TFAS 10/2

[westiemom]

mnj05
scrang
baymare
grover
moto
DrHooch
crazycatlady6
tiresiastheblond
twohopes

How are things? drhooch, I'm thinking of you. 💗

[westiemom]

7 dpo on my first TI w Femara cycle. No symptoms yet. We will see!

[twohopes]

westiemom, ooooh fingers crosses. Another 7 days to go till test time! Hopefully it will go by fast.

For me, cycle day 2 of first cycle post MVA. It's a blood bath today, but luckily the cramps are not too bad. Yesterday, I had a full on meltdown about how I should be out of the first trimester by now, and not getting my period, but today is a new day and I am over it. Waiting on a call to hear the time of my CD3 testing and scheduling a hysteroscopy/mock transfer. Continuing to lose weight so we can starts stims in my December or my January cycle. It's a new day! We'll also try naturally for the two or three cycles between now and then.

[scrang]

Tomorrow is transfer day! Just started my antibiotic and when I picked it up at Target, the pharmacist had to confirm I wasn't pregnant. I said no but I will be on Tuesday! She looked at me like I was nuts and said how do you know so had to explain the whole thing...I felt like an infertility teacher.
Otherwise, just getting really nervous but trying to stay positive!

[twohopes]

scrang, OOOOH best of luck tomorrow and keep us posted during the TWW!!

[westiemom]

scrang good luck tomorrow!!!

[moto]

Hi! I've started my estrogen injections for my FET, which is supposed to be in about two weeks.

I'm freaking out though - I had my annual physical with my PCP, and she did routine bloodwork. The office called yesterday and said that my "thyroid panel was slightly elevated." They want me to come back in 2-3 weeks to retest. They didn't seem to worried about it.

I did some googling and it seems that thyroid problems can impact implantation and/or cause miscarriage. I called back to try and get my exact numbers but they haven't returned any of my calls since yesterday. I know I should probably mention this to my RE but I'm afraid they are going to make me postpone, and I really don't want that. But obviously I want to do what's best for the embryo. Does anyone know anything about thyroid levels and FETs??

[scrang]

moto Yes, my doc wanted my thyroid level to be around 1.5 for good implantation and carrying the pregnancy. Def find out your number...taking meds takes up to 30 days to refect (at least for me!). And I've had to continue throughout pregnancy so it's definitely something you want to monitor.

[scrang]

Woohoo, this girl is PUPO!! Thank goodness for valium, I was so nervous and shaking! All went smoothly so in 10 days, we'll know.

[mnj05]

FX scrang!!

FX for you too westiemom!!

Hugs twohopes. I've had a couple of moments like that recently. Not fun in the least.

[mnj05]

As soon as we close on our houses, we'll have enough money for a transfer so we're just hanging out for a while. It'll be the last transfer and I'm a little nervous. Truth be told, I go back and forth on whether to transfer again. Why can't this be easy?

[twohopes]

I completed CD3 today, not because we are cycling but because we are about to get authorization by our insurance. Sigh. I think it is ok new for 37. AFC is 10, FSH is 6.2, E2 is 24, LH is 4.5.

[moto]

Good luck westiemom and scrang!! Hopefully the rest of you can cycle asap!

scrang - are you on any thyriod meds? I talked to my RE and apparently my clinic has different standards for patients who are on thyroid meds and those who aren't, which is weird. If you ARE on meds they want your level to be below 2.5, and if you AREN'T, they want it below 4.5. Such a huge difference! Anyway they tested me a month ago and I was 3.5, which according to them is fine. My PCP says my level is 4.02, and apparently at her lab the higher cutoff for "normal" is 4.01. My RE says you can't compare levels from different labs because they have different equipment or something. The whole thing is confusing. I'm trying to tell myself that my RE managed to get me pregnant before, so if he's not worried I'm trying not to be either. My RE is retesting my level next week just in case.

[tiresiastheblond]

westiemom, Fx, fx, fx!!!!!

scrang, congratulations! Absolutely everything crossed for you!

moto, ugh, it's always something. I hope you can get your thyroid levels resolved quickly and easily.

twohopes, those sound like excellent CD3 results. Hopefully they'll help you breathe a bit easier.

mnj05, I hope you can make a decision that feels right to you soon.

AFM, after much back and forth, transfer is scheduled for 10/11. It still doesn't seem quite real!

[twohopes]

tiresiastheblond,10/11 is my daughter's 3rd birthday. Could not have picked a better day for a transfer

[twohopes]

moto, That's an interesting double standard. I have Hashimoto's and my RE and my endocrinologist both want my TSH under 2. That being said, before my high antibodies were even discovered, I got naturally pregnant and my first TSH was 2.2 (it was with my successful pregnancy), so I am not sure that there is really a hard and fast cutoff rule.

[moto]

tiresiastheblond - the double standard is odd and makes me nervous. Everything I google seems to say that 2.5 or lower is needed, the lower the better - so I'm surprised my RE only requires it to be under 4.5. I emailed my nurse to tell me what my TSH levels were in 2015 when I had my successful IVF. If it was highish then I'll feel better about it, since that all worked out. My RE is usually irritatingly conservative about things, so I'm trying to trust that if this were a problem, he'd make me cancel.

[twohopes]

Oct 6, 2017 7:20:46 GMT -6 moto said:

tiresiastheblond - the double standard is odd and makes me nervous. Everything I google seems to say that 2.5 or lower is needed, the lower the better - so I'm surprised my RE only requires it to be under 4.5. I emailed my nurse to tell me what my TSH levels were in 2015 when I had my successful IVF. If it was highish then I'll feel better about it, since that all worked out. My RE is usually irritatingly conservative about things, so I'm trying to trust that if this were a problem, he'd make me cancel.

moto, I am annoyingly empirical in my thinking and decisions, so I think I would probably look up the scientific literature (and I, for better or worse, have unlimited access to medical journals and databases, sigh) in order to make a final personal deliberation. Have you ever looked up any studies on the subject?

[scrang]

moto Yes, I'm on Synthroid and have been since we started the IVF process. My highest number they ever tested was 3.4 and I've been on varied dosages, right now being the highest at 100mg. Like I said, my RE wanted me down between 1.5-2 and then my OB wanted me there as well, hence the meds for all this time. I would double check with your doc but if he's not worried, then he knows what you need. All doctors are different. I remember being tested long ago (non infertility related) and my level was like 7 something and they said that was borderline fine/med worthy. So there you go!

[moto]

twohopes - I don't have any special access to medical articles, but I did find a study that found that having slightly higher TSH numbers had no impact on pregnancy outcomes - I think it was from 5-6 years ago. I found lots of articles and websites (but no actual studies) claiming that having a high TSH would impact implantation and/or cause early miscarriage. That's what got me all freaked out. But I couldn't find any good studies proving it or talking about why.

scrang - that's weird that 7 was normal! It's all so confusing. So they started you on meds for IVF because you were at 3.4? It's frustrating to me that they are all so different about it. I'm going to have to just trust my doctors, but it's hard. Here's hoping they know what they are doing.

I called my PCP and talked to her about it - she was very much against going on something like Synthroid "just in case." She said numbers fluctuate normally and she's seen someone have a 4 and then a few weeks later have around a 1. She had me do repeat bloodwork, so we'll see where I'm at now and go from there.

[scrang]

moto Yes, I think you're right...we all have to trust our doctors that they're caring for us as they see fit.
I was 3.4 right before we started everything for this transfer back in June and I was already on 75mg of Synthroid so I was upped to 100mg. I've always had weight issues and my neck has always looked a little swollen where the thyroid is, so I've had it tested many times. It's always come back borderline around 7, not enough to warrant meds. So when the RE tested me back in 2014 and it came back at 3.1, I thought I was fine. But nope, he wanted me below 2, so on the Synthroid I went. I remember reading something about it in the book It Starts With the Egg, but can't remember the details, sorry! But I do have to say that once I bumped my dose up to 100mg, my TSH dropped from 3.4 to 1.4 in 30 days!
I know it's hard to just let go and trust your RE (especially with Google sitting on your shoulder whispering in your ear!), but I hope you can resolve this with him soon.

[twohopes]

moto, Here are a couple of studies to maybe discuss with your doctor when you connect finally. Do you know if you have antobodies too? (I do have very high antibody levels, but strangely enough I have normal TSH which is a whole other ballgame). One if about IVF with donor eggs

Normal "high" thyroid stimulating hormone (TSH) levels and pregnancy rates in patients undergoing IVF with donor eggs. Clinical and Experimental Obstetrics & Gynecology, 2014;41(5):517-520. Clinical and Experimental Obstetrics & Gynecology can be contacted at: I R O G Canada, Inc, 4900 Cote St-Luc, Apt#212, Montreal, Quebec H3W 2H3, Canada
"With prior approval of the Ethics Committee, 233 patients undergoing IVF with donor eggs, in a two-year period, were included. Patients were grouped depending on the thyroid stimulating hormone (TSH) level. Pregnancy rates were compared. Statistical analysis was made with the Chi-square test. Pregnancy rates, depending on the TSH level, were 56.6% in patients with TSH levels below 2.49 mU/L vs. 21.6%, in patients with levels above 2.5 mU/L. This difference was statistically significant (p < 0.001). Mild abnormalities of thyroid function may adversely affect the pregnancy rates in patients undergoing in vitro fertilization with donor eggs."

Investigating the optimal preconception TSH range for patients undergoing IVF when controlling for embryo quality
Green, Katherine ; Werner, Marie ; Franasiak, Jason ; Juneau, Caroline ; Hong, Kathleen ; Scott, Richard
Journal of Assisted Reproduction and Genetics, 2015, Vol.32(10), pp.1469-1476[Peer Reviewed Journal]
Purpose The ideal thyroid-stimulating hormone (TSH) range for infertile women attempting conception has not been determined. Current recommendations include optimizing the preconception TSH value to [less than or equal to]2.5 mIU/L, which is the established goal for pregnant women. The aim of this study was to determine if there is a distinct range of TSH [less than or equal to]2.5 mIU/L for infertile women undergoing in vitro fertilization (IVF) that improves reproductive outcomes. Methods One thousand five hundred ninety-nine euploid blastocyst transfer cycles were evaluated in which TSH measurements were obtained 8 days after embryo transfer. Only euploid embryo transfers were included in an effort to control for embryo quality. Patients were separated into TSH groups utilizing 0.5 mIU/L increments. Implantation, live birth, and miscarriage rates among the TSH groups were compared. Outcomes for individuals on thyroid hormone supplementation and those not requiring supplementation were evaluated. Results There was no difference in implantation (p=0.56), live birth (p=0.36), or miscarriage rates (p=0.10) between TSH groups. Receiver operating characteristic (ROC) curves for implantation, live birth, and miscarriage approached the line of no discrimination, signifying that there is no value of TSH within the recommended range for pregnancy ([less than or equal to]2.5 mIU/L) that predicts IVF outcomes better than other values in this range. Live birth rates for patients requiring thyroid hormone supplementation and those not on medication were similar (p=0.86). Conclusions The recommended TSH range for pregnancy ([less than or equal to]2.5 mIU/L) may be applied to infertile patients attempting conception without a need for further adjustment.