I wanted to share a bit about the process for a frozen embryo transfer (FET) with hopes that it helps if you find yourself in a similar spot or if you have friends/family going through it. Keep in mind, I am not a doctor and I’m not in the medical field so I might get little details wrong and everyone’s experience will be a little different since the treatment and protocols are personalized based on each situation. Plus, I’m going off memory of what the doctors tell me, so don’t take any of this as medical advice or as an indication that your process will be exactly the same.
What I am hoping to share is what I’ve experienced mentally, physically and emotionally since fertility treatments involves so much more than doctor appointments. Also, if you decide to leave a comment, please be kind. This is a hard, sensitive time for Tommy and me but I truly do hope that sharing my experience can help others.
We did an egg retrieval cycle at the end of 2019 (which I can write about if y’all are interested) so we’re now starting the process of using a frozen embryo. Most people get a lot of eggs out during the retrieval but because I have premature ovarian failure, that’s not what we’re working with. Given that, our doctor wants to be as precise as possible when we do transfer our embryo so we are doing an ERA cycle.
ERA stands for Endometrial Receptivity Array (ERA) and it’s a diagnostic procedure to help determine whether the endometrial cavity is ready for embryo implantation. It’s a type of mock cycle where we’re doing everything that they would do leading up to a frozen embryo transfer, but they won’t actually transfer this month. Instead, they’re checking things along the way and adjusting medications and timing and doing a couple biopsies and tests (including the ERA) so we have a higher likelihood of success when we do transfer.
Once we decided we were ready to start the process, all I had to do the first month was notify the fertility clinic when I started my period. Then, I went in about a week later.
The first step was an appointment to measure my uterine lining, have a uterine lining biopsy and then to start taking estrogen pills 2x a day, baby aspirin once a day and applying an estrogen patch every 3 days. The biopsy was painful for a few seconds but the measurements were significantly more painful and that lasted about 5 minutes. That part should NOT be painful but moving the device around internally was causing extreme pain, bringing me to tears, and they’re not sure why. Thankfully, that hasn’t happened since.
After a few days of estrogen pill and patch fun, I went back in to have my lining measured again and to get bloodwork. The thickness hadn’t gotten to a point where they were happy moving forward with the next step in medication, (they were looking for 7-8mm and I was only at 4mm) so I continued the estrogen protocol. They also also added in another medication, Trental, (a tablet that I take 3x a day) to help with blood flow to my uterus. That caused even more dizziness and weird headaches that seemed to circle throughout my neck and forehead. It was a super odd sensation.
Last Friday, I went back in for another lining check and more bloodwork. My uterine lining was almost where they want it and my blood flow has improved so we’re moving onto the next step – daily progesterone in oil (PIO) shots in the booty. They drew some squares on my butt with a permanent marker (it’s a suuuuper cute look, ha) to make sure we inject in the right spot and told me to massage the heck out of it after the injection since it can cause a lot of pain if I don’t.
Apparently the progesterone can cause constipation, which has already been a struggle since I started estrogen (GREAT) so I’m going to be even more conscious about my diet and take my fiber supplement more regularly. I’ll also add in a stool softener if need be.
I’m on day 3 of the PIO shots and the shots themselves don’t really hurt, but the medication is very viscous (since it’s in an oil) so it’s incredibly uncomfortable going in. The pain lingers for days, but I’ve found that warming the vial before injecting helps and afterwards, a hot shower, running and a heating pad all all help. The lingering pain feels a bit like dry needling pain… just a dull ache.
So what happens next is I continue the estrogen pills and patch, aspirin and blood flow medication and keep doing the daily progesterone shots. I start taking yet another pill tomorrow (Medrol). I’m not entirely clear what it does, however. Then, I go back later this week for the ERA biopsy and more bloodwork.
If all looks good there, we’ll stop medication and let my period start. Once that happens, I call them back and we start the whole process over — medications and appointments and all — with the hopes that we can transfer an embryo the next month. However, I know multiple women who have gotten to the transfer week and things weren’t ideal for a transfer so it didn’t happen, so I’m trying not to get too far ahead of myself and just taking it one appointment at a time.
The medication side effects are rough, for sure, but the waiting and the unknown and the unpredictability are the hardest part (The accompanying emotions aren’t fun either.) Thankfully, I’m in good hands. Everything that I’ve read online says the success rate for an FET for someone my age (38) is around 25-35% but my fertility clinic – Carolinas Fertility Clinic – has one of the highest success rates in the country, at 80%.
Physically, I noticed dramatic fatigue, dizziness and nausea after starting estrogen. I’ve also had problems falling asleep and have been awake until 2 am multiple nights. The fatigue and dizziness are oftentimes so bad that I can barely get out of bed and have had multiple days where I worked from my bed or worked from the couch. But other days I feel totally fine throughout most of the day, But without fail, by the end of the night, I almost always have nausea.
The needle doesn’t hurt (and needles don’t bother me) but the first time we did the shot, I almost passed out and had to lay on the sofa for 15 minutes. The second time I was fine and today, I just got a little dizzy but was fine a few minutes later. I’m thinking it’s just nerves and a rush of adrenaline.
Mentally, all of the nausea, dizziness and fatigue has been frustrating since I’ve felt pretty darn bad on some days and I’m not even pregnant. So thinking about being sick for two months before I’m even pregnant is mentally hard. But I try to just take it day by day and I’m also tremendously grateful that I now work for myself so I do have the flexibility to work less and work in bed.
I had the ERA biopsy last Thursday. Honestly, I barely knew it was happening. I didn’t find it painful at all, but I had taken 800 mg of ibuprofen before had. After the biopsy, I got a nice break from shots and all the pills. I’ll get my results back in a week or so, and the next step is to start the estrogen pills and patches again, once my period starts. Then, we repeat the whole process.
I sobbed after the first appointment we went to when starting the process, but I’ve been okay since then. The pain started the tears and then I just couldn’t stop crying since it was all so emotional, thinking about the whole process the last time we were at the clinic three years prior and what might happen this time around. Thankfully, Tommy was with me at that appointment and just held me while I cried.
Tommy is hugely supportive and thanks me every day, multiple times a day, for going through all the medications, appointments and side effects. After the first appointment, I told him he didn’t need to come because sometimes the wait time is extreme. (At my second appointment, I waited 90 minutes to even be called back. It was like this during our egg retrieval process too so I’ve learned to take my laptop and just work while I wait.)
I carry a lot of guilt and fear around that, even before we know the outcome. And yes, I know logically it’s not my fault, but we’re going through all of this because of my body, ya know? I would tell someone else in my same shoes that it wasn’t her fault, but I’d also understand the emotions completely.
When I start to feel overwhelmed by everything I need to remember (so many pills with various timings and changing schedules) or the potential FET transfer (what if it fails?!), I remind myself that ultimately, God is in control and he works all things for our good. I also LOVE this verse in the Bible:
he is before all things, and in him all things hold together.