IUD Removal & Whats Next?

This is all the supplies fo

Removal:

Honestly, that was not that bad.

It was quick and easy.

I cramped a little bit, but it was nothing I was not used to.

I was very surprised with how small these devices really are.

Whats Next?

This is how small a Mirena IUD is.

Well, since we already stopped the Arava, and Methotrexate 3 months ago, and I have already completed a preconception appointment with Dr. Perni to come up with a plan for pregnancy, we have a general idea what the next steps are for us.

We have a Fertility Appt on January 3rd 2020, with Dr. Nash at Reproductive Gynecology and Infertility in Akron, and he will be requesting that Andrew get a Sperm Analysis, and likely will want me to get an HSG, but after that, I forsee him RXing me Femara and Gonal-F, since this is what worked with my son. We need to discuss with him the possibility of conceiving naturally with Gonal-F and Femara, or if we should realistically consider IVF. We will also need to talk to him about PIGD (pre implantation genetic diagnosis) which is something our MFM agrees we should get, and she also agrees that when we are pregnant we should get MaterniT21, and an Amniocentesis.

The current plan is:

Follow Dr. Nash' recommendation. He will transfer care to Dr. Perni at 13 weeks. As far as meds go:

Progesterone in Oil until 13 weeks

Cortef, Florinef and Prednisone for management of my Addisons.

Synthroid for management of my Hashimotos.

Metformin 1000mg X2 for my Type 2 Diabetes

Lovonox 40mg X2 Daily, to prevent complications with Factor V Leiden and my history of DVT/PE

Makena Injection at 18 weeks to prevent pre-term labor.

Novolog 70/30 and Lantus during pregnancy since Bydureon is not safe.

Ixinity 1500 IU for delivery to prevent hemmoraging, and taken for 6 weeks postpartum with Lovonox.

Endocrinology wants to see me in March. Rheumatology in April. Pain Management as needed. Neurology in February. Hematology has been seeing me monthly, so once I am pregnant we will plan what to do with Dr. Escuro and Dr. Samaras.

Endocrinology has recommended I start on DHEA  which also studies show help improve pregnancy loss risk. I have severely low DHEA levels due to my addisons, and low DHEA causes a whole boat load of problems.

Dr Perni wants to Plan to induce, and do biophysical profiles, fetal echo cardiology, amnio and MaterniT21. She also wants Andrew to get Genetic Carrier Testing done to ensure that he does not carry anything in his family history that he is not aware of.

As far as our plan?

We're going to just try, and have fun. Not try, not prevent. But have tons of fun.

I am using many methods. I have OPKs, Pregnancy Tests, Proov to check for progesterone level, I am using OvuSense to try to detect my BBT more reliably, and also try to see if I ovulate, and we are also charting. We are going to be using Fertility Tea, and Pre-Seed as well, so that we can have more fun "exploring" one another, and enjoying our intimacy.

We're hoping and praying that it happens in 2020, and that it will be without heartbreak, or loss.