose of gaining information you would use to help your RI's illustrate/prove that MTHFR is also and infertility issue?

I suppose if it's the latter, I'd personally be inclined to take an HPT not just now, but every cycle.

BUT...all that said, if this particular cycle is just a little too raw on account of your SIL's recent news, I'd hold off. It's not an easy decision, but I'll pray for your discernment, I promise.

How long are your post-peak phases normally? Is Peak +12 late at all for you?

the misfit said...

Wow, that's really tough. I completely agree that AF is better than those rotten tests. At least with AF I can console myself that I am (a) realistic and (b) patient (though neither of these things is really true - I'm just once burned, twice shy. Or maybe a dozen times burned. You get the idea).

So ordinarily I exhort others to avoid the hpts, to enjoy the modicum of peace in that that I've found. But I absolutely agree with your point about needing to see the results. Here's what I might do (if I could find hpts cheaply). You could tell yourself that you will test in x pattern every cycle you're on this treatment regimen (i.e., I will test FMU on p+12-15 every cycle unless I am already in my next cycle), and just write the results down on your chart? That way you're gathering data (like with an opk), not playing he-loves-me-not, which will make you crazy. Would that work?

This_Cross_I_Embrace said...

Hmmm... misfit, I like that idea! Gathering data! That could work!

I don't think I explained it well enough, about why I think I should test. It's more for checking as early as I can for the results of this treatment protocol, rather than trying to diagnose something. (There is no way to diagnose implantation FAILURE. You can diagnose chemical pregnancies, but that's not what I've been experiencing.)

So, since starting Lovenox, I just want to see if it works, and it'd be good to know as SOON as it works, because then I can keep on top of other issues that may arise like progesterone levels... possibly increase my Lovenox dose, etc.

Does that make more sense?

Thank you all for the prayers and advice... I'm still not really wanting to test, but I *may* tomorrow... or Friday if I chicken out.

Tridentine Wife said...

I am a notorious HPT so my answer would obviously be to test, but if you're nervous about seeing a BFN, wait it out as long as you can. I'm curious to see the miracles of lovenox!

Ann said...

Will your dr. give you an early beta on a routine basis? Mine does b/c he like to monitor the P4. If not, I'd honestly POAS, BUT I am different. I'd rather see the line before AF comes. Given your preference at seeing AF instead of a line & the situation with SIL, you might want to wait & see if AF comes.

The RI's theories make sense to me. Your approach on these new meds sounds promising.

As for the symptoms, I really don't put stock into those that early in PGy. My only early symptoms ever were sore boobs which I have anyway pre-AF. It wasn't until after 14-15 dpo that the symptoms really increased. I know everyone is different, but that was my experience.

Thanks for the run down. I do enjoy your blog. Best of luck!

JellyBelly said...

Don't test until peak + 15. Or even peak + 16. HBTs are expensive. I wouldn't test any sooner.

Hugs!

Leila said...

Where I live (Arizona), the dollar stores sell HPTs, so it is very cheap. And they are just as accurate (I know from much experience). Check your dollar stores! Crazy that I bought my last few tests for $1 each, yet next door at the drug store they would cost from $10 to $20 each! Different brands, true, but same exact chemicals and results.

God bless you all.

Sew said...

test and while you are waiting for the test results take off the word verification! Love ya!

Sarah said...

Hey, you! Sorry about your SIL. I know how you feel about testing, so I don't know what to tell you there! Just know that I am always praying for you, have my fingers perpetually crossed, and I MISS YOU TONS!!!

lowly said...

I would like to say wait...but honestly I wouldn't have the will power myself.
I pray pray pray this is it for you!