I Have No Words....

NEFI has recommended that S&S no longer use me as a surrogate. I did not respond to his protocol after 2 cycles and that is all he is willig to try. My agency called and said that she spoke with another RE who they often use who said he would definitely work with me and will accept the testing from NEFI, and that there are many other things to try when one protocol doesnt have the results they are looking for. I am majorly bummed. Bummed for me and Bummed for S&S. This match is over. My agency will match with me another couple. But its just so sad. I want so much to do this, to help someone. Its been a year and I am back to the beginning. I am not ready to give up on surrogacy, its just a lot harder than I thought it would be. Its hard not to get discouraged and wonder if it is meant to be at all. I am not ready to give up though. I leave it in God's hands.

Just Research

I just want to copy and paste some things I found on Google about a thin lining.

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A normal endometrium requires adequate blood flow ; and high estrogen levels. Thus , if the lining is thin there are 3 possibilities: the estrogen levels may be low; the blood flow is poor; or the endometrium is damaged. We need to systematically examine all these 3 possibilities , so that we can pinpoint what the problem is in the individual patient , and then try to correct it.

However if the lining remains thin in spite of high doses of estrogen, this means the problem is either one of poor blood supply ; or a damaged endometrium. Some doctors have used color Doppler ultrasound to measure uterine blood flow, but the results with this have been mixed. Others have tried using vaginal viagra to try to improve endometrial blood flow. Since there is no reliable method to assess uterine blood flow , the next step is to determine whether the endometrium has been damaged or not. There are two possible causes of end-organ damage when the endometrium is nonresponsive. One is that the endometrium has been anatomically distorted because of intrauterine adhesions ( a common cause for this in India is uterine tuberculosis. This condition is called Ashermann syndrome; and this can be diagnosed either with a hysterosalpingogram , which shows filling defects within the uterine cavity ; or with hysteroscopy , during which procedure the scars can be surgically removed. However in some patients , even though the uterine cavity is anatomically completely normal ; the uterine blood flow is normal; and the estrogen levels are high, the endometrium remains persistently and frustratingly thin. We then hypothesize that the endometrium has suffered end-organ damage as a result of which it does not respond to estrogens. This condition has never been adequately studied; and it does not even have a name ! Most doctors just call it - " Thin endometrium" . The Latin equivalent for this would be leptometrium ( lepto = thin) . Maybe we should coin a name to describe this condition , so that we can study it properly. Today, this can be an unsatisfying diagnosis to make, because we cannot prove this diagnosis ; and neither can we correct this problem.

During my clomid cycles and fresh cycle I had no lining issues. In prepping for my FET cycle(s) my lining never got thicker than 5-6 mm. We did oral estrogen, vaginal estrogen, patches, and IM, and nothing worked! At one point my serum estradiol was up to 2500 and still my lining was only 5-6 mm. I did baby aspirin, cut out caffeine, high dose vitamin E, nothing worked. I was convinced my body didn't like exogenous estrogen. So we did an ovulation induction cycle (have PCOS and wasn't ovulating) with follistim. My lining got to 7.4 mm on the day before I triggered, so it was probably even a little thicker at the actual time of ovulation. It worked, and now I am pregnant! Also, during the follistim cycle I stuck with the baby aspirin and vitamin E, but went back to drinking my cup of coffee a day

Basically we used follistim to do an ovulation induction cycle, mimicking a natural cycle. We did low dose and got one follicle, which my husband and I took advantage of. I triggered with hcg, and started progesterone supplementation even though I had a CL, and 5 days later we transferred 2 frozen blasts. We also did use Ganirelex to prevent me from ovulating, and let the follicle grow a bit and the lining thicken up before triggering. We did add a big of vaginal estrogen 3 days before triggering--not sure if that made a difference or not.

I had this same problem with a FET in October and ended up having it canceled. We tried again this past month and my dr had my use a low dose of Gonal-F. My lining was between 9-10 when we had our transfer last week. Just a thought you may want to ask about. Good luck!!

The "natural cycle" I did was basically done like an ER without the actual procedure. I did 2 shots of stims..don't remember what med it was. That was just done to increase my estrogen levels because I have long cycles and we didn't want to wait for ovulation to happen. I was monitored every other day until levels were where they needed to be then did a trigger shot. Then transferred 3 days later.

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So I think I have some ideas if NEFI ever gets back to me. I just emailed my contact there, the PA, who had been out of the office. I asked if there was a game plan. Now I have the above examples to ask them about. And also why they did not increase the estradiol more? Maybe my body needs a higher level of it for some odd reason? I would really like to have a natural cycle monitored and see what happens then. Or attempt a natural FET cycle. Maybe we could schedule the flights etc for 5 days after I have a surge indicating ovulation. I know there is hope and options out there. Hopefully S&S do not give up on me yet. I have not heard from them since thursday. Neither has the agency.

Another Cancelled Cycle :(

I feel like crap. Again my lining stalled at 4.4 ish. Again my blood levels were over 2000. My uterus will just not be manipulated.  I guess they can not increase the estrogen when my levels are so high. I have no idea what other options there are. I heard one surro took vaginal Viagra to help it thicken? I have never heard of that?  Googled and found:

Viagra is administered in the form of 20mg vaginal suppositories) inserted four times per day. Treatment is commenced soon after menstruation ceases and is continued until the day of the hCG trigger (when used with ovarian stimulation, the day of the LH surge (in natural cycles or, until the commencement of progesterone in ¡°embryo recipient cycles ¡°(ovum donation, FET¡¯s, gestational surrogacy and embryo adoption). While ideally the treatment should be sustained throughout the first half of the cycle, most women will respond within 48-72 hours, such that Viagra can be used to ¡°rescue¡± a poor lining provided that there is enough time remaining prior to ovulation, egg retrieval or progesterone administration. and also: We recently demonstrated that the vaginal administration of sildenafil (Viagra) for several days prior to the “hCG trigger “ or progesterone administration enhances uterine blood flow and estrogen delivery to the uterine lining, and so improves endometrial thickening. In October 2002, we reported on the administration of vaginal Viagra to 105 women with repeated IVF failure due to persistently thin endometrial linings. All of the women had experienced at least two (2) prior IVF failures attributed to intractably thin uterine linings. About 70% of these women responded to treatment with Viagra suppositories with a marked improvement in endometrial thickness.

So I will be suggesting this when I next talk to NEFI. S&S have not emailed me back nor has my agency. I feel like they are looking at me negatively :( I feel like they must be talking about whether or not to continue to use me as a surrogate or not. Man does this just suck.

My agency wrote me back. She definitely doesnt sound like she is looking at me any differently which is good. I told her about the viagra. Maybe it will be a magic pill for me too :)  or maybe there is something wrong with me and I will not get to continue this match. I really think a different protocol will work better for me. I just wish NEFI saw that too. :(

Tomorrow My Baby Turns 8!

I can not believe how fast time has gone! She is no longer a baby. 8 years old tomorrow. Might as well be a full blown tween. I think I have the most gorgeous child ever, though I may be biased. I am so proud of her. A better daughter does not exist.

I wish I would have really paid attention when people said the time goes fast. I wish I had a clear memory of every single minute of her life.  Stupid estrogen is making me cry at work, but if I had the chance to relive everything I would do it in a heartbeat.

Successfully met goal # 1

Well my uterus has met the first goal! My ultrasound this morning showed a lining of a 4. :) I have not heard back from NEFI yet about the results. I'm not sure if we will increase the estradiol again or not. I hope we do so that my lining is really good. The US tech was the really nice one this time. She was training a new lady so the US took like 25 mins. But I got to see a lot of my uterus and ovaries and hear her explain everything. She said I was lucky because I have a lot of follicles in my ovaries. That makes me feel good about my own fertility. We made the plane reservations, the rental car reservations and the reservations to board the dogs.  The next goal is 7.  I want to see at least a 7 on ultrasound next week.

Ok Uterus, you did great. I am so happy with the progress so far. We are on our way to transfer and hopefully the beach this summer, if you do really well :) You really are doing great, keep up the good work! Next week I want to see a 7. Can you muster that? I am giving you lots of estrogen to help, and once we get a fluffy lining we can add the progesterone. You grew about 2 over 6 days, so I would like to see a growth of 3 over the next 6-7 days. After that I will be happy with only another 2, for a total lining of 9 at transfer, just to prepare you. But you are doing well this month, I like what I'm seeing. Just have to hear back from NEFI

A Bad Dream?

I'm really hoping that my dream last night was just a manifestation of my nerves that my uterus will again not cooperate, and not foreshadowing anything. I dreamed that I was at NEFI and the PA told me that my lining again was not built up enough and she would have to suck out what was in there. And it really hurt. Then S&S came into the room and a couple tests were run and a nurse came in and said because I was exposed to something prior to age 11, I was no longer a candidate to be a carrier. I said, but that was in PA and not CO, does that make a difference, then we got to talking about an allergic reaction I had to something, and then I woke up almost terrified. I lay awake for awhile trying to calm down. I would be so upset to find out that I could not go through with this, or even worse, that I myself am infertile. The serenity prayer came to mind "God grant me the serenity to accept the things I cannot change; courage to change the things I can; and wisdom to know the difference." So now I just try to relax. I have been told how important being stress free can be to a cycle. And I am just so worried now because of last cycle. :(

I guess its silly to get so upset over a dream, and my dreams have been pretty out there the last few nights, since restarting the estradiol. In fact I already feel pregnant, which is weird. My dreams, and the way my body feels, is different from last month and feels different than normal. I had a dream about an old friend, Wynn, the other night. Then a weird one about Josh. And last night my daughters father was with me at NEFI in my dream, and when we got the bad news about my lining he said he had to leave and was gone. This dream followed the random, weird, chaotic, suit of the dreams from the previous  nights. Its just because it hit a very real fear that its bothering me.

Onto, the facts.... I have my next US and lab work on 12/8 8:15 am. (And I hope to see my lining at least a 4, two weeks before transfer.) AF was lighter than it has been, so I know my lining does get thicker just based on that. (That should reassure me.) I am taking the estradiol as prescribed and we already know my body absorbs it very well. I am doing everything I can. The only other thing I could do, is try to relax the next 3 days until my appt with CCRM. Also, I better refill that estradiol. Off to call Walgreens and try as best I can to distract myself and stay busy.  To quote my surro coordinator "grow lining, GROW!"

Added in the late afternoon: My uterus is doing something. I am having a ton of cramping, mild, and a full feeling. If I lean forward in my chair, like I like to at work, It causes most of the cramping. I dunno... but it is doing something.

Cycle # 2 Begins!

Soooo.... I woke up at 715 to an email from NEFI, Dr Lavy's office, that they still had not heard from S&S. I had sweet talked the PA at NEFI to send my orders to CCRM late last evening and I made myself an appt for 815 mtn time this morning. So when I woke up to that email I knew I had to call S myself and try to reach her. I knew she would want to move forward with 12/22. I got her at work and she of course said "you don't even have to ask" :) So I went in for my baseline US and labs. I just heard back from NEFI and I am at baseline on both. I am starting estradiol again tonight. 2 mg vaginally twice a day. I go back 815 mtn time on 12/8. I want to see at least a lining of 4 by then :) S&S are worried that I might miss Xmas, but I think we could catch a flight back on 12/23 in the evening. And I found out that S&S have 10 totsicles :)

Ok uterus, look here.... We have a job to do, and I really need you to do your part. You've been able to skate by without really doing anything for almost 8 years. It is time now to live up to your potential. I need you to take in this estrogen and make a nice, thick, triple stripe bed for one or two little tiny embryos. Then I need you to keep them safe for 9 months. Can you do that? You can have a break after that. This is what you are specifically designed to do and I would really appreciate it, if you could just do it. S&S are counting on us and we can not let them down. OK? I will take us to the beach this summer if you cooperate. How does that sound? I need you right now. Ok, lets do this :)

Aunt Flow

Last night I had a dream, and in this dream I was injured and was bleeding all over, I was bleeding from my eyes. It was seriously weird. Well after my shower this morning I found out that Aunt Flow had arrived. I emailed Dr Lavy's office and they wrote back 3 hours later to say that if I can get in with CCRM tomorrow we could transfer 12/22!! YAY! So excited. So straight away I called CCRM but I had to leave a message. One hour later CCRM says they can not schedule me without orders from Dr Lavy. So I call them :) They will not send orders until S&S approve the transfer date. Well it is almost 7pm on the east coast and Dr Lavy's office still has not reached S&S. I am forcing myself to be indifferent about it. I'm doing everything I can on my end :) And that is all I can do. CCRM had afternoon appts so maybe by the time I get to work at 9 tomorrow morning, they will have orders :) My back is hurting so much the past 2 days. My mom said she always had back pain instead of cramps with af. So maybe I really am becoming my mother :) Not a bad thing :) fingers crossed for tomorrow :) :)