Infertility

Changes in trigger doses?

Okay, this may be the all the hormones talking, but has anyone else noticed a difference in how the feel/side effects if your RE changed your trigger dose from one cycle to another?  Last cycle I triggered with 5,000IU of novarel & didnt really feel much different.  This cycle, they had me take 10,000IU instead and I keep getting pretty bad stomach cramping.  Im still on the doxycycline too, but if I get an upset stomach from it, it lasts maybe an hour. 

 

Also, any ideas why the change?  I was so excited they were telling me to trigger, I didn't even question it.  I'd love to hear what you guys think.  

"Everything will be alright in the end. So if it's not alright, it is not yet the end."
Me:29 DH:29  TTC since 1/11 Dx: unexplained IF/early DOR/immune issues 
Feb'12- July'12-testing(all clear minus slight arcuate ute), 3 IUI with clomid all BFN
8/30IVF#1 Antagonist protocol- ER 9/11-8R, 7M, 5F. 
ET 9/14 2 embies transferred. 1 10cell Grade 4, 1 8cell Grade 4. No frosties. BFN
IVF#2 Antagonist protocol plus baby aspirin- ER 12/5-16R, 12M, 8F!
ET 12/10 5dt! 1 fully expanded blast & 1 early blast. No frosties. BFN
3/13 hysteroscopy & polypectomy, Consulted w Dr. Kwak-Kim.  
DX: High NK cells, cytokines, DHEAs& PAI1;  hypothyroid, +APA, restricted bloodflow
7/13 IVF#3 Long lupron protocol with PIO, Crinone, Prometrium, and vivelle
(plus synthroid, metformin, baby asa, metanx, PNV, Vit E, D, calcium, fish oil, CoQ10, IVIg infusions and lovenox per Dr. Kwak-kim)
ER 7/19 14R, 11M, 9F(4 natural fert, 5 with ICSI)
ET 5dt 7/24 2 fully expanded blasts.  SURPRISE 3 FROSTIES!!!
Beta #1 8/2 335!!!! Beta #2 829!!!  1st u/s 8/14 showed TWINS!!!!!
11/11: TEAM PURPLE!!!!!
3/21/14-L&W born at 37w via csection

Here Comes the Sun Blog
PAIF/SAIF welcome!

Re: Changes in trigger doses?

  • Hmm no experience triggering with 5000 both of my cycles were with 10000. Sorry I couldn't be more helpful.

    Me 38 MH 41 - TTC since June 2010 - dx with Severe MFI. Straight to IVF with ICSI. IVF #1 - ER 06/13/12 - 9 Eggs Retrieved - 4 ICSI'd - only 2 fert. 06/15/12 - 2DT - 3 cell & 6 cell with fragmentation. Beta 06/29/12 - IVF #1 = BFN. 07/20/12 - WTF Appt -Told by our RE to quit IVF. Second Opinion from RE is good. IVF#2 - November 2012. Estradiol Pills Started 11/6. Stims start 11/16. ER 11/26 - 7 eggs retrieved - all mature. 4 fertilized with ICSI. ET 11/29 Transferred 3 embryos. Beta is 12/10. 1st Beta 81 2nd Beta 160 and 3rd beta 360!!! First U/S 12/21/12 - We saw one beautiful gest. sac. 2nd U/S is 01/04/2013 - H/B 183 02/05/13 - NT Scan - everything looks good and IT'S A BOY!  Aiden was born 08/20/2013.

    IVF #2 is in progress.  ER was 05/12/14 - 11 eggs retrieved, 8 fertilized with ICSI.  ET was 05/15/14 - we transferred 3 embryos as we did on the cycle my son was conceived.  We were able to freeze 3 embryos. Beta is scheduled for 05/26/14.  1st beta - 111.  2nd beta - 159 didn't double :( 3rd beta Friday 5/30) - not a lot of hope left. Beta # 3 is 247 - probably ectopic.  Beta # 4 is 813 - possibly vanishing multiple sydrome?  06/05/14 - 5w4days - first U/S - we see a gestational sac and yolk - still have hope!  06/17/14 - 7w1day - U/S and saw and heard the heartbeat - Finally!  06/27/14 - 8w4days - Baby and heartbeat look and sound great :)  EDD 02/01/14 and It's a boy!


     "Everything will be okay in the end. If it's not okay, it's not the end."


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  • That's a good question, I'm not sure.  Are you on different meds this time around?  Are you at risk for OHSS?  Those things may have something to do with it.  

    Good luck with the trigger, that's exciting! 

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  • Oh gosh, I left all that out didnt I?  All my meds are the same, they just tweaked the doses and added baby aspirin.  I dont think Im at risk for OHSS, I counted 16 follies on the last u/s yesterday, but I had maybe 4-5 lead follies & the rest were smaller than 15.  E2 level on saturday (I didn't get yesterdays level) was in the 1100s.  I had to wonder, doesnt the hcg kind of give you that last boost to grow/mature?  maybe the higher does would boost those borderline follies?  IDK lol.
    "Everything will be alright in the end. So if it's not alright, it is not yet the end."
    Me:29 DH:29  TTC since 1/11 Dx: unexplained IF/early DOR/immune issues 
    Feb'12- July'12-testing(all clear minus slight arcuate ute), 3 IUI with clomid all BFN
    8/30IVF#1 Antagonist protocol- ER 9/11-8R, 7M, 5F. 
    ET 9/14 2 embies transferred. 1 10cell Grade 4, 1 8cell Grade 4. No frosties. BFN
    IVF#2 Antagonist protocol plus baby aspirin- ER 12/5-16R, 12M, 8F!
    ET 12/10 5dt! 1 fully expanded blast & 1 early blast. No frosties. BFN
    3/13 hysteroscopy & polypectomy, Consulted w Dr. Kwak-Kim.  
    DX: High NK cells, cytokines, DHEAs& PAI1;  hypothyroid, +APA, restricted bloodflow
    7/13 IVF#3 Long lupron protocol with PIO, Crinone, Prometrium, and vivelle
    (plus synthroid, metformin, baby asa, metanx, PNV, Vit E, D, calcium, fish oil, CoQ10, IVIg infusions and lovenox per Dr. Kwak-kim)
    ER 7/19 14R, 11M, 9F(4 natural fert, 5 with ICSI)
    ET 5dt 7/24 2 fully expanded blasts.  SURPRISE 3 FROSTIES!!!
    Beta #1 8/2 335!!!! Beta #2 829!!!  1st u/s 8/14 showed TWINS!!!!!
    11/11: TEAM PURPLE!!!!!
    3/21/14-L&W born at 37w via csection

    Here Comes the Sun Blog
    PAIF/SAIF welcome!
  • Yes, you are exactly right, the HCG gives them an extra boost!  I'm sure that's why they did that...I would try not to worry, the standard trigger is 10000 units anyways.  Your E2 sounds great and hopefully the HCG will cause some of those smaller follies to catch up!  My REs office likes follicles between 14-20 at trigger time so it sounds like you've got a good number and are on the right track.  When's ER?  
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  • imageeandk18:
    Yes, you are exactly right, the HCG gives them an extra boost!  I'm sure that's why they did that...I would try not to worry, the standard trigger is 10000 units anyways.  Your E2 sounds great and hopefully the HCG will cause some of those smaller follies to catch up!  My REs office likes follicles between 14-20 at trigger time so it sounds like you've got a good number and are on the right track.  When's ER?  

    7:30 Tomorrow morning.  Thanks for the input, I wasn't sure if thats what I heard about the trigger or if the hormones were making me hallucinate lol.  

    "Everything will be alright in the end. So if it's not alright, it is not yet the end."
    Me:29 DH:29  TTC since 1/11 Dx: unexplained IF/early DOR/immune issues 
    Feb'12- July'12-testing(all clear minus slight arcuate ute), 3 IUI with clomid all BFN
    8/30IVF#1 Antagonist protocol- ER 9/11-8R, 7M, 5F. 
    ET 9/14 2 embies transferred. 1 10cell Grade 4, 1 8cell Grade 4. No frosties. BFN
    IVF#2 Antagonist protocol plus baby aspirin- ER 12/5-16R, 12M, 8F!
    ET 12/10 5dt! 1 fully expanded blast & 1 early blast. No frosties. BFN
    3/13 hysteroscopy & polypectomy, Consulted w Dr. Kwak-Kim.  
    DX: High NK cells, cytokines, DHEAs& PAI1;  hypothyroid, +APA, restricted bloodflow
    7/13 IVF#3 Long lupron protocol with PIO, Crinone, Prometrium, and vivelle
    (plus synthroid, metformin, baby asa, metanx, PNV, Vit E, D, calcium, fish oil, CoQ10, IVIg infusions and lovenox per Dr. Kwak-kim)
    ER 7/19 14R, 11M, 9F(4 natural fert, 5 with ICSI)
    ET 5dt 7/24 2 fully expanded blasts.  SURPRISE 3 FROSTIES!!!
    Beta #1 8/2 335!!!! Beta #2 829!!!  1st u/s 8/14 showed TWINS!!!!!
    11/11: TEAM PURPLE!!!!!
    3/21/14-L&W born at 37w via csection

    Here Comes the Sun Blog
    PAIF/SAIF welcome!
  • Very exciting, good luck tomorrow!!!
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  • They lowered my dose from 10,000 to 5,000 when they told me I was high risk for OHSS.  10000 sounds normal to me.

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    Married June 2011 Dx: anovulatory due to prolactinoma (1.5cmx 1.5cm in 2006)
    April 2012: MRI- questionable cyst 8mg by 12mm in pituitary ; referred to RE by Ob-gyn after amenorrhea x 4+ months, provera ineffective, low estrogen level
    cycle 1: May 2012, clomid 50mg; cycle cancelled, thin lining, no response
    cycle 2: June 2012, femara 5mg; cycle cancelled, no response
    cycle 3: July 2012, femara 7.5mg; cycle cancelled (largest folli on Cd12 & cd 16: 11, lining 4)
    Repeat MRI July 25,2012- Cyst unchanged, likely old infarction.
    Aug. 8: met with RE, move to injectables if HSG and SA normal
    Aug. 23: HSG all clear; DH- perfect
    Switched to a new RE in early Sept. IVF here we come
    Genetic testing reveals: Fragile X- Intermediate risk/grey zone.
    IVF#1: ER 11/30: 14 retrieved, 10 mature, 7 fertilized. E2 prior to trigger 5200. Decision made to freeze 6 embryos and transfer later due to OHSS.
    IVF#1.2/FET #1: estrogen injects start 1/18, FET delayed to try to thicken lining. lining 5.4mm. FET- 2/18- transferred one 3AA expanded blast. BFP 5dp5dt. Beta #1- 2/27 9dp5dt- 102.27 beta #2 3/1: 147 :(, beta #3 3/4: 268 told to stop meds and let nature take its course. requested 4th beta (3/6); Beta hell for 2 months.

    FET # 2: endometrial scratch 5/6, added estrace vaginally and ASA to delestrogen and PIO. June 10- transferred one 4AA hatched embryo, BFP 4dp6dt, Beta 1 (9dp6dt) 187, Beta 2 (11dp6dt): 412; Beta 3 (15dp6dt ): 4452. U/S #1- one beautiful embryo with a heartbeat of 133 at 7 weeks.  8 weeks: heartbeat 156. EDD 2/26/2014: born 2-3-14 induced due to Pre-E and HELLP at 36w5d.

    12/1: met with RE to discuss trying for #2


  • Good luck tomorrow!!!
    Me: 43 DH: 39 - AMA, DOR
    Mommy to Sami (IVF), Born 8.30.13
    Surprise non-assisted BFP - 12.29.2014, Beta 1 = 322, Beta 2 = 760
    EDD 9.7.2015

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  • IVF 1 I triggered with 10,000 ius HcG and this round I was instructed to only use 5,000 ius. My estrogen was 3,723 that morning; that is why I did a halftrigger. did not need much of a boost for the follicles nearing the mature stage

    I did not notice a change in how I felt between the 2 cycles. I felt awful and was bloated and constipated both times!

    GL!

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    TTC since 10/2010
    IUIs # 1-5 = BFFN
    IVF # 1(July 2012) = BFN
    IVF # 2 (November 2012) = BFP (MIssed MC D&C @ 8w3d on 1/10/13)
    IVF # 3 (June 2013) = BFN 
    IVF # 4 (September 2013) = BFP Fraternal twin boys! (Loss at 21w6d due to IC on 1/26/14...devastated.)
    3/21/14--TAC (transabdominal cerclage) w/Dr. Davis in NJ
    IVF # 5 (May 2014) = BFN
    FET (August 2014) = BFN

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