Intro and questions

tlc35 · November 2014

Hello wise ladies of 3T. I had planned to wait till next cycle to intro but I'm just not sure what to do and I'm hoping for some advice. Since I am 37 and H is 45 we started testing after TTC for 8 months and are finishing up our testing cycle.

I had my follow up RE appointment and it was a mixed bad but mainly pretty good. My ovarian reserve is good and my H has good swimmers. The big issue is that my lining has been thin for 2 cycles in a row. He had me start vaginal estrace for this cycle and progesterone supps for after O which I think is good. But if this doesn't work then he wants to go to injects + trigger + TI, and I don't know if we are ready for that. Our main concern is the risk of multiples which is a 20% risk of twins and 5% risk of higher order multiples. I know that clomid can thin the lining so I don't think that would be a good idea. Also we are going OOT to visit family Dec 19th so I don't know if we can cycle next month anyway. I am considering asking for a femara cycle or just another one like this one with no stims but extra estrace and progesterone. Thoughts? TIA

dominicandreamer · November 2014

Hi and welcome to the board!

dancerspose · November 2014

I don't have any advice to offer, but wanted to say welcome and good luck!

tlc35 · November 2014

rainbowbridge14 said:

Welcome, but sorry you have to join us.

IMO, if you are not sure you are ready to take a step it is best to communicate that to your RE and see what your other options are. A femara cycle seems to make sense, but I would see what your RE's rationale is in suggesting injects so soon and ask what his/her thoughts are about other options.

Thanks. He did say that he jumps straight to injects in patients who have already had a loss because the m/c rate is lower with injects than oral meds.
I will probably try to call next week and I also want my H to talk directly with the doc as he asks me questions that I didn't think to ask.

tlc35 · November 2014

:-h Hi OSE!

tlc35 · November 2014

Hmm, Ketchup, thanks for commenting, that is what he said. I just looked around on pub med and couldn't find anything to confirm of refute. It is really the only practice around but I could try to get a 2nd opinion within the practice.
I might just call and ask if I can do a femara cycle or 2 first since I don't want to do clomid because I have lining issues. I do ovulate on my own but often fairly late in my cycle.
Thanks ladies for the welcome and for giving me more things to think about.

wanderlust508 · November 2014

Hello and welcome to the board! I don't know much about injects or Femara (currently benched and was only on Clomid for my 3 IUI cycles before I had to take a break for surgery).

I hope you are here briefly and that things work out for you soon!

SND1231 · November 2014

Welcome.. my RE said that Femera does have a less chance of multiples, I am not sure about less chance of m/c with injects. I would definitely ask for some more information. I will say that even Femera thinned my lining. I might be that odd rare person, but just my experience. Good luck!

meredithcarole · November 2014

Obviously I have no idea what I am doing so I cannot offer advice, but hi :-h

cateyes543 · November 2014

Hey TLC, so sorry to see you over here but welcome! No advice since I am newish too but wanted to say hi!!!

Rachaeleigh · November 2014

Hi :-)
I don't have too much to add. I know it seems like a big step, as I was really hesitant to start injects and IUI as well.
For us, at that time, we really felt like we trusted the dr so that meant taking her advice and moving forward.
Unfortunately, 5 IUIs later and I'm not pregnant, but I'm glad we started the process when we did.
Also, my RE at that time also briefly mentioned something about injects bc of Rpl. However, the next RE didn't seem to believe that

DSculley1824 · November 2014

Hi and welcome! This cycle with Letrozole/Femera I only had one follicle (it was 22mm when I was told to trigger). My lining never thinned, it was 9.5 also at the time of my trigger. Never have had injects though.

deelopi9 · November 2014

Hi, welcome to 3T and I'm sorry you find yourself here. I would be completely honest with RE on where you feel comfortable starting the protocol and see what recommendations he gives you. Clomid thinned my lining and I had more follicles w/ clomid cycles than with Femara. The two cycles I was on Femara my lining was good. Good Luck!

BunnyBerry · November 2014

Welcome! Though sorry you have to be here.

Glad you have some good results! Estrace/estradiol worked wonders on my lining. I hope it works well for you.

The risk of mulitples/HOM is directly related to the number of mature follies. One of the reasons injects are used is to try to get more chances each month with more follies. But you could talk to your RE about dosing your injects to aim for 1 or 1-2 follies, and consider canceling if you get 3. That doesn't entirely eradicate the chance for HOM, but it helps - our RE's office cancels any non-IVF cycle with over 3 follies (I believe for any age woman) and they have a less than 1% triplets rate.

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