IVF advice !?!

gnl42 · May 2014

Hi ladies! I'm (unfortunately) still in the IF process and hope you don't mind me asking about your experiences. My ER was on Friday with 23 eggs retrieved and 18 fertilized. I was told they were "doing well", but will get a detailed day 3 report later today. My RE is pushing for a freeze all/ FET next month for 2 reasons:

1) My estrogen was ~7000 at trigger. I do not have OHSS now whatsoever, so at this point, she is only concerned about late onset OHSS. However, I feel great (believe it or not), U/S is good, and we are only planning on transferring one embryo, so I think the risk is not that high given the entire clinical picture.

2) My lining is still hanging around 7.5 mm - which is what I'm more concerned about. It didn't even make it to 7 last time, so this is actually an improvement for me. And I have the triple stripe this time, which didn't look so great last time.

We are waiting until the morning of scheduled transfer (Wed) to make the final call. We'll see what the final word is on the embryos, but if we end up with a good amount, then I'm tempted to go for it. I feel that there is no guarantee my lining will be better for FET if we wait since this seems to be a recurrent issue for me. I'm feeling VERY impatient since my first cycle was cancelled altogether.

Has anyone here had success with either of these problems??? Any advice?

blueberries8 · May 2014

I think my take on it would depend on how good your clinic is at freezing/thawing. Your lining sounds reasonable -- not great but ok. Also, it sounds like your E2 did get very high, so late onset OHSS is a real risk if you get pregnant (which hopefully you will!). I totally get wanting to proceed as quickly as possible, though.

If the FET success rates at your clinic are comparable to fresh, I'd hold off because you don't have anything to lose except for the time issue (which I get isn't inconsequential when you've already been waiting a very long time). However, if your clinic's FET success rate is lower than their success rate for fresh cycles, I would probably weigh that over the lining and OHSS concerns and proceed with a fresh transfer. Good luck!!

kmc84 · May 2014

Bump ate my post...

kmc84 · May 2014

Did you trigger with Lupron or HCG?

gnl42 · May 2014

Thank you @blueberries8 for your response! I will check on the fresh vs FET rates - that should definitely be another fact to consider. RE has mentioned several times that the new research coming out is showing that FETs might actually be better than fresh transfers, so maybe this is why she wants to go that route. There are just no guarantees either way and I just want to at least start trying something!!

@kmc84 I had to trigger with hcg bc I was already on Lupron (but we kept the dose low at 3300 IU)

gnl42 · May 2014

I'm also taking cabergoline for OHSS prevention - a few more pills left!

Ironmom2be · May 2014

I had my E2 over 9000 both times. I've never had OHSS. They put me on dostinex both times (10days) 1st time we did a freeze all and an FET the next month. Resulted in my daughter, 2nd time we chose a fresh transfer and I'm currently 15w from that cycle.
So I've been "at risk" twice and never got ohss. So I think everyone responds differently. I hear ohss is terrible, my RE said this time around he would have never done a fresh except that we had a history and I didn't get it last time.
Good luck, it's never fun to freeze all but I'm so thankful everyday for my daughter I can't imagine having it any other way.
Best wishes for success with your cycle whatever you decide!

kmc84 · May 2014

I'm glad to hear you did a lower dose of HCG. My first IVF was cancelled due to early OHSS before I even got to retrieval. My estrogen was (only!) over 4,000, but I was miserable! So much pain and abdominal bloating-and I had well over 45 follies. If @Ironmom2be‌ can be over 9,000 and not get OHSS, I guess it really is individual!

I would be leaning towards an FET honestly. Good luck either way! I hope either this or an FET gets you here!

ColleenS629 · May 2014

I don't remember what my estrogen level was with my IVF but I did get late onset OHSS which did get worse because I got pregnant. I agree that you should talk to your doctor about the success rates and your concerns. At my clinic, their FET success rates are great but slightly lower than fresh... But my RE said that was because they typically use the best ones for the fresh cycles and subsequent FETs have lesser quality embryos than were transferred with the first, fresh transfer. He said when comparing IVF fresh transfer with freeze all then FET transfer, the success rates were the same.

gnl42 · May 2014

Thank you to everyone for your replies!

@ironmom2be i'm also on dostinex (cabergoline is the generic name). I can't believe your E2 was >9000 and you were able to go ahead and have a successful transfer! Congrats on #2

@kmc84 VERY good point. We never know how our bodies will react. The #s are just that, but we all respond differently through out this process.

So... my cbc from yesterday showed that I was hemoconcentrated (despite chugging >3L per day of coconut water), so that was the final straw. My RE said she would not do a fresh transfer bc she does not want to put my health at risk. It is pretty hard to argue with that, though I still tried (and failed). We are planning on doing an FET in June. I can only hope that my lining gets thicker this time and we don't have a new problem. So far, there has been something every step of the way. Thanks again, ladies - you give me hope!

kmc84 · May 2014

I know the freeze all is a little depressing-I'm sorry. I think it was a very smart move though. At least you can know in June your body will be so much healthier come transfer time which will hopefully result in a healthy pregnancy. Good luck and take care of yourself!

Ironmom2be · May 2014

Thanks,@ gnl42. Good luck with your FET. I suspect you will feel MUCH better next month! Best wishes to you.

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