IF Testing & Treatment w/o 5.17

keikilove · May 2021

Yesterday ended up being busier than expected. We got home super late and crashed. I tagged a bunch of you while at the airport but when we got off the plane/off airplane mode it was all deleted. Trying again:

@BusinessWife It sounds like you’ve got solid plans to keep you occupied during this cycle. House hunting sounds like a great thing to dive into. That’s awesome. What is MFP? I so hope that this cycle goes exactly the way you want it to.

@bows22 I am crossing everything that your hysteroscopy gets moved up somehow. I feel like you’ve waited so long to start treatment & I just want you to be able to move forward! Also, that butternut squash meal sounds amazing.😋

@zwink1 Welcome back! I don’t think our paths crossed but your SN sounds familiar. Nice to see that you are among familiar friends here.🙂 Sorry for that tough change in RE & OB. That has to be a bit traumatic at first. I hope you love the new RE that your friend has recommended.

@photographerwife I’m sorry for that potentially bummer news your RE have you. But AFC changes from cycle to cycle— hopefully your AMH level comes back great & you’ll have nothing to worry about there. I laughed when you said you’re in the south and less cultured with food. I was like, Girl, that IS culture! Who else can cook delicious crawfish boils, soul-comforting foods, and decadent desserts like the cooks in the South? So good! 😋

@acleverusername Woohoo, it sounds like everything is really lining up perfectly! How serendipitous about your #1 choice RE vs #2 choice RE. It must feel like such a confidence boost to have Dr. Aimee co-signing on your protocol. I’m curious: what meds exactly are you starting 5 days DPO? Or did I miss this somewhere? I’m always interested to see different protocols.

@Anyone I missed, I’m sorry! I hope I caught everyone here.💗

Diagnosis (if you've been): RPL, RIF, DQ Alpha match (causing elevated NK cells & activity), blood-clotting disorders, AMA, DOR

Status (WTO/TWW/TTA): TWW

What are you doing this cycle? (Testing? Treatment?): We went ahead with the IUI yesterday. MH’s sperm count was at 7 million to start, and after the wash we were left with 5 million. It’s not great, but much better than the last two cycles where he produced only 2mil and 1 million, respectively. Our RE said he’s very lucky to have started to recover so quickly from the damage he did a few months ago; she said that when that kind of drastic sperm count drop happens she usually doesn’t see any improvement for a full 3 months. So I’m happy about that. Also, she did see that I had 3 collapsed follicles in my right that looked like the eggs had just been released, and then one on my left that was about to release. There was another smaller one on my left so she told me to take the trigger to make sure everything released and doesn’t turn into cysts. We didn’t measure any of them because they’d mostly already ruptured. She was happy with the timing so I’m just 🤷‍♀️ hoping for the best.

How are things going?: Fine. It’s been very stressful trying to time everything and arrange travel. Visitors are back in full effect in my state, so prices for flights and hotel have skyrocketed. We put in a lot of money just to fly over, so that’s part of the reason we went ahead with the IUI. Also, Dr went ahead with a new treatment for me of a Neupogen uterine wash that is supposed to help with implantation. I will do injections of it as well starting in a few days. FX it makes a difference. I wanted to try it now to see how I respond (and what it does to my bloodwork) before we move to IVF next month, because I plan to use it with the next embryo transfer as well.

Any questions?: This has been at the back of my mind for awhile, just a wondering. When I first joined the IF thread I shared my AFC count from my first RE visit (I was disappointed with just 6 or 7 follicles) and I was discouraged by a veteran member here. She said it’s not the culture of the board to share our numbers because what was disappointing to me was what some on this board would be wishing for. I know we’ve been openly sharing all of our numbers here for awhile now, and I enjoy learning what’s normal for some, but I do wonder if anyone else feels differently? I realize the culture shifts as people graduate/new people join, so just thought I’d put this out there as a question for the group.

GTKY: Are you a Savory or Sweet kind of person? I used to be sweet all the way, but changing my diet for TTC has cut that sweet tooth desire out quite a bit. Now I enjoy a piece of dark chocolate almost daily but everything else I used to enjoy tastes too sweet. I wouldn’t normally say savory because I don’t enjoy lunch or dinner food in general, but I guess I like foods that are a combo of savory with a bit of sweet. I grew up on a lot of Asian flavors so umami/sweet/salty/savory is probably my most satisfying combo.

[Deleted User] · May 2021

@keikilove Glad you were about to proceed with the IUI and that YH's numbers seem to have improved so quickly! MFP is my fitness pal. I used it to log everything I ate for a good year and lost a lot of weight that way. I cant say my head is 100% in the game yet, but at least getting started again is a step in the right direction. FX for everything this cycle! <3

keikilove · May 2021

@BusinessWife Oh, I love My Fitness Pal! I use it to log my runs & walks but haven’t used it for food tracking. Good to know how useful it can be. Good luck with it once you get 100% back into it! And thank you for the well wishes.💕

acleverusername · May 2021

@keikilove hooray that you were able to go ahead with the IUI! It’s great to see YH’s sperm is starting to recover. And how great that you had 4 follicles again! Is that just with Letrazole? What dose, May I ask?

Interesting bit of history re: not sharing AFC. Since I started posting to IF last July (2020) everyone was very open about AFC, no. of eggs retrieved, fertilized, blast formation and then PGT-A normal. If we’re sharing those latter details, then why not AFC? But then again, I have a good starting AFC. Perhaps someone who has DOR can weigh in whether or not hearings others’ higher AFC is bothersome. At the end of the day, even though I might have a decent AFC, there’s no telling how many eggs I’ll have retrieved and that will make it to PGT-A normal embryos. That’s art.

As for my protocol, I’ll be starting with 225IU Gonal-F, 150IU of Menopur and 25 units of Omnitrope (HGH). With the exception of Omnitrope, these are the standard starting dosages my clinic employs. My RE didn’t think I needed the HGH, since I neither have DOR nor am over 38 (but like, I will be in 4 months...) so I insisted on adding it to my protocol since it’s one of those things that “doesn’t hurt” but could make egg quality substantially better. Only thing is that I have to pay out of pocket for it and it’s not cheap. Have you ever used HGH as part of your protocol?

[Deleted User] · May 2021

I always think a good rule of thumb is just to spoiler any kind of stats like that. You never know who may be having a rough day.

I don't always remember, but I have also tried to spoiler in depth weight talk, because I know that can be triggering, too. But I know you can't always spoiler everything or necessarily anticipate what will be triggering for someone else on any given day.

acleverusername · May 2021

Good point @BusinessWife; could be something like *TW Stats*...

keikilove · May 2021

@BusinessWife Great points. Thanks for sharing your thoughts on this. I could be wrong, but I think it *might* have been you that gave me the advice about the culture of the IF thread way back when. But maybe not, it was a long time ago and many members have come and gone.

@acleverusername Thanks to you too for chiming in with your thoughts on this. I started posting here in the IF thread just over 2 years ago, I think. At that time the entire board was more strict & had a slightly different tone (IMHO: more directness, a lot more snark, but also a lot more humor on a daily basis). And there were many of us who were terrified of breaking the rules.😬 Anyway, if my memory serves me correctly about that time, it was not common to post all of one’s stats (AFC or otherwise). If people did, I think they usually put it in a spoiler. I do remember some people getting a LOT of eggs at retrieval and spoiling those numbers. I would open the spoiler and be like “Dang, I’ve only got these measly few at baseline?” I had a lot to learn about how it all works!

keikilove · May 2021

@acleverusername Thanks for sharing your protocol! It makes me want to go back and check what my first protocol was. Did you have to do anything at all to down-regulate before starting after O? It doesn’t sound like it since you’re going right into it after O. As for the HGH, yes I use it now and have been for the last 9 months. I paid that pretty penny for it at first but now get it for free. Details of how to save money on it in spoiler.

There is an Omnitrope company discount card. https://qv.trialcard.com/omnitrope#/app/layout/home You fill it out online and receive an electronic card number in your email. You give that number to your pharmacy and they keep it on file for 12 months. You can get a free vial every 21 days, up to $5,000 worth of free meds per year with that card. I know that Integrity Pharmacy and Freedom Pharmacy honor the coupon, not sure where else. Integrity overnights it for free. Only catch to getting approved on the Omnitrope website is you have to say that your insurance doesn’t cover it (usually true) or that you’re uninsured, and that you have one of the pre-existing conditions in the drop-down list to get it covered. Select Turner syndrome or Adult Human Growth deficiency, I think. PM me if you need/want any more help with this.

Also, the dosage I was on for my IUIs was 5mg Letrozole. Going to spoil my stats😁

I first tried it last year with 2.5mg I think, and had 2 or 3 follies, can’t remember. Then, this year I tried 5mg plus 75IU Follistim for 5 days, and had 3 follies. The next month I did just 5mg Letrozole, no Follistim, and had 4 follies. I presume I had more follies that month thanks to the effects of Follistim in the prior month. This time I did 5mg Letrozole again, plus 75IU Follistim for 4 days. In all of these cycles I also did 6 units of HGH, except in this last cycle I tried 12 units of HGH. The one thing I noticed is that Follistim seems to dry out most of my EWCM.

[Deleted User] · May 2021

@keikilove It might have been me! lol I know AFC has not historically been something triggering for me personally, but I see how it absolutely can be. Blast results / freeze reports things like that, I didn't realize how hard that can be to read some days, until I was going through it myself. People still do that on the IF board, they will waltz in out of nowhere and be like,

<div class=" Spoiler">hey guys, I just had my retrieval last week and I came back with blah blah blah like 12 well-graded embryos "IS THAT GOOD????" <<<bangs head against the wall>></div>
So yeah. lol That's why.

acleverusername · May 2021

@BusinessWife 😭🤦🏼‍♀️FML!!! That’s why I love this community so much better; people don’t just drop bombs like that. Except for the Peggys.

@keikilove no down-regulation! Just starting in the luteal phase of my natural cycle. I kinda like that. The doctor explained that by starting in luteal phase, when progesterone is rampant in the body (and progesterone shuts down any natural FSH production), I’m more likely to recruit more follicles / have them grow as a cohort. So, I’m really hoping that’s the case. My previous ER in Sep 2019 was an EPP protocol and (stats in spoiler)...

...and I had several distinct cohorts of eggs. By trigger time, there were 3 that were 18-19mm; 9 between 15-17mm; 3 that were 14mm and ... get this ... there were 7 more that were 12-13mm; and 6 that were 10-11mm. Keep in mind that my AFC that was measured in Jan 2019 was 22. The clinic I went to did “minimal monitoring”; they didn’t do a baseline the cycle of ER; and I also only had 2 monitoring appointments. I did end up taking estrace for about 14 days (my period was delayed because of travel and time zone changes). When I reviewed my protocol with Dr Aimee, she said that I was over-suppressed. Anyways, I had very little idea about what I was doing when I did my ER. In hindsight, I wouldn’t have gone with that clinic if I were to repeat as I really don’t think they got as many eggs as I could have had. Alas... can’t do anything about that now!

acleverusername · May 2021

Bear with me as I tell you that today I went down a rabbit whole to try and better understand how Clomid and Letrazole both work in the body. It is SOOOO interesting.

With Clomid, it binds to estrogen receptors in the hypothalamus, making it think that there is no estrogen in the body. (But there actually is.) Which causes the pituitary gland to “panic” because of lack of estrogen and start producing FSH and LH. This makes the follicles grow.

With Letrazole, it actually shuts down androgen > estrogen conversion in the adrenal glands. So, it does actually stop estrogen production. The pituitary then starts to produce more FSH and LH.

So, while the end result is the same, the difference in the mechanisms is SO interesting.

I also learned that Clomid’s half life is super long... 5-6 days ! And that’s why some ppl have side effects to Clomid so long after stopping it (FYI @runningoncookies ) and also why there’s a higher risk of multiples with Clomid.

Okay, biology lesson is over for now. 🤓

[Deleted User] · May 2021

@acleverusername Oh that is super interesting! I never took either, so I didn't know why doctors would seem to use them semi interchangeably, but that they are actually quite different in mechanism!

laura-kay · May 2021

Quick check in - things have been crazy at work and we are take a small break from treatments while we decide what to do next. We aren’t benched so to speak but we don’t know what we want to do yet for future cycles.

Fingers crossed for you all!

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