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Infertility
update on me and feedback from 2nd opinion (long)
After picking myself up off the floor from our recent failed IVF, we went for a second opinion with a well known local RE. I have one more IVF which will be covered by my insurance, but it has to be done in state. So, my future consult / cycle at Cornell would not apply and therefore not be covered.
After much discussion between DH and I, we decided to do 2 more IVF's. One that is covered (with our new RE) and potentially one OOP at Cornell.
So CD 2 is tomorrow and I go in for bw and u/s.
New RE was brilliant. He specializes in IF with high FSH (mine has only been a 10.2) and poor responders (which I am in addition to unexplained). He had a really refreshing view on a lot of topics related to IF. Here is what my new RE recommended changing for me:
He looked at my trackrecord. With 3 years of IF treatments and only 1 m/c on a FET, he wants me to do a forced FET. He said that from looking at my trackrecord, one possibility is that my body just doesn't do well trying to get pregnant with so many meds still in my system. So next IVF, we will have ER and freeze everything after fertilization. Take a cycle or 2 off to let my body recover, and then proceed with the ET.
No ICSI. I was shocked to hear this b/c I am a 'poor responder'. School of thought has always been to use ICSI if you only have a few eggs. We have no male IF. He wants to remove any extra manipulation of the eggs unless we absolutely need it, so no ICSI. Makes me nervous but I am willing to try it.
Mini stim IVF protocol. very low dose as opposed to the high doses I have been on to get me to respond.
He also showed me a few studies that show great PG success rates with women taking progesterone in the 2WW on UNmedicated cycles. He said that because I have the coverage, let's try another IVF...but after that, at least 3 months of only crinone in the 2WW. I am unexplained and he feels that it could be something as simple as extra progesterone to help get me PG.
So, I am about to get on the crazy train again and do another IVF. I'll keep you posted on how the mini stim protocol goes for me. Thanks for reading my extra long post!!
Our beautiful daughter arrived after 4 long years TTC!
Christmas Eve 2011 we got our miracle surprise BFP!
unmedicated cycle Beta #1 = 674 Beta #2 = 1905
This discussion has been closed.
Re: update on me and feedback from 2nd opinion (long)
I am so glad that you like your new RE - I think a second set of eyes is so important.
Good luck!
The docs at CCRM think that part of the reason for the very high success rates they are seeing with CGH/MA is because of the forced cycle break between stimming and transfer.
I don't understand the logic here at all.
What stim protocols have you done?
Yodamistress - Good to know about CCRM's thoughts regarding forced breaks between ER and ET. Once he pointed that out to me, it made a lot of sense.
As for the mini-stim - I'll find out my meds tomorrow. I have done long lupron for IVF# 1 (over-suppressed and converted to IUI), antagonist protocol for IVF# 2( retreived 4 follicles), and 2 fresh IVF cycles with an Estrogen Priming Protocol with very high doses of follistim + menopur .
His thoughts on the Mini-stim IVF are to start out on much lower doses and try to stim longer (without taking BCP and no Lupron). He said not all patients can handle the high dose of stims for prolonged periods. He gave me some published articles on this recent research. I will dig them up and post them tonight or tomorrow. I am skeptical as well, but I figure it is worth the shot. He said the he will increase the dosage if necessary as we see the progress in the b/w and u/s. So he is not opposed to increasings the meds, but he will not start off that way.
This is really interesting. Can I ask what CGH/MA is?
OP - your REs perspective sounds refreshing. That is also really interesting about only Crinone in the 2ww and no other meds. Best of luck to you.
TTC in 2008. Stage II/III endo, Hashimotos hypothyroid, low morph (3%).
2 cycles Clomid/Ovidrel/TI/Crinone=BFN.
IUI #1 - 4 Follistim/Ovidrel/IUI/Crinone = BFN.
IVF #1 - Antagonist w/ ICSI 4/10. 17 retrieved, 5DT of 2, BFN
IVF #2 - Long Lupron w/ ICSI 6/10. 15 retrieved, 3DT of 2, BFFN!!
Lap 7/21/10
IVF #3 - Clomid/Antagonist w/ ICSI 10/10. 14 retreived, 3DT of 3, BFP 10/20 but m/c. No HB 11/15/10 - D&C 11/17/10.
FET - 2 blasts, 1 survived the thaw. Transfer 2/19. Beta #1 3/1 375, Beta #2 3/3 885, Beta #3 3/8 4261, Beta #4 3/11 9005. U/S 3/8 1 sac 1 yolk, U/S 3/16 1 heartbeat 114bpm!
James born Oct. 24th 2011 via c-section at 38 weeks!
Surprise BFP - Jack born April 28, 2013 via VBAC after PTL at 33 1/2 weeks!
IVF #1 = BFP!! So blessed to have our baby boy! IVF #2 = Convert to frozen - 1 frostie! IVF #3 = Convert to frozen - 1 frostie! FET #1 = 8/14, Two transferred, One stuck! Praying for another healthy miracle! Due: 5/2/13
Wow, that's awesome! Your RE sounds a lot like mine. May I ask who it is? (you can pm me if you'd like)
Re: mini-stim - I know it seems like backwards thinking. But for high FSHers/poor responders like me it's actually one of the preferred methods. It's about getting a few quality eggs by stimming gently as opposed to trying for tons of eggs which a) we probably won't be able to produce, and b) make it very hard on the body.
Early loss 10/08
Lap 1/09
IVF #1 "natural IVF" - 1 egg retrieved, missed m/c
Tried several mini-stim cycles with no response
Switched clinics - dx'd as carrier for Fragile X
IVF #2 MDL protocol Jan/Feb converted to IUI, BFN
IVF #2 take 2: Antagonist, one embie, BFN
IVF #3: Antagonist, no fertilization
One last ditch effort at OE IVF (antagonist with Clomid) cancelled
DE cycle #1 Jan/Feb 2011, BFP, ectopic
DE cycle #2 June/July 2011 - BFP
10/28/11 Baby girl lost at 17 weeks due to pre-term labor. We love and miss you.
DE cycle #3 June/July 2012 - BFP, twins, both heartbeats stopped, D&C
2 frosties but don't know what's next
FET Dec 2012: BFP! Praying this one sticks for the long haul!
I would also like to know what CGH/MA is.. i'm thinking congenital something and maternal age?
"Smudge's Story - How to Grow a Dandelion" will return soon!
The Dandelion Archive
"If dandelions were hard to grow, they would be most welcome on any lawn."
Very interesting. I would love to read those. Have you/he talked at all about the MDL protocol? It is supposed to be the cat's meow for low responders.
CGH = comparative genomic hybridization and MA = microarray. These are both types of genetic testing. CCRM is seeing success rates of about 85% when two normal embies are transferred, regardless of age. On the one hand, having a verifiable genetically normal embie SHOULD increase the success rates. However, many of the women who get to the point of doing CGH/MA have already had 3, 4, 5+ failed cycles locally. It is hard to believe that in all that time they NEVER had a single normal embie but then they go to CCRM and *poof* magically have 1 or 2 or 3 normal blasts. Seems likely that doing the FET with vitrified embryos is playing some kind of role