Infertility
bethann1022
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Introduction, been lurking for quite awhile so it's about time! (REALLY LONG POST, SORRY!
bethann1022
member
in Infertility
Hi everyone,
My husband and I have been together for 13 years, were married in 2011 and began TTC shortly after the wedding. I have PCOS and do not ovulate on my own so I knew it would require some professional help. In 2012 we saw an RE for an evaluation, went off birth control and started some testing. Everything checked out fine for both of us, except again, it was definitive that I do not ovulate on my own and would require at a minimum Provera to initiate AF with clomid and/or letrozole. However, due to job changes and my husband returning to school we took the next couple years off, tried naturally with no success. In May 2015, we decided it was time to really get serious about TTC. I was 30, my husband 36 and we went back to the fertility specialist, completed all evaluation testing again, but with some additional tests such as HSG, endometrial biopsy and additional bloodwork, same results. The RE at this point recommended I try to lose 10% of my body weight to increase chances of pregnancy as well as reduce risk for complications, although it was not a requirement. I started in a weight loss program and had surgery in February 2016. After six months of weight loss, approx. 50lbs down, we went back to the RE and were told that "our chances were much better" for an easier time getting pregnant as well as experiencing a healthy pregnancy.
However, since September 2016, easy has definitely not been our journey. We started with two rounds of letrozole at 2.5mg and 5mg with the goal of an IUI during each cycle, however we never got there as my body had no response to letrozole. In fact, the response was so obsolete that the doctor recommended we move onto IVF as she did not believe, we would have any different outcome with an increased dose of letrozole or trying clomid. I also questioned if we could do injectables with IUI, but at a baseline ultrasound, my follicle count was around 40 (because of PCOS), so she felt it would be impossible to control follicle growth with injectable medications and the cycle would most likely be cancelled because of too many mature follicles. She assured us that our highest chance of success would be an antagonist IVF cycle.
After talking it over with my DH, we decided to move forward with IVF in November, hoping for a fresh transfer beginning of December. I was started on Gonal-f, then Menopur added on CD5 and then cetrotide added two days later. I stimmed for 13 days and had around 30 follicles between 13-18mm at time of trigger. 16 eggs were retrieved, 12 mature, 9 fertilized (without ICSI), however I was disappointed when only 2 made it to 5 day blast stage. We went through two consecutive single embryo FETs in January and February of this year, both resulting in BFN.
At this point, I sought a second opinion, who agreed with my RE that the protocol used was most likely the best one for us based on my PCOS. However, she suggested some additional endocrine testing which I completed and everything was normal. At my follow-up with my RE, she discussed possibility that our lack of success was most likely poor egg quality because of my high androgen levels (Thanks again PCOS). She suggested I restart on metformin (had been on five years ago but could not tolerate GI side effects), and she also reassured me she would increase frequency of monitoring at start of cycle and start me on higher doses of stem medications as last time, it took approx. 10 days for my estradiol level to get over 100.
Toward the end of March, I started my second IVF cycle, same medications but higher doses. Instead of gonal-f 125u daily we started on 225u daily. Whoa did this make a HUGE difference. Within 3 days, I could feel pressure and sharp pains in my abdomen and when I went back after just 3 days of medications my estrogen level was already well over 100. After six days of stim medications, I already had 25 follicles 13-16, so she had to significantly decrease the medications. After eight days, there were 30 follicles 14.5-19 and I was triggered. However, also the identical outcome on retrieval day as the first cycle. 15 eggs retrieved, 12 mature, 9 fertilized, this time 3 made it to 5 day blastocyst stage. We discussed PGS testing, however my RE was opposed to it, as I am only 32 and she stresses that she believes the first cycle failed due to quality of embryos, most likely d/t decreased egg quality.
We were not able to do fresh transfers for either cycle as both times my progesterone elevated, so a freeze all was required. My doctor put me on cabergoline for both retrievals to try to prevent OHSS and while I had a tough time recovering from both procedures and may have had mild OHSS, it was tolerable and I recovered within a week each time. We discussed an ERA test to confirm lining receptivity, but decided to hold off until after this most recent IVF cycle and transfers, as we are hopeful it was an embryo quality issue and my lining has been optimal thickness each time.
After getting insurance approval for a double embryo transfer, I was prepped with estradiol patches in late April and just underwent my double FET yesterday, May 2nd. I am now in the dreaded TWW and hoping that this one goes by more quickly and calmly than the last two. For my first TWW, I couldn't help but POAS every day starting on 3dp5dt as it was the first time, there was even a remote chance we could be pregnant. However, after seeing negatives each day for 8 days in a row, it was really depressing and I swore I wouldn't put myself through that again. For the second FET, I started on 4dp5dt and POAS every other day but when still BFN on 8dp5dt, I again lost all hope. This time, my goal is to not POAS until the day of beta (as I don't want to be surprised with phone call, too anxiety provoking for me), which is next Friday 5/12! Luckily, I am going to be much busier during this wait, as my DH and I have a planned trip Friday- Wednesday and so hopefully I won't even be tempted until 9dp5dt, which day I have work meetings all day and so won't test before as I need to be composed that day.
Sorry for the REALLY long post, if you read my entire history I really appreciate it. I have been reading your posts and following many of your stories for many months now and I truly admire the strength you all have and your ability to fully support each other through the struggles and successes. I hope to become part of this wonderful group and am also here to support each of you through your journeys. This is not an easy road for any of us, but I know this community makes it just a little bit easier. As many of you, I am reluctant to share my infertility struggles with my friends and most of our family members as they do not understand. They try to be compassionate, but after trying to share with a few people and getting responses such as "Just relax, I swear, my friend was having trouble getting pregnant and finally after she stopped trying it worked" and "oh my sister has trouble with her periods, we always thought she'd have trouble getting pregnant, but as soon as she stopped the pill she got pregnant the first month, I'm sure that will happen to you." It will be nice having a place where I can participate, and share with people who truly understand. T
hank you so much and I look forward to getting to know everyone!
Beth
My husband and I have been together for 13 years, were married in 2011 and began TTC shortly after the wedding. I have PCOS and do not ovulate on my own so I knew it would require some professional help. In 2012 we saw an RE for an evaluation, went off birth control and started some testing. Everything checked out fine for both of us, except again, it was definitive that I do not ovulate on my own and would require at a minimum Provera to initiate AF with clomid and/or letrozole. However, due to job changes and my husband returning to school we took the next couple years off, tried naturally with no success. In May 2015, we decided it was time to really get serious about TTC. I was 30, my husband 36 and we went back to the fertility specialist, completed all evaluation testing again, but with some additional tests such as HSG, endometrial biopsy and additional bloodwork, same results. The RE at this point recommended I try to lose 10% of my body weight to increase chances of pregnancy as well as reduce risk for complications, although it was not a requirement. I started in a weight loss program and had surgery in February 2016. After six months of weight loss, approx. 50lbs down, we went back to the RE and were told that "our chances were much better" for an easier time getting pregnant as well as experiencing a healthy pregnancy.
However, since September 2016, easy has definitely not been our journey. We started with two rounds of letrozole at 2.5mg and 5mg with the goal of an IUI during each cycle, however we never got there as my body had no response to letrozole. In fact, the response was so obsolete that the doctor recommended we move onto IVF as she did not believe, we would have any different outcome with an increased dose of letrozole or trying clomid. I also questioned if we could do injectables with IUI, but at a baseline ultrasound, my follicle count was around 40 (because of PCOS), so she felt it would be impossible to control follicle growth with injectable medications and the cycle would most likely be cancelled because of too many mature follicles. She assured us that our highest chance of success would be an antagonist IVF cycle.
After talking it over with my DH, we decided to move forward with IVF in November, hoping for a fresh transfer beginning of December. I was started on Gonal-f, then Menopur added on CD5 and then cetrotide added two days later. I stimmed for 13 days and had around 30 follicles between 13-18mm at time of trigger. 16 eggs were retrieved, 12 mature, 9 fertilized (without ICSI), however I was disappointed when only 2 made it to 5 day blast stage. We went through two consecutive single embryo FETs in January and February of this year, both resulting in BFN.
At this point, I sought a second opinion, who agreed with my RE that the protocol used was most likely the best one for us based on my PCOS. However, she suggested some additional endocrine testing which I completed and everything was normal. At my follow-up with my RE, she discussed possibility that our lack of success was most likely poor egg quality because of my high androgen levels (Thanks again PCOS). She suggested I restart on metformin (had been on five years ago but could not tolerate GI side effects), and she also reassured me she would increase frequency of monitoring at start of cycle and start me on higher doses of stem medications as last time, it took approx. 10 days for my estradiol level to get over 100.
Toward the end of March, I started my second IVF cycle, same medications but higher doses. Instead of gonal-f 125u daily we started on 225u daily. Whoa did this make a HUGE difference. Within 3 days, I could feel pressure and sharp pains in my abdomen and when I went back after just 3 days of medications my estrogen level was already well over 100. After six days of stim medications, I already had 25 follicles 13-16, so she had to significantly decrease the medications. After eight days, there were 30 follicles 14.5-19 and I was triggered. However, also the identical outcome on retrieval day as the first cycle. 15 eggs retrieved, 12 mature, 9 fertilized, this time 3 made it to 5 day blastocyst stage. We discussed PGS testing, however my RE was opposed to it, as I am only 32 and she stresses that she believes the first cycle failed due to quality of embryos, most likely d/t decreased egg quality.
We were not able to do fresh transfers for either cycle as both times my progesterone elevated, so a freeze all was required. My doctor put me on cabergoline for both retrievals to try to prevent OHSS and while I had a tough time recovering from both procedures and may have had mild OHSS, it was tolerable and I recovered within a week each time. We discussed an ERA test to confirm lining receptivity, but decided to hold off until after this most recent IVF cycle and transfers, as we are hopeful it was an embryo quality issue and my lining has been optimal thickness each time.
After getting insurance approval for a double embryo transfer, I was prepped with estradiol patches in late April and just underwent my double FET yesterday, May 2nd. I am now in the dreaded TWW and hoping that this one goes by more quickly and calmly than the last two. For my first TWW, I couldn't help but POAS every day starting on 3dp5dt as it was the first time, there was even a remote chance we could be pregnant. However, after seeing negatives each day for 8 days in a row, it was really depressing and I swore I wouldn't put myself through that again. For the second FET, I started on 4dp5dt and POAS every other day but when still BFN on 8dp5dt, I again lost all hope. This time, my goal is to not POAS until the day of beta (as I don't want to be surprised with phone call, too anxiety provoking for me), which is next Friday 5/12! Luckily, I am going to be much busier during this wait, as my DH and I have a planned trip Friday- Wednesday and so hopefully I won't even be tempted until 9dp5dt, which day I have work meetings all day and so won't test before as I need to be composed that day.
Sorry for the REALLY long post, if you read my entire history I really appreciate it. I have been reading your posts and following many of your stories for many months now and I truly admire the strength you all have and your ability to fully support each other through the struggles and successes. I hope to become part of this wonderful group and am also here to support each of you through your journeys. This is not an easy road for any of us, but I know this community makes it just a little bit easier. As many of you, I am reluctant to share my infertility struggles with my friends and most of our family members as they do not understand. They try to be compassionate, but after trying to share with a few people and getting responses such as "Just relax, I swear, my friend was having trouble getting pregnant and finally after she stopped trying it worked" and "oh my sister has trouble with her periods, we always thought she'd have trouble getting pregnant, but as soon as she stopped the pill she got pregnant the first month, I'm sure that will happen to you." It will be nice having a place where I can participate, and share with people who truly understand. T
hank you so much and I look forward to getting to know everyone!
Beth
Re: Introduction, been lurking for quite awhile so it's about time! (REALLY LONG POST, SORRY!
Maybe your friends and family don't understand/know enough to care about the dosage/follie counts, but I for one am both interested and hopeful that your second IVF cycle, with the difference in dosages, made such a huge difference - I very much hope that means better egg/embryo quality!
I also don't really talk to other people about IF that much, mostly because I do not like the "just relax" advice, and am not so good about biting my tongue. (Read: I have been vicious to some who've offered more obtuse comments.) It's amazing how much ignorance there is, and I'm trying to choose my battles. I would never, ever tell anyone who is struggling with a medical condition to: "just take a vacation, that'll solve it!" It makes me so mad that IF is seen differently, that this one medical issue so many people feel such licence to ignore the advice of doctors and researchers, and to say: "it's maybe because she's just too tense." It makes me want to spit, and it makes me think that there's even more misogyny in our world than I realized. (end rant)
Anyway, FX that this transfer is the one! I find out if my IUI worked on 5/12 too!
I have a phone consult for an RE tomorrow morning and we will move forward from there... I definitely understand people not understanding IF. I've told only a few people after my mom made some harsh comments because I want to avoid any negativity. People don't understand that just adds to the stress of TTC.
I'm here to talk if you need it! And you'll find the ladies here are immensely supportive.
*TW*
Welcome! Im sorry you find yourself here but this community is so helpful throughout the IF journey. Hopefully your stay is short!! I'm lurking from the PAIF boards and had a serious sense of dejavu reading your history. I figured I'd comment to hopefully give you some hope.
I also have PCOS and went through 4 cycles of timed intercourse and 3 iui's prior to deciding to move on to IVF, which we mistakenly believed would fast-track us to pregnancy.
Cycle one was cancelled due to poor response to meds. Cycle two--of 18 mature follies, 7 were retrieved, 6 fertilized, and no blasts on day 5. We had two "fair quality" morullas, which our RE recommended transferring. BFN.
Cycle three-again, 18 mature follies, 12 retrieved, 2 mature and fertilized. Both arrested before day 5. No transfer. We were told it's definitely an egg quality issue, and that we should consider donor eggs.
Cycle four-25+ mature follies, 22 retrieved, 10 mature and fertilized, ended up with two blasts on day five. Our RE recommended transferring both due to overall poor egg quality, so we did, and I am now almost 12 weeks with triplets.
My point is dont give up hope!! I was certain I would never have a biological child and I am on my way to three. It's all about getting the *right* egg!! Sending baby dust your way!!
srh18 i just wow'd out loud and scared my OH!! Such a wonderful miracle indeed!! Did one egg split 3x or 1 split 2x? I'm thrilled u got your healthy embryos!!
Unexplained Infertility - but I am 40...Low AMH .30
7 - IUI (50mg-150mg Clomid) Feb - August 2016 all BFN
IVF#1 August 2016 (Antagonist protocol 4/5 eggs) Cancelled cycle
IVF#2 Sept 2016 (microdose luporn pro - disappearing follies, ONLY ONE, convert to IUI) BFN
IVF#3 November 2016 (4 ER, 3 F, 3DT)-BFP
IVF#4 March 2017 //EPP (10 ER (1 wonky so 9 ER) 7F, 3B (5AB, (2)5BB) PGS tested- ALL abnormal
IVF#5 April 2017 // EPP (7 ER, 7F yes! 6B) 2/5 day 4/6 day - 2 PGS normal! yes!!
IVF#6 May 2017 // Antagonist didn't have time for Estrogen Priming...(4 ER, 3 F, 3B) (5AB, (2) 5BB) 2 PGS normal, yes!!
IVF#7 June 2017 // EPP praying this is it and then on to an FET!
@Hopeful_mom I am so thrilled for you finally getting your two normal embryos!! I know this has been a long road for you. When will you transfer? For me, both embryos stuck and one split, so we have a singleton plus identical twins! A miracle indeed.
Unexplained Infertility - but I am 40...Low AMH .30
7 - IUI (50mg-150mg Clomid) Feb - August 2016 all BFN
IVF#1 August 2016 (Antagonist protocol 4/5 eggs) Cancelled cycle
IVF#2 Sept 2016 (microdose luporn pro - disappearing follies, ONLY ONE, convert to IUI) BFN
IVF#3 November 2016 (4 ER, 3 F, 3DT)-BFP
IVF#4 March 2017 //EPP (10 ER (1 wonky so 9 ER) 7F, 3B (5AB, (2)5BB) PGS tested- ALL abnormal
IVF#5 April 2017 // EPP (7 ER, 7F yes! 6B) 2/5 day 4/6 day - 2 PGS normal! yes!!
IVF#6 May 2017 // Antagonist didn't have time for Estrogen Priming...(4 ER, 3 F, 3B) (5AB, (2) 5BB) 2 PGS normal, yes!!
IVF#7 June 2017 // EPP praying this is it and then on to an FET!
How many more retrievals will you do? I know the process is certainly disheartening at times. I'm hoping you get a few more normal embies so you can have your miracle baby(ies). I'm rooting for you!
I need every cheerleader and prayer I can get!! I keep saying this is a group effort!! I've started my 6th cycle of IVF anf hopefully make it to ER which will make it my 4th ER. I'd love to think its my last but its up to my body to decide that. Maybe I'll do 2 more, I would love for this to be it but we shall see. Honestly I never want to have to stem and go through IVF again soooo the fact I'm in it I just want to get this part over with once and for all. Come on healthy embryos!!! Its just unfortunate I MC for one and my age does factor into this process for me. The fact that I am making unhealthy embryos means it only going to get worse as time goes one...why I wish I didn't waste so many months on IUI! I'm excited for you to find out the genders soon!! How many weeks are you?
Unexplained Infertility - but I am 40...Low AMH .30
7 - IUI (50mg-150mg Clomid) Feb - August 2016 all BFN
IVF#1 August 2016 (Antagonist protocol 4/5 eggs) Cancelled cycle
IVF#2 Sept 2016 (microdose luporn pro - disappearing follies, ONLY ONE, convert to IUI) BFN
IVF#3 November 2016 (4 ER, 3 F, 3DT)-BFP
IVF#4 March 2017 //EPP (10 ER (1 wonky so 9 ER) 7F, 3B (5AB, (2)5BB) PGS tested- ALL abnormal
IVF#5 April 2017 // EPP (7 ER, 7F yes! 6B) 2/5 day 4/6 day - 2 PGS normal! yes!!
IVF#6 May 2017 // Antagonist didn't have time for Estrogen Priming...(4 ER, 3 F, 3B) (5AB, (2) 5BB) 2 PGS normal, yes!!
IVF#7 June 2017 // EPP praying this is it and then on to an FET!
I don't have any specific knowledge or expertise on all your struggles with PCOS and unsuccessful IVF attempts but my heart is with you. Please keep sharing and know you are supported!
We lost C2 Apr 2015 (ectopic) but my obgyn was able to save the left tube. We were told that IVF was our best chance. So I got on bcp for about 6 months,stopped, then decided to go back on and found out we were pregnant again with C3. I made it to 7 weeks 3 days and found out it was another ectopic. I felt that getting pregnant naturally was not going to be my testimony but that IVF would work for my DH and I. We got married 3 months ago and decided it's time to start our family. We have our first initial visit with a fertility specialist in about a month. A friend of mine who went through IVF and now has a beautiful baby boy told me to read "It Starts with an Egg". I'm eager to learn how to get the best eggs possible.
So I pray that God grants us all our hearts desire and that next Mother's Day we are either holding babies in our arms or carrying them close to our hearts with swollen feet and 3am cravings.. Be encouraged!
Lanell
Dx:PCOS
2012-2015: TTC #2 (2 rounds of clomid + metformin)
04/13/15: Second ectopic pregnancy
02/29/16: Third ectopic pregnancy
Tubal Infertility
Married: 2/11/17
7/21/17 : Consult with RE
10/12/17 : Second consult with a different RE
1st IVF Cycle scheduled for Feb 2018
02/13/18 : ER (22 follies,16m Eggs, 11 fert, 5 blasts)
02/18/18 : ET - 2 beautiful blast 3AA,2AA (highest quality)
02/27/18 : First Beta - 193!!!
03/01/18 : Second Beta - 546
I have been doing very well and the triplets are also progressing nicely. I'm 14+3. Thank you for asking!
For my fourth cycle I added acupuncture (started about 5 weeks prior to starting stims) and we increased my meds pretty significantly in an "aggressive protocol"--just aggressive for me, mind you, I think I was on maybe 2 vials of menopur and 175 gonal f or something. It was pretty high compared to what I had been on previously. Those were the only differences.
It was painful but surprisingly comforting when my re began to talk about egg donation. I had been in a tough boat where the dr was so confident that I would get pregnant so fast and then when I didn't it became more and more disheartening. I wanted a baby and I knew no matter how it happened, when I held the baby in my arms, he or she would feel like the specific human being i had been waiting for. I just really believed that, and so to have an option that I knew would end in a baby was a good thing for me.
I am sorry there are still questions for you regarding quality/implantation. I was fortunate in never doubting implantation was not a problem; my lining was always thick and after my chemical my re had no worries about implantation. Have you asked about tests for your lining, like a scratch or ERA, I think it's called? I'm not super familiar with the tests but I've read about other women on the boards having them done.
Best of luck to you!!!
"I've really tried to let go of the expectations I had for others about the support they could give. Otherwise I would just keep being disappointed that they don't understand"
That part really hit home for me. It's one of the many lessons I've learned about life/people from the IF/IVF process. As someone who finds it difficult to ask for help, this has been especially problematic for me.
@srh18 sending you a PM