Sara - so sorry about the cycle cancellation. I know you must be bummed. It is great you already have some options for your next cycle. Personally I am for the shorter cycle. I am convinced I was oversuppressed by the Lucrin. It also takes half the time - less needles and you feel like things are happening straight away.
Meredith - good luck for EPU and the week ahead. At least is sounds like you are going to get a decent bunch of eggies so surely there will be a few good uns in there! Glad your ovary pain has subsided. Looking forward to hearing how it all goes I have a bit of an estrogen issue - slumps a few days after AF finishes and believe this cycle got a good emby because of the higher E2 levels. Do you think the E2 patches you take might address this? I am seeing my FS on Tuesday and want to be armed with some good suggestions as DH wants to try this naturally this month...
Cuddlepie - ooooohhhh - sounds a bit painful. You must be responding beautifully. Good luck with your scan . I still look like I am in my second trimester! BTW I have PM'ed you.
Buliej - thanks for posting that link on DHEA. I thought it was legal here
AFM - BT Monday. Feeling incredibly emotional this morning and even had a big SOB But my symptoms have basically gone. AF is due today, but I am taking a P4 pessary each night, so it may not come before BT anyway. Must admit, I am feeling a bit down. I just do not think it is our month...
Meredith, I just want to cheer you on for today, I have a good feeling about it...hope you get lots of juicy eggs.
WTH, wow, AF due today, so you are almost there. Can I tell you that pessary doesn't really stop AF if it wants to be here. I had my AF arrived exactly a week after TF in my 1st cycle and it was quite devastating, I didn't have a chance to dream. So what I am trying to say is, all the cramping and no AF is a great sign that something is growing inside of you. I am still singing PUPO for you hun!
Sara sweetie, hope you are feeling ok ATM and good luck with making your decisions
AFM, did the b/t and scan, endometrium is 5mm thick which is good on Day6 and they can see about 9 follicles altogether and the biggest one is 12mm. I am still waiting for the call to tell me everything is on track. But I was a bit disappointed that I didn't have more follicles. I remember last cycle I did a check up on D6 with no drugs, I have 11 on the left and 4 on the right or sth like that. You'd think with the drugs I should get more...
Anyway, I decide just to wait and see, at least there will be another week of injection ahead of me, I am not going to stress about it...
Also, news from DH's family, his pop passed away 3am this morning. ITs not a completely surprise as he has been struggling but still I feel really sad for him. He spent more time growing up with his nan & Pop they are like his parents....so DH has to drive 6 hours today to Tamworth and will be back end of the week in time for EPU. I will be missing him and no one is doing my injection anymore. It will be taking me much longer to get two needles in than usual....
WTH - correction - you can't buy DHEA here (a least the kind that this protocol calls for) without a dr's RX which means you have to find a doctor who is willing to try this approach and the proper form of DHEA for this can only be purchased (with RX) from what is known as a compounding pharmacy. I understand from my readings on the web that some AUS women whose FS won't go for it, go to another dr (GP?) to get the prescription. I find the articles all interesting, but I'm not convinced it's a magic solution. Although I've read about women trying it - I can't seem to find anyone talking about results and there have been no new studies that I can find.
Also, I was on pessaries and when I had my first BFN, AF came right on schedule. So it's a good sign that you haven't seen her!
Cuddlepie - those numbers sound good - I hope you feel happy.
HI ladies, Sorry about the late post but its been a loooon day.
What did I say about ovary pain subsiding?!!
Fel ok when I got up but as it neared EPU time I could barely walk. They were running quite late at the hospital and when the pain got really bad I started to get quite worried that I was ovulating already. Had to lie down with heat pack until they got me in!
Anyway, all went fine. 21 eggs collected but not jumping up and down as I know a fair proportion of those will be too immature. Won't find out anything more until Monday as clinic doesn't do any calls on Sun. Oh, unless we get none fertilise so actually hoping we don't hear anyting until Mon.
Still feeling pretty drained and sore but relieved at least this part is over
WTH - As the others have said,P4 pessaries won't sop AF so if she's not here then all sounds good. Praying you can get through the w/e without seeing the dreaded witch.
As for using E2 patches... I am sure they helped me this cycle but I am not sure you could actually use them in natural cycle. Elevated e2 will actually feedback to your body and tell it to slow down producing FSH ( cos it thinks the follies are growing), hence you may not ovulate without the external FSH IYKWIM. I could be wrong so certainly ask your FS
CP - Sounds like your scan was right on track. Hoping all those 9 follies grow and grow over the next few days When is your next scan?
Buliej - sounds like you need to grill your FS about the DHEA. I am on a few new ( non protocol) things this cycle which were only because I pushed my FS to let me try them. Fortunately I have a FS who is very open to trying "untested" treatments.
Sorry for being MIA - I am thinking of all of you, just feeling a bit deflated.
Cuddlepie: Nine is really good, there may even be some more with your next scan. Grow follies grow!
Really sorry to hear about DH's grandpa, that must be very hard for him especially that it's happening during such an important time in your lifes. Also imagine that it's quite hard for you not to have him with you now.
Meredith: 21 eggs wow! That's great, hope you get a good result with fertilization
Was wondering if you don't mind if you could tell us a bit more about the experimental treatments/meds you tried - is there anything you think that could help for someone who responds slowly or low egg numbers? Wondering about those E2 patches.
WTH: Hope AF is still missing, keeping fingers and toes crossed and praying for a good result for you, hang in there only one more day - will you do a test yourself in the morning? Have you thought about where you'll be when you get the result from the BT, just to make sure you have support? Sending you some more babydust
Buliej: That sounds interesting with the DHEA, are you thinking about trying it yourself?
Sara69 - I am thinking about trying DHEA but only thinking...I really want to understand what they think it can do and what the adverse reactions may be (i've read a bit about these and although they don't sound major, they sound unpleasant (acne, hair thinning!, oily skin) and they have nothing on long term effects yet) - but I'm not sure if the women who had adverse reactions were taking DHEA under the supervision of a dr and/or taking the proper form of DHEA as there are a few different forms). I also would prefer to do it with my FS's support. So I'll explore and give it some more thought, but am not close to a decision at this point.
One of the interesting points I've read about DHEA is that even the clinics that use it are having trouble getting women to volunteer for a proper clinical trial - as they all would have to be "older" - and half would be getting a placebo (and not know about it as it would be a blind study for the subjects) and no older woman wants to waste time with a placebo - makes total sense - but I think it means that the learning is slow and that some doctors will be reluctant to buy into it because they won't see the kind of study they are used to. I could be way off - I'm not a dr - in fact, science was my worst subject!
Meredith - I hope you get a decent number of good embryos from your pick-up - I think all sounds good so far.
WTH - will be checking in to hear about your BT
Meredith - I'd also be interested in hearing what you tried this cycle - and how your results this cycle compare to prior cycles
Sara - feeling for you atm. Don't know how I would have coped with a cancelled cycle.
Buliej - I agree, you need to feel supported by your FS when trying anything new as ultimately, we need doctors working "with" us for the best outcome
Sara and Buliej - My extra meds were mainly to help with persistently thin endometerial lining and recurrent m/c. I was on pregnyl 100iu every second day as a substitute for Luveris (LH) as I have had very low E2 in thepast ( have used this before and defnitely worked well for the E2). This cycle we also added the E2 patches to try and get my levels high right from the start to work on the lining as i seem to stim quite quickly. The "untried" treatment was sildneafil pessaries and if you are wondering what the heck that is.... viagra (yep!). Only works in pessary form and the theory is that is improves blood flow to the uterus to help with lining. Has been tried a bit in the US but no one here seems to use it all as not thought to be proven to work yet. Had to be specially made by compounding pharmacy and cost me a real packet. But, my lining was better than it has been in the last 5 cycles so I am fairly happy with it. I do have to add, however, that this is actually my first full IVF cycle. I have done 7 OI/IUI cycles so never had E2 at these levels either so who knows which one helped the most.
Also using prednisolone daily as an immune supressant due to history of recurrent m/c and I have had some tests in Sydney which showed elevated NK cells.Thats a whole other topic but controversial in some Drs minds whether this is a true cause of m/c ( and recurrent IVF implantation failure).
About the one thing I don't have, is an issue with egg numbers so sorry, I can't help with any extra tips on that issue
WTH - how are you doing? Praying AF has stayed well away and wishing every bit of luck for tomorrow's BT. I have a good feeling for you
My sense is that the difference in health insurance coverage is one of the things that influences what is offered here vs the US. In the US, the government doesn't pay for anything, thus the more "experimental" drugs are paid for by the patients in the same way as the "proven" drugs...private health insurance may cover some drugs - but often even "proven" drugs are not covered by private - one of my close friends in the US had to pay for all her fertility drugs - her private insurance covered not one (I think she said it cost her something between US$3,000-5,000... a crazy amount - and that's only the drugs!). Here, since the government pays for so much (relative to the US), they probably only want to pay for what has been proven.
I don't object to this approach, however, I think that a good FS should present all options so that we have the choice of whether to try the more unproven drugs if we are willing to pay for them (as you did) and take the chance that they may or may not work. I'm not quite sure that anyone other than a woman who has gone through a hard time conceiving understands our mindsets and what we'd be willing to try (within reason, of course) to give ourselves better odds.
I've read a bit about NK while researching various treatments - unless I'm mixing this up with some other issues I've read about, I recall some doctors recommend baby aspirin and/or heprin for this - is that right?
I spoke to my FS last week briefly in advance of our app't with her this week. She has agreed to run a full genetic test on us to see whether the trisomy was spontaneous (and therefore less likely to occur again) or if one of us is a carrier. I'm hoping that she'll agree to just run the whole gamete of tests, as I would rather deal with all potential issues up front than do it by elimination as things crop up and waste time.
WTH & Meredith -- thinking of both of you today, hope things go well.
Also wondering if you can help me understand the email from my doctor as I think you've both done an antogonist cycle - is there any issue with implantation (because of progesterone levels) if you don't go on the pill before an antagonist cylcle? I'd like to go with her recommendation to wait for my next period but don't want to go on the pill after that.
This is her letter:
To get started on another cycle we have 2 options. Ideally a flare cycle coming off the oral contraceptive pill is the preferred option, as a flare cycle run off a natural cycle runs the risk of having as progesterone rise, during the cycle. This ultimately may affect implantation. In your situation now, we could commence the pill now for 3 weeks and than cease it to get a cycle start. It may be better though to wait to get some of your own pituitary and follicular activity back. This would mean waiting until you get another period, which could be 4-6 weeks and then starting the pill for 3 weeks.
The other cycle option, is an antagonist cycle. In this cycle we would wait until you get you period, and then start the FSH on day one. Instead of Lucrin, and antagonist called orgalutran is started on day 5. This cycle allows less suppression of the pituitary and would get us stared sooner. Looking at both options, I think at this stage the second option is probably preferable.
Hey guys, wow, lots of post! I was a bit slack yesterday as not feeling too well, so didn't manager to post...but feeling a lot better today, being at work actually helps. B/t and scan tomorrow, so fingers crossed that I will have more follicles.
WTH, not long to go, hang in there, you must be anxious by now...
Meredith, I am so looking forward to hearing the fert report and I hope it will be good news that most of them are fertilzed and going strong.
Sara, without much knowledge on this, it seems antagonist cycle seems a better option to me especially if your lack of response is due to Lucrin. I don't like pills, so prefer not having them to mess up with natural body rhythem. But that's just my personal opinion. Good luck hun!
Hi Buliej, seems you have done your home work from all aspects, I hope the decision will just come naturally.
Buliej - Personally, i would be with you on asking for ALL the tests to be run. At least doing it now, you won't regret not doing something more down the track. That was my mindset when going to have the NK cell testing. It is only done in Sydney so I had to fly up there for the day just to have the blood test and meet with the reproductive immunologist who is currently the "guru" on the whole topic. I didn't expect to get anything from the test , was just wanting to know that I'd done it IYNWIM. Low and behold,however, I had quite high levels, and was certainly reccomended to try treatment. The preferred treatment is prednisolone started from day 1 of FSH and continued to 20weeks pregnancy ( hopefully we get that far!). Asprin/ heparin or clexane (which I will be starting tomorrow) can be used for many other conditions causing reccurent m/c / implantation failure and sometimes used with the pred but really the prednisolone is the main treatment for purely NK cell issues.
Sara - ah, from your Dr's email, I gather that Flare cyle is not what i thought. Sounds like you start FSH and Lucrin on same day when you get natural period. Don't really know why you would get progesterone rise ( maybe early ovulation?) but you should ask your Dr. The antagonist cycle could start with your natural period also but they use orgalutron( antagonist) instead of Lucrin to prevent premature ovlation. I did start this cycle off the pill as I don't cycle regularly( or rarely ever!) natrally.
Certainly got good results thusfar so no complaints from me with this protocol. I haven't ever been downreg, though, so no idea whether results would be similar or not.
I guess since you were so supressed on your previous cycle, i would certainly strongly consider antagonist cycle with or without the pill beforehand.
WTH - have been thinking of you all day. Praying there is some good news in here soon
AFM - got the call this morning - 14embryos growing nicely from my 21 eggies so very happy. Was probably expecting less given a lot seemed to immatre at my last scan but guess they must have grown on well. My normal nurse is not in today so the one i talked to didn't seem to know if the remaining 7 eggies were just immaure or ddn't fertilise. Doesn't really matter but I'd like to know.
Anyway, will find out tomorrow how many are suitable for biopsy and at this stage, they think my transfer will be day4 (Wed).
Meredith - those sound like great results - so far as numbers. When you say "it" is only done in Sydney - which tests are the "it" - the NK specifically or the whole lot? is there a medical term for the whole lot that the FS would understand rather than my saying "i want every BT there is for things that could impact conceiving can carrying a baby"? I'd be fine with flying to Sydney to get some peace of mind as I feel like I have a very small window of opportunity left and I don't want to discover more issues down the road.
Sara - I've done a flare cycle - but that's the only kind I've done so I can't compare it to any others. I call the clinic on the first day of AF, and then I start sniffing (2x/day) the Syranol (sp?) either that day or the following day and start injecting with gonal-f the day after I start the nasal spray. I found it pretty easy to deal with.
Meredith, that's a great result, 14, YAY! so you are doing Day 3 biopsy, is that the general practice in Melbourne? I know WTH did Day 5. Wow, so TF is on Wed, its all happening. So happy for you!
I can wait for my EPU day as I have been feeling sick from the FSH...counting down the days...
Sorry for bombarding you with posts today, just got an appointment with my FS for tomorrow and want to make sure I have all bases covered, this is my list of questions, can you think of anything else?
What is currently happening in my body in terms fo hormones - why will it take 4 to 6 weeks for my period to appear?
What is a flare cycle?
What is an antagonist cycle?
Will we do the blood test to check FSH level on first day of period ? is it correct that this can show how many eggs can be expected?
Is the progesterone issue a problem if I go for the antagonist cycle?
Is there any reason why I shoudl take the pill before an antagnist cycle?
Should I use E2 patches?
Would pregnyl 100iu every second day or Luveris be useful for me?
What do we do if the second cycle also shows low egg numbers?
Is it correct EPU is only done for 4 or more eggs?
Would it make in any sense to do the genetic test on day 3 and transfer day 4 instead day 5/6 if there are low egg numbers?
It's me. I have been lurking and did POAS yesterday, but did not want to post my result until I found out this afternoon. It's a BFN. No frosties so back to the drawing board. Seeing FS tomorrow and am armed with lots of ideas to improve egg quality (1 blast from 7 embryos is considered a "big drop-off"). Buliej - I am REALLY going to push for DHEA and will let you know how I go.
The thing I am finding the toughest is that I seem to be able to make chromosonally wrong babies so easily. Put in a perfect one and it doesn't take I know you girls on this thread can understand what I have just written more than anyone.
Sorry no persies right now. I will keep popping in here. This is such a special and valuable thread.
WTH: Oh no I am so so sorry to hear that. That's a really tough one. Sending you hugs
Hope your appointment tomorrow will show you a way ahead. Not sure if that helps now - but perhaps consider asking your FS if it could have something to do with possibly inserting the embryo so late? KMN said something about this in an earlier post.
I'll try to answer those questions that I know a bit about (based on my own experience)
Here's the description of these cycle types from my clinic's web site:
FLARE CYCLE
When starting a Flare Cycle, you will be instructed to contact the Nurses on the first day of your period. The Nurse will discuss your treatment plan with you. You will start either Synarel nasal spray or Lucrin injections (which prevent the premature release of the eggs from the follicles) in combination with Gonal F or Puregon injections (Follicle Stimulating Hormone).
Both these medications will continue for 6 - 8 days, then a vaginal ultrasound will be performed.
Vaginal ultrasound (stimulation scan)
As instructed, you will continue with the Lucrin or Synarel and the FSH injections for approximately eight days and then a vaginal ultrasound is performed.
The Nurse or Doctor performing the ultrasound will record the number and size of the follicles, the thickness of the lining of the uterus (endometrial thickness) and if any irregularities such as ovarian cysts are present.
Based on the ultrasound information, one of our Doctors will decide the optimum time to administer the hCG injection and therefore when the Ovum Pick-Up (OPU) will occur. Occasionally, a poor result or an overstimulation may be found on the scan, in which case the Doctor will discuss the best option for that situation.
FSH and GnRH Antagonist Cycle
Your Doctor may prescribe the pill (oral contraceptive pill) prior to this cycle, or alternatively when you ring the Nurses with Day 1, you may start the pill for a few weeks prior to starting your injections of FSH (Gonal F or Puregon. The Nurses will instruct you when to start the daily injections of FSH. You will continue these injections for approximately 6 days and then a vaginal ultrasound will be performed.
Following the scan, your Doctor will make a decision regarding when you should start the GnRH antagonist (Cetrotide or Orgalutran) and how many days you will need to continue this medication.
Vaginal ultrasound (stimulation scan)
As instructed, you will continue with the FSH injections for approximately six days and then a vaginal ultrasound is performed.
The Nurse or Doctor performing the ultrasound will record the number and size of the follicles, the thickness of the lining of the uterus (endometrial thickness) and if any irregularities such as ovarian cysts are present.
Based on the ultrasound information, one of our Doctors will decide the optimum time to administer the hCG injection and therefore when the Ovum Pick-Up (OPU) will occur. Occasionally, a poor result or an overstimulation may be found on the scan, in which case the Doctor will discuss the best option for that situation.
so sorry about the cycle cancellation. I know you must be bummed. It is great you already have some options for your next cycle. Personally I am for the shorter cycle. I am convinced I was oversuppressed by the Lucrin. It also takes half the time - less needles and you feel like things are happening straight away. 
I have a bit of an estrogen issue - slumps a few days after AF finishes and believe this cycle got a good emby because of the higher E2 levels. Do you think the E2 patches you take might address this? I am seeing my FS on Tuesday and want to be armed with some good suggestions as DH wants to try this naturally this month...
. I still look like I am in my second trimester! BTW I have PM'ed you.
But my symptoms have basically gone. AF is due today, but I am taking a P4 pessary each night, so it may not come before BT anyway. Must admit, I am feeling a bit down. I just do not think it is our month...
Meredith, I just want to cheer you on for today, I have a good feeling about it...hope you get lots of juicy eggs.
I know you girls on this thread can understand what I have just written more than anyone.
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