Friday, July 27, 2012

welcome weaning? not sure

First of all, I know. I know, I know, I know. The placenta takes over. By about 10 weeks, it's all placenta all the time.

Still. I am experiencing weaning worries.

Probably not entirely rational.

On Monday, after the ultrasound, I got a call from the U.S. RE congratulating us on the great u/s and the continuing pregnancy. I tried to ask him questions about weaning and he referred me back to the nursing staff. I decided not to be a door mat and just voice what my concern was. He still was quick to get me off the phone, but tried to answer my question. He seemed very sure in saying that ovaries don't do anything once the placenta takes over.

That's also what my research on the subject has led me to believe, but when one has ovaries that cannot be visualized on an u/s and have never put out any amount of estrogen or progesterone, one has to be 100% sure of this. There's another life at stake now.

The nurse phoned later on in the day. She said that she wanted me to stop my PIO the next day and start prometrium. I balked. At 7w1d? Are you kidding me? When I expressed my discomfort, she showed a willingness to negotiate. While she asks me to trust the treatment team, she also wants me to be comfortable with the steps taken. She mentioned that most women want to get off the injections as soon as is possible, and so that's why the transition to vaginal progesterone happens now in their protocol. I said I had no problem at all with sticking a 1.5" needle in my ass every night (and two on some nights) for as long as it takes. So, I bought myself another week of PIO. Weird on this brings me greater peace of mind.

I am waiting to receive the weaning schedule, but our nurse said that I would be off all medications by August 15. That will be week 10, when it's all placenta all the time.

Dr. RE, our local doctor, wanted to make sure that was well handled, because of what happened last time. We established that the m/c didn' happen because of a lack of progesterone, since I was due to completely wean the day of the u/s of doom. It's hard to have one doc who says we should be cautious and one doc who says you're just like everyone else.

Maybe I am just like everyone else, or other women who go through DE. But the fear is that my complete failure in having a working reproductive system is somehow going to affect the pregnancy. It's not that crazy to think that, really, since we are talking about reproduction. On the other hand, we aren't talking about reproduction anymore (that happened in the lab already), but talking about gestation. And perhaps gestation really is all placenta all the time.

I am thanking my lucky starts that Dr. RE went ahead and booked me for an u/s at 9w. SG did not order another u/s and so I would not have had one until 12w or so through my family physician. That would have meant getting through many weeks of FEAR and ANXIETY without any reassurance (ok, the constant nausea helps to remind me of what's going on).

On a much sadder note, my heart breaks for Jay who just found out yesterday that her little one did not make it. Please go send her some love if you'd like.


  1. I'm sorry that you are so worried. I agree with the comments in regards to ovaries failing and wondering if they will run everything amuck. I had the same feelings. It is hard to trust medical teams when everything is seemingly out of everyone's control. I had a hard time stopping PIO shots even at 12 weeks (when my clinic scheduled it). I am crossing fingers and wishing you all the best and beyond.

  2. Oooof. I can totally empathize with not wanting to wean. A friend of mine who has also gone through multiple IVFs (and multiple miscarriages) is now nearly 16 weeks pregnant. The doctors always wanted her on prometrium once a day for the first 10 weeks. Since this was a change in the protocol from previous ones where she was taking it 2x a day, she went rogue and took 2 a day (and never told them). At 10 weeks she weened herself down to 1 per day. At 12 weeks, she stopped, but not without a lot of trepidation. I hope that everything goes smooth-as-can-be for you. Perhaps you can ask the nurse if there are any studies that have shown adverse side effects to taking progesterone up to 12 weeks in the pregnancy? If not, you can show her a ton of studies that talk about the effects of stress and pregnancy!! Here's to an uneventful 9 months!! :D

  3. I would keep doing the PIO, even if the only thing is does it make you feel better. The first IVF I did until 14 weeks, and the second 12. There was no harm done and I felt a lot better about it. Both times RE's did the weaning schedule.

  4. In this regard, I'd think you'd be like any other DE patient, as none of our ovaries have anything to do with the pregnancy (deliberately shut down and all). That said, I started weaning at 10 weeks from both estrogen and progesterone, per Dr. Gorgeous. VERY slowly. Ended just past 12 weeks. With my completely "natural" pregnancy with LG, I also weaned from progesterone by 12 weeks.

  5. Ooof, difficult stuff. I like the suggestion that you ask if there's any harm, and if not, keep on all the drugs you can! I'm sure your team is right, but ...I'm also sure it's impossible to trust them entirely, not when everything is so damn precarious.

  6. I am a die hard PIO gal too- I just feel it does "more" that any other form of progesterone support. I've also wondered about the weaning process with my m/c's. If there is no harm in staying on the higher dose and PIO, I say go for it! Thinking of you my dear friend! hang in there!

  7. I wanted off cooter shooters as early as I could, but also did that at 12 weeks. If it doesn't hurt, I'd still be on the PIO, too. Add it to the pile of lucky charms, fortune cookies, and prayer beads. Wanting to cover every base is very natural given the bazillions of worries that will roll in your head.

    This bit is the most terrifying by far. My tip is to let the worries in when they come knocking and visualize them as solid objects and feel their heft and then put them down. I imagined them as stepping stones .

  8. the weaning is something I've querried already and I SO get your anxiety. I'm glad the clinic showed some flexibility cause it's their job to ease your mind as much as stick to the clinical regime. And if it feels better to you to stay on the PIO then I say do it. However, (and I'm only speaking for myself, not putting words in your mouth AT ALL..)I do wish I was able to relax more and just put the trust some people do in the decisions of the clinic. It does sound a lot less anxiety ridden If I could act like that, but I know I cant and wont and will always question everything because its so hard to put myself into the same category as 'everyone else'. Anyway, for you Augusta, just take it one week (or day) at a time.
    I like Misfit's tip for visualising worries above. It's a good one :)
    Lots of love to you my PREGNANT friend!

  9. It's very hard not to feel anxious about this. I felt anxious about stopping the suppositories. Anxious when I stopped Lovenox. Anxious when I was told to stop aspirin. Each time, I tried to keep doing them but lost those battles with my doctor. And each time it was okay. But my heart was in my mouth each and every time. It's so hard to imagine rocking the boat, in any way.

    I am so glad - SO GLAD - that you will have an ultrasound at 9 weeks.

  10. Yes, the weaning ... I remember it well. Its so hard for us to let go of the very things that we think are keeping our little bean going. But as hard as it is, you also have to try to trust in your body and in your RE on this one. I am so happy that you'll have a 9 week ultrasound. Thinking of you and your little one and throwing all of my positive energy your way!

  11. I agree with Adele...I felt anxious every time something changed (progesterone, meds, lovenox, heparin) and it's hard not to. I'm glad you have another u/s coming up which will hopefully make you feel even more secure.