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Thread: Protocols at different IVF clinics - sorry it's long

  1. #1

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    Default Protocols at different IVF clinics - sorry it's long

    Hi everyone
    By starting this post I guess it's pretty obvious I plan on having another crack at it. #-o
    I know from previous posts in here that a lot of you have a lot of knowledge of drugs and dosages etc. I chose to be ignorant this cycle as I used to obsess about everything on my previous cycles. Now I'm sorry. I know I'm 8 years older now than my last stim cycle but I only ended up with 1 good egg this time out of 7 follies. 4 of them were 20mm? I still ovulate lock clockwork naturally and have 5 days of EWCM (sorry if that's TMI).
    I was on Synarel (twice a day), Gonal-F (300), Ovidrel for trigger, then Crinone (one at night). From reading some of your posts, I think I was under hormonised (I think I made that word up). During the cycle I had no side effects and thought that was great. Now, I'm questioning if that was because my dosage wasn't high enough?
    My first stim cycle (1995 SIVF) I was on Lucrin (15 u?), Metrodin (3 amps?), Pregnyl (10000iu) for trigger then Pregnyl (2000iu) twice post procedure. The dosage was reduced though as I started to get sick. 20 follies and 10 eggs.
    My second stim cycle (1997 - CityWest) I was on Synarel (twice a day), Metrodin (225), Profasi for trigger then Profasi (2000iu) every 3 days x 4 times post procedure. 22 follies and 10 eggs.
    If anyone out there can help me about dosages etc, I'd really appreciate it before I meet with my specialist next week.
    I am also thinking of changing clinics - anyone out there with Hunter IVF (affiliate of Monash) or Monash? I've had very positive feedback from HunterIVF about my situation as well as FertilityFirst (Hurstville is a bit too far to travel from here).
    Sue


  2. #2

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    I have to say that Im not really sure on the dosages on the particular dsrugs you have listed Sue (ie. Metrodin & Profasi). I have only had experience with Gonal F and Puregon.

    Sorry...

  3. #3

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    Thanks Keen
    I was starting to think my post was just too long and boring for everyone to take in. It probably is!! :-({|=
    Do you mind if I ask how much Gonal-F or Puregon you take? Do you taken Crinone? I was only using 1 a night but I've seen in other posts where most take 2.
    Considering I'm almost 43 8-[ I would have thought I'd have been on high dosage.
    Hope all goes well for you this cycle.... [-o<
    Sue

  4. #4

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    Sue,

    I am curious as to why they kept changing your meds, and each cycle seems different from the other.

    My gripe with my clinic was always that they seemed to want to not change anything, and kept trying the same old same old, but I can see from your posts how this may have been worse.

    My first two cycles were flare, 100iu puregon and we got 6 and 7 good quality eggs respectively, of which 5 and 6 fertilised. Dr then decided to try for more eggs, and put me on 100iu with a down reg cycle. I didn't respond at all.

    Next cycle I was put on 200iu down reg which yielded 10 eggs, only half of which were good quality and only these 5 fertilised. My last (and successful) cycle was also on 200iu down reg, 10 eggs, 9 fertilised, 3 made it to blasts, and bingo, a BFP.

    What was different about this cycle? I did a blast transfer instdea of a 2 day transfer. The meds and other stuff was the same. I didn't get the teenist, tiniest bit of HCG in all previous 4 IVF or 3 FET cycles. In fact, I was beginning to believe that I was one fo those women for whom IVF wouln't work.

    Also re Crinone. I asked my clinic recently about why I wasn't being given as much LP support as other women, and apparently your P4 levels dictate whether you need more or less. You should ask about your levels and why you're only getting 1 Crinone application a day.

    After my 4th cycle, I thought of changing clinics, coz the feedback I was getting from other women at Concept made me believe that they weren't progressive enough. But there is something to be said for being assertive, not only did I get the green light to do blast transfer, I could have had PGD if I wanted, plus I'm the first patient my Dr has allowed to have 2 blasts transferred. Yes they are conservative, but you need to be read up and be able to have a strong hand in managing what you want done. I only decided that after my last failed cycle. I wish I had done it months ago!

    I'd been meaning to reply to your post for a while, but coz of the length of it (sorry!) needed a good quiet ten mins. If you want, I'll be happy to have a chat about protocols and what you're had done before, and what you want to try. And maybe give you some idea on how to tackle this next appt.

    Good luck.

    love
    sushee

  5. #5

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    I'd love to chat about it Sushee. Thanks so much. Trying to find out stuff on the internet is too confusing and I really want to go in this time telling them what I want.
    If I'm sensible, I won't change clinics. I'd have to travel to Newcastle and that's around an hour north - a bit difficult for me working full-time and having just had so much time off. I just don't like the fact that my clinic only do EPU one day a week. I still feel that had a negative effect on my follies.
    I don't even know what 'flare' means nor 'down-reg'!!!
    As for Blast, I didn't even know what that was either. Serves me right for not reading the book but I was trying to be ignorant. Apparently, I'd paid for it - the doctor didn't even tell me about it. But, as I only ended up with one emby they put it back after 2 days. They told me they only do blast if there are a good number to choose from, then transfer the best. They probably didn't want to risk it not making it to 5 days? When the nurse finally contacted me (4 days after I left a message about AF) she said "oh, you'll probably have to go for donor eggs now". I don't really want to do that after just one attempt without adjusting the drugs first.
    Anyway, I'm so glad you've contacted me - I knew you would know about this stuff.
    I know you are a very busy person, but if you've got 10 minutes here or there to discuss I'd be so grateful. I am unable to PM through BB so here is my email:
    [email protected]
    Thanks again
    Love
    Sue

  6. #6

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    Sue,

    not busy so much as not really allowed to surf the net at work (have to be sneaky) and not enough strength to fight off the teenagers from the puter at home!

    I'll email you...

    love
    sushee

  7. #7

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    Sue,
    I was on for a stim cycle....puregon or gonal f 150 which was reduced through the injection period to bring up the smaller stubbon bugga's (I usually only had one or 2 big follies) this could give me a pickup of 12 or so , synaral 2 sniffs( I have been known to be sniffing 3 weeks before starting inj) a day then I was triggered with Profasi. Night of P-U I started with pessaries 2 a day.
    My Fet cycles were a bit different...I did the hmm can't think of the name of the tablets...hmm starts with P it's the one all the girls take.
    My IVF nurse told me about how they were trialling doing Stim drugs and triggering for FET cycles and doing a transfer 3 days later ( this was over 12 months ago) First go at that and bingo.... I wasn't happy with the quality of mine...I was getting so many but not good size, it's a bit of a bugga to go back for scans almost daily and altering drug dosage.
    Ohh proganova..thats the P word.
    The result of the FET cycle is crying better run...I am so glad you are going to give it another go.
    Bec

  8. #8
    Blue Sky Guest

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    Hi Sue,
    My IVF cycles were down reg stim cycles. First one I was on synarel - 2 sniffs a day - plus 187.5 gonal F. Dr was worried about OHS so he brought me down to 150 gonal f. I apparently had over 20 follies at EPU but only got 5 eggs. I there was only one or 2 that were able to be fertilised but apparently they didn't take.
    2nd cycle I was put onto Lucrin jabs instead of synarel and the Dr kept me on 187.5 gonal f. I drank lots of water that cycle and from 17 follies they got 13 eggs.
    I can't remember what drugs I used for the trigger sorry.

    I'm not sure if there is a protocol for the amount of drugs or type that they use - from my experience (I was using gonal f during my AI attempts as well) they just seemed to be playing around with the dosage until they get it right? I guess next time they will be playing around with my luteal support dx!!

    Hope that helps you.
    blue xx

  9. #9

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    Thanks Blue.
    I was on down-reg too (Sushee had to explain that and a few other things to me - thank goodness). It's all changed so much in 6 years. Sounds like you and I were on the same drugs. Except my Gonal-F was double yours!!!! But, I had absolutely no side effects! Did you have any luteal phase support?
    I don't really have enough time left for them to keep playing around with dosages so I hope they get it right. I really think it was the timing of my EPU that was messed up.
    I'm probably just looking for excuses too!!
    See what happens on Thursday. Thanks everyone for your comments. I can go to my appointment a lot more informed and know what questions to ask. Wonder if I should throw him and ask about levels????
    Sue

  10. #10
    Blue Sky Guest

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    Hi there again Sue!
    My luteal support was 1 progynova tablet x3 a day plus 1 x progesterone pessary twice a day. That was upped to 3 a day when I started to bleed.
    He he - the GP was looking at me strangely when I was talking about "proggy-nova"... then he said, "ohhhhhh pro-gynova..." I like my pronounciation better though!
    Yup, I say ask away!! My Dr forgot that he had decided to change me from the synarel to lucrin - had to remind him. Good luck for Thursday. I'll probably chat to you before then - bb addict that I am!!
    cheers
    blue

  11. #11

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    hi suzieq

    i have heard different things about Hunter... I am cycling through Sydney IVF and so far all good. If you want to email me on [email protected] I can fill in the bits for you..

    Love Leis x

  12. #12

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    Sue- the thing about stimming is this, the drugs do not discriminate as to exactly what follies and eggs are produced. In that you have some good and some bad eggs in your ovaries, which ones react to the stimming drugs cannot be selected. It's a numbers game I believe. Being conservative in your dosage of follicular stimming drugs is always best given that increasing your dose can adversely effect your quality.

  13. #13
    luckydraw Guest

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    Hi Sue, after reading your long long story. Can I ask you whether you have ever tried herbal medicines before?

    I know the IVF process is somehow very invasive, maybe you need letting your body adjust a little bit. I know plenty Asian women given birth to their babies around 40. Surely, herbal medicine needs to take longer time so I don't know whether it is suitable for you or not. But for me, I took them for nearly four months this year, I can tell the difference.

  14. #14

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    Thanks girls.
    Sheree, you have echoed what I have been worrying about. Given that I still have 'text book' ovulation during natural cycles, I think my dose of 300 Gonal-F was way too high. I think I may have been overcooked as a very wise woman has suggested. Interestingly, I had no ovarian pain whatsoever during the stim cycle. Even after the trigger. I am in my ovulatory phase naturally at the moment and have had pain for around 24 hours and some bleeding. My poor ovaries are probably still trying to recover.
    Hi Luckydraw. Yes, my ex and I tried natural therapies for 2 years before IVF - tok me that long to get him to the clinic. I also used to have 12 months break between IVF attempts and would go back to the natural stuff. The last 2 years we were TTC I tried so many things - chinese medicine, hypnotherapy, aromatherapy, reflexology, massage, the blood-type diet - I could go on and on. I have a chinese massage therapist who is going to make me some rice wine. Just 1 tbsp a night. Not sure if it's any good for fertility but she says it's good for warming the whole system - circulatory/digestive. I really believe it's all connected. Can't hurt!!
    Thanks again.
    Sue

  15. #15

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    Actually Sue I get no O pain while IVFing but on natural cycles I do!

  16. #16

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    Oh, that makes me feel a bit more normal. I was starting to worry they'd done some damage to my poor old ovaries.
    Excuse my ignorance, what is OI? Ovulation Induction?
    Der
    Sue

  17. #17

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    Yep Ovulation Induction= clomid

  18. #18
    luckydraw Guest

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    Ya, to make the system warm is the way to say (warm or cold). Having herbal medicines is bit complicated esp cooking. But as you say, this sort of medicines doesn't harm your body.

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