Antagonist Vs. Long Stimulation Cycle

[briggsy's girl]

BG, you are so lucky only have 3 shot of Orgaultran, they say it really hurts. I am not looking forward to start that.

ahhhh, it was only three shots on THAT cycle - have probably had about a dozen of them in total cos i can't use the normal down reg protocols at all!

they DO hurt more than the fsh shots - but no more than the trigger. you have to have them around the same time everyday so they continue working (i was having them at 10am or something for IUI cycles, 8pm for the IVF cycle) and can't have trigger shot within 24 hours of last shot. i just set an alarm. was great dashing off to the shower room at work to shoot up! i think people were beginning to wonder what i was doing but i didnt care!

i had two different types of antagonist shots - cetrotide for IUI and orgalutron for the IVF cycle. the orgalutron needle didn't seem to have the same point on it, so kinda felt blunt going in - thankfully i have a fatty pumbah tum so lots of flesh for it to go into. i only bruised once from all the antagonist and trigger shots/progesterone support shots combined over three years, so it can't be too bad!

[buliej]

CP - good luck with this cycle - I hope it's the one! Please check out the link to the safety net issue - it's really important.

[Cuddlepie]

Thanks for the tips BG...that's reassuring...Gee, I didn't know you did that for 3 years babe, I thought I've been on this forever....

Julie, got the link and will write a letter at the weekend, thanks for doing this hun, we certainly need to stop it...

[buliej]

CP - as for the shots, there's a thread with some suggestions on how to help it hurt less - I can't remember where it is, but it's fairly recent and shouldn't be so hard to find. I found that if I pushed the needle in quickly (and it is blunter and possibly thicker than the gonalF needle), but pushed the plunger in very slowly, it didn't hurt as much. I did find that when I asked DH to do it (because I couldn't get the needle in - I didn't realize how much harder I had to push), it hurt so much more. I was much better at controlling it when I did it myself as I do with the gonalF. I think I had 4 shots all up.

[briggsy's girl]

Thanks for the tips BG...that's reassuring...Gee, I didn't know you did that for 3 years babe, I thought I've been on this forever....

we were diagnosed in Jan 06 as having fertility issues, and were at the "trying game" a year before that. first AC (clomid) cycle mid 06, BFP Sept 08, so a bit over two years of assisted conception i guess. i think it took us 13 cycles of being "helped", two natural pg and angel babies, 3 AC angels before our Gremlin.

thing is, it's all relative - for me, this was a long time - but i then compare with others (Ellie for instance) that were at it for 10 years and wonder why i thought i had it so tough. i think we ALL need to accept that, individually for us, no matter how long the journey, it's physically and emotionally tough on the US and that's what we have to recognise. don't compare your journey to someone else - just look at what YOU have been through, what you've achieved, what you've survived - you'll find you're one strong chicky and didn't even realise it!

[Cuddlepie]

Thanks BG, that really helps...I guess sometimes its so hard Not to compare, especially seeing some ladies coming in and out just like that (don't take me wrong, I am so happy that they don't have to wait that long) but it really derpesses me...I feel I am a IVF veteran now although I only been through 3 cycles so far with 1 angel in the space of more than 2 year of AC. It just feels soooo long. My nurse got pregnant had her baby and now back to work and me, still trying. Same with my APist...she will be back in May and see I am still the same. Thanks for making me feel a lot better...

Sorry guys, a little bit off the topic, now I am going....

[Cuddlepie]

Bella, just wondering how you go with your scan and b/t? I hope its all on track.

I had my second b/t and u/s today and seems to have 7-8 follicles altogether, which for me is not stunning just fairly normal. I am a bit worried about the sizes varies so much and I won't be ended up as much as I wish, like the biggest one is 20mm and smaller ones are 10mm.

Anyway, just things you wonder along the way really to make is not much fun...

[bella55]

Hi Cuddlepie,

I have been thinking about you!
Well i had first B/T and U/S Saturday - E2 levels 520 and only one or two dom follies. Went for another yesterday E2 up to 1420 5 large ranging from 16-12 and 20 follies in total. I was a little dissapointed they arn't bigger but my FN says "i'm coming along slowly and thats better than coming along fast - they are growing wel" I don't know i don't feel great about it but hey! I have another B/T and U/S on Wed and they are guessing EPU fri or Sat. I'm very bloated though - when i had my last down reg IUI cycle my E2 levels were 1500 with 2 follies 18 and 17mm when we triggered - i have read though that the orgalutran makes you develop slower????

Hope your travelling ok - i have some nice bruises on my tummy!!

xxBella

[Cuddlepie]

Bella, good to know that you are on track and EPU is on Friday, I hope I will be one day after you...

I think your E2 level is very good and you don't want too high E2 level at EPU, it is said in research that women with high E2 levels tend to have low implantation rate.

Mine on Saturday (which is D6 on FSH) was 780, I think its on lower side so hoping today's result will be better. I tend to agree that Orgalutran is slowing you down a bit, because on Friday scan I had follicles range from 8, 10, 11, and today seems some of them only grow for about 2mm after 3 days.

DH has been my male nurse for the last 3 days, he is doing very well with all the needles, maybe he should get the 2nd job...hehe....

[Baby Dreamtime]

Hi everyone

CP, thinking of you and hoping this cycle goes well. Just out of curiosity, why did your FS recommend changing protocol? Assuming as you are looking at similar number of follies, it had something to do with egg quality?

Bella, GL to you also, I will be interested to see how your follies grow. I had not heard that the orgalutran might make the follies grow slower.

AFM, I just thought I would drop in to say that today I have started my first short cycle, having done 4 down reg cycles previously. My protocol sheet states it is a boost cycle, I am still reading up on in, but this post has helped alot. Just for sharing, here is my plan if all goes to plan:

Day 1 AF arrived
Day 2 FSH
Day 3 FSH
Day 4 FSH
Day 5 FHS
Day 6 FSH + orgalutran + scan
Day 7 FSH + orgalutran
Day 8 FSH + orgalutran + scan
Day 9 FSH + orgalutran
Day 10 FSH + scan + trigger
Day 11
Day 12 EPU

I am loving the fact it is so short. I have discussed with FS that fact that I have PCOS tendencies, in down reg cycles normally having around 20 follies, my magic FSH number on down reg seems to be 100. So to be conservative I am starting on 75 assuming to get a slightly less response. Fingers crossed.

FS explained the standard protocol for antagonist cycle was 9 days of FSH, antagonist from day 5 of FSH, and providing by 9 days of stims the lead follie is over 16mm and there are at least 2 other follies of 16mm, straight to trigger. I would have thought that the follies might be too immature to trigger at 16mm, I wonder if they believe there is an extra growth surge once the orgalutran is stopped, between trigger and EPU, more so than a down reg? Hmm. Very interesting.

I am just hoping now that I won't over stim and end up with too many follies, as we are aiming for less but better quality.

Also quick question re orgalutran and the air bubble, the nurse told me to inject with the air bubble at the end, but to keep going and inject the air itself as this will seal the injection site. But the instructions say to expell the air before injecting. It also says to draw back the plunger once the needle is inserted to see if any blood is pulled back, and if this happens it means the needle is inserted incorrectly, and to discard and start again? Is anyone doing this. At $80 a pop, this sounds crazy. Any thoughts?

TIA. x

[bella55]

BDT - DO NOT EXPELL THE AIR - INJECT IT!!! Your nurse is correct it seals to ensure you get the full amount of medication - ignore the instruction sheet - i am a nurse and beleive me you will lose medication if you try to get rid of the air! Just remember when you give it it does take quite a bit of pressure to push down the plunger - oh and i numbe the site first for 1 min with an ice brick - haven;t even felt it!

As for your protocol it sounds very similar to mine - i am interested however about trigger with follie at 16mm - this makes sense because i have been really disapointed with the size of mine and have been wondering how on earth they would be at 18-20 (which is when they normally trigger i read) by Fri - so that makes me feel better - maybe they do mature more once the orgalutran stops!!!

GL - will post after my scan and B/T tom morning.
xxBella

[Cuddlepie]

BDT, welcome to Antaganist cycle group! Well, my FS suggested because I've done 3 down-reg cycles and just come to think of it, it has sth to do with egg quatlity. Because we had 8 eggs (2nd down-reg cycle) and 9 on the 3rd but ended up with 2 and 3 blasties. He thinks change of protocle could potentially increase the number of blasties, especially DH's SCSA is excellent so its drawn to the egg quality. I am hoping I would have better result also have the mentality that I have nothing to lose really to try sth new.

You little planning sheet sounds wonderful but atm I am on my D9 on FSH (with E2 of 2110) and D3 on Orgalutran, with the follicles are around 10mm, seems that I have some growing to do. So trigger won't be until Sat/sun at the earliest. Longer than I thought.

I was worring about over-stimulate at the start as well, because I respond well on down-reg cycles. But now it seems that my body is responding a bit slow on FSH, I have to increase the dose from 150 to 175 on Day 6. Don't want to scare you hun but seems like new protocle can make body do different things.

I have a question, do you do orgalutran and trigger on the same day? How much gap do you have to leave? Just trying to predict how far long till trigger and how many more Orgalutran I need to buy.

I do get rid of the air bubbles before injecting it, just have to be careful, I use my thumb to prevent pushing too much further so you don't lose the drug, it also helps to loosen up the plunger for ease injection. But if you have trouble of getting rid of the bubbles, like Bella said, its not a big deal really....forget about the instruction sheet, I read the part of drawing blood etc, yeah, its so expensive, who would want to start again! It is literally like drawing my blood...

Best of luck girl, my next b/t and u/s will be Thursday, clinic just called. So will let you know how I go. I hope the theroy of growing quickly after trigger is right so I don't have wait that long.

[Sara69]

Hi CP, on the day of the trigger you do all your meds again (I took Puregon, Orgalutran and Pregnyl). I am normally taking my meds at 10pm and as I had to take the trigger at 8pm they ask me to take the meds two hours earlier at 6pm.

BDT: Agree with Bella, don't worry about the airbubbles just inject them - I tried to get rid of them and lost half my meds one night, everything was fine in the end but it's not worth it.

Sara

[bella55]

Hi Girls,

I have trigger tonight - nothing else def no orgalutran so check with your clinic CP. EPU for me Fri - very excited and nervous!

xxBella

[Cuddlepie]

Thanks Sara, but I do remember somewhere BG said that you have to have 24hrs gap between Orgalutran and trigger....Bella, when was you last shot of Orgalutran?

Best of luck for the EPU and enjoy the drug-free day today hun...I hope you get lots of good quatlity eggs!

[Sara69]

Hi CP, maybe ask the clinic, I definitely only had a 2 hour gap. Hope everything is going well for you

Sara

[Baby Dreamtime]

Hi everyone,

CP, I hope you went well with your scan and BT today, and hope those follies are coming along nicely. I am seeing my FS on Saturday, and will ask re the speed of growth once stopping orgalutran. I am still feeling a little nervous, but in a similar head space as your are it seems, trying desperatly to find some positive hope. And hoping too I will stimulate ok, I love to plan and hope the days will match up, I have already worked out EDD (25th Dec 09), how sad is that!

Bella, GL for your EPU on Friday, look forward to hearing how you go.

Sara, thinking of you too, how can your FS tell there are only 3 follies, are these resting follies before any FSH that are expected to grow to egg? I agree with CPs comments per your last cycle, 1 blastie from 3 eggs is an excellent result. I know you have heard it so many times before, but it only takes one. Praying for you.

Hugs, xx

[Sara69]

Hi Girls,

BDT Thanks for thinking of me, no she doesn't know how many follies there are this time she just made a guess based on nine follies last time with an FSH of 9.7, will just have to wait for ultrasound. HOpe things go well for you on Satruday.

CP: Thinking of you, hope follies are growing nicely.

Bella: good luck with EPU.

Sara