Hello there, it’s been a long pause. I’ve enjoyed the mental and physical break from dealing with infertility issues, but now it’s time to jump back in! I’m working on catching up with all of your blogs that I’ve missed- lots of exciting things happening! Now, on to my current task: figuring out my first frozen embryo transfer (FET)!
In case anyone remembers my last post, I was deciding between teaching a class that is very incompatible with infertility treatments vs. not teaching the class and going forward with the FET, which if you remember back even further, we put off our fresh transfer from our first IVF cycle in September/October because of another class that I am still finishing up teaching! Ok, now that we’ve got that out of the way… on to today!
It is day 1 of my new cycle, I am getting ready to do our first transfer, probably with just one of our 3 frozen embryos. Another recap- I have 2 embryos that were frozen on day 5, one ranked good, one ranked fair, and the third embryo was frozen on day 6, ranked fair. My RE is suggesting we transfer just the one ‘good’ embryo now, and likely, if that doesn’t work out for us we will transfer the other 2 ‘fair’ embryos together. But we still have some time to think about this part.
Today I had my baseline appointment to make sure all systems are go for starting the FET. I had my thyroid levels tested last week because I want to know that they are in the right ballpark before we start all of this- my TSH was a respectable 1.9 mcIU/mL, and my free T4 came back at 1.0ng/dL. I am seriously skeptical of Kaiser’s analysis because my free T4 has come back at exactly 1.0 every single time I’ve had it tested at Kaiser. Before I switched to Kaiser little over a year ago, it was always 1.something and it varied each time I was tested. I find it much more likely their tests are not as sensitive than that it has stayed exactly constant for all this time. I will have to investigate this further…
Back to my appointment, after a quick (and messy- sorry, the downside to going in on day 1!!) ultrasound checking my lining, and ovaries, they did another blood draw to check my estrogen and progesterone levels, and threw in a pregnancy test for fun. Surprise, surprise- that one was negative! Still awaiting the other results.
Next I headed to the pharmacy to pick up my estrogen patches and a refill of my levothyroxine. I’ll be using 2 Vivelle patches every 3.5 days starting this Wednesday evening (my day 3). I will continue using these until 9 weeks pregnant (if all goes well). A rundown on the protocol I’ll be following (as far as I can tell so far):
- Day 3: Begin Vivelle patches, continue taking vitamins & start taking baby aspirin again
- 6 days before transfer: Begin progesterone shots & prednisone pills
- Transfer: Doxycycline and Valium
The tricky part is that normally your lining would be ready (8mm or thicker) after about 3 weeks of patches, but for me, 3 weeks will fall on Dec 31. So my RE is scheduling me for the transfer the following week (Jan 7). I’m a little concerned that this means I’ll be on the patches for a full week longer than ‘normal’ and I won’t even start the progesterone shots until after that 3 week mark. I wish I had asked my RE more about possible effects of this delay at the appointment, but I was just trying to get all of the details down on paper.
Anyone with FET experience please share your knowledge! I am just starting to learn about this process.
-I forgot to mention they also gave me a flue shot- it had been a nice break from shots! I’m really dreading starting up the progesterone shots again, a small part of me is glad I will get to wait to start those until after the holidays, but not if it might jeopardize my chances of the FET being successful! Why is the timing always tricky for everything I do IF related!?!
seaofinfertility 
if it reassures you, i have kaiser, and my free T4 has varied bit by bit – usually 1.3-1.6. i trust their labs.
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Thanks! Maybe it’s just something with my local lab’s assay, my RE suggested calling the lab, but he really didn’t seem sure of what to tell me!
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My my my. Someone has spent some time thinking about EVERYTHING! I feel for you! I’ve done one FET if you have any questions? It happens to have been successful!
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Thanks, I do have questions! I’m just learning more about the natural FETs- is that what you did? I wish I had asked my RE about doing it that way instead- advantages/disadvantages etc. How did you decide your FET protocol?
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Yes I did an FET natural cycle. The Docs were pretty sure I’d develop OHSS if we went ahead with a fresh transfer. I monitored two cycles and had LH surge and Progesterone blood tests, which must have come back good as they booked me in for the transfer three days later!
I trust my Doc to the moon and back, so I just do whatever he tells me to! We are really lucky to have the best clinic in our country at our back door.
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That’s fantastic, congratulations!!
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My best wishes to you, whatever you decide to do!
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I just had my FET (yesterday) and I ended up taking estrogen (estrace tablets) for about 3 weeks in amounts stepped up each week. Then I had an ultrasound to check my lining. My lining was still a little thin (probably because I had done one of my dose increases a few days late, my bad) and I stayed on the estrace for a few more days before starting progesterone.
Obviously it’s too soon to know if this will be successful or not, but being on the meds a few days longer was not treated as a big deal, and my RE had told me before the protocol even began that the amount of time on estrogen could be flexed a few days if there were scheduling conflicts (or lining issues) no problem. What mattered most was that once the progesterone shots started, the transfer had to be a set number of days after that (based on the age of the embryo) and a minimum lining thickness of 7mm (measured the day I started progesterone.) Taking estrogen for longer should just keep thickening your lining. If you’re concerned about it being too thick, maybe request it be checked at some point during that last week, but from what I’ve read on forums, etc, people have done transfers with linings anywhere from 7-13mm. So it seems to me it’s not an exact science.
I think the worst part of the FET experience was how badly I had to pee. I drank a little too much water a little too soon then had to wait hoping my bladder wouldn’t explode. I was a little worried at one point that I might pee on the poor doctor placing my catheter (while the other one pressed the ultrasound into my lower abdomen) and forever be ‘that patient who peed’ (didn’t happen, phew). If I have any advice it’s don’t over do the water 😉 Good Luck!
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Thank you for the reassurance and advice! I was in touch with my RE and he didn’t seem to think the lining being too thick would be a problem. I am on schedule to start my estrogen patches tonight! I hope all goes well for you with your wait and that there is good news coming!
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