Infertility

Baseline Eval for IVF#2

I had my baseline ultrasound (and bloodwork, of course) for the start of IVF #2 this morning. If my bloodwork is good (somthing about my numbers need to be low and I don't know what that means) I'll start on micro-dose Lupron on Friday.

I'm trying to be much more engaged in this cycle and not just "lay back" and go with the flow, since I wonder if I had asked more questions or pushed on some things when it wasn't going so well with IVF #1 I might have had a different result. My clinic is not very upfront with information (they seem to just tell you the bare minimum they think you need to know- i.e. change your dose to X and come in on Y day for more test, etc.) and even after doing all sorts of reading about IVF, I didn't feel comfortable asking questions or know exactly what to ask, so I feel feeling more comfortable asking questions now that I've been through the process before.

Per the ultrasound, I currently have 4 follicles on each side, and I asked the RE (not mine) who assisted the tech if that was all I could expect and she said, "yes, unless some were hidden," which freaked me out, since last time I only ended up with 9 total, with 7 mature eggs and 4 fertilized and only two "good/fair" embryos, neither of which took and nothing to freeze. When we did my baseline in Oct before starting cycling, I had 6 on each side and 12 total. I don't know what I started with on my first IVF, since no one told me (again with the not sharing of info!!!)

According to my RE, when we had our WTF appointment, we should get more follicles with the micro-dose Lupron protocol, but when I asked that to the nurse who gave me my meds calendar (after the ultrasound) for the next week, she was much more evasive about the outcome we might get from the micro-dose Lupron. The whole "we don't know how you will react," etc. and I couldn't get her to confirm that the whole point of the micro-dose Lupron was to get more folllicles, so now I'm confused.  She did say that this was a much more agressive protocol than the antagonist protocol I was on for IVF #1. 

Mostly I'm just venting/sharing, since I don't have anyone else to talk to about this, but I'm also wondering if anyone knows more about the micro-dose Lupron protocol and if I can expect to get more follicles from it. I started taking a bunch of supplements last month (on the RE's recommendation) CoQ10, DHEA, etc., but according to my acupuncturist I would need at least two months for those to start being effective. So I'm wondering if I would be better off postponing this cycle to allow the supplements long to work and see if I can get more follicles at baseline. We are all OOP so it is very scary to think that we wouldn't get more embryos out of this cycle. I mentioned being concerned about my starting point to the nurse, but she didn't think it was anything to be concerned about and that it would be way to early to consider cancelling.

***************************Loss Mentioned***************************


Me 37 y/o, DH 45 y/o; DH vasectomy reversal (his 2nd marriage) 11/8/12; TTC since 12/8/12. IVF due to MFI. DOR diagnosis April 2015.

 

IVF #1 BCPs/Antagonist w/ICSI Jan 2014 = BFN

IVF #2 MDL w/PICSI March 2014 = BFN

IVF #3 EPP/Antagonist w/PICSI May/June 2014 = BFP!; MMC 6w4d

IVF #4 No suppression/Antagonist Nov 2014/Converted to IUI #1 = BFN

IVF #4.1 Feb 2015 = cancelled

IVF #4.2 April 2015 - Lupron Stop Protocol with ICSI = PGD testing of embryo indicated it was abnormal

IVF #5 June 2015 EPP with Antagonist 

 

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Everyone welcome!

Re: Baseline Eval for IVF#2

  • I don't know anything about that protocol, but I have definitely seen women end up with more follies than they had at the AFC. I'd definitely trust the doctor over the nurses, as a general rule. The nurses may or may not be really trained on these things. Not sure about the supps and timing. The general wisdom is 2-3 months, but I'm not convinced that information didn't get transferred from sperm development. From what I know on the actual research on these things, I don't think there's been studies looking specifically at how long you have to take them for them to be effective. It would be based on what is known about how long it takes an egg to develop into maturity. My doc told me that's 50-60 days, so I guess that's where the two month thing comes from. Do you know how long you'll be on BCP?

    Good luck!!!
    **********************siggy/ticker warning**********************

    ***Losses mentioned.*** TTC #1 since May 2012. Me: 37, OH: 41. Ectopic August 2012 => tubal damage. :'(  Stage 1 endo removed June 2013. IVF #1 Oct/Nov 2013: Long Lupron with Gonal-F. 7R, 7M, 7F. 2 txfer@3d. Nothing frozen.  => M/C @ 8 wks. :'( Selected RPL panel all normal. Very hyper and brittle response to stims. IVF #2 (antagonist protocol) Feb 2014 => Converted to IUI (Perfect conditions). BFN. IVF #2.1 w/ new RE June 2014: Antagonist protocol. 33R, 31M, 30F, 19 blasts to test!!! I made it through without crashing!! :) Hats off to Dr. Fancypants!! ET of one 5AB blast. BFN. 13 10 CCS'ed snowflakes! FET #1 PUPO as of 7/29 Betas: 8/7@24, 8/9@97, 8/11@334 (etc.) Two sacs on 8/15, one seen on 8/18 after a bleed. U/s 8/25 (6+3) "perfect": 5.9 mm + HB@120bpm! U/s 9/4 (7+6): 15.9 mm + HB@172 bpm! Please, PLEASE stick this time!!!!
    http://i955.photobucket.com/albums/ae39/catfreeburg/866da40f5178fed79efe23fc8a4e8a_zps4498a9cc.jpgimageimageimageimage
    image
    Carol77B
  • My first IVF was micro dose lupron flare protocol.  At my baseline I had three visible folicles.  Over the cours of stimming that grew to I think 8 (5 on left, 3 on right if I'm remembering correctly). At my egg retrieval I had 13 retrieved of that 10 were mature and 9 fertilized with ICSI.

    Of course each of us are different, so my results are unique to me and not really an indication of what will happen for you.  However, you can see that I did end up with more than the initial three. 

    Good Luck to You!!!

     

    **** siggy warning - bfp & loss ****   ---- All Welcome ---

    Me: 44 - Hashimoto's (under control), DH: 38 - (minor issues)


    IUIs: 2 in 2012 ... Both BFN
    IVF #1: 10/16/13 ... BFP, however it was not viable and ended in an early loss at 7weeks.
    IVF #2: Feb '14 ... Cancelled. Positive beta at baseline appt, became very early loss.
    IVF #2: Apr '
    14 ... Retrieval Only. 2 embryos made it to day 3 freeze & will be batched with IVF #3 for PGD testing.
    IVF #3: June '14
    ...
    Retrieval Only. 4 embryos growing, all arrested before day 5. Two from April thawed, but also arrested.
    Currently benched while determining how to proceed.

    "Keep going until you can't fail"

     

    image   image

     image  image


    Carol77B
  •     
  • @pblge I took my last BCP last night (was on them for 18 days).

    Thanks @PrivateOne, that's the type of reassurance/success story I was looking for!

     

    ***************************Loss Mentioned***************************


    Me 37 y/o, DH 45 y/o; DH vasectomy reversal (his 2nd marriage) 11/8/12; TTC since 12/8/12. IVF due to MFI. DOR diagnosis April 2015.

     

    IVF #1 BCPs/Antagonist w/ICSI Jan 2014 = BFN

    IVF #2 MDL w/PICSI March 2014 = BFN

    IVF #3 EPP/Antagonist w/PICSI May/June 2014 = BFP!; MMC 6w4d

    IVF #4 No suppression/Antagonist Nov 2014/Converted to IUI #1 = BFN

    IVF #4.1 Feb 2015 = cancelled

    IVF #4.2 April 2015 - Lupron Stop Protocol with ICSI = PGD testing of embryo indicated it was abnormal

    IVF #5 June 2015 EPP with Antagonist 

     

    image
    Everyone welcome!

  • Hi @Carol77B - I am currently on microdose Lupron flare, CD 9. I was labeled a poor responder after my first IVF was converted to IUI in November. The microdose Lupron flare is, from what I've heard, supposed to increase follicle count without compromising quality? My AFC was 15, but my scan this morning showed 17 measurable follicles, so it is very possible that more will develop. At my baseline appt last week the tech mentioned that b/c I was so bloated from my period they had a hard time seeing my ovaries, so just remember, the ultrasounds aren't 100% conclusive either :)

    Also, I just started with the DHEA and CoQ10 last month, so I was only on it for 1 month prior to the start of the cycle. My RE's recommendation was to start DHEA and CoQ10 once I start this IVF cycle - he never said anything about beginning beforehand, even though I did.

    GL with the cycle!!
    **All welcome**
    http://tryingtotakeheart.blogspot.com/

    TTC since November 2010
    Me: (28) slightly high FSH (9), slightly low AMH (1.7), average AFC, DH: (33) all tests normal
    HSG & 3 TI Clomid cycles with OB/GYN April - August 2012 - all BFN
    November 2012 met with RE
    November 2012 Clomid + Trigger + IUI = BFN
    December 2012 Clomid + Trigger + IUI = BFN
    January 2013: Benched for cysts
    April 2013: Laparoscopy and Hysteroscopy = mild endo and 2 polyps removed
    May 2013 = First +OPK ever! Glimmer of hope!
    November 2013: 1st IVF: gonal f/ganirelix: converted to IUI on CD 7 due to poor response (3 large follicles with several trailing behind). IUI #3 = BFN
    January 2014: WTF Appointment: "stubborn ovaries" will need new med protocol: flare gonal f, add menopur and lupron
    IVF #2: Stims start 2/19 - MDL flare protocol with Gonal & Menopur; Triggered 2/28, e2 6000, ER March 2: 34 R, 20M, 9 fert, 4 2PN's frozen. No blasts made to freeze :(
    FET #1 June 7th - 2dt, Transferred 2... BFN
    WTF revealed very poor quality - looking to do another fresh cycle
    August 2014: 2 polyps removed, revealed thru HSG
    Updated labs: FSH 6.5 and AMH 4
    October 2014: IVF #3: Stims started 10/14 - Cancelled due to premature luteinization
    November 2014: IVF attempt #4: Rising progesterone levels again - trigger given early; ended up with 6 2PN embryos all frozen.

                         
    Carol77B
  •     
  • I just did the MDLF protocol & I think it is mainly for poor responders and/or those of us with LOR/DOR.  My AFC was 5 prior to beginning my first IVF cycle but I had a total of 8 follies once I started stims.  We only got 5 at ER (the other 3 stopped growing) & of those 5, 4 were mature & all fertilized.  We transferred 2 & the other 2 did not make it to freeze. 

    GL with your second cycle!!   

    Me (36) - LOR, DH (34) - MFI (low count & poor motility)

    TTC since 01/2012

    11/2012-04/2013 Unmonitored Clomid cycles through OB/GYN; Referred to RE

    05/2013-Benched due to cyst

    06/2013 - Clomid 50 mg + HCG Trigger + TI = BFN

    07/2013 - Clomid 50 mg + HCG Trigger + IUI #1 = BFN

     08/2013 - Clomid 50 mg + HCG Trigger + IUI #2 = BFN

    09/2013 - Benched for lap & hysteroscopy (Stage II Endo Removed)

    10/2013 - Menopur + HCG Trigger + IUI #3 = BFN

    11/2013 - Menopur + HCG Trigger + IUI #4 = BFN

     12/2013 - Clomid + HCG Trigger + IUI #5 = BFN

    2/2014 - IVF #1 - Microdose Lupron Flare Protocol - 5R/4M/4F w/ICSI; 2 embies transferred on day 3 (none to freeze)

    2/27/14 - First BFP Ever!!!  EDD 11/3/14

     

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    Carol77B
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