WTF Appointment update (long)

lincoln79

well, it was better than I anticipated. until now my RE has been pretty conservative.

his thoughts:

great looking embryos

two IVFs, two pregnancies

not sure that he thinks it is implantation failure/repeated loss instead of just bad luck but he is willing to try the following for the next cycle:

lovenox

intralipids

prednisone

higher dose of stims to hopefully get enough eggs to split them in half and fertilize half with mh frozen sperm he banked when he got his testicular cancer diagnosis (pre-radiation) and half with fresh sperm

basically, throwing everything that might help but can't hurt. it is pretty much everything I have seen anyone else use on the boards except for IVIG (which intralipids is a substitute for), endometrial scratching (which I forgot to ask about) and PGD/PGS.

we have had terrible luck with our embryos thawing post freeze, so we are going to wait on the PGD/PGS.

still seeing the RI on Monday in Chicago (yeah mini-get away), but as far as I can tell there is little else one can do in the actual cycle than what he just offered.

so heading off to an adventure on Monday and the plan we have is to go for IVF #3 on August 5th (after I am done teaching a summer course and before the start of fall semester) with all these additional meds/treatments.

honestly, i haven't taken more than one cycle off since January 2012 and after 3 failed iuis, two surgeries, 2 ivfs, 2 m/c and 1 d&c, i am emotionally and physically ready for a short break. i feel guilty about that since i will turn 34 in june, but i think this is the best plan for us.

any additional thoughts welcome.... 

 

WindyCity33

I have nothing to add but wanted to wish you so much luck!

And you're coming to my hood! If you need restaurant or to do suggestions let me know! 

ETA: I couldn't remember who you're seeing when you're here so I scoped out an old post. You're really in my hood. The dr's office is in my shrinks building and across the street from my OB.

luvboston

I don't want to sound like an but using prednisone, lovenox and intralipids without a reason is stupid. First of all intralipids are not a substitute for IVIG unless you have high NK Cells. If you don't have high nk's intralipids are doing nothing for you except giving extra nutrients because they are used for patients with severe intestinal problems that don't give them enough nutrients. Has your RE looked at blood flow in your uterus? If so and he see's a blockage then Lovenox makes sense, do you have a thrombophilia? And what is he using the prednisone for? Too much prednisone can interrupt your adrogens. Also does he even know how to test for implantation failure? You could have high tnf and low LADs which could be inhibiting implantation. And if he is giving Lovenox why not baby aspirin? 

I am glad you are seeing the RI at least hopefully the proper tests will be done. 

jschwind22

I'm glad you feel good about the appointment, Lincoln!  I can't wait to hear about your RI appointment.  Good luck and have fun in Chicago!

lincoln79

luvboston:

I don't want to sound like an but using prednisone, lovenox and intralipids without a reason is stupid. First of all intralipids are not a substitute for IVIG unless you have high NK Cells. If you don't have high nk's intralipids are doing nothing for you except giving extra nutrients because they are used for patients with severe intestinal problems that don't give them enough nutrients. Has your RE looked at blood flow in your uterus? If so and he see's a blockage then Lovenox makes sense, do you have a thrombophilia? And what is he using the prednisone for? Too much prednisone can interrupt your adrogens. Also does he even know how to test for implantation failure? You could have high tnf and low LADs which could be inhibiting implantation. And if he is giving Lovenox why not baby aspirin? 

I am glad you are seeing the RI at least hopefully the proper tests will be done. 

no, i totally want honest opinions of people that have been down this road longer than I have. i wasn't very clear (it's been a long day). i am going through the tests the RI has for me and any additional my RE feels necessary with those as the options he sees as likely. I have been on baby aspirin for about two years trying to get pregnant. the prednisone (5 or 10 mg depending on my tests) is from a long history of needing steroids for calming my system down from an autoimmune disease that went too long undiagnosed (I have had to be on 1000 mg by IV times three days several times in my life). i will definitely look into intralipids vs. IVIG after my testing comes back. 

again, honest opinions is definitely what i want and hope as we all try to find our way through this mess so thanks for looking out for me! 

BzeetyD

Have you considered cycling elsewhere?

I say this because we cycled 3 times with the best clinic in our area (w/ 3 IVFs and 2 pregnancies) and there was not much new that they could do for us when we asked about a 4th cycle. 

Other places with other labs might give you a chance you didn't know you had.

Obviously I am biased but our results were so different for us this time around.

A thought to ponder after you see the RI. 

 

Crystal120410

Enjoy your break and try to forget IF for a little while!

lincoln79

thanks for your perspective bzeety. i hope this is it for you!

luvboston

lincoln79:

luvboston:

I don't want to sound like an but using prednisone, lovenox and intralipids without a reason is stupid. First of all intralipids are not a substitute for IVIG unless you have high NK Cells. If you don't have high nk's intralipids are doing nothing for you except giving extra nutrients because they are used for patients with severe intestinal problems that don't give them enough nutrients. Has your RE looked at blood flow in your uterus? If so and he see's a blockage then Lovenox makes sense, do you have a thrombophilia? And what is he using the prednisone for? Too much prednisone can interrupt your adrogens. Also does he even know how to test for implantation failure? You could have high tnf and low LADs which could be inhibiting implantation. And if he is giving Lovenox why not baby aspirin? 

I am glad you are seeing the RI at least hopefully the proper tests will be done. 

no, i totally want honest opinions of people that have been down this road longer than I have. i wasn't very clear (it's been a long day). i am going through the tests the RI has for me and any additional my RE feels necessary with those as the options he sees as likely. I have been on baby aspirin for about two years trying to get pregnant. the prednisone (5 or 10 mg depending on my tests) is from a long history of needing steroids for calming my system down from an autoimmune disease that went too long undiagnosed (I have had to be on 1000 mg by IV times three days several times in my life). i will definitely look into intralipids vs. IVIG after my testing comes back. 

again, honest opinions is definitely what i want and hope as we all try to find our way through this mess so thanks for looking out for me! 

When you see the RI make sure you ask about prednisone dosage because I was told by Braverman and Beer that 5-10mg does nothing, 20 mg was really the starting point for what they felt worked on immune issues braverman goes all the way up to 40mg. 

rrdiva1

nothing to add, but my love! what a crazy ride ya know. Sounds like kitchen sink has been thrown in which, i am in same boat.i so want is for you hun!

hootie123

I would also suggest another REs opinion on your case - especially since you are taking a break anyway.    I've taken a lot of breaks between all of my IVFs and honestly I think its the reason that I'm still sane at this point. 

GL and ((hugs))

Gregermis

Nothing to add but some positive vibes!! Sounds like a break might really do you some good... Both emotionally and maybe even calming things down for a sticky transfer. Good luck sweetie!

liz4paws

I definitely don't know enough about this to be helpful, but I'm wishing you all the luck in the world.

hmz819

I think you have a great plan.  Get the immune testing and see what that says then make a plan from there.  Maybe even look into setting up a consult with another RE just to see if a "fresh pair of eyes" can find anything else that can be tweaked to bring you your take home baby. 

August will be here before you know it! 

JSM0801

I really hope you get some answers and a plan moving forward! Enjoy your next few months of a well needed break! 

Scoop77

Hey. It took me a glacier's age to get back to you, but I PM'd you back finally on the RI.

I took intralipid and prednisone, too. I also accepted advice to up stim dosage to hopefully get more eggs to have more fertilized and yadda yadda.

That did not work out so well for me. First time, I had 14 eggs, 12 of which fertlized and 10 turned into embryos. We transfered one very high quality embryo and had two high-quality embryos to freeze.  

The second fresh cycle, we got 25 eggs. I appeared to be coming down with OHSS so transfer was cancelled and we froze all. We wound up with three fair-quality frozen embryos.

I actually did worse on the higher stim dosage.

That's just one anecdotal experience, but figured I'd share. My RE told me, when I asked whether there was a chance I'd get more eggs but of lower quality, "oh, no, that's not something I'd worry about."

And that's what appeared to have happened.

Scoop77

I just realized what a Debbie Downer I'm being.

Mwah mwah.

lincoln79

Scoop77:

I just realized what a Debbie Downer I'm being.

Mwah mwah.

no worries, all any of us know is our own experience. my first cycle we started with really low stims, went to high mid-cycle, then finished that cycle at medium level.

(12 R, 10 M, 9F, 6 at 5d) 

2nd ivf we had the medium the whole time (8R, 6M, 5F, 2 transferred, 3 not good enough to freeze)

If i could have 12-15 that would be great. hoping to get the right dosage for that.

thanks for sharing your experience.