Because I’m special, DAMN IT!!

I’m home.

Sorry I haven’t updated. I’ve been very tired, and, frankly, sad. I’ll explain the sad part, but let me update chronologically.

Insanely early morning flight on Wednesday. Dropped my bags at the hotel and took a cab to the clinic. Short wait, then the u/s tech checked my bladder and said it wasn’t full enough. (I just had to pee when I got off the plane.) Chugged a LOT of water. Definitely full enough, but then the RE was delayed with a hysteroscopy. The tech handed me a small cup and said I could pee just that much. Damn, it’s hard to stop once you start peeing when your bladder is painfully full. Still waiting, so the u/s tech checked me again. “Oh, you’re very full!” Duh! Handed me another cup and said I could fill it 1 ½ times. OY!

Then the RE was ready. Last time we transferred 3 lovely day 2 embryos and I did not get pregnant. This time we decided on 4. They all survived the thaw with all cells intact. Although, honestly, I really don’t think one of them counts, as it was only 1 cell. We transferred a 5 cell, two 4 cell, and the little 1 cell. Then I lay on the table in bladder agony until I could get up to pee. I swear, it felt like I peed for 5 minutes straight. I know it wasn’t really that long, but it sure felt like it.

Why am I feeling sad? At my urging, the RE checked my progesterone levels. Let me preface this by saying that before I started cycling I did a lot of research on the effectiveness of vaginal versus intramuscular progesterone (PIO). Here are a few research articles: one, two, three. My NY RE is adamant about vaginal progesterone being as effective as PIO. When I consulted another top NY RE before cycling and asked him about the research, he agreed with it, but said he prefers PIO because there was a problem several years ago with one brand of vaginal progesterone. So, I felt fairly confident about not needing to stick myself in the ass with a long, large gauge needle. The day of my FET last month I had my levels checked as well, since I had read about the exceptions who do not absorb it well vaginally. It was a bit low, so the RE told me to add more. Progesterone supplements are very important for a FET since there is no corpus luteum (empty egg follicle) producing progesterone. At the time I was using four 200mg capsules up the hooha a day. She had me add an additional three 100mg prometrium pills per day. Also up the hooha. So I was poking progesterone up there SEVEN times a day. We figured that would be enough.

Anyway, as I said, at my request, we checked my levels on Wednesday before I left the clinic. As the last time, I was shoving a lot of progesterone where the sun don’t shine. Shortly after I got back to my hotel I got a call from the RE. My levels sucked. I was so exhausted at this point, but I got in a cab and went back to the clinic for a vial of PIO and some big scary needles. Even though there was no reason to think I wouldn’t absorb vaginal progesterone well, I’m feeling guilt and sadness for the 3 beautiful embies that were transferred last month.

Although I have every reason to be hopeful about this cycle, I’m feeling the failure of the last cycle all over again.

Any tips from self PIOers? A friend used em1a cream. Any thoughts on that? So far I have found it easiest to inject while sitting. Easier to twist around and keep the syringe steady. I have also added 1ovenox (blood thinner) injections this cycle as a precaution, since I have a heterozygous MTHFR gene mutation. This single mutation is generally not thought to cause thrombophilia, but we are being proactive. But because of the 1ovenox, I am much more apt to bruise badly from the big PIO needles. The last couple of nights I used a warm compress on my butt (used the little hotel room coffee maker to heat up water, then poured it over a washcloth), but I think that contributed to the BIG bruise (about 3”x1”) I have on one side. And that’s the side I have to inject again tonight. Damn. I was thinking about trying an ice pack this time. Suggestions please.

So there you have it. Good times.

Let the 2WW insanity begin!