Vitamin D and Confusion

So, I went for my check up with my OB/GYN last week.  He said that all the blood test results from the RE (gotta love when Mom and Dad argue in front of the kids) were “nonspecific” and “typically no big deal” and that he would only recommend that I take a low dose aspirin (81 mg) every day while pregnant.  He said it seemed to him that one of the results (the lupus anti-coagulant) showed that my real problem is inflammation, not anything to do with blood clotting disorders.  He said that he’d like to know more about my inflammation (low Vit D is linked to high inflammation) and would just rule out blood clotting issues.

And, you ladies who have gone through infertility and identifying its cause(s) know what came next:  another needle stick for yet MORE blood work.

It turns out that my homocysteine levels are normal, which means that I likely don’t have any problems with blood clotting.  Good news, yes.  Take that, MHTFR!  I don’t even have to care about you (Dad, aka OB/GYN, says 5% of women have that genetic mutation and most of the time it doesn’t cause any problems at all).

But, my Vitamin D levels are really, really low (26).  So, now I have to take daily calcium with Vitamin D and once a week have a giant dose of Vitamin D, then get my Vit D levels checked again in 3 months to see if all this Vitamin D is doing anything.

I wish I had a magic genie who could tell me what all this means and what I should do.  Should I keep on taking the Vitamin D and then wait to do IVF once I get the follow up bloodwork done?  It seems to me that would be a good idea.  But maybe, I should just get on into the office and get things taken care of, regardless of how my vitamin D levels look.  The link, as far as I can tell, between Vitamin D and infertility is somewhat shaky and mostly linked to ovulation.  I’m ovulating, at least as far as I can tell, every month… but maybe the vitamin D will make the eggs mo’ bettah.  Who knows, really?  I do know that I’ll keep taking the Vit D and all the other vitamins and I’ll be sunbathing, even in January.  Thank goodness I live in the South, where sunbathing in January could potentially be really nice.  We have had temperatures in the 60s and 70s for the past 2 weeks.  I’ve been outside enjoying the weather, but now I guess I’ll be outside with a purpose.

There will be time, there will be time

And indeed there will be time
For the yellow smoke that slides along the street,
Rubbing its back upon the window panes;         25
There will be time, there will be time
To prepare a face to meet the faces that you meet;
There will be time to murder and create,
And time for all the works and days of hands
That lift and drop a question on your plate;         30
Time for you and time for me,
And time yet for a hundred indecisions,
And for a hundred visions and revisions,
Before the taking of a toast and tea.

That quote above is from “The Love Song of J. Alfred Prufrock,” one of my all time favorite poems.  It’s so sad and so frustrating, yet also so beautiful and lyrical.

I was thinking of this poem because we changed our minds about the IVF cycle and decided to do the March/April cycle instead of the January/February one.  There are many reasons, but I guess these are the main ones:

  • I’m still 10 pounds (instead of 15, yay!) heavier than when I started the first IVF.  That is still about 50 pounds over where I should be and where I’d be happiest.
  • I still have this dream/hope/unrealistic notion that maybe I can get pregnant without IVF, and I’d have only had one chance to try that idea out if we do the January cycle.  Doing the March instead means we have November, December  and January to try.  Yes, I know that I have DOR (diminished ovarian reserve) and that I should be anxious about time.  But I have to also not be too hasty.
  • Partly money.  Doing IVF right now means we’d be completely strapped until February next year.  That’s not comfortable.
  • Mostly TIME.  I’m going to try to graduate in May.  That means I have to collect all my data and write 3 chapters of my dissertation by March and defend BY April.  The sooner the better with all that dissertation stuff though, since potentially, I’ll spend most of March and April in IVF land.  When I think back to this summer, I can’t really remember what IVF was like.  It’s like my brain is refusing to capture all of that. I do remember that it took a lot of time.
“There will be time, there will be time…”  Who knew that time would start to seem so short already, that I’d feel like I’m running out of time for my own life.  I’m 34, not 94, but I still feel like I don’t have enough time in my life for all the things I want to have happen in my life.
 I’ll be  in the official 35 and over category the next time I’m going into that egg retrieval/egg transfer phase and get to hear all the statistics about that.  Probably means she’ll put every embryo that happens back up in there and I’ll end up as the new Kate.  If that happens, I’m definitely getting a personal trainer and a chef.  I wanna look good on E!

Riddikulus!

I wish that I were in Hogwarts many times.  Yes, I know Voldemort/Tom Riddle is a total PITA but everything else is pretty sweet.  Plus, if I were in Harry Potter, then I could use my wand and shout RIDDIKULUS! at anything the boggart presented to me and it would just immediately turn into something funny.  That’d be pretty neat, right?

Well, we finally made a somewhat solid decision and are going to do the IVF in the January/February cycle.  I am already dreading the daily round of shots and the constant visits with Wandy.  I’m still crazy/hopeful enough that I’m not going to go pay the money for the IVF or start the BCP until I actually start my period this month.  Crazy because, yeah, right, 2 weeks of baby aspirin will magically fix me (I bet Hermione knows a spell for infertility.  She went to the library…).  Hopeful, because why can’t I have that story, that “she was all set to do her second IVF after a miserable failure the first time…” story.

The biggest concern I have about this, is that we’ll fork out yet more money (if I can’t qualify for free drugs, that will be over $20,000 we’ve spent (total) for 2 medicated cycles, 1 IUI cycle, and 2 IVF cycles.  That’s the price WITH insurance.  Once the insurance is up, I don’t really know what our options will be.

If there was a boggart in front of me right now, it’d turn into a negative pregnancy test with a $20,000 price tag.  Now, how did that spell go…?

 

2 Answers, Many Questions

So, I had been wondering if my friend, who was trying to get pregnant, was pregnant.  She is.

My other friend, who has fibromyalgia, has been trying since last summer or the summer before… and she’s pregnant now too.   She just announced it on FB by talking about how much she hated her first trip to BabiesRUs.  There are worst ways to let people know, I guess.

So those questions have been answered.  But the ones I’m really interested in are still out there.  Ones like:

  • Should I do IVF in January or March?   (the reason for this question follows)
  • Can a person with a messed up tube, the start of diminished ovarian reserve,  and a bunch of blood mutations get pregnant WITHOUT IVF?
  • Should I go back and see the doctor again to ask her those two questions?  (Like her answer will be anything other than, “January,” and “No!! The reason why I told you last time to do IVF in January is because you are all kinds of to’ up and need some help. Big Help!”).
  • Why is my tooth still hurting?  Could cold sensitivity that develops after a filling be anything other than something that needs a root canal? (That one just keeps sneaking in there, even when I’m trying to think of other things.  Aching teeth are so annoying.  I refuse to ask Dr. Google because I’m scared of the answer).
  • How many more people will get pregnant before I even try my second IVF?
  • How does one go about finding/funding a surrogate?  Can I just put an ad up on Craiglist? Would it say:  Womb needed.  Must be nonsmoker and willing to quit drinking for 10 months or so.  Must be willing to get knocked up by my husband and me, but we’ll pay you for it.  As we are not rich, we can pay you with tree cutting services, nursing, cobbler/cookie making, and editing?
Well, those are the ones I have right now.  For real, I’ve tried googling MHTFR + blood clotting disorders and PREGNANT, but most of them lead me to ladies discussing IVF.  I’m guess if you add in my other two factors (busted up ole lefty tube and decreasing numbers of eggs), and you get a slim chance at best.
If I were on Big Love Season 4, Dr. Rocket would have had me knocked up without me having to do anything except take one progesterone shot.  He’s good like that.

I’m a Mutant

Well, I’ve always suspected it, but now I know it’s true:  I’m a mutant.  No, I don’t have any cool powers, like Storm or Wolverine.  But, I do have some messed up genetics.

The bloodwork showed that I’m heterozygous for MTHFR, with one copy each of the C677T and A1298C mutations.  I also have some problem with Anti-Phosphatidylethenaolmine (say that 10 times fast!  GO!) with the issue in my IgG levels (normal result is is 0-10, mine is 34.3.  Anything above 20 is elevated).  In the Lupus Anticoagulant tests, my Plasminogen Act Inhibitor 1 and Dilute Prothrombin Time are higher than they should be.

What does all this mean?  Well, I’m still figuring all that out.  Here’s what I’ve got so far:  The MTHFR mutations mean that my body can’t hang on to folic acid.  The treatment?  Take lots of folic acid.  The other mutations mean that I’m prone to clotting and that can impede implantation and carrying past week 6 or so (general risks outside of pregnancy are higher rate of heart attacks and thrombosis).  The treatment?  SHOTS EVERY DAY WHILE PREGNANT.  Yep.  That’s right.  My doc says I need to take Metformin while stimming and also Lovenox once I get to transfer.  She said I’d need the Lovenox until at least week 8 of a pregnancy, but that if she were my OB/GYN, she’d continue the shots until Month 8, if not all the way through.  I just can’t get away from needles.

That’s all once the IVF stuff starts.  I’m also on a cocktail of vitamins and such right now.  Here’s my daily medications:

  • Aspirin, 81 mg (“baby aspirin”)
  • Prenatals with extra Folic Acid (1 mg)
  • More Folic Acid
  • B-vitamin complex (with B6 and B12)
  • DHEA, 50 mg (that’s for low ovarian reserve, not blood clotting)
So, yeah, that’s were we are for right now.  I think we’ll do the IVF in January if we can get the cash together in time and it that feels like the right time.  I may wait for the March cycle, I can’t decide.  My insurance money is almost out. I have enough for one more cycle’s medical costs, but not enough for drugs and medical costs.