An Ultrasound, Acupuncture and Choosing Embryos

This has been a busy week! I helped my sister move, had my screening ultrasound, mediated in Sandy and Utah County courts, had 3 cavities filled at the dentist, saw Wicked (the musical), went for my first acupuncture treatment and am babysitting two of my nieces as I write this!

Screening Ultrasound

Our embryo transfer day is coming up fast, so on Tuesday I went in for my screening ultrasound. In the screening they just look to make sure my uterine lining (endometrium) has thickened enough to make a nice home for a growing embryo. Mine measured 12 mm thick, which means the estrogen pills I have been taking are working. The doctors want the lining to be 7 mm or more, so I am in good shape.

Endometrial thickness has become my topic of research this week! I asked the nurse and found out that mine was 14 mm thick at this time in my last cycle. From what I have found, most doctors consider optimal thickness between 7 or 8 mm and anywhere from 14 to 16 mm (most reliable websites said 14 mm). I figure 12 mm is pretty good since it will likely continue to thicken some over the next few days. Too thin is not good for implantation-in fact if it is less than 5 mm it is very unlikely a pregnancy would occur. Thicker is usually better, but some studies have found a decrease in pregnancy rates when the lining is thicker than 14 mm (which mine probably was at the time of my last transfer, since it was at 14 mm a week before it).

After the ultrasound I met with the nurse and she put me on the schedule for our embryo transfer: Monday August 11. We won't have an exact time until Sunday, but I suspect it will be in the morning since our other two have both been before noon. She also reviewed the medication changes with me: same protocol as last time...decrease estrogen from 3 pills a day to one and start progesterone injections (which we did last night and the shot was just as bad as I remember it).

Choosing Two Embryos

At my appointment on Tuesday, Dr. Moore mentioned our embryos and I told him we for sure wanted to use the best one, but hadn't decided which other one to use yet. I assured him we would email him with our decision in the next two days.

Yesterday Dr. Moore called Ryan with some interesting news that would impact our decision: the embryologist had not frozen all of our remaining embryos each in their own straws; the 5B2- was frozen in its own straw, but the two 6B2- embryos were frozen together and the two 6B3 embryos were frozen together. (To read about the quality of the embryos and the chances of twins click here.) In other words, if we want to transfer two embryos we can't use our best one as one of those. We decided to do the two second best of our remaining embryos (the 6B2- embryos). We emailed the doctor last night just before walking into the theater to see Wicked, so our decision is final.

Acupuncture

I have been reading a lot about acupuncture and infertility lately and found that many women use acupuncture to help improve their chances of achieving a pregnancy with IVF. I have read about women who go in for regular treatments once a week for months before a transfer and even some who go in for daily treatments the week before or treatments right before and immediately after an embryo transfer. In several studies acupuncture has been shown to improve the chances of IVF resulting in a pregnancy. Even though it is not a surefire remedy, it can't hurt. I decided that since we have failed twice, I might as well try something new this time around.

Acupuncture is a useful treatment for IVF because one of the main benefits increased blood flow throughout the the body-including to the uterus. Good blood flow to the uterus is important for implantation of an embryo. Acupuncture can also help to balance hormones and align meridians. In Chinese medicine, meridians are the defined pathways that allow the flow of energy (chi) to reach specific organs. It is believed that illness occurs when there is a blockage in one of the meridians. Acupuncture is also great way to relieve stress and help keep the body balanced and healthy.
 
Today I had my first acupuncture treatment at the Center for Reproductive Wellness in Millcreek. Lisa, the acupuncturist,  has 14 years experience in acupuncture and even did an extended internship in Beijing in 2001. She specializes in fertility treatment, but practiced general acupuncture for several years and worked in the medical field for years before that. I like her approach to treatment because she practices eastern medicine, but supplements her treatments with western medicine ideas.

When I first arrived we discussed my medical history with an emphasis on my past infertility problems, treatments and procedures. I really liked Lisa and felt very at ease with her. We discussed some of the different options for using acupuncture to improve the chances of IVF; for example she offers a service where she actually comes to the office where a patient is having their embryo transfer done and does a treatment right before and immediately after the procedure (that costs more than we can spend right now). She was not pushy at all and just told me about some of the different things she has had patients try.

About an hour in, we finally got to the treatment part. She dimmed the lights and had me lay down on the table (like a massage table) with a pillow under my head and one under my knees, and rolled up towels under my hands at my sides to elevate them slightly. Next she used cotton balls with rubbing alcohol to cleanse the areas where she was going to place the needles. 

I have always heard that you can't even feel the needles go in, but I found that is not true. I did not feel all of them, but I did feel most of them. The needles are very thin and about two or three inches long with light blue ends. She started by putting some needles (2 or 3?) in my forehead, then in my scalp, then one in each ear and hand. By the time she was done I had several needles in my stomach, down my legs, in the sides of my heels, one in each foot between my big toe and the toe next to it and one behind each ear (sorry I did not get a picture). I never felt more than a little pinch-almost like the feeling of plucking out a single hair from your head.

The next part felt a little strange: she flicked each needle to sort of activate them and I felt a sensation like a little jolt of electricity (she called it a zing). She put an infrared heat lamp over my feet and legs and turned the lights all the way off. Then she left me to just lay still, listen to the calming music and relax for 30 minutes. A couple of the needles caused a dull achy pain (one hand and one foot), but she said that some pain or tingling was normal and after a few minutes it went away.

She came in and "zinged" the needles one more time and moved the heat lamp up over my stomach about 10 minutes in. Before long my hands started to feel heavy and the feeling slowly moved up my arms. By the time she came back to take the needles out I felt like I had a heavy quilt over my body. I felt like I was sinking into the table...and I was SO relaxed and even a little tingly. I left the office feeling great (and ready to take a nap)! I lay still on a warm massage table with my eyes closed and soft music playing in the background for an hour once every three weeks while I get my eyelashes filled and that leaves me pretty relaxed, but this was a totally different feeling than that. It's hard to describe. I just felt so at peace and calm.

I definitely liked the acupuncture treatment and will do it again. I plan to go in on Monday before our embryo transfer if Lisa has an opening (she gave me her cell phone number so I can call her on Sunday night after I get assigned a time) and then probably one more time about three days after. If it increases my chances I am in. Plus I felt good enough after that even if it didn't work I would still want to get an occasional treatment for the stress relief benefits.