Early Pregnancy Symptoms and Big Fat Positives
Stage IV Endo, BFP with 3rd IVF
I have never posted anything online but I realized how much this site brought me hope during some difficult times that I thought it would be selfish not to do the same for someone else. I’ve provided as much information as possible because I liked knowing the details but consequently this is a long post. To give a little bit of background, I am 33 years old and was diagnosed with stage IV endometriosis when I was 30. At the time of my diagnosis, my father was dying of ALS, I had just gotten married, and I started experiencing abdominal pain (needless to say it was a high stress time which I believe exacerbated my endo). After testing and laproscopic surgery, endo was confirmed. As much endo tissue was removed as possible, my ovaries were put back in their proper position, and my tubes were cleared. At my 6-week follow-up with my surgeon, I expressed that I wanted to start a family (I had just gotten married) and he immediately sent in the fertility specialist at the hospital. I knew from previous research that endo can make conceiving difficult and I wanted to start the process as soon as possible. During that apt, the fertility specialist ordered another HSG just to confirm my fallopian tubes were still clear post-surgery, along with blood work to assess my ovarian egg reserve and whether I was ovulating or not. Turns out both tubes were clear at that point, my AMH (egg reserve) level was good (I can’t remember the number), and I was ovulating. We decided to do a round of IUI. Two follicles grew well and my husband’s sperm count was excellent. We were not successful. During the two week wait, I interviewed for a new job and was offered the position. Because I was starting a new job, I asked my specialist if I could wait three months before proceeding – she agreed. As the end of the three month mark approached, I called the case manager I was assigned and said that I had been experiencing some bad pain and thought another HSG should be performed before doing another round of IUI. Turns out both of my tubes were blocked. I live in Canada and our healthcare system allows for three paid rounds of IVF with bi-lateral blocked tubes and our insurance company paid for our medication. Two months later I stared my first round of IVF:
Day 1 of period started birth control pill
Day 18 of pill, went for ultrasound to ensure everything was calm with no cysts from using the pill. Brown spotting within a week of being on the pill until it was time for meds. Stopped pill that day and waited for my period
Day 3 of period stared 150 Puregon, 75 Menopur (did this for two days)
Added Femara 5mg on day 3 of injections to control the estradiol in my blood to help reduce the inflammation of endometriosis, along with Puregon and Menopur
Started Orgalutron 250 units on day 5 of stim meds to prevent ovulation
Used stim meds for 10 days. Injected Ovidrel on the night of day 10
18 eggs retrieved, 11 mature. ICSI used to inject sperm. Six eggs fertilized normally
Two embryos transferred on day 3, 1 six cells and 1 eight cells but not the greatest quality. None made it to freezing.
Prometrium, 600 mg vaginally
AF arrived on Day 13
BFN, Beta of 7 on day 16
After the first round was not successful, my specialist recommended that I go on Depot Lupron for a maximum of 6 months to calm the environment and stop the endometriosis from growing. We decided on five months and they were not easy but I knew it would be worth it (hot flashes, painful sex from lack of lubrication, and mental fog). We started our second round in October. My specialist added Omnitrope to the medication mix and switched out Puregon and Menopur for Luveris and Gonal F. Omnitrope was not covered by our insurance and cost ~$1,100. I also had a uterine scratch prior to my period starting. My embryo quality was much better this round and we made it to a Day 5 transfer with an advanced morula and an almost morula. However, once again, BFN, with no beta level detected:
Gonal F 200
Femara 2.5 mg starting on day 2 of injections until trigger shot
Orgalutran 250 starting on day 5 of stims
10 eggs retrieved, 7 injected by ICSI, 6 fertilized normally, none made it to freezing
AF showed on day 13
BFN, no beta
Prometrium, 600 mg vaginally
For my final covered round of IVF, I did some things differently. I was back on Lupron for three months. Even though I didn’t feel great, I forced myself to workout at least three days per week (I was always in good shape with a healthy BMI but during my last time on Lupron, I just didn’t have the energy). Two months before the start of the next cycle I started going to acupuncture once a week to help prepare my body for the next round. I started using the clinic’s counselling services to process what I was going through to ensure there wasn’t any emotional baggage that could be stopping this from succeeding. I have a friend who is a naturopath and I started on two homeopathic remedies (one to prep my uterus and one to cleanse my liver). During the three month period I took 3mg of melatonin at night but stopped during stim phase. This apparently can help with egg quality. I started eating organic, including organic meat. During my stim phase, I visited an Osteopath twice. On my third and last shot of Lupron, my specialist did another uterine scratch. This time it hurt so much but I left the office thinking it was going to really help. This time, my specialist did not wait for my period to start but had me come in three weeks after my last Lupron shot for an U/S and bloodwork to make sure everything was quiet inside. Everything looked good and I started my injections. I was happy about this decision because periods are never fun for me. My Luveris medication dosage was increased from 200 to 250 and my follicles were maturing at a good pace. I continued acupuncture three days a week during the stim phase. We continued to use Omnitrope as well. I stimmed for 12 days instead of the usual 10 mainly because I started from a suppressed state being on Lupron. It took a little longer but they grew slowly and consistently. Thirteen mature eggs were injected and ten fertilized normally. What I had learned from the last two rounds is that my embryos don’t really like the petri dish. Because I had a beta reading (albeit small) on round one and none of round two with a five day transfer, the embryologist and specialist agreed we should transfer the top two embryos on day 3 (even though they were good enough to wait until day 5).
On transfer day, I went to acupuncture after the transfer and went to a movie that night. I continued to go to acupuncture throughout the two week period to help keep cortisol levels low and help me relax. This time during my two week wait, I went to lunch with friends, booked a facial, popped into work, etc. I didn’t just sit still at home. The biggest difference this time is that on day 8, I experienced period like cramping but it felt like it did when I was younger and before my endo (more like a warm uncomfortable feeling but not painful). My acupuncturist had told me that the only symptom that seemed to be consistent among those who conceived was that cramping would be fleeting. In other words, it would last for a day or so and then be gone the next day. To my surprise, the very next day I felt totally normal and actually put on a pair of tight jeans. Then, on DPO 11, I experienced cramping and it was painful. I started doubting myself because of how uncomfortable I was. Again, the next day I felt fine. In my previous rounds my period started on DPO 13 by 2pm. This round, I felt very bloated on day 13 but no sign of my period and for once, no period like cramping. Also, I had no breast pain throughout the entire two week wait even while on high doses of Prometrium. DPO 14, still no sign of my period but I felt very bloated and my breasts started to hurt. I was bloated for quite some time and it was uncomfortable because my ovaries were still really large from the stim meds and pregnancy hormone can make them even bigger. I also started getting incredibly hungry. I started getting up at 4am and eating a full plate of leftovers, going back to bed and getting back up at 7am for breakfast. I had a metal taste in my mouth one morning when I woke up on DPO 8 that didn’t last long. I had no spotting and I could not see the veins on my breasts. I wasn’t nauseous until around 6 weeks pregnant.
Gonal F 200
Omnitrope 3.33 starting on day 4 of meds
Orgalutron 250 starting on day 5 of meds
Ovidrel on day 12 of meds
24 eggs retrieved, 13 injected with ICSI, 10 fertilized normally
Transferred one 8 cell top quality and one 8 cell good quality, none made it to freezing (the specialist on call that day even mentioned that we had some good looking embryos)
Prometrium, 600 mg vaginally (200 mg three times a day)
BFP, Beta 468 on Day 16
I never kept any pregnancy tests in the house and was too nervous to buy any. I asked my case manager if I could come on DPO 16 instead of their recommended DPO 18 because day 18 fell on a Sunday and I didn’t want to get up super early for testing. I got the call by 11am on Day 16 telling me I was pregnant and that the beta was high enough that I didn’t need to come back for further bloodwork (468; the clinic likes a level of 200 on day 18 so I was well above). My ultrasound was booked for 45 days later at which point I got to see the single heartbeat. I am now 27 weeks and the baby is healthy. Because I have endo, when my belly has a growth spurt, I have been in some intense pain (I mean on my hands and knees with tears streaming down my face). But each time I knew it was growing pains which meant the baby was doing well. I always preferred reading the list of symptoms by DPO but there really weren't any other than on DPO 8.
Needless to say, the stakes were high this round but I felt a calm I had never before. I did research egg donation which helped me realize there were other ways to conceive to help decrease the anxiety I felt and it did help. I also believe trusting my instinct to transfer on Day 3 regardless of how good the embryos were made a huge difference, along with the uterine scratch. Who knows what else played a role or perhaps it all worked in combination. This is a horrible process and it is impossible to relax; however it can happen and I wish you all the best!