My WTF appt today

jencity9

Basically, my RE's biggest concern was egg quality which he said should have been better for my age. (We had 22R, 20M, and 8F... 2 transferred and 6 didn't make it it to cryo). So he wants to do te same protocol but add menopur and also told me to start taking pregnitude.

I'm the one who brought up the issue of the tube being partially blocked with just a small opening for te dye to drain through and he agreed I should do an HSG again (my 4th). If it's fully blocked he would recommend removing the tube first. Otherwise we can move forward if it is still draining.

He actually recommended not doing ICSI this time if sperm looks good because the rate of fertilization with ICSI and regular were the same so he says we might as well save the money. (Although not doing ICSI still makes me slightly nervous!)

The weird thing though is that he had me doing a ton of blood panels that I have not done before. They are common for PCOS, but unsure why I have never done them before (at least the fasting ones). So next Wednesday I have the HSG and Thursday the fasting labs including 2 hour glucose test. I'm worried about the possibility of diabetes, as it runs in my family and I am overweight. And always tired. (Do you know how this could potentially impact moving forward with another IVF?)

For the first time in the last four years of seeing him, the RE mentioned my weight and if I was doing anything like exercise, etc. he didn't seem to think it was significant enough to put more treatment on hold. I'm assuming it was brought up because of the fact that IVF #1 did not work and we are looking at reasons why. My BMI is at the high end of 31.

Assuming my HSG is okay still (not looking forward to it because it hurts more each time) I will start the long Lupron protocol again right after that. Oh and also he said he would plan on transferring 2 if good quality and 3 if not as good. That surprised me. We did 2 this last time because quality was eh. I am totally okay with this though because I highly doubt all would take.

Thanks for letting me get all that out! Any thoughts?

jessimi06

I was on pregnitude for our IVF cycles, and I think it really helped with egg quality and maturity (all 6 were mature, 5 fertilized, and 4 made it to blasts). I'm mobile so I cant see your siggy, but are you on metformin already? I have PCOS and am higher on the BMI scale (31), and although I am not diabetic, I am borderline IR and am at risk for diabetes and am on it. It's helped regulate my androgen levels as they're high, and helps with egg quality.

As for ICSI, if you have any sort of MFI, I would do it. Overall, fertilization rates are higher with it, and if you get better quality eggs it could end up making a difference.

GL on your HSG and your next cycle!

AMShark

At my WTF appointment for IVF#1 my RE also said she was concerned by my egg quality.  I was already on Menopur (but then, I'm older, 37), but for IVF#2 I added Human Growth Hormone (HGH), and I ended up going with the Omnitrope brand.  I  don't know if they would recommend HGH for someone your age, and I don't think there are really conclusive studies to show that it helps, but I had a better response for IVF#2, so I'm all for it.

My RE also had me start taking CoQ10 as a daily supplement.  Again, this was supposed to help egg quality.

I would be a little worried about skipping ICSI, because I didn't do it for IVF#1, and my fert rate was miserable - but if your RE is giving you that advice, then he/she is probably pretty confident in it.  Unless you are completely stressed about it, I think its ok to go with the RE's advice on this one.

I don't have PCOS, and I know everyone has a different protocol.  I just thought I'd give you a little feedback from my perspective.

pblge

***PAIF response***

Hope you don't mind this post. I just wanted to follow up on @jessimi06's Metformin point. If you have PCOS indicators, Metformin is thought to improve egg quality. In my case, the only symptom I have of Metformin is a slight stacking structure to my ovaries, but my second RE put me on it anyway. My results were amazing, although I can't be sure if that was the reason. It's worth a serious conversation about being put on it, even if your results are inconclusive. Be warned, though, that it's a drug that often comes with pretty hefty side effects!

Good luck! I hope that this next round will do the magic!

Mrs.Ess

I second the metformin and coq10 for helping with egg quality if you could potentially have PCOS. The only indicators I have for PCOS are ring of pearls appearance on one ovary and and weird coarse hairs on my face sometimes (ew).

For me, side effects on regular metformin were really bad... Explosive diarrhea, cramping, it was awful and I could never really tell when it was coming on. This time I'm on extended release and actually get constipation and nausea but I will still take that any day over the previous issues. Good luck to you!

jencity9

@jessimi06‌ My RE has never mentioned metformin, but I may ask about it especially now that they're doing all these tests. I think maybe before I just had a couple PCO symptoms and now he is considering I have more or something? Unsure. My DH has slight motility issues.. I think I will have to have the ICSI talk again with the RE lol.

@AMShark‌ I will ask about both those things! I would assume that at least the CoQ10 would be fine since that's a regular vitamin right?

@pblge‌ Thanks for commenting! Do you know if I would need to be on metformin for a certain amount of fine for it to have an effect on the eggs? I am going to ask about it.

@mrs.ess Those are pretty much my symptoms too... The string of petals and some light hairs on my abdomen. Metformin sounds horrible!!!! LOL. But of course I am willing to take that if it helps. The things we do!