Yesterday morning I headed to the lab with my two requisitions - one for LH and progesterone as part of my FET protocol, and one for TSH and CBC as part of the routine updating of my bloodwork for my fertility clinic's records. A 40-minute wait and three vials of blood later, I was good to go.
I was hoping my blood would show low numbers for LH and progesterone indicating that I hadn't ovulated and wasn't about to. Ovulation would mean that my estradiol pills haven't been doing their job and also that my body is prepping to shed the lining.. that would be bad because then there wouldn't be a nice cushion for my embryo to stick to. I wasn't particulary concerned about the routine TSH and CBC check.
I had a relaxing morning and then headed out to meet hubby for lunch. It's kinda nice to have a lunch date on a weekday because that's not something we can normally do. While we were eating, I checked my blood results online on My E-Health. First up was progesterone - 1.7 meaning there was no way I ovulated - YAY! Next was LH - 12.9 indicating that I'm not likely to be currently ovulating - another YAY!
The CBC was good too. It showed that my red and white blood cells were in the normal range. This was a bit of a relief because last time I had them checked, my white blood cells were out of range. This was due to the IVF meds, but it still scared me.
The results for TSH took a while longer. When they showed up, I saw a level of 3.88 which is well within the normal range, but not within the desired range to do fertility treatments. Most clinics want your TSH to be under 2.5. This also explains why I've wanted to sleep so much and take naps after a full night of sleep. I thought it was the estradiol pills, but now I realize the fatigue is from hypothyroidism. All the meds I've been taking increase TSH too, so when unmedicated, it's possible my natural TSH isn't as high.
When I went in for my initial consulation in the summer of 2014, my doctor said that my level was higher than he wanted to see, and he'd re-test me in a few months. By November 2014, my level was significantly lower, showing that it was moving in the right direction, so I was never sent to have it tested again... until now!
So if it's within the normal range, what's the big deal? Well, even though under 5.5 is considered normal according to the lab reference range (although recently, endocrinologists say under 3 is the "new" normal), levels over 2.5 in the first trimester are highly linked to miscarriages. So unless you're pregnant, 3.88 isn't a big deal. And since I'm intending to be pregnant in a week, I got pretty jumpy.
After lunch I headed to my parents' place for a while. I was waiting for the clinic to call me even though I knew I might not get the call til the following day. I worried that they would cancel my FET and that I'd have to sit around and wait for months to try again. I felt sad and mad. I wish they had tested it routinely to make sure my TSH kept going down, so we could have prevented this. Then I realized that maybe I wanted them to cancel it, so that I wouldn't waste my embryo. I'd rather not get pregnant then get pregnant and miscarry. Dr. Google confirmed what I already knew: going ahead with this level of TSH was pretty much asking for a miscarriage.
Eventually, I thought I'd drive myself crazy, so I called the clinic myself to talk to a nurse even though I was supposed to wait for them to call me. As usual, I got the voicemail. I explained that I was concerned about my TSH level and that I wasn't sure if my cycle was cancelled and that even if it wasn't, I didn't want to go ahead with it unless they could treat my TSH simultaneously. And then I went back to waiting for a phone call. I thought about how I'd taken 60 of those little blue Estrace pills, how I'd paid a good chunk of money, and how I'd woken up in the wee hours to take trips to the clinic... and now it might all be for nothing.
I was relieved to get a quick response - the doctor reviewed my results and said I'd start Synthroid right away to deal with my hypothyroidism and get my TSH down and that we'd continue with the transfer as planned. If I get pregnant, they'll test the TSH again to make sure it's gone down. Umm.. well that was simple. And unexpected. And made me feel silly for letting my thoughts take over without even knowing what would happen.
Fertility treatments make your mind funny like that. You try to be positive, you try to be optimistic, you hang onto hope even when the odds are against you, but one tiny thing really can ruin everything. This time I was lucky, but I've already had two cancelled treatments, so I know it's a very real possibility. I'm glad it didn't happen for the third time, though. I feel relieved and happy and blessed and excited that things are moving forward.
Our transfer date is Tuesday, September 8th, the first day of the fall semester! With two days of bedrest following the transfer day, that means I'll need Wednesday and Thursday off of work too. And since I don't normally Fridays, that means I'm missing the entire first week. Not ideal, but I'm still lucky because:
A) it's registration week, not classes;
B) I have a colleague who can cover for me; and
C) I have another colleague who's helping me get set up for when I begin teaching the following week.
So now there's five more days. FIVE. MORE. DAYS!!! My entire life might change in 5 days and that is just oh-so-exciting. Meanwhile, I'll be busy trying to keep track of all the stuff I need to pump into my body to get ready for our little snowflake to be thawed and brought home to my uterus. I'll save that for my next post though.