XP ~ What should I ask at my WTH appointment?

pbj1975 · December 2012

I posted this on the IF board, but I didn't get a very big response. I hope that it's ok to post it here.

A little background: I am 37, my husband is 35. Both of my tubes are blocked. We started TTC in August of 2010. My 1st IVF was earlier this year. I had an ER in March. 8 eggs were retrieved. 7 initially fertilized. I had to have an FET, which happened in June. Of the 7 embryos, only 1 of them made it to transfer day. Obviously it didn't stick.I have had issues with cysts on my right ovary, so that is why it took me from June until now to get to cycle 2. I was on BCP's & then Lupron before stimming (pills for 3 weeks, the Lupron started October 30th & continued all the way through the stimming).I just had my ER last Wednesday. I initially had 4 follicles, but it went down to 2 at my last monitoring appt. On ER day, they were actually able to get 3 eggs. Only 1 fertilized, but it stopped growing before I could get to my 2 day transfer. My FSH level was 6.5. I could look up other levels if that will help. My RE said we may want to discuss donor egg (I am not ready to think about that!)...I don't know if he was saying that just as an option, or if there is a real concern.

We are doing a phone consultation (the clinic is almost 2 hours away & it is so hard to take off from work) & I want to have a list of questions prepared. My heart feels so broken, but I am a fighter! Any insight you all could provide would be greatly appreciated!

Jen

PrettyAccountant · December 2012

Hi Jen! You are always welcomed to post here. I wanted to say how sorry I was. I was awake and on the boards when you were off to your transfer and then I saw your post and my heart broke for you.
I am on my phone so I can't see siggy's but from what I remember from your posts and what you wrote, I wonder if a change in protocol would work for you. Right now it seems your egg quality issues are winning this battle because of your fertilization rates and that your embryos arrest early in the game. I don't recall if you have any MFI issues.
I don't have many answers but I wanted to say you are welcome here and I am so sorry about your cycle.
The board can be very quiet so give some other women time to respond.

Mrs.McIrish · December 2012

Do you know what protocol you did for the first round? I would suggest EPP or just antagonist. The BCP's probably over-suppressed you. I did terrible on a microdose lupron flare. As Pretty Acct said, does you have any MFI at all? Can I ask where you are cycling? I see you are in upstate NY so I am thinking you might be where I am going for donor eggs.

glueck · December 2012

I am so sorry pbj. Heartbreaking.

I agree with Mrs McIrish that it sounds like you are over-suppressed on the long protocol, and you need the antagonist. Egg quality may be in question, but its certainly time to try EPP Antagonist.

Not until then would I consider DE if I were in your shoes. If its one or the other, you have to follow your heart. Thats another matter altogether.

What protocol did you do the first IVF?

Can you share your AMH level? Sometimes its more telling than your FSH.

Sending you a big hug.

pbj1975 · December 2012

Thank you ladies for your answers!

Let's see...

We don't have any MFI issues. My hubby's sperm checked out fine. He was originally tested a year ago. Do you think we should re-test?

My first protocol...I need to go dig up my paper work. That was with a different doctor back in March...checking now.

I tried to find a number for my AMH, but I couldn't see one anywhere. It looks like they never tested? Or I am missing it.

The first time around (8 eggs were retrieved):

I was on Follistim, 225 once a day.

Menopur, 225 once a day.

At some point (I don't remember when) Ganirelix was introduced.

Mrs. Mc, I am going to CNY in Albany. Is that where you go?

I am trying so hard to not freak out & worry, but y'all know how that game goes. This sucks. If you have any advice or know of any good questions I should ask, that would be so hopeful.

Thanks for making me feel welcome

Mrs.McIrish · December 2012

Yes, I am going to CNY too. While I like my nurse and the place is nice, new and pretty, I am not too impressed with their skills. I did not cycle there with my OEs but they overstimmed my donor and my embryos were crap. I feel like I don't even have a doctor and am leading my own treatment. Plus I have heard that K.iltz tells everyone their embryos are beautiful when they are crap and then give you the "persistent is key" line. What happened that you had to freeze the embryos for IVF1 and do an FET??? Their FET rates are terrible so if at all possible, you need a fresh transfer.

pbj1975 · December 2012

Mrs.McIrish:
Yes, I am going to CNY too. While I like my nurse and the place is nice, new and pretty, I am not too impressed with their skills. I did not cycle there with my OEs but they overstimmed my donor and my embryos were crap. I feel like I don't even have a doctor and am leading my own treatment. Plus I have heard that K.iltz tells everyone their embryos are beautiful when they are crap and then give you the "persistent is key" line. What happened that you had to freeze the embryos for IVF1 and do an FET??? Their FET rates are terrible so if at all possible, you need a fresh transfer.

Oh boy, that doesn't give me hope. My first IVF was with a different RE closer to where I live. He is the only RE in the area. I was not happy with him at all. CNY or NYC was my only other option. My friend went to CNY and has a baby boy. I just feel so helpless. Do you have any suggestions? I like everyone I have met, but I just don't know what I am doing or what questions to ask. My experience with the other RE was crud, so anything had to be better than him

Mrs.McIrish · December 2012

It's a tough one. I am there for the prices for DE but if I had more money I'd go elsewhere. I just looked up the SART number for your age and they only have an 18.8% live birth rate. I think their lab just isn't that great. I'd go to NYC if you can but know that it is hard. If you have to stay there, I'd ask for an estrogen priming protocol since you weren't a great responder. You may not get a lot but you need to see how your egg quality is. Since you only had 1 embryo to put back with #1 and no ET for #2, there's no reason to think you have immune/implantation issues at this stage. You need some eggs to get some embryos. Have you had a saline sono to make sure your ute is clear?

pbj1975 · December 2012

Mrs.McIrish:
It's a tough one. I am there for the prices for DE but if I had more money I'd go elsewhere. I just looked up the SART number for your age and they only have an 18.8% live birth rate. I think their lab just isn't that great. I'd go to NYC if you can but know that it is hard. If you have to stay there, I'd ask for an estrogen priming protocol since you weren't a great responder. You may not get a lot but you need to see how your egg quality is. Since you only had 1 embryo to put back with #1 and no ET for #2, there's no reason to think you have immune/implantation issues at this stage. You need some eggs to get some embryos. Have you had a saline sono to make sure your ute is clear?

What does SART stand for? I am really worried

I did have a saline sono done & that was fine. I have so much anxiety.

Mrs.McIrish · December 2012

pbj1975:
Mrs.McIrish:
It's a tough one. I am there for the prices for DE but if I had more money I'd go elsewhere. I just looked up the SART number for your age and they only have an 18.8% live birth rate. I think their lab just isn't that great. I'd go to NYC if you can but know that it is hard. If you have to stay there, I'd ask for an estrogen priming protocol since you weren't a great responder. You may not get a lot but you need to see how your egg quality is. Since you only had 1 embryo to put back with #1 and no ET for #2, there's no reason to think you have immune/implantation issues at this stage. You need some eggs to get some embryos. Have you had a saline sono to make sure your ute is clear?
What does SART stand for? I am really worried
I did have a saline sono done & that was fine. I have so much anxiety.

SART= society of assisted reproduction.

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