Thursday, May 20, 2010

Walking Pharmacy (FET Medications)

This post is going to be very boring for anyone who isn't looking for information on an FET. However, as I am wanting this blog to also be informative for people hunting information Embryo Adoption, I want to include the information.

So unless you want the boring details on all the different medications you're on for a transfer, skip this post.

DISCLAIMER: This post is NOT intended to be medical advice or comprehensive in its information. Never begin a medication protocol without discussing it with your doctor and your spouse and doing your own research. This is informational ONLY, for those just beginning to research the Embryo Adoption Process and who want to know what to expect.

I'm currently taking all of these every day, except numbers 1 and 12, which I alternate.
FET Meds

An explanation of each:

1: Progesterone: You will likely be on some kind(s) of progesterone. In 3 transfers, I've been on several kinds. This particular one is a vaginal cream called Crinone. In previous transfers, I've taken a vaginal suppository called Prometrium. You can also get it in injection form, which I am also on (see below for more info). In every transfer, I've been on multiple kinds of progesterone. Progesterone matures the uterine lining and makes it receptive to an embryo to implant. Progesterone typically starts the week before the transfer and, if pregnancy is achieved, continues throughout the first trimester.

2. Fish Oil Capsule: I take this every day as a supplement to make sure I'm getting the right kind of Omega 3s. The kind of Omega 3 Oil found in fish is only found in fish, and I hate fish, so I take the capsules. Omega 3s are good for your health anyway, but studies suggest it's especially beneficial for mom and baby during pregnancy.

3. My Daily Vitamin: Your doctor may prescribe a prenatal vitamin, or coach you to just take your regular vitamin and a folic acid tablet on top of that. My doctor has told me there's essentially no difference. I take this particular combination because it's one of the few vitamins I've found that is in capsule form (no nasty vitamin taste!) and it doesn't upset my stomach. Your vitamin/folic acid regimen should begin well in advance of your transfer so that levels are good when the baby is introduced.

4. Folic Acid

5. Levothyroxine: Thyroid medication. Though you may not have thyroid issues, your doctor may want to check your levels before your transfer, and after, especially if you have metabolic or hormone issues (which may women facing an FET do). Messing with all your hormones can wreak havoc on your thyroid. My problem is genetic, but was not discovered until a transfer cycle.

6. Cephlex: Antibiotic. Your doctor will put you on an antibiotic for the few days before and just after the transfer, to make sure you don't develop an infection from the procedure. I've typically been on either Zithromax or Doxycycline, but in this case, I already had a sinus infection, so my doctor just had me use this one, stronger antibiotic for both. Your doctor may or may not put your husband on an antibiotic too (my first doctor did, second doctor did not). The way I understand it, it is to prevent you from infecting him if you did develop anything.

7. Prednisone: I actually take 2 of these per day, but that's my last one so it's only shown once. Prednisone is a steroid. Both of my doctors have prescribed a steroid for just before the transfer until a few days after it. It is believed that it aids in implantation, and suppresses your body's tendency to attack the embryos as "foreign."

8. Acidophilus: I take an acidophilus supplement to ease the impacts of the medications (most specifically, the metformin and the antibiotic) on my stomach and digestive track.

9. Metformin: I have PCOS, and I take Metformin to treat its ovulatory and insulin effects. If you are on it already, most doctors keep you on it throughout the first trimester of pregnancy.

10. Estrace: is a form of Estrogen. It is begun a couple of weeks before your transfer and continues through the first trimester. Estrogen is essential for your uterine lining to develop appropriately for a baby and pregnancy. In a naturally occurring pregnancy, your body would produce its own estrogen for this matter, but since your body didn't manufacturer this baby, it doesn't know to start its engines and produce it accordingly, so you have to do this step artificially until the body catches on.

11. Baby aspirin: increases blood flow to your uterus and the uterine lining, which aids in implantation. If you start spotting, your doctor may determine that your blood flow is adequate and take you off it.

12. Progesterone: I take progesterone in Ethyl Oleate. You may take it in that form, or in an oil compound. I previously took it in sesame oil, which is common. I was taken off it due to an allergic reaction. The oil is drawn up with the big needle, and then you switch the needle to the one with the blue end, which is much finer in diameter. This is the needle used to inject the medication. Your doctor will instruct you to administer it in either your hip or your thigh. It typically begins a week-ish before the transfer, and continues throughout the first trimester.

I was terrified of the shots at first, but if you or your hubby are taught well how to administer them, they're a piece of cake. Put the bottle in your bra for half an hour or so to warm it. This thins the oil and makes it easier to administer. Don't artificially heat the oil because you don't want to burn yourself from the inside. If you don't want to go the bra method, use some other form of natural heat (such as friction between your hands).

Rub the top of the bottle with an alcohol swab. Fill the syringe with air, then plunge it in to the bottle and depress the air out. Then draw up the medication, slightly over the amount you're going to take. Trade heads on the needle. Flick out any air bubbles out of the needle and plunge some of the medication out if needed. Swab the area of the skin with an alcohol pad. Pull up the area, and pinch it, HARD. Relax the muscle by lying or sitting, or standing on the opposing leg.

Put the needle in straight, quickly, and all the way. Plunge the medication as quickly as it will let you, then withdraw the needle quickly. Massage the area hard, especially if you're using an oil compound. You don't want the oil to sit under your skin because you'll get knots and bruises. I also recommend putting a heating pad on the area after you're done to aid in the same purpose of dissipating the oil. Make sure you alternate sides so that you don't develop any one area that's too tender. Often times, it's the knots and bruises that hurt, not the injections themselves, so make sure you take the time to work them out.

13. Not pictured: Birth Control. If you suffer from irregular periods, your doctor may choose to put you on birth control for one cycle, in order to be able to better schedule your protocol and anticipate when the best time for a transfer would be. I did the BC route for transfers 1 and 2. With this one, I was regular enough on my own that I was able to skip the birth control, which I appreciated greatly.

14. Not pictured: Valium. The uterus' natural reaction to something invading it is to want to cramp up and expel it. Your doctor will more than likely, put you on valium (or something similar) to relax your uterine muscles for the day of the transfer, and prevent it from cramping up and wanting to kick out the embryos and the transfer tools. Make sure you make all decisions about thawing and transfer before you take the valium, because it can be very altering. You typically take this one hour before your transfer, on the day of transfer only.

That's it!

I've been on 3 FET protocols with two different doctors and they've roughly been some variation of this. Your doctor may have his own preferences but some combination of these kind of drugs (a vitamin, estrogen, progesterone, a steroid and an antibiotic) is pretty standard. Feel free to ask any questions and I will answer to the best of my ability!


  1. WOW! I have 'heard' about all the meds, but to 'see' them! Thanks for the post. This will be a challenge for me. I am a natural & organic girl and AVOID drugs and only go that route IF nothing else is working.

    I am grateful for your post, because now I have an organized list of questions to ask the RE on my visit in a couple of weeks! : )

  2. Your title made me laugh. :) I'm also taking half a million pills each day (ok, just 14, but still!) and feel a bit like a walking health food store. ;) Seems to help, though; I feel better and stay healthier, so I guess it's worth it!

  3. You really are a walking pharmacy and Lord willing, I will be soon too!