Not Responding Well to Stims, First IVF Cycle?

Hollowvic

I'm a regular on 3T and have posted a little bit on this board.  This is my first IVF cycle, went in yesterday morning for my 4 day monitoring appointment, after 3 days of stims and apparently I didn't respond that well, my E2 level was a little low.  So they doubled my dose of Bravelle (not happy about that).  I was really upset after getting the phone call yesterday afternoon and now I'm just worried I won't respond.  Anybody not respond well early on stims and go on to respond better after getting their dose of meds upped?  I go back Monday to see if I'm responding better but this has me stressed.  The nurse said not to worry as this is the point of monitoring, I get that but still, not responding well can't be a good thing.

Hollowvic

@MeatandBandP they didn't give me the numbers, they just said the estrogen was a little low.  I guess I should have asked.  This is all new to me so I took it as bad news, I think the nurse felt I was a little nuts, but whatever!!!!

Justone13

Same as pp. what's your e2 level?

Hollowvic

@MeatandBandP I will say how many viles, I'm not sure what the actual does is but I started with 2 viles of Menopur with 4 viles of Bravelle (1 injection). They doubled my Bravelle, so now I do 8 viles of Bravelle, but Menopur stayed at 2 viles, now I have to split it up into 2 injections.  

jessimi06

********grad/siggy warning*********






My e2 and follies were always slow to start and they had to up my meds too. Some people's ovaries just take a little longer/more omph to wake up. Hopefully the increase in meds will give them the boost they need!

Hollowvic

Those not including the saline vile.

Justone13

@Hollowvic‌ Thats quite a bit of meds you are on but I still wouldn't stress yet. I'm a poor responder so it normally takes me 13-15 days of stims at a high dosage. When you go back ask for your e2 level. Were you on bcp to start?

Hollowvic

@Justone13‌ I am going to get my E2 level when I go in on Monday. I'm trying not to stress, it's out of my control at this point. I'm Praying I get a better response on Monday.

Hollowvic

I Will find out the follie sizes and E2 levels on Monday and report back. Thanks so much.

CML11

I was a very slow responder this cycle. My first E2 was like 26 vs previous cycle it was 84 in Day 2. I was behind in numbers most of my cycle, and stimmed longer at a higher doses.
Wish you luck!

zazu13

****saif****

I responded poorly on my first cycle. They tried to up my dose mid cycle but it did not work and I was canceled. Starting over at a higher dose did the trick and I made it to retrieval. Good luck.

Hollowvic

@MeatandBandP‌ I got my E2 levels. The first one on Friday was 33, I think she said I had 5 follies that measured 7mil (I could be wrong about that though). I just got the call that today my level is at 433 and I go back on Wednesday for another U/S and bloodwork. They didn't tell me how many follies today and I forgot to ask. I don't know why they don't just tell you.

Pookster1020

I had an issue in the beginning and they actually changed the location of my injection to my thigh and that did the trick.  Good luck to you!

Sha259

Hollowvic said:

I will say how many viles, I'm not sure what the actual does is but I started with 2 viles of Menopur with 4 viles of Bravelle (1 injection). They doubled my Bravelle, so now I do 8 viles of Bravelle, but Menopur stayed at 2 viles, now I have to split it up into 2 injections.  

At 75 mg per vial, your initial dose was 150 mg Menopur and 300mg Bravelle. After your adjustment, you were on 150mg Menupor and 600 mg Bravelle. That seems pretty high to me as a dose. Has your response changed at all? So you were at 433 after 7 days of stims, 3 of which were at 600 mg FSH? I'm no expert, but that does seem low.

I'm thinking that if you don't respond well with Bravelle, your RE may switch your FSH/LH combo to something different if you need to cycle again. How were/are you being suppressed this cycle? did you do BCPs before your Lupron?

I know for my IVF#1, I responded poorly early on, but my RE suspected it was because I was over-suppressed. After modifying my suppression for our next try, things worked out better.

Keep us updated on how you are feeling, and what your RE says. I hope that things work out for you.

Hollowvic

@Sha259‌ they upped my dose after 3 days of stims, then after 6 days of stims, 3 on the doubled dose I am at 433 I think. I go back tomorrow and hopefully I did better. The doctor said my ovaries woke up. I honestly don't know what to make of it at this point. All I know is I will be stimming for at least 3 more days. I won't be cycling again, this is my only shot. We're tapped out emotionally and financially.

Hollowvic

@Sha259‌ a girl at my RE who is cycling with me is on the same dose as me. The doctor told me my numbers looked good. Is he lying? No was on BCPs for almost 6 weeks, then overlapped Lupron for a few days, then was on Lupron for about a week on its own before starting stims.

Sha259

Hollowvic said:

@Sha259‌ a girl at my RE who is cycling with me is on the same dose as me. The doctor told me my numbers looked good. Is he lying? No was on BCPs for almost 6 weeks, then overlapped Lupron for a few days, then was on Lupron for about a week on its own before starting stims.

I would definitely not say your RE is lying, don't worry. He is the one checking your levels and follicles, so I would trust him. It does seem like you are finally starting to respond, which is a good thing. It could be as he said, that your ovaries finally woke up with the change in dose and you will see a drastic improvement in your response at each monitoring appt over the next few days. 

I was just commenting on the fact that, your body could have required such a large dose of FSH in the first place, because he completely over-suppressed your ovaries at the start of the cycle. My first cycle protocol was BCPs, no overlap, and Ganerelix, and that proved too much for my sad ovaries. 

Even my last cycle protocol, where I did no BCPs at all, but did Lupron for 2wks pre-stim, I didn't have tons of eggs to work with in the end. But they do say, the first cycle, the RE is really learning how your body wants to respond, there is no way to know at IVF#1 which protocol is best for you.

Keep us posted!

Hollowvic

@Sha259 Well today showed about 10 follies on the right side and about 6 or 7 on the left side but the left side isn't doing as well and they are small.  My E2 level today is into the 900's but I forget the exact number, on Monday is was at 433, when they called me they said this is good.  I feel like after 8 days of stims, 5 days on the highest dose possible it isn't that great.  My RE told me not to stress and that my lining looks really good.  I don't know why I feel like he doesn't want to stress me out as I'm very stressed so he's telling me everything looks good.  I understand the first IVF cycle is kind of a trial and error but like I said, this is my only shot.  I go back tomorrow so we'll see.  A girl at my RE who started stims the same day as me, but different meds is already triggering tonight and doing her ER on Friday.  So obviously she did way better than me, she's only a couple of years younger than me, still in her late 30's.  They say 3 day bloodwork showed I have good ovarian reserve and no issues, but I'm starting to wonder.

Sha259

I know, when I started IVF #1, my RE cancelled me early on (Day 3 of stims) even though I could have continued on, specifically because I was responding poorly (even with excellent OR). I was pissed at first, but then realized he did it for me. Since he cancelled my cycle because he didn't want my insurance to bill me for a less than stellar cycle. So at that point all I was out was the cost of the meds I took. It also gave him the opportunity to regroup and change strategy for the next take, without me going through the discomfort of ER for only 4 eggs.

Try not to worry yourself @Hollowvic. I understand your concern considering this will be your only IVF cycle. Does your RE understand this?? Have you voiced your concerns about your progress to him and discussed all possible outcomes considering that progress? If you feel he is giving you lip service, and you don't like it, tell him. That way, if he has a reason for his comfort so far, he can impart that information to you, and possibly ease your mind.

Carol77B

It is so hard not to compare your results with others, but you will make yourself crazy if you do. I know that I sometimes find it frustrating when my RE or nurse told me this, but it's true that you really just need one good embryo to transfer and it is much better to have quality over quantity.  

And eight days of stimming isn't very long at all, my clinic states that their average is between 10-12. A lot of growth happens the last couple of days of stimming.

 

jnissa

There are a lot of people here who would have killed for 16-17 follies! I'm not sure how old you are (you said that a girl who was a few years younger than you in her late thirties, so I'm assuming you're at least 40?) - so those are great numbers in terms of quantity. I ended my cycle with only 5 follies total. 

I know that you're feeling stress because you're on a one-shot deal, but try to remember that stress impacts this too. Your RE likely would not want to continue a cycle if he thought it was for sure doomed to fail because it's bad for his numbers too. 

Also, you have no idea why the other girl is triggering. It may be because she has an aggressive lead follie and they need to pull the trigger now. Every case is so unique - do not try to figure out yours by comparing it. 

Hollowvic

@jnissa‌ I just turned 39 and she is 36, almost 37 so she's about 2 years younger than me, so I have a year before yam 40.

kristyn831

Hang in there, @Hollowvic‌! I ended up with 4 more measurable (over 10mm) follicles at the end of stimming than I had on my 7 day u/s. The day of ER, retrieved an additional follie not previously seen. You seem to have measurable follies and your E2 is rising as it should.