Choosing when to TTC, Mulitples, Fertility Treatments

[clk 3,519]

I have a few questions. I'm just asking for opinions and gathering information right now. My Mirena recently decided to fall out after just a few months, and it got my husband and I talking about kids again. I'm only six months out from surgery. Right now I don't know that it's the best timing, but I also don't know that there's anything wrong with the timing, either.

Those that know they're going to try to conceive (TTC) or are already doing it: Did you wait to get to goal before starting? I'm just curious here. I had a perfectly healthy twin pregnancy that started when I was 210 pounds, so I'm not concerned that my current weight will negatively impact my ability to carry or conceive. I just wonder how many wait, and if they worry once they get to goal that they'll never get back. Do people that get pregnant usually return to goal? I'd hate to get so close and never get this close again, you know? I think I'd feel the same way if I got to goal first, though.

Does the amount time out from surgery impact pregnancy? I know a lot of people wait one year because of the honeymoon period and the best weight loss is supposed to be in those first months. I've been a consistent, if somewhat slow, loser. I have no doubts that I'll reach my goal now and expect that I'd be able to lose after another pregnancy, too. But are there other reasons for people to wait?

Does anyone know of any stories of multiple pregnancy post-VSG? This is a very real concern for me. We did IVF w/ICSI and put back a responsible number of embryos but still got our twins as a result. I'd love to hear stories. I don't know that I'd have multiples - certainly the statistics say I wouldn't, but we're doing FET this time around and I've got this gut feeling, much like last time, about multiples. They're great and the pregnancy wasn't hard. But I am VERY concerned about another set of multiples. Not from a "could we handle it" perspective, because when you try for years and years to get pregnant you'll take all the babies you can get. At least, we will. But I'm very worried that my sleeve would cause serious nutritional issues. I ate a tremendous amount of food (mostly Proteins but my nut also recommended lots of carb and fats) while pregnant with my twins (and I "only" gained 60 pounds). There is no way I could eat those calories in solid food now that I'm sleeved. This is complicated by the fact that I am now lactose intolerant and those easy, nutritious foods like cottage cheese and greek yogurt are off limits. I think I'd have to supplement and drink shakes from sunup to sundown.

On that note, do those of you pregnant supplement with shakes/Ensure or something similar? I wonder if it's easy to get enough nutrition simply through eating with the sleeve. I still hate eating and I still rely on one Protein shake a day to get my Protein up between 80-90 grams a day.

And, totally unrelated to VSG - has anyone had a FET here, even before being sleeved? Are you willing to share your experience here or PM me? I've read dozens of stories online but I'm always ready to learn a bit more about the experience.

Sorry to rail off so many questions. I'm just curious. On the boards where I talk about FET there aren't many WLS patients. And of course, I doubt there are a lot of post WLS people here doing fertility treatments. But most of my questions are strictly pregnancy related, so I suppose I might find some ideas here.

Thanks, ladies. Good luck to everyone currently trying and congrats to everyone currently expecting.

~Cheri

[Tiffykins 673]

I can only share my experience. There is more to it than the "honeymoon phase" to wait at least a year. Our bodies endure pure hell during the rapid weight loss phase, hormonal changes, metabolic changes, dietary changes etc etc. The key after surgery if/when you get pregnant is to get out of ketosis (most go into ketosis due to high protein/low carb diets. Fetal brain injury can result from a mother staying in ketosis. Also, Vitamin deficiencies in the mother can cause major birth defects. So, it's recommended to wait a year after goal so your body can adjust to all the changes, and give you the best possible outcome for a healthy pregnancy and delivery. It's not even a year post surgery. The recommendation is a year past hitting goal. But, most end up pregnant before even getting to goal.

NOW, with all that being said. I was cleared just 8 months post-VSG. I had reached goal, my labs were stellar, and I was eating closer to 1200 calories a day with 100 gr of Protein and 100 gr of carbs. No longer in ketosis and trying to maintain my weight. There were other extenuating circumstances to me convincing my surgeon, PCM and discussing it with the nut that I was going to TTC.

Since I am close to 20 months out, I have zero issue getting in 1500-2000 calories a day from food sources. I typically hit 60-100 gr of Protein, and the onlyr carbs I try to keep under control is white carbs. I've been below goal for a year now. My labs are still stellar. And, here we are in our 11th month of TTC and NOTHING ha. I go next month to start the fertility assistance program with our insurance. Essentially, it's lab work for me, hormone levels and then they'll put me on Clomid. I'll do that for up to a year, and then we'll have to figure out the next step after that. The mister has already been checked and his swimmers are superb. YAY HIM :cheer2:

I've seen more band patients struggle with weight regain and not being able to get it off than I have RNY or VSG patients. The couple of VSG'ers that got pregnant at goal, were able to lose within 6-12 weeks of delivery. They only gained between 17-26lbs from what I can remember from their stories.

I have cut myself off from the pregnancy board on obesityhelp.com because I'm pissed we are not pregnant yet. I'm far too obsessive to frequent that board anymore and it's just a devastating emotional blow time after time when I go there to read other people's stories.

For me, I wasn't willing to wait. I knew what I needed to do to ensure a healthy pregnancy. Of course, I had my gallbladder removed the same month I was released so that was my 4th surgery in 16 months. My body, I'm guessing, just isn't ready, but I'm not getting any younger. I've done the whole "ohhh I don't care, ohh it'll happen when it happens" and that is SO not my personality. I bawled like a 2 year old in a temper tantrum when I got my last negative result on Tuesday.

I go Monday to my PCM to get the referral to the fertility doc. We'll see what happens. . .

[clk 3,519]

Tiffy - thanks for your response.

I talked to my PCM today and he straight up said not to TTC just yet. I am still having issues getting my food in, and he said I really ought to wait until at least next July. So for now, we're going to shelve the TTC. Not that there's much to "shelve" since our embryos are in a freezer in Ukraine! My labs are okay but not as great as they could be. I have a real problem eating enough calories - like I said I'm still dependent on one Protein shake a day to get calories and Protein up. That said, I easily keep my calories around 1,000 a day while I'm on shakes and while my carbs aren't up to 100 yet I shuffle between 50-70 net carbs a day. I still lose at the same pokey rate as I did when I was eating only 20-30 a day and I feel better.

I just wanted to reassure you. Trying to get pregnant and going through that disappointment every month sucks. There is nothing like that horrible feeling every time you get a little excited that it could be this month...and then your period starts. I used to get so hopeful that I'd actually cause my period to be late with the stress. I was a monster by the end of the third year we were TTC.

My docs kept telling me it was my weight, though. "Just lose a little more weight and it'll happen." Nobody tested DH at all because he has other children from his first marriage. When we finally got a RE that tested him it turns out he has severe male factor infertility. I mean, we did ICSI and he had TEN normal, healthy swimmers in the sample. There was no way we were getting pregnant on our own. We had a better chance of winning the lotto! But I understand - we tried for SO stinking long - every month was this horrible disappointment replete with tears, yes, tantrums and then depression. I finally had to stop charting and try to adopt that "it'll happen when it happens" stance, too. But patience is NOT my strong suit, either. I saw no reason why I couldn't just get pregnant. I had friends bawling to me about not wanting to be pregnant with their third kid in four years...and I was the most unsupportive friend ever. I just wanted to tell them all to shut up! It all seemed so horribly unfair.

I know a lot of women that went through secondary infertility. Hopefully the Clomid will do the trick and you won't have anything to worry about. You're still young so your eggs should be in great shape. You're right that you've been through a lot - it might just be your body saying "take it easy, we've been through a lot lately." Have you had a HSG yet to make sure you have no blockages? Tricare covers them, so see if you can get one done if you haven't yet. Bring it up to your fertility doc for sure. If you have a problem like a blockage, Clomid won't do the trick and you'll just waste time and energy.

In any case, a close friend of mine had some luck with Clomid and had her daughter three years ago. Having her daughter resolved the issues and they had no trouble conceiving a second child a year and a half later. Hopefully you'll have a similar outcome and will only endure this one round of Clomid. We did two rounds of Clomid before they figured out my DH was the problem. It caused me a few side effects but wasn't bad at all. We moved right from Clomid to IVF with ICSI once we had his diagnosis.

Take care and thanks for the information. I am not a patient woman and I might have charged ahead without consulting my PCM first. I think I'll need to get my eating in order and maybe even lose another 30 pounds before I go the TTC route again. I still want to see someone have a kid and then get back to goal and post here, though!

~Cheri