Quick question for you ladies, TW***

suzycupcake · March 2018

and hopefully I can start my own post for this.

If you did a treatment cycle and

*******TW in spoiler

bfp and then loss

Would you request to do the next cycle exactly the same as before? We did femara, ovidrel, and IUI for our 3rd cycle. No cysts from the femara. The only thing is though we may have only gotten one follicle with the femara. Would you ask that the dosage be increased for the next cycle or maybe add a low dose injectable? I'm trying to decide what to do here since I'm now cd1. My ovaries hyper responded to Clomid when we did that the two cycles prior and I got huge cysts from it so I'm concerned about injectables. I have pcos too so I don't want to get a bunch of follicles going in over drive. I have a very experienced and trustworthy RE. I just want to be able to have some opinions from a few ladies before I go in there this week.

ginny_203 · March 2018

Hi @suzycupcake first, so sorry again for your loss. We had a similar thing happen in January with a CP on our 2nd IUI. We followed the same protocol on our 3rd IUI which wasn't successful, and I do think it's worth a conversation with your doctor.

After our CP, I did ask the doctor whether the dosage would be increased because I was only producing 1-2 mature follicles, but he declined because the approach had worked for us. I ended up switching REs afterward because I didn't like how unwilling that doctor was to reexamine protocols and try something new. This IUI cycle (my 1st with new RE and 4th overall), we tried a completely new protocol switching from clomid to fermara and introducing follistim to help make more mature follicles which has worked - we now have 4 mature for our IUIs Monday and Tuesday.

suzycupcake · March 2018

That's great to hear and thank you @FutureMrsMerati for sharing this with me. Good on you for advocating for yourself! And I'm also so sorry again for you too. I do understand the logic of doing the same thing on a basic level, but with fertility in general, the chances of success are only 20% so that doesn't make sense. When it comes to IF, it doesn't make any sense at all to do the same thing.

I definitely don't want 4 personally because it scares the crap out of me (and maybe for uneducated reasons), but I do want to at least get 2. I may have gotten 2 last time. I had to ask for another u/s the day of the trigger (it was a Saturday) because I wasn't going to waste money on IUI on Monday if no follicles were going to mature. There was one mature at the time. Another was right behind it, but there's no way to know for sure if it caught up by Monday. When we did Clomid the first time, we got 3. The second time, I have no idea because everything was a blur. I was going through a difficult family time.

I really wish they did very close monitoring with IUI in the same manner that they do with IVF. I don't want to rely on IVF to find simple problems that could've been fixed during IUI with more care and monitoring.

That gives me a lot to think about. Thank you again!

mockingjay1 · March 2018

After our loss we kept my femara dose the same. I successfully ovulated and was having 1-2 follicles each cycle. It technically worked, it was just a chromosome issue (and most CPs are as well). IMO there is no reason to change anything because it was likely bad luck with a chromosome issue and adding in injectables will just put your at a higher risk for HOMs. I know a lot of ladies are comfortable with 3-4+ follicles a cycle, but working in the NICU definitely made me never want to have more than 2 mature follies.

LadyMillil · March 2018

Sorry for your loss. IUI didn't work for me but my RE never changed my protocol because she was happy with how I responded to the meds. Even with the same dose of clomid each cycle I produced between 1-4 follies, so it is completely possible that using the same dose for your next cycle will result in more follies. Like PP I don't think I'd change the protocol unless your RE suggested it because the cycle did work and increasing meds or adding in injectables could result in over responding.

kristimh80 · March 2018

@suzycupcake You sound exactly like me! I have PCOS ovaries and when I did IUI's they even have me on a combo cycle of femara and follistim and I'd be lucky to get 1 viable egg those cycles. The only time my body responded with 3 - 4 eggs was when I did straight follistim the last cycle. So, I'd maybe ask even if that was an option or if they could try a combo cycle with you. My body didn't respond to femara at all, which it sounds like yours isn't either.

tosh24 · March 2018

I agree with PPs but just wanted to add my two cents from another perspective. If you are planning on moving to IVF at any point, I would highly recommend trying a combo or straight inject IUI cycle to see how your body responds to stims. I did 3 femara IUIs and then two combo femara/inject IUIs. Those last two cycles were disasters. The first combo cycle I O'd early and the second cycle I overstimmed. These failures gave me and my RE valuable information that we used to inform my IVF cycle (started monitoring earlier and started on an ovulation suppressant earlier as well as only used low-moderate dose stims because I hyperstimulate). To have to learn those lessons during an IVF cycle and potentially flush thousands of dollars down the drain would have been devastating both emotionally and financially. I'd much rather cancel an IUI cycle than an IVF cycle.

puppyluv13 · March 2018

For all but one of my IUI cycles I did a combo of fermara and follistim. We ended up getting a BFP on the 3rd cycle that unfortunately ended in a CP. After that, my RE decided to switch it up and I skipped the fermara all together and only did follistim that final cycle (at an increased dosage). She said that my follies weren't responding to the fermara like they did in the earlier cycles, so increasing the injectibles should do the trick. It ended with a BFN and a really painful cyst, BUT I was happy to switch things up. Like a PP said, I don't understand keeping the same strategy time and time again.

suzycupcake · March 2018

Thank you everyone for sharing your experiences and opinions with me. I spoke to my RE about it and asked what she thought. She agreed that doing the same thing didn't make sense either. This morning, she said she wants to increase the femara dose only and not do injectables. I'm supposed to start taking them now on cd2 so we can start monitoring earlier. She said if we get to right before the trigger and there is only one follicle, then she will add a small dose of injectable to get another one. I think I'm happy with that approach. I have a history of overstim with Clomid so we had to switch to femara after two iuis.

Quick question for you ladies, TW***

Re: Quick question for you ladies, TW***

Choose Another Board

Search Boards