Infertility

Advice Would Be Appreciated :) Fresh vs. Frozen/OHSS

Hi Ladies! 

I'm hoping to get some advice from those of you who have done IVF and had to trigger with Lupron and/or Pregnyl. 
My doctor is advising we not go forward with a fresh transfer and wait approx 5 weeks to do a frozen transfer. 

My E2 levels on day 10 of stims were 3800 and today (day after trigger with Lupron and Pregnyl) was 5300ish. 
From what I've seen on the follicle reports, there are a lot of eggs >20 and many are 18mm+. 

We were initially planning on doing a fresh transfer but now my doctor is suggesting we wait and do frozen. I was pretty upset when she told me after my day 10 of stims appointment. I guess I just wasn't expecting this delay. 

She called me today and said that if we want to, we can go ahead and do the fresh transfer but I would need to be started on estrogen patch, injection, etc. She said the success rate could go down about 20%. But I could expect some discomfort/bloating/etc. 

I'm torn as to what to do.... I don't want to "waste" a good embryo on a fresh cycle if they don't think it will work. But on the other hand, I kind of want to try and at least see what happens. This is all going on before I even know how many (if any) embryos we will end up with at the end.... 

What would you do (or what did you do if you were in a similar situation)? 

Thanks for any advice, my ER is scheduled for tomorrow and I'm so nervous as is.... :blush: 
4/15/16: Beta 379, 4/18/16: Beta 1358! 
5/2/16: 2 heartbeats  <3  <3
5/11/16: Baby A hb180, Baby B hb166 

Due 12/22/16 with two! 

Re: Advice Would Be Appreciated :) Fresh vs. Frozen/OHSS

  • I had estrogen levels around 4500 right before my retrieval. I did a fresh transfer and really wish I hadn't. There was no way (for me) that a fresh transfer with levels that high was ever going to work, so I'm sad that I wasted two embryos. What if those were the only two normal ones I got? I know it is a bummer waiting. It would have been worth it to me to wait.
    About us:
    Me - 28, Lean PCOS
    DH - 31
    Married June 2010, TTC since March 2014
    Blog: ourbinarystar.com

    FET cycle #3 Transfer July 28th 2016, Triplets born healthy on February 26th 2017 at 33w1d!

  • I hated having to choose between fresh and frozen! We've all been trying so long that any delay just feels rotten! But the chances of getting your BFP are much higher with a frozen, especially if your estrogen is already that high. We made the decision to wait so we could get the PGS testing, but also so we knew my body was as zen as possible for the transfer. I know it's hard to wait, but I would.

    ---Trigger warning---

    Me: 31 DH: 27
    TTC since April 2013
    Two cancelled IUIs in Aug and Sept '15 due to low motility/count
    IVF round 1: January 2016
    ER: February 17, 2016; 9 retrieved, 7 mature, 7 fertilized
    Day 5 Blastocysts: 5 BB, 1 AB, all normal from PGS
    FET date: May 11, '16; transferred 1 AB embryo
    First beta: May 23, '16: 998!!  Second: May 25, '16: 1648
    EDD: January 27, 2017
    BabyFruit Ticker
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  • I would wait and do a frozen. The reason the success rates are higher with FET is your body has had time to adjust from the high doses of hormones. You want your body to be ready to accept and get pregnant. I honestly wouldn't want to waste the med for the fresh knowing my chances dropped that much. Good luck! 

    RE DX for me: Anovulatory cycles/Mild PCOS  RE DX for DW: Endometrioma on left Ovary.
    Reciprocal Ivf Feb 2016. DW eggs and I am carrying. EDD: 10/27/16

    Pregnancy Ticker
  • How bloated do you feel right now?  I have not had OHSS (and with DOR, it's not likely I will), but I have experienced and sharp and painful spike in bloating after triggering.  I was stuck wearing stretchy skirts (no pants fit), and I even had to buy some larger underwear.  It was temporary (couple weeks), and it wasn't as severe as what women experience with even mild OHSS.  And I understand that if you get pregnant, you continue feeling that way, and that doesn't put you on track for a comfortable pregnancy.

    Of course, freezing carries its own risks, but it also gives you the chance to do PGS testing, which can be worthwhile.

    If I were in your position, I'd freeze.  But of course, I have total respect for whatever choice you make-- it's not an obvious choice.
    Me- 39 (turning 40 in April), TTC for the first time ever (since Jan 2015), low ovarian reserve
    Married 3/14/14 to my wonderful wife, but her sperm count is rather low
    TTC with frozen donor sperm and science

    7 IUIs, 7 BFNs.
    2 IVF attempts, both cancelled and converted to IUI, both BFNs.
    Decided that my tired old ovaries are ready to retire.
    Next step- reciprocal IVF, using my wife's eggs, my uterus!  
    fresh 5 day transfer (2 embryos) 4/17/17- BFP! 
    Identical twins "due" 1/2/17 (but anticipated arrival sometime December)

  • @AandDM2014@dragonfaerie@twomommiestobe thank you so much for your responses & good luck with all your next steps, I hope we can all achieve the successes we are looking for soon! I have to have a long talk with DH when he gets home, weigh out our options...maybe flip a coin (lol, that's a joke, can't count on a coin to make these decisions :neutral:

    @KLake42 to be honest, I felt more bloated on Fri (day 8 of stims) than I do now. My energy level over the last few days has gone back up as well...That's partially why I approached the doctor about this, I don't feel too bad. Of course, I know that can change after ER - and if it is successful to continue that way into the pregnancy. Part of me just wants to stay the course we planned and the other (probably more logical part) is trying to understand that waiting might be the better option. 


    4/15/16: Beta 379, 4/18/16: Beta 1358! 
    5/2/16: 2 heartbeats  <3  <3
    5/11/16: Baby A hb180, Baby B hb166 

    Due 12/22/16 with two! 

  • When I initially met with my RE, he showed me that my clinic's fresh vs frozen success rates were pretty similar. I am with you on the waiting part, but like others above said, it may be out of your hands. I am a firm believer in that everything happens for a reason, even the waiting in your case. I myself am not considering maybe it's best to wait and do a FET vs fresh because I'm seeing others indicating that success rates might be higher. This will be my first transfer and I also want things to work from the first try and not waste time. I think in the end, you have to wait and see where you are once you have the retrieval and then decide on your next step. GL to you and FX for a good cycle! 
    ***History & TW in Spoiler***

    Spoiler
    ***bfp & child warning***
    TTC - since 2014
    7 rounds of Clomid - BFN
    IUI #1 - October 2015 - BFN
    IUI #2 - November 2015 - BFN
    IUI #3 - December 2015 - BFN
    IVF #1 - March 2016
    Retrieval #1 - April 2016
    FET #1 - May 2016 - BFP!!! DS - Born January 2017
    Trying for baby #2...
    FET #2 - January 2018 - BFN  
    No more embryos left; switched to a new RE
    IVF/Retrieval #2 - January 2019
    IVF/Retrieval #3 - March 2019
    FET #3 - April 2019 - BFP!!! - DD: Born December 2019
    Trying for baby #3...
    FET #4 - October 2021 - BFP!!! - Due June 2022


  • I triggered with Lupron after 8 days of stimming and did a fresh transfer 5 days later. My RE prepares for fresh transfer after ER and if you choose to do a freeze all, assuming you will have embryos to freeze, then you stop the medications. My advice is to follow the recommendation of your RE. A fresh transfer might have been the planned but it really depends on how your body responds to stimming. Good luck with whatever you decide
  • Frozen. New research is showing that it's actually about your progesterone number. Our RE doesn't do fresh if the progesterone level is above 1.6 two days before the ER. Studies are showing that high progesterone before ET changes the receptivity of the uterus and, therefore, limits implantation. **** success mentioned Because of this we decided to suck it up and wait and we are glad we did. We just got our first beta back at 649.  
    ***Loss and success mentioned***
    Me:34, Wife: 32
    IF reasoning = MFI: Zero Sperm Count using FairFax donor bank
    IUI #1 - #3: 2011 = BFN
    IVF: 2011 = BFN, lost all 10 embryos (with C/Ps)
    Jan 2014 - OBGYN (not RE) found and removed wife's "field of" uterine polyps after failed IVF

    Moving on to surrogacy (actually a planned adoption)
    Surrogate IUI#1: 7.17.12 = BFP!! 15dpiui = 256, 17dpiui = 346
    Oliver Zane born - 3/29/2013 on Good Friday!

    IUI #4 - #6: 2014-2015 = BFN (with C/Ps)
    Switch sperm donors, start ketosis diet to reduce inflammation late 2015
    IVF 2: Jan and Feb 2016, 3 great looking, 8 cell 3 day embryos. Two ET, one frozen
    2.18.2016 (8dp3dt) = BFFP!
    2.22.2016 (12dp3dt) = 649!!

    Started foster care experience in 2012. Now waiting to adopt our foster daughter, 7, who has lived with us for 3 years. 


    "Wait for your God, and don't give up on Him - ever!" Hosea 12:6 (msg)

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    image
  • I was forced to do a frozen due to OHSS and it worked and I had my son.  I think giving your body a break is super important - IVF is no joke on your body.  The 5-6 week wait was miserable but worth it. Back then though, my doc's protocol was Lupron with every FET making it around 6 weeks.  He since changed his protocol for FET and you just get your period, start on patches right away and that's supposedly enough.  Then we add Progesterone and transfer - whole thing is only like less than 3 weeks from start of period to transfer.  Might be worth asking and saving yourself a week or so :)
  • It's completely up to you, but I would go with what your RE says. Also, I second what @Cmartin6706  said about progesterone. Both of my IVF cycles were switched to FET's because my progesterone was over 2.  I know the idea of not trying the fresh transfer sucks and it's more waiting, but it will give your body the time to get back to"normal" and be in the best possible condition for that embaby to implant!
    *TW* Pregnancy/Loss Mentioned
    Spoiler
    Me: 37 /PCOS DH: 37/no issues TTC: 7/13
    Started with RE 12/14; 3 failed rounds of clomid, started letrozole
    IUI #1 & #2- BFN
    IVF #1 - 9/15 Cancelled Day 9
    IVF #2- started stims 10/24  ER- 11/15 6 eggs- 5 fertilized/ 1 frozen
    FET #1 -1 embryo-12/9/15- BFN
    IVF #3- started stims 1/22/16  ER- 2/8 33 eggs(!)- 21 mature, all 21 fertilized - 6 snowflakes!
    FET #2- 2 embryos- April 4th-BFN
    ERA-June 8- results show need 12 addt'l hours of PIO
    FET #3-  2 embryos transferred August 14,2016  BFP! on 8/24! Beta #1-22  Beta #2-83 Beta #3-368 
    Confirmed singleton-Heartbeat on 9/19-160bpm! EDD: May 1, 2017, It's a girl!!
    Pre-term labor/loss-stillborn at 18w. 
    FET #4- 1 embryo-Aug 12th-BFP on 8/23 Beta #1-112 Beta #2-298 Beta #3-1010
    Confirmed Identicals!- Heartbeats seen on 9/8  Miscarriage on 9/18
    FET #5- 1 embryo- 1/12/18-BFN
    Lots of testing and finally determined I have elevated natural killer cells. Will begin prednisone and IVL treatment before next round.
    IVF#4- April 2018 8 eggs, 7 fertilized/3 frozen
    FET #6- 1 embryo- 6/11/18- BFP on 6/21 Beta #1-446, Beta #2-1841 
    Confirmed singleton- 6/29/18 HB-157 EDD: February 22, 2019. It's a Boy!



    BabyFruit Ticker 
  • lurking.. (i hate saying that now)...

    I really wanted a fresh as well, but I had a 30 eggs retrieved, 25 of those being mature.  I did experience mild OHSS symptoms and it was painful.  My RE told me as we were nearing retrieval that because of the possibility of OHSS and also other reasons (progesterone), I would have to do frozen.  I was disappointed, but after the retrieval, there was no way I would have been ready physically or emotionally in just a few days for a transfer.  My first FET worked, and it was a much more relaxing and healthy way to try to conceive. I feel that with the time that the FET allows your body to "reset", you are in a much better place to have implantation and the transfer be successful.  I'd definitely heed the advice of your RE.
  • Thank you everyone for your responses, definitely helped me with some perspective! I talked to the doctor today at my ER and she said that we can prep for a fresh transfer and watch for how my body responds before Sunday. We agreed that if there are any OHSS symptoms present, I will do a FET in approx 5 weeks. 

    Congrats to the BFPs in the group! I hope the rest of us catch up soon :smile: 
    4/15/16: Beta 379, 4/18/16: Beta 1358! 
    5/2/16: 2 heartbeats  <3  <3
    5/11/16: Baby A hb180, Baby B hb166 

    Due 12/22/16 with two! 

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