Baseline Eval for IVF#2

Carol77B · February 2014

I had my baseline ultrasound (and bloodwork, of course) for the start of IVF #2 this morning. If my bloodwork is good (somthing about my numbers need to be low and I don't know what that means) I'll start on micro-dose Lupron on Friday.

I'm trying to be much more engaged in this cycle and not just "lay back" and go with the flow, since I wonder if I had asked more questions or pushed on some things when it wasn't going so well with IVF #1 I might have had a different result. My clinic is not very upfront with information (they seem to just tell you the bare minimum they think you need to know- i.e. change your dose to X and come in on Y day for more test, etc.) and even after doing all sorts of reading about IVF, I didn't feel comfortable asking questions or know exactly what to ask, so I feel feeling more comfortable asking questions now that I've been through the process before.

Per the ultrasound, I currently have 4 follicles on each side, and I asked the RE (not mine) who assisted the tech if that was all I could expect and she said, "yes, unless some were hidden," which freaked me out, since last time I only ended up with 9 total, with 7 mature eggs and 4 fertilized and only two "good/fair" embryos, neither of which took and nothing to freeze. When we did my baseline in Oct before starting cycling, I had 6 on each side and 12 total. I don't know what I started with on my first IVF, since no one told me (again with the not sharing of info!!!)

According to my RE, when we had our WTF appointment, we should get more follicles with the micro-dose Lupron protocol, but when I asked that to the nurse who gave me my meds calendar (after the ultrasound) for the next week, she was much more evasive about the outcome we might get from the micro-dose Lupron. The whole "we don't know how you will react," etc. and I couldn't get her to confirm that the whole point of the micro-dose Lupron was to get more folllicles, so now I'm confused. She did say that this was a much more agressive protocol than the antagonist protocol I was on for IVF #1.

Mostly I'm just venting/sharing, since I don't have anyone else to talk to about this, but I'm also wondering if anyone knows more about the micro-dose Lupron protocol and if I can expect to get more follicles from it. I started taking a bunch of supplements last month (on the RE's recommendation) CoQ10, DHEA, etc., but according to my acupuncturist I would need at least two months for those to start being effective. So I'm wondering if I would be better off postponing this cycle to allow the supplements long to work and see if I can get more follicles at baseline. We are all OOP so it is very scary to think that we wouldn't get more embryos out of this cycle. I mentioned being concerned about my starting point to the nurse, but she didn't think it was anything to be concerned about and that it would be way to early to consider cancelling.

pblge · February 2014

I don't know anything about that protocol, but I have definitely seen women end up with more follies than they had at the AFC. I'd definitely trust the doctor over the nurses, as a general rule. The nurses may or may not be really trained on these things. Not sure about the supps and timing. The general wisdom is 2-3 months, but I'm not convinced that information didn't get transferred from sperm development. From what I know on the actual research on these things, I don't think there's been studies looking specifically at how long you have to take them for them to be effective. It would be based on what is known about how long it takes an egg to develop into maturity. My doc told me that's 50-60 days, so I guess that's where the two month thing comes from. Do you know how long you'll be on BCP?

Good luck!!!

PrivateOne · February 2014

My first IVF was micro dose lupron flare protocol. At my baseline I had three visible folicles. Over the cours of stimming that grew to I think 8 (5 on left, 3 on right if I'm remembering correctly). At my egg retrieval I had 13 retrieved of that 10 were mature and 9 fertilized with ICSI.

Of course each of us are different, so my results are unique to me and not really an indication of what will happen for you. However, you can see that I did end up with more than the initial three.

Good Luck to You!!!

Carol77B · February 2014

@pblge I took my last BCP last night (was on them for 18 days).

Thanks @PrivateOne, that's the type of reassurance/success story I was looking for!

doglover1234 · February 2014

Hi @Carol77B - I am currently on microdose Lupron flare, CD 9. I was labeled a poor responder after my first IVF was converted to IUI in November. The microdose Lupron flare is, from what I've heard, supposed to increase follicle count without compromising quality? My AFC was 15, but my scan this morning showed 17 measurable follicles, so it is very possible that more will develop. At my baseline appt last week the tech mentioned that b/c I was so bloated from my period they had a hard time seeing my ovaries, so just remember, the ultrasounds aren't 100% conclusive either

Also, I just started with the DHEA and CoQ10 last month, so I was only on it for 1 month prior to the start of the cycle. My RE's recommendation was to start DHEA and CoQ10 once I start this IVF cycle - he never said anything about beginning beforehand, even though I did.

GL with the cycle!!

jlr96 · February 2014

I just did the MDLF protocol & I think it is mainly for poor responders and/or those of us with LOR/DOR. My AFC was 5 prior to beginning my first IVF cycle but I had a total of 8 follies once I started stims. We only got 5 at ER (the other 3 stopped growing) & of those 5, 4 were mature & all fertilized. We transferred 2 & the other 2 did not make it to freeze.

GL with your second cycle!!

Baseline Eval for IVF#2

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