Hello/My Intro

Grateful&Thankful · February 2014

Hi Ladies, I think it is time to introduce myself. I've read the board requirements and I believe I meet the criteria. Here's my story:

In 2007 I had no idea I was pregnant and had to have emergency surgery to remove the pregnancy. My tube had ruptured and I had tons of internal bleeding. As a result, I lost my tube. While the doctor was in there, they assessed my remaining tube and noticed that it was not in good shape. They took pictures and discussed their findings with me once I had woken up from my surgery. At the time, me and DH were not married and not really thinking about kids. My doctor pretty much told me that I would probably need to remove my remaining tube in the future and IVF may be my only option. Like I said, we were not ready to have kids so I just pushed it to the back of my mind. Fast forward to 2011. At this time DH had been married for a while and we decided to see an RE. We knew we would need to go straight to the RE and my OB agreed.

I was very naive about my condition and just thought that we would do IVF and it would work (yea, what a joke). I thought I had my age (30) on my side. I knew nothing about IVF and just blindly trusted everything my RE told me. My first cycle was an antagonist and was my worst cycle ever. He told me that this was the best protocol for someone who had DOR and that since I didn't do well on the protocol that I would probably not respond well to any other protocol. I started doing research and switched to another RE within the clinic. My 2nd doctor listened to my concerns somewhat and agreed to change my protocol. We did a micro flare. I did much better with IVF2 and even got pregnant. I had taken COQ10 & RJ. Unfortunately I developed a SCH & ultimately lost the pregnancy. We were not sure if it was due to an abnormal embryo or the SCH. I m/c at home so we were not able to test the fetus. I did IVF3 with the same doctor but my response was so/so and I decided to self cancel before ER. At this point my doctor told me that if I did not switch to DE, they would not allow me to cycle again. I happily told them good bye and moved on to my current clinic.

At the new clinic I was armed with a better understanding (somewhat) of how my body responded to the meds and the whole IVF process overall. This time, my doctor really was receptive to trying new things. With a little uncertainty, I tried an antagonist/agonist conversion. It was a bad cycle. I only retrieved one mature egg out of 9. The embryo quality was great but it did not stick. Now, I was convinced that my body did not like any type of ganirelix or antagonist protocol. This was my concern initially after comparing how well I did on IVF2 (micro flare) compared to IVF1(antagonist). My doctor agreed with me after we poured over my records (e2 levels specifically) from each cycle thoroughly. For some reason I seem to do better with some form of lupron. My doctor does not do flare protocols so we did a traditional LLP for IVF4. I had a decent cycle but we still seemed to have a maturity issue. I did get pregnant but it turned out to be chemical. The weird thing was...now that we switched to a lupron protocol, my e2 skyrocketed EARLY. I had to trigger early because my e2 shot up and so did my LH. So I went from being a poor responder to being a somewhat fast responder-WEIRD. My doctor figured that if we dropped the stim dosage for the next round, I would not stim so quickly. We did that for IVF5. We cut the gonal down drastically (from 600 to 300) and used 1/2 vial of menopur. Well my e2 still took off quickly and by day 4, I already had follicles in the 13-15 range. After day 6, I already had two over 20. I just felt like that was not a good sign and decided to cacel the cycle.

For IVF 5.5 (I feel sick just typing that). We are going to do LLP again, but skip the bcp and raise the lupron dose. I hope to not stim so quickly. I feel like we could be close, but we have to get the protocol just right. Also, my FSH has been great (at around 7.5) lately but I know they say that you are only as good as your highest FSH. Sorry this has been a novel but I know that unfortunately a lot of you have been through so much too so you can relate to my misery. I am currently waiting on my period so that we can start our new cycle. My period is late and I am sure that has everything to do with the fact that my last cycle was cancelled. I just hope I don't have any cysts when I go in for my next appointment. I am getting really tired of going through IVF and I don't know how much more I can take. I look forward to joining you guys and supporting everyone however I can. Thanks again for listening.

Mrs.McIrish · February 2014

Sorry to see you over here sweetie:-( Have you ever considered mini-stim/low stim or embryo banking? Where are you located? I know others (myself included, just not "enough) did better with quality with low stim. When you only get a few, it seems like the massive doses fry the eggs. That was my last OE RE's theory.

zazu13 · February 2014

** PAIF **

Welcome and so sorry you have to be here. I had good FSH levels and thought I had age on my side as well. We had less than stellar embryos and early losses, but transfer and stim #5 with a new RE and several changes in my protocol brought us the news we'd prayed for. Wishing you the best of luck and hope you find support in your journey here.

sorrellam30 · February 2014

Welcome, I hope that five is IT for you and that this is the right protocol too, it's so frustrating trying to find what works. I hate that for us ladies we've had to go through so many trial cycles to learn when it should be a one and done

Grateful&Thankful · February 2014

Thanks for the welcome ladies.

@Mrs.McIrish- I cycle in NY. My next round will be a low-medium stim. Since we dropped to 300 last time, we're gonna drop even more & see what happens. The quality of my embryos (looks & cell wise) has improved so much since I moved to this clinic but that immaturity issue really hurts my chances. I just wish we could somehow fix that. We may add HGH in a future cycle. I've thought about embryo banking but I've never had success with getting to the point of freezing. My doctor would prefer to freeze at the blast stage and not day 3.

@Zazu13- Would you mind telling me the details of your winning protocol? Thanks!

@Sorrellam30- GL with your current cycle. I'm going to catch up on some of the recent threads on this board & try to get to know everyone.

liz4paws · February 2014

Welcome, and I'm so sorry everything you've been through has brought you here. You will find an amazing group of supportive ladies here. *hug*

DoublePortion · February 2014

Welcome! FX you find the protocol that'll do the trick!

zazu13 · February 2014

Grateful&Thankful

You bet. We did:

endometrial scratch / biopsy the month before cycling

no BCP

Estrogen Priming

max stim dose (600 IU) with 2 vials menopur and 450 Follistim /Gonal-F for 10 days

Ganirelix on last few stim days

HGH on stim days 7,8, 9 (Omnitorope)

HCG trigger

Intralipid infusions before and after transfer then every 4 weeks

Lovenox

Crinone

Neupogen uterine "wash" on day of egg retrieval

I think that's it... our previous failed cycles / losses had been with Antagonist protocol at doses ranging from 350 - 725 with mini-dose of HCG and one attempt of Lupron Flare with Follistim and Menopur. I don't know what the reason for the succcess was this time (or a combination of factors) but I would do it all over again in a heart beat.

beachy6 · February 2014

I'm so sorry for all that you have been through. There are some of the most wonderful ladies here and I'm sure you'll find amazing support. Welcome!!

rlk2 · February 2014

Welcome to the board but sorry to see you over here...This is such a wonderful group of supportive ladies that really know what its like to have been through the ringer!

STL34 · February 2014

I am so sorry you are going through all of this. I had a problem with immature eggs at retrieval on 2 of my 3 cycles. My first cycle all eggs retrieved were mature. We only had 4 to retrieve, though. My next 2 cycles had 7-9 eggs retrieved but only 4 mature each time. I am pretty convinced that 4 is the maximum number for me. I am DOR, too. And, my first 3 cycles were when I was 30 and 31. My first and third cycles were LL. My second was antaganist and we had horrible quality embryos that cycle.

My third cycle is the one that worked for me. It got off to a rocky start. They had me do estrogen and overlap with lupron and then do a few days of progesterone to induce a period. At baseline I had a cyst. They tried a bunch of things to get rid of the cyst and had me wait a while (I was still doing lupron and Lovenox at this point). They finally drained the cyst and had me start stims. We started at 300 iu of Gonal-F and increased it using step up amounts and then decreased using the same steps. There were two days that I did one vial of Menopur each day. I was on Lovenox, HGH (I took this every other day during stims), Nuepogen and did two intralipid infusions that cycle. But, my doctor at the time and my new RE believe that doing assisted hatching and a day 2 (new RE prefers a day 3 transfer, though) transfer is what made a difference. Even with low embryo numbers I did blast transfers the first two cycles.

Good luck! I hope this next cycle works for you!!

EDIT - I will be a doing a lupron flare protocol with my new RE. She believes that because of my DOR, I need to start stims earlier in my cycle. So, I will start stims on day 2 or 3. She will also push my follicles a little larger than my previous doctor in hopes of having more mature.

Grateful&Thankful · February 2014

zazu13 said:

Grateful&Thankful

You bet. We did:

endometrial scratch / biopsy the month before cycling

no BCP

Estrogen Priming

max stim dose (600 IU) with 2 vials menopur and 450 Follistim /Gonal-F for 10 days

Ganirelix on last few stim days

HGH on stim days 7,8, 9 (Omnitorope)

HCG trigger

Intralipid infusions before and after transfer then every 4 weeks

Lovenox

Crinone

Neupogen uterine "wash" on day of egg retrieval

I think that's it... our previous failed cycles / losses had been with Antagonist protocol at doses ranging from 350 - 725 with mini-dose of HCG and one attempt of Lupron Flare with Follistim and Menopur. I don't know what the reason for the succcess was this time (or a combination of factors) but I would do it all over again in a heart beat.

Thank you so much. That was very helpful! I really want to try using HGH in a cycle but I feel like I want to try to get this immaturity issue under control before we buy a $1k dollar med. It sounds promising, especially for my issues but I'm torn b/c it might also be the very thing that gives me mature eggs.

Grateful&Thankful · February 2014

STL34 said:

I am so sorry you are going through all of this. I had a problem with immature eggs at retrieval on 2 of my 3 cycles. My first cycle all eggs retrieved were mature. We only had 4 to retrieve, though. My next 2 cycles had 7-9 eggs retrieved but only 4 mature each time. I am pretty convinced that 4 is the maximum number for me. I am DOR, too. And, my first 3 cycles were when I was 30 and 31. My first and third cycles were LL. My second was antaganist and we had horrible quality embryos that cycle.
My third cycle is the one that worked for me. It got off to a rocky start. They had me do estrogen and overlap with lupron and then do a few days of progesterone to induce a period. At baseline I had a cyst. They tried a bunch of things to get rid of the cyst and had me wait a while (I was still doing lupron and Lovenox at this point). They finally drained the cyst and had me start stims. We started at 300 iu of Gonal-F and increased it using step up amounts and then decreased using the same steps. There were two days that I did one vial of Menopur each day. I was on Lovenox, HGH (I took this every other day during stims), Nuepogen and did two intralipid infusions that cycle. But, my doctor at the time and my new RE believe that doing assisted hatching and a day 2 (new RE prefers a day 3 transfer, though) transfer is what made a difference. Even with low embryo numbers I did blast transfers the first two cycles.
Good luck! I hope this next cycle works for you!!
EDIT - I will be a doing a lupron flare protocol with my new RE. She believes that because of my DOR, I need to start stims earlier in my cycle. So, I will start stims on day 2 or 3. She will also push my follicles a little larger than my previous doctor in hopes of having more mature.

I believe AH helped me too. My best cycle so far was my flare cycle. My new RE does not believe in that type of protocol tho. My embryo quality was not great for the flare cycle but I did get pregnant. I believe what ended up happening was that b/c I responded so poorly to the Antag protocol on cycle 1, they KILLED me with stims for my flare cycle (450 gonal, 300 menopur) and my body didn't need the overkill of meds. I think that had I done it with a more moderate does of stims, I would have had greater success. My doctor also waits till my follicles are all over 20 to trigger. She likes to see mine at 22-24. That has given me better results. I have noticed that the general rule of 200-300 e2 per mature follicle does not apply to me. My new RE thought I was being dramatic about it but I explained that looking over my records, it seems like it's more 600 e2 per mature follicle for me. My first cycle with my current RE, I triggered at 800 something and although there were 9 follicles ranging from 16-24...only one was mature at ER. So after that round my RE totally believed me and got on board with trying out new ideas that I had. My RE didn't totally dismiss my ideas before but now input is taken very seriously. We feel like we are really close to a winning protocol but we have to nail the combo of meds. When do you start your new cycle? I will be starting my lupron in 2 weeks if all goes well.

hmz819 · February 2014

Welcome. Good luck with your upcoming cycle!

STL34 · February 2014

@Grateful&Thankful, I am not sure when we will start this cycle. I was supposed to start a little over a week ago. But, I was postponed due to a cyst. They had me try triggering it and then checked my progesterone on Friday to confirm I ovulated. I am now on high doses of estrogen and waiting for CD1. I will do baseline on CD2 or 3 depending on when it falls and hopefully (if everything is clear) start stims that night.

My previous RE didn't believe in the flare protocol. So, I've never used it.

Good luck!

PrettyAccountant · February 2014

Welcome - good luck with your cycle!

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