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March TWW Updates

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Re: March TWW Updates

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    Just got off the phone with my RE. We discussed the past cycle & what's in store next.

    She said my AMH does still appear to be low meaning I likely have a reduced egg reserve. She said not to worry about this too much right now as she feels we have good chances to still get pregnant based on cycle #1. With the reduced AMH, it tells her I'll always need a higher dose of hormones to be stimulated.

    On TIC cycle #2, we'll start at 5 vials per day with Menopur. There's a chance of overstimulation with this. She said they can take a "fire storm" approach and quickly switch to an IVF cycle if my insurance will approve it. That can take 2-4 weeks for approval, so we'd have to act quickly or even get the approval before hand.

    She recommends a max of 3 TIC cycles, then it would be IVF. However, it's up to us if we want more or less TIC cycles. She said we have a better chance per cycle with IVF, but the TIC is still a good option since the first try responded so well.

    DH and I are going to talk about this tonight and see what we want to do.

    Have any of you done both TIC cycles and IVF before? What is involved in an IVF cycle versus a TIC? I understand that they somehow extract your eggs, fertilize them, then put them back in. But I don't know any of the details of how they actually do that. I know she mentioned there's a lot more monitoring too with IVF.

    *km*
    me 29  |  him 32  |  married: 4/27/2013

    TTC#1 (2/14/2017 - 4/7/17):
    Menopur = 19.66mm (R) & 17.02mm (L)| Ovidrel: 3/14/2017 | TIC 3/14-3/17/17 | *TWW* | Beta #1 3/30: 7.27 | Beta #2 4/3: 11.94| Beta #3 4/5: 8.02 | Beta #4 4/7: 2.24 | Ended as chemical pregnancy.

    TTC#2: (4/10/2017 - 5/12/17):
    Menopur = 13.59mm (R) & 21.68mm (L)| Ovidrel: 4/27/17 | TIC 4/27-4/30/17 | *TWW* | Beta #1: 0.1 = BFN

    TTC#3: (5/16-present)
    Menopur = 17mm + 13.5mm (L) 19.5mm (R) | CD11 Ovidrel 5/26/17 | TIC 5/26-5/28/17 | *TWW* | Beta #1 6/12: 9.91 | Beta #2 6/14: 13.89 | Beta #3 6/16: 20.81 | Beta #4 6/19: 41.46 | Beta #5 6/21: 24.50 | Beta #6 6/30: TBD - Will test until numbers reach zero.
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    @katherind I am glad they are working out a plan with you. Is TIC timed intercourse? With all these meds there is certainly a chance for too many follicles. If you do IVF, they can control how many viable blasts they put back in you and then you might have some leftover to store. There is certainly a lot to read about IVF. I'm not there, yet. 
    *TW*
    me 36  |  him 42 | 
     married 5/2016
    ttc with TI June 2016 - Nov 2016 = BFN 
    Nov 2016 dx male infertility - intermittent azoospermia during intercourse & unexplained

    •  Dec 2016 - IUI #1 | cd 30/10 dpiui: BFP | 8w4d: MC by D&C due to blighted ovum
    •  Mar 2017 - IUI #2, 100mg Clomid (cd 3-7) | BFN
    •  April 2017 - IUI #3, 100mg Clomid (cd 3-7) | BFN
    •  May 2017 - IUI #4, 100mg Clomid (cd 3-7) | BFN
    • June 2017 - IVF #1, 5 eggs retrieved, 4 fertilized, 2 high quality blasts chillin'. During retrieval, Dr. had to go through my uterus so we switched from fresh transfer to frozen. Giving my uterus a full cycle to heal.
    • August/September 2017 - Natural FET #1, transferred one day 5/6 embryo on Sept 3rd, Beta #1 171, Beta #2 402.6 | Saw heartbeat at 6 weeks, 3 days | BFP
    • April 2017 - Baby Boy Beckett was born. 
    • August 2019 - FET, transferred one day 5/6 embryo | BFP
    • December 2019 - Diagnosed with low AFI of 3.41 on 12/3, cause unknown. No tear in membranes, no issues with Baby Girl. On bedrest.
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    @irisheyes81 They said my estrogen went back down to 22 on Thursday. I'm a bit upset with how the doctor has handle my meds. I know he is trying to avoid having too many follicles but he is not aggressive with my dosage. I know that I will need extra help with my diagnosis. I'm just upset and sad.

    @katherind That sounds great! It looks like your doctor has a game plan. I'm waiting to see what my doctor says on Monday. DH thinks he will suggest IVF. Unfortunately, I don't know enough about it but I think it would be a good option.

    ~AC~

    Me: 31 | DH: 33 | Married: 11/11/2011

    Me: Empty Sella Syndrome

    AMH: 12/2016=0.97, 06/2017=0.70


    TTC#1 (11/18-12/12/2016): Menopur 75iu increased to 225iu= 5mm follie * Cancelled

    TTC#2 (3/17- 4/06/2017): Menopur 225iu increased to 300iu = 8mm follie RS& 7mm follie LS. * Cancelled

    TTC#3 (6/20/17): Progesterone for 14 days. 

               (7/8-7/17): Gonal F 225iu and Menopur 75iu=  5.59mm LS &  5.09mm RS. 

               (7/18-7/27): Gonal F 225iu and Menopur 150iu= 6.14mm LS & 6.23mm RS.

               (7/28-7/30): Gonal F 150iu and Menopur 150iu= 11.6mm  LS & 11.79mm RS.

               (7/31/2017): Ovidrel shot - TIC 07/31-08/02/2017 - TWW- BFN :(

    TTC#4 (8/25-Currently) Gonal F 225iu and Menopur 150iu= appt. on Wednesday


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    @AC93639 -I'm sorry you're feeling discouraged.  I did IVF, but I knew from the beginning (DH sperm issues) that I would go that route.  Honestly, it wasn't as bad as I anticipated.  I had built it up in my mind so much that I was surprised that I didn't find it terrible.  There is a lot of monitoring.  I think that worst part is for people who pay out of pocket.  I was soooo lucky that my insurance covers IVF.  Please feel free to message me if you have any questions about the process.  I would be happy to chat with you :)

    Me: 33, DH: 40
    July 2016: IVF #1 (froze embryos)
    Aug. 2016: Hysteroscopy to remove a few polyps & Laparoscopy
    Oct. 2016: FET #1 BFN
    Nov. 2016: FET #2 BFP (ended in CP)
    March 2017: IVF #2 Fresh Transfer of 2 Blasts = BFP!!! (EDD: 11/27/17)
    Froze 5 Blasts
    DS born on 11/2/17!!!  
    Back to try for Baby #2 :)


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    @jaejaystark Yes, TIC = Timed Intercourse Cycle.

    On the first cycle they gradually increased me from one to six vials over a 30 day period. It took many days at 6 vials/day  to get anywhere and I only got two decent follicles. I'm hoping the 5 to start won't overstimulate. They monitor every two to three days, so I'm hoping they can catch it early if it does start overstimulating.

    DH and I want to try two more TIC cycles then reevaluate. Both of us are on the fence about IVF and I think we need to do more research before we decide on that route.

    *km*
    me 29  |  him 32  |  married: 4/27/2013

    TTC#1 (2/14/2017 - 4/7/17):
    Menopur = 19.66mm (R) & 17.02mm (L)| Ovidrel: 3/14/2017 | TIC 3/14-3/17/17 | *TWW* | Beta #1 3/30: 7.27 | Beta #2 4/3: 11.94| Beta #3 4/5: 8.02 | Beta #4 4/7: 2.24 | Ended as chemical pregnancy.

    TTC#2: (4/10/2017 - 5/12/17):
    Menopur = 13.59mm (R) & 21.68mm (L)| Ovidrel: 4/27/17 | TIC 4/27-4/30/17 | *TWW* | Beta #1: 0.1 = BFN

    TTC#3: (5/16-present)
    Menopur = 17mm + 13.5mm (L) 19.5mm (R) | CD11 Ovidrel 5/26/17 | TIC 5/26-5/28/17 | *TWW* | Beta #1 6/12: 9.91 | Beta #2 6/14: 13.89 | Beta #3 6/16: 20.81 | Beta #4 6/19: 41.46 | Beta #5 6/21: 24.50 | Beta #6 6/30: TBD - Will test until numbers reach zero.
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    AC93639AC93639 member
    edited April 2017
    @lovedontcostathing Thank you for the kind words and for the offer. I honestly not sure what I will be doing. 

    Went to the doctor today to discuss my "options" and was told that I should look into adoption or oocyte donor. I'm so furious and feel like there wasn't any support from their office. He told me that 4 vials of Menopur is the highest dosage (on Menopur's website it says 6 vials is the max) and that there was no option.

    I refuse to believe this as a final answer. Am I crazy to feel this way? I understand that the medication was not producing the results fast but it's not like there weren't producing any results at all. We pay out of pocket for these meds (very expensive) but I'm willing to give it another try. I want to find another doctor who will be more aggressive on my medication. What do you ladies suggest? 

    Thank you. :( 

    ~AC~

    Me: 31 | DH: 33 | Married: 11/11/2011

    Me: Empty Sella Syndrome

    AMH: 12/2016=0.97, 06/2017=0.70


    TTC#1 (11/18-12/12/2016): Menopur 75iu increased to 225iu= 5mm follie * Cancelled

    TTC#2 (3/17- 4/06/2017): Menopur 225iu increased to 300iu = 8mm follie RS& 7mm follie LS. * Cancelled

    TTC#3 (6/20/17): Progesterone for 14 days. 

               (7/8-7/17): Gonal F 225iu and Menopur 75iu=  5.59mm LS &  5.09mm RS. 

               (7/18-7/27): Gonal F 225iu and Menopur 150iu= 6.14mm LS & 6.23mm RS.

               (7/28-7/30): Gonal F 150iu and Menopur 150iu= 11.6mm  LS & 11.79mm RS.

               (7/31/2017): Ovidrel shot - TIC 07/31-08/02/2017 - TWW- BFN :(

    TTC#4 (8/25-Currently) Gonal F 225iu and Menopur 150iu= appt. on Wednesday


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    @AC93639 I'm so sorry for your frustration. It's really tough when things don't go our way. I don't know your history, but have you tried IUI with injections? If you only produce a couple of follicles on injections, I'm thinking you could still try to do egg retrieval and IVF. You know some women do mini-IVF in which they only produce a couple of eggs, or even natural (one egg). 
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    katherindkatherind member
    edited April 2017
    @ac93639 sorry to hear you are frustrated. I would find another RE to start. You are correct. Six is the max dose for Menopur. 

    *km*
    me 29  |  him 32  |  married: 4/27/2013

    TTC#1 (2/14/2017 - 4/7/17):
    Menopur = 19.66mm (R) & 17.02mm (L)| Ovidrel: 3/14/2017 | TIC 3/14-3/17/17 | *TWW* | Beta #1 3/30: 7.27 | Beta #2 4/3: 11.94| Beta #3 4/5: 8.02 | Beta #4 4/7: 2.24 | Ended as chemical pregnancy.

    TTC#2: (4/10/2017 - 5/12/17):
    Menopur = 13.59mm (R) & 21.68mm (L)| Ovidrel: 4/27/17 | TIC 4/27-4/30/17 | *TWW* | Beta #1: 0.1 = BFN

    TTC#3: (5/16-present)
    Menopur = 17mm + 13.5mm (L) 19.5mm (R) | CD11 Ovidrel 5/26/17 | TIC 5/26-5/28/17 | *TWW* | Beta #1 6/12: 9.91 | Beta #2 6/14: 13.89 | Beta #3 6/16: 20.81 | Beta #4 6/19: 41.46 | Beta #5 6/21: 24.50 | Beta #6 6/30: TBD - Will test until numbers reach zero.
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    @AC93639 -I'm sorry about your appointment...your dr. didn't seem very sympathetic/ willing to think outside of the box.  I think you should definitely get a second opinion.  They are already talking about adoption and egg donors, but didn't suggest IVF?  That seems pre-mature on their part.
    Me: 33, DH: 40
    July 2016: IVF #1 (froze embryos)
    Aug. 2016: Hysteroscopy to remove a few polyps & Laparoscopy
    Oct. 2016: FET #1 BFN
    Nov. 2016: FET #2 BFP (ended in CP)
    March 2017: IVF #2 Fresh Transfer of 2 Blasts = BFP!!! (EDD: 11/27/17)
    Froze 5 Blasts
    DS born on 11/2/17!!!  
    Back to try for Baby #2 :)


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    AC93639AC93639 member
    edited April 2017

    @liljoy Thank you for your reply. My body doesn't produce enough hormones to menstruate so I lack hormones to produce any follicles. Dr. had me on  Menopur which I was able produced two follicles (6mm & 8mm) but not big enough to do the trigger shot. I would be willing to try IVF but I think with my condition, it would be hard. I will have to research it more.

    @katherind Thank you. I told him that I knew someone who was taking 6 vials a day (you) and he discarded it. It sounds to me that he hasn't had a patient with my condition and is scared to increase his normal dosage of Menopur a day. I'm trying to stay positive and find another doctor that will work with me. I told my DH that I wanted a second opinion before I accept this as an answer.

    @lovedontcostathing Thank you. He really wasn't sympathetic at all and it really bother me how fast he came to this conclusion. I think he was waiting for me to cry and be sad with the news but I didn't give him the satisfaction. Of course he offer his adoption services and his donor program. :|

    Thank you ladies for your support. I didn't know who else to talk about this with. :)

    FX to all of you!!

    ~AC~

    Me: 31 | DH: 33 | Married: 11/11/2011

    Me: Empty Sella Syndrome

    AMH: 12/2016=0.97, 06/2017=0.70


    TTC#1 (11/18-12/12/2016): Menopur 75iu increased to 225iu= 5mm follie * Cancelled

    TTC#2 (3/17- 4/06/2017): Menopur 225iu increased to 300iu = 8mm follie RS& 7mm follie LS. * Cancelled

    TTC#3 (6/20/17): Progesterone for 14 days. 

               (7/8-7/17): Gonal F 225iu and Menopur 75iu=  5.59mm LS &  5.09mm RS. 

               (7/18-7/27): Gonal F 225iu and Menopur 150iu= 6.14mm LS & 6.23mm RS.

               (7/28-7/30): Gonal F 150iu and Menopur 150iu= 11.6mm  LS & 11.79mm RS.

               (7/31/2017): Ovidrel shot - TIC 07/31-08/02/2017 - TWW- BFN :(

    TTC#4 (8/25-Currently) Gonal F 225iu and Menopur 150iu= appt. on Wednesday


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    @ac93639 Your condition sounds a bit like my Kallman's Syndrome. I have a similar issue where my brain doesn't send a signal for my body to produce enough hormones to menstruate.

    Was this your only cycle with this RE? You could be like me and just need the higher dose since your body lacks hormones like mine.  I'm sure there are differences between the conditions that only an RE could advise on, but something seems off with this RE. I would absolutely get a second opinion if you can.

    *km*
    me 29  |  him 32  |  married: 4/27/2013

    TTC#1 (2/14/2017 - 4/7/17):
    Menopur = 19.66mm (R) & 17.02mm (L)| Ovidrel: 3/14/2017 | TIC 3/14-3/17/17 | *TWW* | Beta #1 3/30: 7.27 | Beta #2 4/3: 11.94| Beta #3 4/5: 8.02 | Beta #4 4/7: 2.24 | Ended as chemical pregnancy.

    TTC#2: (4/10/2017 - 5/12/17):
    Menopur = 13.59mm (R) & 21.68mm (L)| Ovidrel: 4/27/17 | TIC 4/27-4/30/17 | *TWW* | Beta #1: 0.1 = BFN

    TTC#3: (5/16-present)
    Menopur = 17mm + 13.5mm (L) 19.5mm (R) | CD11 Ovidrel 5/26/17 | TIC 5/26-5/28/17 | *TWW* | Beta #1 6/12: 9.91 | Beta #2 6/14: 13.89 | Beta #3 6/16: 20.81 | Beta #4 6/19: 41.46 | Beta #5 6/21: 24.50 | Beta #6 6/30: TBD - Will test until numbers reach zero.
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    @katherind When I read your condition, I knew that we had similar issues. I was happy to see that you were progressing and it gave me hope. :) This was my second cycle with this RE. He started me out on 75 and slowly increased me to 150 on my first cycle. He increased me to 225 on my second cycle and kept me on 300 for 9 days with no increases. Yes, I think you are right that I will need a higher dose. I'm not giving up yet!

    Wishing you luck on this cycle! :)

    ~AC~

    Me: 31 | DH: 33 | Married: 11/11/2011

    Me: Empty Sella Syndrome

    AMH: 12/2016=0.97, 06/2017=0.70


    TTC#1 (11/18-12/12/2016): Menopur 75iu increased to 225iu= 5mm follie * Cancelled

    TTC#2 (3/17- 4/06/2017): Menopur 225iu increased to 300iu = 8mm follie RS& 7mm follie LS. * Cancelled

    TTC#3 (6/20/17): Progesterone for 14 days. 

               (7/8-7/17): Gonal F 225iu and Menopur 75iu=  5.59mm LS &  5.09mm RS. 

               (7/18-7/27): Gonal F 225iu and Menopur 150iu= 6.14mm LS & 6.23mm RS.

               (7/28-7/30): Gonal F 150iu and Menopur 150iu= 11.6mm  LS & 11.79mm RS.

               (7/31/2017): Ovidrel shot - TIC 07/31-08/02/2017 - TWW- BFN :(

    TTC#4 (8/25-Currently) Gonal F 225iu and Menopur 150iu= appt. on Wednesday


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    @ac93639 Thanks! I started round #2 on Monday. My RE started me at 375 units a day on this round. I have my first monitoring appointment tomorrow to see if any follicles have developed yet.  FX!  

    *km*
    me 29  |  him 32  |  married: 4/27/2013

    TTC#1 (2/14/2017 - 4/7/17):
    Menopur = 19.66mm (R) & 17.02mm (L)| Ovidrel: 3/14/2017 | TIC 3/14-3/17/17 | *TWW* | Beta #1 3/30: 7.27 | Beta #2 4/3: 11.94| Beta #3 4/5: 8.02 | Beta #4 4/7: 2.24 | Ended as chemical pregnancy.

    TTC#2: (4/10/2017 - 5/12/17):
    Menopur = 13.59mm (R) & 21.68mm (L)| Ovidrel: 4/27/17 | TIC 4/27-4/30/17 | *TWW* | Beta #1: 0.1 = BFN

    TTC#3: (5/16-present)
    Menopur = 17mm + 13.5mm (L) 19.5mm (R) | CD11 Ovidrel 5/26/17 | TIC 5/26-5/28/17 | *TWW* | Beta #1 6/12: 9.91 | Beta #2 6/14: 13.89 | Beta #3 6/16: 20.81 | Beta #4 6/19: 41.46 | Beta #5 6/21: 24.50 | Beta #6 6/30: TBD - Will test until numbers reach zero.
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    @katherind Good luck today!

    ~AC~

    Me: 31 | DH: 33 | Married: 11/11/2011

    Me: Empty Sella Syndrome

    AMH: 12/2016=0.97, 06/2017=0.70


    TTC#1 (11/18-12/12/2016): Menopur 75iu increased to 225iu= 5mm follie * Cancelled

    TTC#2 (3/17- 4/06/2017): Menopur 225iu increased to 300iu = 8mm follie RS& 7mm follie LS. * Cancelled

    TTC#3 (6/20/17): Progesterone for 14 days. 

               (7/8-7/17): Gonal F 225iu and Menopur 75iu=  5.59mm LS &  5.09mm RS. 

               (7/18-7/27): Gonal F 225iu and Menopur 150iu= 6.14mm LS & 6.23mm RS.

               (7/28-7/30): Gonal F 150iu and Menopur 150iu= 11.6mm  LS & 11.79mm RS.

               (7/31/2017): Ovidrel shot - TIC 07/31-08/02/2017 - TWW- BFN :(

    TTC#4 (8/25-Currently) Gonal F 225iu and Menopur 150iu= appt. on Wednesday


  • Options

    @ac93639 Thank you!

    Just got off the phone with the nurse. No measurable follicles yet, but I expected that based on how long it took last time. They are bumping up the Menopur from 375 to 450 units / day through Monday and we will retest on Tuesday morning.

    They wanted me in on Monday, but they had no availability. She said there's a chance of over stimulating, but they feel where my numbers are so low right now and we took so long last time, that we should be ok. That was not exactly comforting, but there doesn't seem to be an alternative option. We will see what happens. Hoping the extra day doesn't cause any issues.  

    *km*
    me 29  |  him 32  |  married: 4/27/2013

    TTC#1 (2/14/2017 - 4/7/17):
    Menopur = 19.66mm (R) & 17.02mm (L)| Ovidrel: 3/14/2017 | TIC 3/14-3/17/17 | *TWW* | Beta #1 3/30: 7.27 | Beta #2 4/3: 11.94| Beta #3 4/5: 8.02 | Beta #4 4/7: 2.24 | Ended as chemical pregnancy.

    TTC#2: (4/10/2017 - 5/12/17):
    Menopur = 13.59mm (R) & 21.68mm (L)| Ovidrel: 4/27/17 | TIC 4/27-4/30/17 | *TWW* | Beta #1: 0.1 = BFN

    TTC#3: (5/16-present)
    Menopur = 17mm + 13.5mm (L) 19.5mm (R) | CD11 Ovidrel 5/26/17 | TIC 5/26-5/28/17 | *TWW* | Beta #1 6/12: 9.91 | Beta #2 6/14: 13.89 | Beta #3 6/16: 20.81 | Beta #4 6/19: 41.46 | Beta #5 6/21: 24.50 | Beta #6 6/30: TBD - Will test until numbers reach zero.
  • Options
    @katherind sounds like you have a good plan!
    *TW*
    me 36  |  him 42 | 
     married 5/2016
    ttc with TI June 2016 - Nov 2016 = BFN 
    Nov 2016 dx male infertility - intermittent azoospermia during intercourse & unexplained

    •  Dec 2016 - IUI #1 | cd 30/10 dpiui: BFP | 8w4d: MC by D&C due to blighted ovum
    •  Mar 2017 - IUI #2, 100mg Clomid (cd 3-7) | BFN
    •  April 2017 - IUI #3, 100mg Clomid (cd 3-7) | BFN
    •  May 2017 - IUI #4, 100mg Clomid (cd 3-7) | BFN
    • June 2017 - IVF #1, 5 eggs retrieved, 4 fertilized, 2 high quality blasts chillin'. During retrieval, Dr. had to go through my uterus so we switched from fresh transfer to frozen. Giving my uterus a full cycle to heal.
    • August/September 2017 - Natural FET #1, transferred one day 5/6 embryo on Sept 3rd, Beta #1 171, Beta #2 402.6 | Saw heartbeat at 6 weeks, 3 days | BFP
    • April 2017 - Baby Boy Beckett was born. 
    • August 2019 - FET, transferred one day 5/6 embryo | BFP
    • December 2019 - Diagnosed with low AFI of 3.41 on 12/3, cause unknown. No tear in membranes, no issues with Baby Girl. On bedrest.
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