Guest Blogger Jessica Green: Medication

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Today has a lovely subject. Medications.

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Now before I start going into all the wonderful things you may be subject to take during your journey, let me just state, that it will sound like A LOT, but it really isn’t when you get your schedule. It’s a lot easier than it looks. (Coming from the girl who forgot a dose of estrogen last night. Im only 9 weeks and this pregnancy brain is killing me.) But it isn’t. I swear.

Okay, so obviously, as the one I just mentioned, you will be on Estrogen. I’m going to use the internet to help me describe this in an easier way than how I would describe it. I would probably do a terrible job.

Estrogen is most certainly needed during fresh donor-egg and donor-embryo cycles. Oral estrogen pills, typically 6 mg per day, are the norm. Their start date forms part of the synchronization between your and your donor’s cycle. A lining scan at least three days before your donor’s scheduled egg retrieval (or day 14 or 15) gives you time to adjust your estrogen intake. If your lining is too thin, an extra 2 mg, or even 4 mg, may be suggested. (For frozen embryo it is more based on your cycle, rather than your donor.) (http://www.yourivfjourney.com/estrogen-why-do-fertility-patients-need-it/)

So you take that 3 times a day.

And then you have the choice between a progesterone in oil shot, or suppositories. (This is where there is a big difference in commitment to meds I think LOL. You will see in a moment.)

Donor-egg recipients need them too (progesterone). In donor-egg treatment, your ovaries are down-regulated for at least six weeks. If you’ve got premature ovarian failure, they’ll have stopped of their own accord. With your ovaries out of the picture, progesterone support is even more important. One missed dose during donor-egg treatment could spell disaster in those early weeks.

Frozen embryo transfers (FETs) use progesterone support as well. So if progesterone is used in frozen cycles, when down-regulation doesn’t even occur, you can safely conclude that your endometrial lining can’t get enough of it. Well, at least until your placenta is producing gallons of the stuff – typically between weeks 9 and 11 of your pregnancy.

And this is where it gets tricky, and you get to choose. You can take:
a) 1 injection of 2ml of progesterone in oil.
b) 3 progesterone suppositories and 4 prometrium a day (it averages to 1 every 2 hours or so)

Can you guess what I take? That’s right, one time, one needle, bam. Done. There’s no way I could remember that many pills, plus I enjoy my naps. It would just never work LOL.

Now those are the NORMAL things. That’s it, see, not so bad right?

I wanted to just touch on a couple more things that could be a thing, and usually come up after a failed transfer. (Don’t sweat, it happens, its super common.)

Fragmin, it happens, don’t be afraid of the bruises.

Clexane/Fragmin is a blood thinner, or anticoagulant, and it comes in different strengths. Its active ingredient is a substance called enoxaparin. Clexane is used fairly routinely in general medicine to stop blood clots. Think deep-vein thrombosis (DVT), pulmonary embolism and bed-ridden patients who don’t move much.

You’ll probably start taking your daily Clexane subcutaneous injections on your embryo transfer day. But your clinic may start them on day 1 of your stimulating medication. 20 mg daily is common. Doses of 40 mg or more may be suitable for certain patients.

If recurrent miscarriage is an issue, Clexane is thought to help prevent blood clots from forming in the embryo and placenta. It may also increase the production of substances involved in successful implantation, thus reducing the ‘immunological’ causes (if these causes exist at all) of recurrent miscarriage. (http://www.yourivfjourney.com/the-truth-about-clexane-and-fertility/)

And lastly, there is something called intralipids, that is usually at request at the intended parents, it’s not in all cases of FET or fresh donor transfers, but does come up.

Since the 1960s, intralipids have been fed intravenously to patients to boost nutrition after operations. Premature babies get them too. A blend of soya bean oil, egg yolk, glycerin and water, intralipids infuse your body with calories. You might not make these essential fatty acids yourself – or at least not in the quantity given.

A typical course of IVF intralipid treatment is two infusions: the first one 7 to 10 days before your scheduled egg retrieval; the second on your embryo transfer day. Some clinics propose a third infusion after a positive pregnancy test and monthly ones till the 13-week mark.

Okay! Enough about meds! A little about me and this week? Why not.

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I swear I’m starting to show, even the slightest bit. I’ve been losing weight with this thing, and my top part of my abdomen is fluffy, so ugh. Maybe, BUT IT IS SO SOON. You can’t know how big I get, so showing early sucks for me, cause I turn into a planet. You will see, just wait.

BUTTTTTTT. I did get to go see one of my favorite other surrogates. Her name is Holly, and I have to admit, the first time I met her, we look like polar opposites. She very much fits the “mom” look. And I obviously don’t. Either way, she’s carrying for a set of parents overseas. She carried a set of identical twins in 2015, and she’s due in June! I went to go with her and get her pregnant when she went for her transfer. And it was the first time I met my intended parents! They took us out for dinner, and then I vomited it all afterwards. (It’s a long story LOL)

We live about an hour apart and our lives are stupid for trying to see each other on any regular schedule. But I was able to bring my daughter and we went swimming with her and her kids, and it was so nice to be able to sit around and vent about all the life that has been going on these past few weeks.

Shes setting up for her home birth in the coming weeks, as her labours move much too quickly for her to even think about leaving her house. The poor girl would be one of those terrifying videos of the woman birthing in the car. And no one wants to birth like that. No one.

But here we are, getting ready to swim, just so you can see how opposites really do attract. <3

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She’s the cutest.

But for now, this week? Just gearing up for the student burlesque showcase, and I got to see my doula again, and book my appointment with my midwife. So everything is coming together, but there is still just a lot of sitting around and waiting.

OH BUT SMALL VICTORY. My diclectin has kicked in. Which you all should cheer for, because well, cranky, nauseous pregnant chicks are no fun. All the meds for this girl! I am so over the nausea.

AND WAIT. We do a secret sister gift exchange, and I got my gift, and it’s so pretty, so I will show you that too. Even though I still don’t know who sent it. Ha. But it’s a beautiful quartz with a stand. (Not that I knew that in the beginning, I was really confused what the wood thing was, I got help from another surrogate LOL)

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