Secondary IF

I need help. Question on injectibles.

I am having a very hard time.  I talked to my RE Monday and they had three suggestions for me.  Since it seems that I am ovulating each month we can try on our own, do femara with trigger or move to injectibles. 

DH and I are going to TTC this month med free.  I have been ovulating on my own so I am not sure what to do.  The nurse seemed to think I should move right on to injectibles.  I left a message today but did not get a call back.  What is the benefit of moving on to injectibles?  My egg quality is great so I am confused.  Do the injectibles increase the egg quality or does it just help to produce more follicles?  Last month I became pregnant since there was a mature follicle.  I am just not sure what to do and was hoping someone could help me out.

I called my insurance company and the Follistim, Gonal F and Brevalle are all covered under the same tier.  I am wondering which on is the preferred or are they all exactly the same just made my different drug companies. 

I told the nurse I want to do what is going to help me get pregnant and stay pregnant.  She said IVF would be the answer.  I do not have coverage for IVF.  I can add it to my husbands company but we are just not mentally there yet. 

Any advice is greatly appreciated.

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Pregnant with Letrazole (Femara) on the first cycle with DD after TTC 2+ years
TTC#2 with Letrazole (Femara) since January 2012
BFP 06.29.12 EDD 03.11.13 natural m/c 07.13.12
BFP 09.22.12 EDD 05.31.13 natural m/c 10.07.12
CP 11.09.12
BFP 01.01.13 EDD 09.15.13 d&c 01.24.13

BFP 03.26.13 EDD 12.04.13
 

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Re: I need help. Question on injectibles.

  • I guess the question is where does your problem lie? Is your progesterone generally low or are you having repeat miscarriages? I was recommended to move from femara to injectibles but I am very nervous for multiples. They said it can be up to a 35 percent chance of that especially if you are younger and good egg count. If that doesn't scare you then go for it. You will be closely monitored on them too. I told my re I would like to do a few more cycles of femara before moving on. 
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  • My original problem was that I wasn't ovulating every month.  This is my second miscarriage right in a row.  My progesterone was low during the first mc and high during the second.  I am 33 and the thought of multiples scares me a little.  I think only because I do not want my daughter to feel left out.  I do want to have 2 more babies.  I am leaning towards injectibles. 

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    Pregnant with Letrazole (Femara) on the first cycle with DD after TTC 2+ years
    TTC#2 with Letrazole (Femara) since January 2012
    BFP 06.29.12 EDD 03.11.13 natural m/c 07.13.12
    BFP 09.22.12 EDD 05.31.13 natural m/c 10.07.12
    CP 11.09.12
    BFP 01.01.13 EDD 09.15.13 d&c 01.24.13

    BFP 03.26.13 EDD 12.04.13
     

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  • So if you're getting pregnant, why would you need injectibles?  I'm not clear on why she's jumping right to that.  Does your DH have MFI? 

    Have they been able to figure out why you're miscarrying?  Have you tested the babies for abnormalities?

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  • That is my question.  I wish the RE's office had called me back.  I thought I was missing something.  No issues with DH.  No idea why I have had 2 miscarriages.  No testing done. 

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    Pregnant with Letrazole (Femara) on the first cycle with DD after TTC 2+ years
    TTC#2 with Letrazole (Femara) since January 2012
    BFP 06.29.12 EDD 03.11.13 natural m/c 07.13.12
    BFP 09.22.12 EDD 05.31.13 natural m/c 10.07.12
    CP 11.09.12
    BFP 01.01.13 EDD 09.15.13 d&c 01.24.13

    BFP 03.26.13 EDD 12.04.13
     

    Pregnancy Ticker

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  • I chose to move on to inj when ttc#2 because I had been responding to clomid, but not having success. When I met with the RE I told him I wanted to do injects with TI.

    I have two thoughts for you. First were you on a progesterone supplement during your 2ww?  I had very low P4 even while on it so I think it was especially helpful for me. My understanding is that it can help support the pregnancy during the 1st tri, but the results aren't clear whether it prevents m/c.

    My second thought is that with 2 m/cs I think I'd want some testing done before moving on to more expensive drugs, even if your insurance covers them. GL!

    Married 9-4-04

    ***PM me for my IF history***

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  • Ok a couple of my thoughts, I am exhausted and watching 2 kids so this might be jumbled and random.

    At CC, our mutual, RE's office: I talked to Dr P and Dr. C and they both said that they only recommend 3 cycles on injectables.   Dr. M at my first apt said that injectables makes a better quality egg.  (May be this is why you are m/c).  I know with 2 m/c they don't consider that an issue (even tho it feels that way).  I had a whole panel of b/w done after I lost the twins, my OB pretty much ordered any test she could think of to get us an answer.  Maybe you could ask about this at CC.

    As for the injectable drugs.  I would imagine that they would be worried with you producing too many follicles-since you do get pg easily and that multiples would be high chance.  From my research Follistim is the easiest to take.  You don't mix meds, you don't draw it up into the needle.  It comes in a pen, that you turn a little dial to the correct dosage and then you put a fresh needle on and it is the smallest needle out there. I have done 3 cycles and only had 2 bruises.  These shots only go into the skin/fat not the muscle.  I think when you move to injectables into the muscles that is what hurts.

    Email me anytime if you want to talk more.  Also, I am in the 2ww so I am thinking AF will show Wednesday next week and still do want to try and do a playdate!! 

    TTC#1: 14 months on our own (did HSG, b/w, SA);
    BFP on Cycle 14--TWINS! Identical twin boys stillborn at 19wks(1/9/10)
    3 break cycles; took clomid 50mg, BFP #2 Beta #1 35, Beta #2 338!!! Owen was born 2/11/11! 
    TTC#2: 4 cycles on clomid: BFNs
    BFP #3: Cycle #5 100mg clomid; beta #1 21; beta #2 6=CP 
    Cycle #6 break cycle TTC no meds=BFN
    Cycle #7: 150 clomid+ovidril+IUI=BFN (switched to RE)
    Cycle #8: follistem+ovidril+TI=BFN
    Cycle #9 Forced break due to cyst
    Cycle #10 follistem+ovidril+TI=BFN
    Cycle #11 follistem+ovidril+TI=BFN
    Cycle#12 Forced break due to cyst, went on BCP; did repeat HSG, Saline U/S
    Cycle #13 IVF: Follistim/Menapur ER 11-30 11 eggs, 5 mature, 4 fertilized and 3dt on 12-3; BFN
    Cycle #14: IVF#2 lupron/follistim/menopur ER 1-22, 19 eggs, 14 fertilized, 5dt on 1-27, BFP!! beta 1: 63, beta 2: 119; EDD 10-15-13; 1 frozen embie
    Miracle Surprise BFP, EDD 10-1-15; saw HB great Betas, 11weeks lost baby MC at home
    Moved forward with FET transfered solo frostie on 6-4-15, beta 1: 315, beta 2: 738, u/s showed one baby on track EDD 2-21-16
  • I would try injectables if they think that it may increase the quality of your eggs, just because that may help to decrease your chance of another m/c.  I think the focus should be on achieving a pregnancy that will stay viable.  Getting pregnant at the moment isn't the problem, and if you are not prepared for twins, then don't take the risk of having them unless it will also increase your chances of a viable pregnancy.

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    DD conceived after 3 years of ttc.
    MFI - DH had varicocele repair and took Clomid to get DD b. 02/2010

    TTC #2 since 6/2010
    10/2012 DH diagnosed with Epilepsy
    A few failed IUIs summer 2012 and 2013. 
    DH taking clomid and waiting to see if he needs another vericocele repair. 
    Hoping for a 2015 baby or babies. 
    Wishing, hoping, waiting.


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  • Your problem seems similar to mine with not ovulating every month. What is your diagnosis? Do you have PCOS or unexplained? My dr said I am not easy to categorize but btwn PCOS/hypothalamic group. I too have a femara baby as my first. Have u tried upping your dose of femara? You might get better quality egg this way.
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  • imageLauren79:

    I told the nurse I want to do what is going to help me get pregnant and stay pregnant.  She said IVF would be the answer.  I do not have coverage for IVF.  I can add it to my husbands company but we are just not mentally there yet.

    You should have told the nurse that IVF wasn't an option at this time, so what else did she suggest.  I don't see how IVF would improve your chances of staying pregnant.  You have been able to get pregnant, just need help on the staying pregnant now. 

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    DD conceived after 3 years of ttc.
    MFI - DH had varicocele repair and took Clomid to get DD b. 02/2010

    TTC #2 since 6/2010
    10/2012 DH diagnosed with Epilepsy
    A few failed IUIs summer 2012 and 2013. 
    DH taking clomid and waiting to see if he needs another vericocele repair. 
    Hoping for a 2015 baby or babies. 
    Wishing, hoping, waiting.


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