Can't get my Puregon right

Hey hey girls

My body is seriously ****ed up. Last cycle, we did a long down reg and started really slowly. I stimmed for 13 days and my E2 never got over 3200. At EPU, we got 4 eggs.

This cycle, I am on microdose flare with a much higher starting dose of Puregon. I have been on stims for 5 days now and my E2 is already a whopping 7000 :o. I go back tomorrow for a scan and more bloods.

Can anyone give me any idea what we are looking at here? Has anyone gotten off to this much of a riproaring start and not been cancelled? The last few months have been pretty crap and I am terrified of having to start all over again. At what point would a clinic call a cycle off due to potential OHSS? Is freeze-all going to be an option or am I already too far gone for this after 5 days?

Any help would be awesome.

Cheers
Melissa

Hey Melissa
I don't know that I can be particularly enlightening. I do EPU tomorrow. Fri (after 9 days on Puregon) I was at 7783 (E2) and yesterday I was at 9861 but they are still happy (with a half dose trigger) for me to get the pick-up. They did say that if the OHSS flared they'd freeze all until I was recovered. Friday they were talking about coasting me if the E2 was higher.
Good luck- and may your oestradiol come into line!

Hi Josie

Best of luck for your EPU tomorrow - hope you get loads of beautiful little eggies :)

Thanks for your reply. Today, I had a day 6 E2 which was 11000 and my scan showed 12 decent sized follicles and loads of little ones. My FS said in all the years that he has been doing this job, he has never seen follicles grow so much after only 6 days of stims - hahaha I am special!!! Anywho, no Puregon tonight, I have to do another E2 tomorrow and providing it is not over 15000, they will go ahead and do EPU on Friday. I think it is very much experimental as a)he's never seen this happen so quickly before and b) can eggs really mature after only 6 days? We figure we have nothing to lose as he said that if I don't end up preggers, we will not be out of pocket at all. I think because I was given a dose by another FS WAY higher than it should have been, he feels that the clinic is at fault. Either way, we will gladly take a freebie. Hmmmmm, he didn't seem particularly worried about OHSS either.

Oooh! I'm so suppressed excited for you! Its such a tricky balance, finding just the right amount of response. I too wonder if 6 days is enough- fingers are crossed that it is.

That whole thing of the FS giving the too high dose just reminds me that you really have to own your health- you can't just sit back and go for the ride- even when it feels totally out of your control... I think I'm telling myself that.

I've had one nurse really concerned about OHSS and one not- obviously I went with the concerned one! ;)

Fingers are crossed for well cooked eggs- let us know how you go.

You too, chick. Good luck today for lovely lil eggies that fertilise beautifully :)

We got 17- 8 icsi, 6 got to hang out in a dish with some swimmers, a few too immature and 7 winners today. Implant tomorrow providing nausea decreases overnight (nervous/ excited!)

Have you had another blood test? How are things going?

I've had three cycles all up - two were freeze all cycles with pretty bad OHSS - one had me hospitalised for a week and off work for over a month. It really varies as to how different clinics handle over-stimming, some cancel, some freeze all, others still transfer (and that scares the living daylights out of me!).

The only thing I found was that the more hyperstimulated I was, the worse my egg quality (and thus embryo quality) was. Do you have PCOS? That often causes an erratic and unpredictable response to FSH. For my third cycle I followed a very strict low-carb, low-GI, high-protein diet and we kept the OHSS under control and got a fresh transfer and our son out of it. I still got a mild case of OHSS, but only because I got pregnant. I didn't need time off work that time, just needed to take it easy and rest a lot.

BW

Hi BW - nothing so far has suggested PCOS but I do seem to have very odd drug responses. The last two cycles, I did a long down reg, starting on 150u puregon. First cycle, borderline OHSS, second cycle - v little response, even after Puregon was bumped up to 250. This cycle was a microdose flare with 300u Puregon (which I did think was quite a big starting dose for me) and I go crazy. My FS took me off Puregon on Tuesday and has coasted me for a few days which has brought my E2 down to 12000 with trigger yesterday. I honestly think he is very curious as to what is going on as he has never seen fully sized follicles after 5 days of stims. I can't see how I could possibly have any mature eggs after that short amount of time and am fully expecting no eggs at EPU tomorrow. However, if they do drain all the follies tomorrow, even if there is nothing there, that doesn't mean I am out of the woods with the overstimming, though, does it?
I have really been having second thoughts as to whether or not we should have agreed to an EPU. The more I think about it, the more I think perhaps we should have just bitten the bullet and cancelled because now I am super stressed about tomorrow and the next few days.
What other pointers towards PCOS are there? I have had testerone etc done and all was normal, it has never been brought up at scans and I am normal size.

Josie - awesome egg haul chick. Hoping you are feeling better and there are some beautiful looking embies for you. Tentative, experimental EPU for me tomorrow - time will tell what will be found! Good luck!

Mel I've been trying to patiently wait but I'm not very good at it. How'd you go?

We suck. We have learnt though, along with our clinic, that follies can grow in 6 days but they don't necessarily have lovely little eggies inside of them after that amount of time. FS left LOADS of follies untouched and went into the biggest 18, got 6 eggs but as of this morning, only one fertilised. And as we are expecting another phonecall from the clinic tonight (Saturday) to say how the poor wee bugger is going, I am guessing it doesn't look too $h!t-hot. If it is bad news, I have a bottle of wine chilling to drown my sorrows before we start all over again.

Hmmmm, interesting to see what FS comes up with next. Somehow, I don't think she'll go with a poor responder protocol again in a hurry.

How are you doing?

I am crossing my fingers for that one little egg.

Though yes, smart to have the wine on hand.

It will be interesting to see what happens next, protocol-wise.

I'm good. No problems at the moment. Transfer went beautifully with a perfect day 2, 4 cell emby according to the nurse and the doc. Stupidly, a little part of me wants the OHSS to get worse as a sign that the emby is making itself at home. The rest of me is pretending that part doesn't exist and is remaining stoic!

Sending everything I can your way- Go poor wee bugger! You can do it!