IVF for PGD: Cycle protocol and update

Since I’ve been doing my own share of Googling other people’s IVF experiences over the last several weeks, I think it’s time that I document my protocol and experience with my current IVF cycle.

We’re doing IVF for PGD (pre-implantation genetic diagnosis) to screen embryos for the BRCA gene mutation. I inherited this gene mutation from my mom, and each of my eggs is 50% likely to be positive, too. BRCA 1 radically increases the risk of ovarian and breast cancer, so while I’m doing what I can to reduce my own cancer risks, we decided to pursue this option to try to avoid passing this on further. (Read more about our decision HERE)

So, my IVF protocol involved taking a birth control pill for 2 weeks. This ensures that my ovaries aren’t doing anything before we get started. After those two weeks, I started on Gonal F to stimulate follicle growth. I was to do that for 6 days before adding in Luveris and Cetrotide.

Ok, I actually totally messed up and thought I was supposed to take Luveris + Cetrotide instead of Gonal F instead of in addition to Gonal F. The next morning at my appointment, I was so devastated when I found out that I’d missed a dose because I was worried everything had been ruined and my cycle would be canceled. Fortunately, the nurse explained that my follicles had still grown so all was ok. Of all the meds to miss, the Gonal F was the least tragic at that point. So phew! I still was anxious about it for the rest of the day and just so upset that with all the uncertainty that already exists with this process even when you do everything 100% correctly, I hated to think an innocent mistake could mess up a cycle. When a cycle runs many thousands of dollars, eeek!IVF for PGD

Anyway, from then on I took them together. Luveris works with the Gonal F to stimulate follicle growth and the Cetrotide prevents ovulation to keep all those eggs up in there until they’re mature enough for retrieval. While Gonal F comes in an easy-to-use pen, the others required mixing dilutants and powders and swapping needles and instructions with 17 steps. I got the hang of it though and am now pretty much a doctor 😉

I’ve had to go to early morning monitoring appointments every couple days for ultrasounds and blood work. I’m so lucky that the clinic is a 5 minute walk from my office. I know there are other ladies that drive in from 2 hours away, and probably even further. With appointments between 7 and 8am every day or two, I really lucked out with being so close by!

My appointments showed that I had a decent number of follicles in each ovary and they were growing steadily although slightly slower than expected. This just meant that I had to “stim” longer (10 days total).

After so many injections, my belly is now feeling quite tender, but otherwise my only symptom has been major bloating, which results from big swollen ovaries full of growing follicles. The bloating started about 4 days in and has only gotten worse. I constantly feel like I’ve eaten a huge meal, and feel like I’m waddling around. I even have to undo my pants!

IVF for PGD

I’m also a bit more irritable, which isn’t surprising with the hormones flooding my system. Hearing people (Mike) making a noise while yawning has suddenly become the #1 most annoying thing ever. I have no idea why this of all things nearly triggers rage within me. So random. Fortunately I’ve managed to keep myself in check since I know that’s hormone-related craziness. Ok, so maybe I’ve become very irritable, but only a bit more than normal 😉 Otherwise I’ve been going about with business as usual for the most part. I’ve stopped running at my doctor’s recommendation, since swollen ovaries + vigorous activity can lead to twisted ovaries, which I guess is as awful as it sounds. I’ve been walking/waddling, but avoiding doing any more than that.

Tonight I’ll be taking Ovidrel to trigger ovulation, and then my eggs will be ready for harvesting in a couple days. I’m so happy that I only need to take one injection tonight instead of 3.

Since we’re doing IVF for PGD to try to find our healthiest, BRCA- embryos, it really is a numbers game and kind of crazy to consider how they drop off at each stage. Right now it looks like I have at least 10 good follicles, maybe more. Hopefully eggs can be retrieved from all of them. Even then, who knows if we’ll end up with any or one or two or more at the end. It goes something like: # follicles > # of eggs retrieved > # of eggs fertilized > # of embryos that grow into blastocysts > # of embryos that are BRCA- and chromosomally normal. And that still doesn’t guarantee anything when it comes to the success of the later frozen embryo transfer. For now I’m hoping for a successful egg retrieval in a few days and for the rest we will have to wait and see!

Kimberly Snyder’s Glowing Lean 30 Day Meal Plan (and IVF!)

beauty detox kimberly snyder glowing lean meal plan shopping guide download

(If you’re looking for the download for the Glowing Lean Beauty Detox Meal Plan, click HERE!)

If you’ve been following my blog, then you know that I’m a huge fan of Kimberly Snyder, author of The Beauty Detox Solution and The Beauty Detox Foods. You may have also noticed that I’ve been participating in her weekly, and now monthly, Beauty Detox Blogger assignments. She’s the reason I start most days off with the Green Glowing Smoothie, and I find that alone makes a huge difference in my energy levels, digestion and complexion.

I’m excited to share that I’ve decided to follow Kimberly Snyder’s Glowing Lean 30 Day Meal Plan for the month of November. This is a new product that Kimberly just recently launched which provides recipes for 30 days of properly combined, beauty-boosting, super nutritious and simple vegan meals.

November is going to be a big month for me. Mid-month I’ll be heading into surgery to complete my breast reconstruction. Recovery from this surgery is supposed to be much easier than the recovery from the prophylactic mastectomy, which I completed in March, so I’m hoping and praying all goes smoothly.

Also, November marks the 3-month lead up to another big medical event, which I haven’t yet shared with you all. In addition to the breast cancer risk associated with the BRCA1 genetic mutation, which I took care of with the prophylactic double mastectomy, I also am at a greatly increased risk of ovarian cancer. Ovarian cancer is especially troubling for me, since that’s what my mom died of in 2009 at age 55.

BRCA1+ women are advised to undergo prophylactic oopherectomies, the removal of the ovaries, before the age of 35 when the risk of ovarian cancer really kicks in. I’m not going to be undergoing this surgery for a few years still, but in February I’m going to be freezing my eggs for later in vitro fertilization (IVF). There are a few reason that I have decided to do this:

  1. BRCA1+ seems to also be associated with reduced fertility, so I might have trouble conceiving naturally;
  2. We will screen out BRCA1+ eggs, so that I don’t pass on this genetic mutation;
  3. If at anytime during all of this, I am diagnosed with ovarian cancer then I will be able to have my ovaries removed and still have children (once you have the eggs, you don’t need ovaries…just a uterus).

So, what does all of this have to do with Kimberly Snyder’s Glowing Lean 30 Day Meal Plan? Well, I’m going to be following this meal plan to kick off 3 months of fertility-boosting eating. I’m doing this to give myself the best chances possible for the egg retrieval process that I will be undergoing in February. IVF is super expensive and it’s not an easy process, physically and mentally, so I don’t want to have to go through this more than once if possible. I’m aiming to have as many viable eggs as possible ready to go for retrieval in February. And of those, I want to have as many healthy, non-BRCA1+ eggs as possible. Now, we don’t know what role, if any, diet plays into the whole BRCA1 genetic mutation, but we do know that diet can have a HUGE effect on general fertility, so it definitely can’t hurt. I’m also hoping it will help speed along my recovery from my mid-November surgery.

I’ve chosen to kick things off with Kimberly Snyder’s Glowing Lean 30 Day Meal Plan because it’s packed with fertility-boosting foods. Now, Kimberly hasn’t made any claims as to the effects of this meal plan on fertility, so I’ve chosen to go ahead and use it as a resource for this purpose all on my own.

By following the Glowing Lean 30 Day Meal Plan I’ll be avoiding a lot of the foods that have been associated with infertility or trouble conceiving: alcohol, caffeine, refined carbohydrates, and red meat. And I’ll be getting tons of the good stuff: iron rich leafy greens. nutrient dense plant-based meals, and healthy fats from coconut oil, avocado and nuts. Does this mean that I’m going to have lots (or any) viable and non-BRCA1+ eggs? Not necessarily, but I’m going to do what I can to increase my chances!

New to Kimberly Snyder? Find her books here: The Beauty Detox Solution and The Beauty Detox Foods (affiliate links)

Choosing gratitude in face of a difficult diagnosis

This week’s Beauty Detox blogger assignment was to write about something we are grateful for. Practicing gratitude, meaning thinking of or writing down specific things that I’m grateful for, is something I turn to regularly, especially when I’m feeling down or stressed. It doesn’t always make my problems go away, but it does help put things into perspective.

As Kimberly Snyder writes, “It’s impossible to feel sad, worried or angry and feel gratitude at the same time.” 

For this assignment, I immediately knew what I wanted to write about. It’s something that I’ve been contemplating sharing here on the blog, but it’s also something very personal that I wasn’t sure I should broadcast on the Internet. But it’s something that has played a major role in my life over the last several years, and especially this past year, and sent me on a roller coaster of emotions including sadness, fear, disappointment, and anger, but throughout it all, and especially now, an overwhelming sense of gratitude.

In 2012 I received the news that I’d been dreading. My genetic testing results were in, and I found out that I was positive for the BRCA1 mutation. This is the genetic mutation that caused my mom’s ovarian cancer, which she died from in 2009 at only 55. As a result of my diagnosis, I chose to have a prophylactic double mastectomy in March of this year, which reduced my risk of breast cancer to virtually nothing. While I’m not grateful for my BCRA1 mutation, which I could have definitely done without, I am beyond thankful for the knowledge and ability to do something about it.

1915226_103373879680821_1945813_n

Yes, this is the same procedure that Angelina Jolie underwent. And this is another reason I want to share my story. I remember when Angelina’s news came out, I heard a lot of different reactions. At that time, I already knew I had the BRCA1 mutation, but I hadn’t fully committed to a course of action yet. I remember the women talking about Angelina’s surgery at my pilates class. Although some used the word “brave”, most were using words like “extreme” and “drastic”.

I thought, “extreme?” Do they not know how extreme the risk of breast and ovarian cancer is with this particular genetic mutation? Would they still think it was so drastic if they knew that with this genetic mutation, we have a 40-85% chance of breast cancer and a 25–65% chance of ovarian cancer and that cancers occur at younger ages  and are much, much more aggressive than in women without this mutation? Would they think it was so extreme if they knew that there is no single test that can reliably detect ovarian cancer at a pre-symptomatic stage?

For reference, the average lifetime risk for women without the mutation is around 11% for breast cancer and 1.5% for ovarian cancer. Now, look back up at those numbers above. Isn’t that pretty extreme?

I know lots of people will continue to disagree with this choice. But very few of those people are medical professionals or researchers, who are pretty much in unanimous agreement on this topic, which doesn’t happen often. The science is so strong that our government health plans covers 100% of the costs because they know that prevention will cost them a whole lot less than cancer treatment, which also doesn’t happen often.

I’m not out to change anyone’s opinion, but by sharing my story I hope maybe some people will think, “hey, if Jill chose to do this, maybe it’s not really that crazy after all.” I also just met a girl at a party over the weekend who was going to be doing the genetic testing in the near future because her father had prostate cancer (also linked to BRCA). I shared that I am so happy I made the decision to do this, because although I don’t know what else will get me, I know that it won’t be breast cancer. I shared that although it’s major surgery and the recovery isn’t easy, the anxiety I experienced before receiving my test results and before undergoing the surgery was so much worse. I shared my experience, and she told me it was comforting, since now she knew that even the worst case scenario wasn’t all that bad.

My journey isn’t over, since I have a surgery in November to complete the reconstruction, and the next step will be to take care of my ovaries, which is a whole other complex set of decisions. But I am so so so thankful for the opportunity to take these preventative measures. I’m so grateful for my wonderful medical team and thankful for a wonderful recovery with amazing support from my sister, boyfriend, friends and coworkers. I was lucky that I didn’t run into any complications, and I’m completely thrilled with my cosmetic results. I am grateful to my mother for having the test done when she received her own cancer diagnosis and I’m grateful that science has come so far to enable this option which didn’t exist when her own mother died of the same cancer 20 years before. Through this whole process I have been so thankful that I live in a country where this testing and treatment is made available to me at no cost, and thankful for access to some of the leading doctors in this field. I am just so grateful for the knowledge about my BRCA1 mutation and for the ability to do something about it. Thanks mom. Thanks science.

If you or someone you know is faced with this difficult decision, visit My Destiny or the Prophylactic Mastectomy Facebook Group for information and support.