Infertility Veterans

This is crazy, right? (DOR/POF related)

I know this is crazy.  For some reason, I'm still entertaining the thought.  Please feel free to tell me that I've officially lost it.

We got the protocol that my RE wants to use for our last (and I mean final) IVF attempt before committing fully to DE.  The protocol is long.  It includes a full month of priming with testosterone, estrogen and progesterone.  Stims are supplemented with clomid.

I've learned that we can't do a fresh transfer because the testosterone destroys your uterine lining and makes it incredibly unreceptive to pregnancy.  So, to do this protocol, you must have enough eggs retrieved and enough that ultimately fertilize and then enough embies that make it to a five day freeze.  Then you need something that makes it through thaw for transfer.  

Unquestionably, I have DOR and on top of that, I am a spectacularly poor responder.  Proof positive is two canceled cycles.  On the only cycle we made it to ER, we got 6 mature eggs, four of which fertilized.  Since that cycle, my AMH and AFC have degraded somewhat rapidly.

Be honest.  This protocol is a waste of time/money/energy for us, right?  If this is our last option, maybe moving to DE now is the right decision.

 Thoughts?  Thanks ladies.  As always, hugs to you all. 

Baby girl Lila born 2013.
Baby boy Henry born 2015.
Expecting our capstone baby (boy) early March 2018.

Re: This is crazy, right? (DOR/POF related)

  • Hmmm...does your RE have any stats of success with this protocol with other DOR women (as in others who have had previous failed cycles and were poor responders)? If he could show that women who previously with poor response rates were suddenly successful with this route, then maybe. But if not, I think I would feel like you, really hesitant that it would work.

     It's a hard spot to be in. You want to feel like you tried everything, but at the same time, I agree that you don't want to just wastr time/money/energy, if there's not much proven success to go with it. I would definitely ask your RE lots of questions.

    Good luck sweetie! No matter what you choose, I am pulling for you!

    2/11 Diagnosis: DOR-AMH .62, LPD and MFI-4% Morph
    IVF #1-July 2011 7/9/11-Started Stims
    7/20/11-ER:No eggs in 4/5 follicles. Left the 5th follie intact and converted to an IUI
    8/3/11-Beta #1=BFN,
    Nov, 2011 BFP #1=m/c at 7 wks 3 days
    11/11-AMH .47, IVF #2 March 2012...or not!! Surprise BFP on 2/19. Beta #1=161. Beta #2 305 Our little miracle girl is on her way! Due Oct 29, 2012
    <a href="http://s1207.photobucket.com/albums/bb461/andersenspics/?action=view
  • reb259reb259 member

    Such a personal decision but since you are asking I will give you my opinion.  Are you OOP? 

    I would move to DE and skip the cycle with your OE.  I hope you find the answer that is right for you and your H.  Wishing you all the best!  Big hugs... I know how hard it is.

     

    I am AMA and all tests on H came back normal
    3 failed IVF with OE and 2 failed frozen DE cycles
    Last fresh hail mary DE cycle starting Feb 2013
    PAIF/SAIF always welcome
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  • You know I am all for trying with your OE but it does sound like a long shot. I have no faith in my eggs now so I don't believe that I'd even get to day 5 to freeze.  How many eggs is the RE hoping you will get with this protocol?  Do you need a certain number to get to ER or will he take what you've got?

     

    TTC #1 since 8/1/10; Me:41 and BRCA1+, DH:46
    DOR (FSH 24.3)/ terrible egg quality ; homozygous MTHFR c677t
    5 IUI's: 2/11 to 6/11 and 1/12= BFN
    OE IVF#1-4 8/11-6/12= all BFN
    DE IVF#1 11/12 bad embryos= BFN
    DE IVF #2 2/13 BFP/Beta hell: m/c 5w6d
    CFNBC 7 months, not doing well; decided on guarantee program at RBA w/frozen DE
    DE IVF #3 1/14  ET 4BB; BFP;M/C 5w1d, incomplete m/c; MVA extraction in ER 7w1d

    DE FET#1 ET 3/1714; BFP, beta 1 3/27= 197, beta 2 3/31= 1586, beta 3 4/7= 13879!!
    First u/s= Twins with HBs at 6w2d! We are Team Pink x 2!!

    K & K born 11/21/14 at 38wks 4 days

    imageimage

    SAIF/PAIF Welcome


    http://waitingforraintostop.wordpress.com

  • kegkeg member
    imagejillychris:

    Hmmm...does your RE have any stats of success with this protocol with other DOR women (as in others who have had previous failed cycles and were poor responders)? If he could show that women who previously with poor response rates were suddenly successful with this route, then maybe. But if not, I think I would feel like you, really hesitant that it would work.

    Ditto this.  The other thing would be if they'd considering freezing on day 3 and therefore you'd likely have more to freeze.  (My clinic routinely freezes on day 3.) 
    2004-Started TTC; Nov 2007-Lap with endo removed; Jan 2008-Ectopic (mtx); April 2008-IVF #1 (bfp, twin girls); March 2011-FET (cp); June 2012-IVF #2 (bfp, singleton, EDD 3-19-12)

    ***Twin fraternal girls born at 35w6d in 12/2008***

  • As a former poor responder and someone who had two out of my five cycles cancelled this would make me nervous.  I can't remember how many eggs you generally produce but I never would get very many.  On average 4.  Usually two out of the four were questionable on day 3.  So I would worry about even getting to day 5 and then freezing.  Having said all this, you have to pick the choice that feels right to you.  I tried so many times with my crappy eggs that I'm sure many people, including my RE, thought I was crazy.  In the end, it seems to have worked for me.  I know this is not the case for everyone but you just never  know.  No matter your decision, I am hoping for you.
  • If you feel you need one last ditch effort before committing to DE, go for it. Just try to keep an open mind and know that you could walk away with nothing to transfer or another cancellation. Would you need to skip a month and get a period before moving onto the FET portion of the cycle? GL with your decision.
    Pregnancy Ticker
  • We did 4 IVF cycles, but only made it to transfer twice.  I was on the microdose lurpon protocol and massive doses of stims for my final IVF.  We got a whopping 3 eggs, one which was mature, and it did fertilize.  They did ICSI, Assisted Hatching, and a 3DT with my single embie, and now I have a son.  

    Based on my experience, I would obviously tell you to move forward with this cycle. That being said, I would have a huge problem with a protocol that would force me to freeze and FET later. I never had any experience with freezing and FET because I never had anything to freeze, but the thought of that sounds terrifying to me.  Has your RE offered you any other alternatives to this course of treatment?  

    I can't comment on any of the meds you mentioned - all I was on was the lupron, then Follistim and Menopur.

    I wish you all the luck in the world!  ((HUGS)) 

    TTC Child #1 Sept '08, Dx: Unexplained, DOR 2 IUI's = BFN, m/c, IVF 1 = 0 embies to put back, IVF 2 = BFN, IVF 3 = cancelled, IVF 4 = BFP with 1 embie. Our son came into our life on 9/28/11. We are in love! Baby Birthday Ticker Ticker
  • It is only a waste if you really feel done with your OE.  If you don't, it's not a waste.  I know that is an annoying answer, but I've learned it's all about you and how you feel.  I thought I was done, then I lost insurance coverage and now I'm pissed.  I suppose because I'm not entirely done...  IDK.  But I can't tell you it's a waste.  It does sound difficult and long and kind of exhausting, though.  
    My feet and Miss Heidi the rescue mutt!

    image

    15 treatment cycles: four early m/c
    Moving forward with domestic infant adoption!

    Home study approved 5/13, now just waiting...

  • I think the decision would be if you want to be able to say you exhausted every option with you OE... I know with my past cycles I only had 4 eggs/embies and they felt that it was too risky to go for a 5dt.  I would be sad if you put yourself back through the emotional rollercoaster to get some good embies and then have them not make it to a 5 day freeze.  Are they willing to do a 3 day freeze based on quanity and quality?  I don't think you have lost it at all... but I think I too would want to see results for cycles that have similar history to your own and what the results were.  GL in your decision!!  We are here for ya Smile
    Anniversary
    TTC #1 since 3/10:
    DX: Me-PCOS, retroverted/ tilted ute - DH- MFI, DH-4 mo of Clomid therapy= no improvement. Weekly HCG injections.
    Me-34, DH-33
    HSG- unsuccessful, SHSG (dialated)-no blockages
    7/11-Clomid (unmonitored) BFN,
    #1 Fresh IVF 9/11: w/ ICSI & AH (only option): (1 transfered, 8BF) = BFN!!
    #2 FET: 2 transferred (2 6BF) 12/11 = BFFN!!
    Surprise + HPT on break! 2/12 Beta 1: 6 Beta 2: <5 = c/p ( RE had given me provera... So pretty sure this ruined everything)<BR> #3 Fresh IVF 3/12: w/ ICSI & AH (2 transfered 8BF & 7BF, 1 to freeze) = BFMFN!
    New RE 5/12
    6/14 Hysteroscopy
    #4 Fresh IVF 8/12: 5dt of 2 5AB blasts = BFN!... what else is new?!?
    New RE insists its a transfer issue, immunology checked & good
    #5 IVF FET 1/13 under anesthesia : Two 5 day blasts transferred
    + HPT!! Beta1: 2315 Beta2: 6442 Beta3: 31,061
    First u/s 1/30/13: Shows 1 healthy heartbeat!!

    Was he was right? I wasted 4 IVF's and the doctors were not getting the catheter in?!?
    ~~ Bump Bestie/ IRL Lynn0926 ~~
    BabyFruit Ticker
  • Thanks everyone.  Sorry for the post-and-run, but we had to entertain MH's boss tonight.  

    Thanks for everyone's  comments.  In my heart, I know this isn't good for me, or for us.  A part of me feels like I need to fail one last time.  Does that make sense?  It seems so terribly illogical.  And this protocol sounds like it would be very tough.  That said, I know I can do it.  I guess I'm looking for the strength to say no -- to move on.  I haven't found that strength yet.  :(

    Baby girl Lila born 2013.
    Baby boy Henry born 2015.
    Expecting our capstone baby (boy) early March 2018.
  • imagereb259:

    Such a personal decision but since you are asking I will give you my opinion.  Are you OOP? 

    I would move to DE and skip the cycle with your OE.  I hope you find the answer that is right for you and your H.  Wishing you all the best!  Big hugs... I know how hard it is.

     

     

    Yes, we're OOP, reb.  Have been from the start. 

    Baby girl Lila born 2013.
    Baby boy Henry born 2015.
    Expecting our capstone baby (boy) early March 2018.
  • imageAmCheri:

    Thanks everyone.  Sorry for the post-and-run, but we had to entertain MH's boss tonight.  

    Thanks for everyone's  comments.  In my heart, I know this isn't good for me, or for us.  A part of me feels like I need to fail one last time.  Does that make sense?  It seems so terribly illogical.  And this protocol sounds like it would be very tough.  That said, I know I can do it.  I guess I'm looking for the strength to say no -- to move on.  I haven't found that strength yet.  :(

    I get it :o)

    When are they looking for you to begin?

    Anniversary
    TTC #1 since 3/10:
    DX: Me-PCOS, retroverted/ tilted ute - DH- MFI, DH-4 mo of Clomid therapy= no improvement. Weekly HCG injections.
    Me-34, DH-33
    HSG- unsuccessful, SHSG (dialated)-no blockages
    7/11-Clomid (unmonitored) BFN,
    #1 Fresh IVF 9/11: w/ ICSI & AH (only option): (1 transfered, 8BF) = BFN!!
    #2 FET: 2 transferred (2 6BF) 12/11 = BFFN!!
    Surprise + HPT on break! 2/12 Beta 1: 6 Beta 2: <5 = c/p ( RE had given me provera... So pretty sure this ruined everything)<BR> #3 Fresh IVF 3/12: w/ ICSI & AH (2 transfered 8BF & 7BF, 1 to freeze) = BFMFN!
    New RE 5/12
    6/14 Hysteroscopy
    #4 Fresh IVF 8/12: 5dt of 2 5AB blasts = BFN!... what else is new?!?
    New RE insists its a transfer issue, immunology checked & good
    #5 IVF FET 1/13 under anesthesia : Two 5 day blasts transferred
    + HPT!! Beta1: 2315 Beta2: 6442 Beta3: 31,061
    First u/s 1/30/13: Shows 1 healthy heartbeat!!

    Was he was right? I wasted 4 IVF's and the doctors were not getting the catheter in?!?
    ~~ Bump Bestie/ IRL Lynn0926 ~~
    BabyFruit Ticker
  • imageBethany1026:
    Are they willing to do a 3 day freeze based on quanity and quality?

    That's an excellent question.  I'll ask tomorrow.  The option of a 3 day would help me feel better about this protocol.  

    Baby girl Lila born 2013.
    Baby boy Henry born 2015.
    Expecting our capstone baby (boy) early March 2018.
  • imagejillychris:

    Hmmm...does your RE have any stats of success with this protocol with other DOR women (as in others who have had previous failed cycles and were poor responders)?

    Thanks, Jilly. There is some data on this protocol the conclusions of which show promise for people with my problems.  The data treats all POF patients together.  It doesn't differentiate AMA, DOR, endo, etc.  I suspect the people who haven't reaped the benefits are those with DOR.

    Baby girl Lila born 2013.
    Baby boy Henry born 2015.
    Expecting our capstone baby (boy) early March 2018.
  • imageMrs.McIrish:

    You know I am all for trying with your OE but it does sound like a long shot. I have no faith in my eggs now so I don't believe that I'd even get to day 5 to freeze.  How many eggs is the RE hoping you will get with this protocol?  Do you need a certain number to get to ER or will he take what you've got?

     

    My RE requires at least three to get to ER.  Last cycle, I only had two.  

    Baby girl Lila born 2013.
    Baby boy Henry born 2015.
    Expecting our capstone baby (boy) early March 2018.
  • imagelynn0926:
    Would you need to skip a month and get a period before moving onto the FET portion of the cycle? GL with your decision.

    Yes, we'd have to wait one unmediated cycle. I feel silly even talking about this -- as if I could even make it to ER.  Psych eval for our fave donor now should be available soon.   

    Baby girl Lila born 2013.
    Baby boy Henry born 2015.
    Expecting our capstone baby (boy) early March 2018.
  • mm29mm29 member
    I would do it. I'm a really poor responder, canceled once d/t no response, and at the most two eggs retrieved. maybe I shouldn't be giving my opinion, because I am willing to try just abt anything for a take home baby. If it's what you need to bring you closure I personally think it's worth it, for me being oop, it's not abt the money. It's abt being ready to take the next step without regrets. GL with you're decision! (((Huge hugs)))
    ::: Married June 2003:::
    TTC #1 since: Aug. 2008
    Me: 34, DOR, MTHFR-A1298C (heterozygous), decreased blood flow to uterus, Mild Endo
    DH: 38, Balanced translocation 5&10, unexplained MFI, normal SA and SCSA
    Tx History: IUI 1&2= BFN
    IVF# 1 W/ICSI= BFN
    IVF# 2: cancelled d/t no response
    IVF# 3= 1 egg retrieved=immature/not viable
    IVF# 4= c/p
    ***CCRM ODWU***
    Found DHs BT and Me-decreased blood flow to uterus
    Recommended DE IVF w/PGD, incorporate electro-acupuncture. Decided to cycle locally
    ***New RE***
    DE IVF# 1(cycle #6) w/pgd, (freeze all): 30R, 23M, 15F, slow/poor embryo development, 4 biopsied, 1 Normal "Norm"; DE IVF w/PGD, incorporate electro-acupuncture. 
    IVF# 6: (OE/DS) cancelled
    IVF# 7: (OE/DS) 1R, 1M, 1F, arrested day 5
    Plan-DE IVF# 2 (cycle #8): DE/DS in May 2015


    http://icanhazbabyz.blogspot.com/
    imageimage image 
  • It sounds like you're mentally not ready to commit to DE yet. If that's the case, and $$ and time are not priority concerns, then I think you have to do it to help close that book for you.

    That being said, if $$ and time are among your top concerns, I would suggest trying to move on sooner as that does sound like a fairly risky investment. Good luck.

    TTC #1 since June 2010
    Me: 36, DH: 42
    Dx: DOR and MFI

    DH: low count + very low motility; hormones all normal; Sperm DNA Frag. test = poor to fair; male karyotyping normal
    Me: FSH 13.4 + AMH 0.26 + hypothyroidism; Scratch the hypothyrodism (?); Blood clotting and immune panel all negative; endometrial biopsy normal

    IVF #1 (MDLF - Jul/Aug 2011): BFN (9R, 5M, 3F with ICSI, 3dt of 1 10-cell grade 2, no frosties)
    IVF #2 (EP-antagonist - Sep/Oct 2011): BFN (6R, 4M, 3F w/ ICSI, 3dt of 1 6-cell, 1 7-cell, grade 4s, no frosties)
    DE IVF #1 (shared cycle - June 2012): c/p (6R, 6F w/ICSI, 3dt 1 8-cell grade A- and 1 7-cell grade A-; no frosties)
    DE IVF #2 (shared cycle with new donor - Nov/Dec/ 2012): - BFP!!!!! 12/14/12. U/S on 12/27 shows twins!!!!!

    SAIFW/PAIFW
  • It seems risky to me.  I only ever had 1 frostie...and i don't even have issues with my eggs.  What if none of them make it to freeze?  I have never heard of this protocol.  What was his reasoning for suggesting it?
    Warning No formatter is installed for the format bbhtml
  • I've also never heard of this and it sounds so drawn out. From my experiences (not DOR or using DE) getting through the meds and ER +5d is the super difficult part. I would be so fearful to go through all of that and not have anything, but you also don't know unless you try it. Maybe this protocol is a good solution or will help you find some closure.  

    I'd also want a day 3 freeze just so you didn't feel you did this in vain if you don't have good response. I know the doctors know what's best, but it still seems like having something to transfer is better than giving the chance of things fizzling out.

    Our FET was much easier, although I don't know if it's because it was less involved or because I've grown rather apathetic to ever getting a BFP, but probably both. 

    When in doubt and having resources to do it I'd say to get every question and concern answered by the doctor and still waiver in whether you should proceed take your chances instead of always wondering.  Wishing you lots of luck, AmCheri! 

    (Live in Europe) TTC since 1/2010
  • The protocol is fairly new. It's CC.RM protocol #5 developedby School.craft. Basically it's a last-ditch effort for poor responders with multiple IVF failures. CC.RM uses coculture with this protocol, too. 
    Baby girl Lila born 2013.
    Baby boy Henry born 2015.
    Expecting our capstone baby (boy) early March 2018.
  • You mentioned previously the name of the RE who came up with the protocol and if I recall correctly he is renowned for getting results.  On the other hand there are other RE's (sirm for example) who suggest to much LH (which I believe is similar to adding testosterone) is detrimental to egg quality.  Isn't to much testosterone the reason PCOS and AMA patients have problems conceiving?  Is your RE looking to get more eggs from you, or does he suggest this will help produce better eggs?

    I've been on 750iu of follistim on a long drawn cycle with SIRM and have also done low stim (225iu) and I get exactly the same amount of eggs.  Also appears that 8 tabs of Femara on a TI cycle gets about the same results.  So if it were me, if the RE's goal is simply to get more eggs in the hopes of finding a good one, I'd say forget it.  I really don't like that philosophy for DOR.    Have you considered a low-stim cycle?  It obviously hasn't work for me, but it is much easier on your body and the cost is less then a full stim which might give you more eggs in the long run because you could possibly afford more attempts of low stim vs one full blown ivf with tons of meds.     Good luck in whatever you decide

    TTC #1 since 9/07
    Dx MFI, AMA, Endo, AMH .16
    Lap 10/09 Removed endometrioma, stage IV endo and adhesions
    Lap 2/10 Endometrioma cysts & adhesions returned.
    Ivf #1 4/10 Antagonist, ET Cancelled.
    IVF #2 2/11 A/ACP+E2V C/P
    IVF #3 6/11 Letrozole/Antagonist BFN
    IVF #4 11/11 Low stim Antagonist BFN
    Lap 3/12 Lap & Selective HSG
    Many cycles of Letrozole and LP HCG w/TI and LDN
    IVF #5 8/12 Low stim BFN
    IUI #1 10/12 BFN br> S&PAIFW
  • ....if it were me, I think I would move to DE now.  Seems like a long wait with a high risk of spending a lot of $$ with no success
    TTC #1 Since 4/2010, Cycle 30
    Positive for HLA-B27, I'm a mutant :p
    Testing - Me ok, gluten issue? DH - borderline count, low motility
    4/28/11 IUI#1 = BFP!(5/25), EDD 2/2/12 - m/c 5w3d
    7/3, 7/31, 9/25 - IUI#2-4=BFN
    IVF#1 - 1 blast = BFP!! (12/30), EDD 9/9/12, confirmed c/p 4w2d
    FET#1 3/2/12 - 2 blasts =BFP!! EDD 11/18/12, us#1 = twins! Confirmed m/c 5w6d
    4/20-surprise BFP and another c/p 4w2d
    FET#2 7/16/12 - 2 blasts = BFN
    FET#3 8/20/12 - 1 blast - BFP!! Beta #1-2=177, 354
    1st u/s 5w6d, one beautiful little HB :), 2nd u/s 146bpm
    baby girl born 5/10/13

    TTC#2 since 12/17/2014, Cycle 8
    Repeat Testing...FSH=12, AMH=3.8, AFC=28. 
    IUI#5 5/10/15- c/p?
    IVF#2 8/19/15 - cancelled due to cysts
    IVF#2 take two 10/2015 - 5 blasts frozen
    FET#4 12/11/2015 - BFN - 4 blasts remaining
    FET#5 2/18/16 - BFP!!!  Beta1-3, 126, 250, 745!!

    Image and video hosting by TinyPicLilypie Angel and Memorial tickers

    Tons of love and ((hugs)) to my IF sister NMscubagirl


  • imagesarahtoledo:
    It is only a waste if you really feel done with your OE.  If you don't, it's not a waste.  I know that is an annoying answer, but I've learned it's all about you and how you feel.  I thought I was done, then I lost insurance coverage and now I'm pissed.  I suppose because I'm not entirely done...  IDK.  But I can't tell you it's a waste.  It does sound difficult and long and kind of exhausting, though.  

    This exactly! GL in what you decide

    Multiple ectopics, 2 failed IVF's
    IVF #1: Did not get to ET, embies all failed PGD (major chromosomal defects)
    IVF #2: We have 2 chromosomally perfect embies as a result of PGD (Boy/Girl) 1 failed the thaw (Girl) Transferred 1, yet ended as a c/p
    Thought it was the end of our TTC Journey 6/20/2012
    SHOCK BFP 9/28/2012: IT'S A BOY! and everything is normal !!!!!!

    Little A born 38w 2d on 05/23/13 and is a true miracle for this IF Vet!
     

    image              

     


  • I agree with most of the PPs. If you are comfortable with moving on to DE right away, I think you should skip this crazy protocol and just move on. If you feel, however, like you need to try everything possible with OE, go for it because you may regret it later...
    Sorry for the kinda non-answer...
    imageimageimage

    TTC since March 2009 // Me and DH - 28
    Testing Summer/Fall 2010 - Unexplained IF
    IUIs #1-4 ~ Clomid/Ovidrel/TI/IUI ~ all BFNs
    IUI #5 ~ Femara/Ovidrel/TI/IUI ~ BFN
    IUIs #6-9 ~ Research Study Meds/Pregnyl/TI/IUI ~ all BFNs
    IVF Consultation, More Testing
    Diagnostic Cycle ~ Mucinex/Progesterone/TI ~ BFN
    IVF #1 ~ Menopur/Bravelle/Ganirelix/Novarel/Progesterone/Lupron
    7R, 6F // 2 transferred // 3 frosties ~ BFN
    FET #1 ~ Estrace/PIO/Lupron
    3 thawed // 2 transferred // 1 lost // no more frosties ~ BFP!!
    Beta #1 - 456 // Beta #2 - 1176 // Beta #3 - 2933 // Beta #4 - 6753
    EDD: May 16, 2013
    Threatened MC at 6w2d
    Bedrest for SCH // 6w2d through 10w1d
    Elevated TSH and Lazy Thyroid DX @ 10w - Started Synthroid
    Finally released from RE at 13w
    Charles Everett ~ Born 5/20/2013

    Baby Birthday Ticker Ticker


    ~~ My IF Blog ~~ 

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