New plan

So by now everyone is aware that our first IVF cycle was not successful. My beta (a test that measures hCG levels in the blood) was less than 0.5 so that indicates that neither embryo ever implanted. My doctor was very surprised that we had such a perfect cycle and then BFN. BFN is an acronym in the infertile community that means "Big F***ing Negative." It's certainly not scientific, but a great description of what we had.

Jonathan and I have decided to move on to another fresh cycle instead of using the frozen embryos we have in storage. Chosing another fresh cycle requires that we sit this month out to allow my ovaries some time to rest from all the hormones. It will also allow us a greater chance of success and possibly more embryos in storage for future siblings if we are lucky enough to get pregnant our next round. It also give all three of us (me, Jonathan, and our doctor) time to regroup and determine the next plan of action.

Bear with me, this next part is hard to explain. It's hard for me to understand and I've been researching it for months......

I have been on Folgard since May of this year, when I was tested for MTHFR (methylene-tetra-hydrofolate-reductase) abnormalities. MTHFR is a gene important to the production of the amino acid homocysteine. Too much homocysteine in the body can increase a person's risk of heart disease and blood clots. I have heterozygous A1298C MTHFR. This means that one copy of my MTHFR gene is normal, and the other is not. Of all the clotting factors to have, mine is the least severe. It's treated with baby aspirin and the Folgard I mentioned above. Folgard is just a prescription strength Folic Acid and B-complex that I will take for the rest of my life.

Now, what do blood clots and vascular problems have to do with pregnancy? A lot actually. When an embryo is trying to implant the uterus, the tiny, microscopic blood vessels must be able to form so that the embryo can grow into a baby. If a microscopic blood clot were to form in one of these vessels, the embryo would be unable to implant and there would be no pregnancy.

Because I have tested positive for a genetic clotting factor, it is likely that there are other factors I would test positive for that have not even been isolated for testing by the scientific community. So my doctor wants to add another medication in the battle against my blood: heparin. Heparin is an anticoagulant used for people with blood clots. It is also used for women with more severe MTHFR abnormalities or who have reccurent miscarriages. Even though it is not typically used for heterozygous A1298C, thinning my blood even more than just the baby aspirin and Folgard already do will reduce the chances of microscopic clots in my uterus even more.

She would also like to put me on steriods after the retrieval for a longer period of time just in case my immune system is trying to attack the embryos. The steriods will suppress my immune system and calm any inflamation that might be present.

There were also some indications last week that my progesterone (the hormone that supports a pregnancy) levels were low. Next cycle we will be supplementing the injections with oral progesterone as well and checking the levels from earlier in my cycle.

There are certainly some risks to the new plan. Jonathan and I have an appointment with our doctor next Wednesday (9/23) and hope to have more information on what exactly those risks are so that we can make a decision. Though the news that we aren't pregnant is heartbreaking, we are very excited that our doctor is already looking ahead and determined to get us a baby! We feel very blessed to have her knowledge and experience to help us along and we are certain that we're in the right place.

Thank you all so very much for all your prayers and well wishes. We have felt very supported and uplifted by all the comments on the blog, facebook, and in person. Please continue to pray for us in this month off. We need patience and wisdom.

I'll be certain to update everyone of what we learn at our appointment next week.

Love,
The Strunks