Help - wtf is going on with my response to puregon?
Hiya
Bit of background on my first stim cycle. Hubby & I did our first down reg cycle last year with 150u Puregon and responded fantastically (borderline OHSS). We got 25 follies and 12 mature eggs after 11 days stims.
Today I had my first BT after 6 days of stims at 150u again yet my E2 was only 289. We, including our FS has no idea what is going on. My first E2 at the same stage last time was 2275.
My Puregon dose has been ramped up to 250u and I have 2 big questions about what happens next. Will my E2 levels bounce back to normal levels now that my Puregon has been upped or is this cycle doomed? Secondly, if all is not lost and my E2 does take off, what are the chances of overstimming given the higher dosage?
Please, please can anyone help, I am a teary big mess here
Aww, I know it is crappy. I hope it is nothing to worry about though. Last time I did IUI it took a while for me to respond then all of a sudden my follies took off on no increase to puregon - go figure!
Hi... just wondering... do you have PCOS at all? It can lead to a really unpredictable response to puregon and other stim drugs.
Unfortunately, there's no real way to know how likely you are to overstim until you get there. I had OHSS with all three of my cycles - the first two were so bad I was unable to have a transfer and with one of them I spent a week in hospital with it. I know how scary it is.
Hi BW - nope no PCOS here that we know of but our initial problem as to why we had to do IVF/ICSI was MFI and no real investigations were done on me other than my immune issues. We were quite surprised at my response from our first cycle though. I did a sneaky little E2 today (one of the few perks of working in the lab) and it has more than doubled since yesterday's test. Is this ok or does it tend to rise quite quickly once the response kicks in?
I was frantically trawling through BB last night trying to get some answers - wow you really had to go through the wringer to get your wee boy. Thanks for your input
Mine would always rise quickly once it got going. They needed a high dose to get me started and then the rest of the cycle was daily blood tests and puregon dose reductions.
But I have severe PCOS and they kind of expected that with me.
Upping the dose like that won't doom your cycle In a lot of cases, you'll find that FS' will move the dosage around from blood test to blood test (it's happened to me) - I've gone from 150iu up to 300iu down to 250iu all in the same cycle - the constant bloods plus the scans will tell your FS what to do
I don't have a lot of advice re the over stimming... my cycles were always up & down with unit dosages, and I didn't get over stimming in any - but I don't have any history of PCOS, either.
This cycle might just have been a slow start hun.... I can say from experience (and I know BW will back me up here) - that sometimes the cycles you think are the crappiest, and you want to just be done with and start again, are the most successful
One of my crappiest cycles resulted in Carmelo... and BW got her DS as a result of a cycle that she had no hope for, either
Thanks so much for all of your responses - I am definitely feeling a lot calmer about things now. We had to cancel our last cycle cos I found out I was coeliac, along with other blood tests that showed dodgy antibodies and I had this horrible moment of panic yesterday that we may be faced with another cancellation. I spoke to my nurse today and she was really reassuring as well.
BW & Hollybolly - it is so great talking to people who have come out the other side of this and have their little bubbas - keeps the hope there.
Hollybolly is correct - After having 26 and 35 eggs collected for my first two cycles and getting quite ill (but still eventually ending up with 4 and 7 blastocysts to freeze) I was initially ecstatic to find out I'd got 20 eggs for the third cycle and would be allowed to transfer.
It all came crashing down the next day when I found out that only 12 eggs were mature and only 3 embryos had fertilised...
I'd written off the cycle (one day three put back and the other two frozen) and was planning out how to save up for the next one because I didn't even believe the two frozen embryos would work... and now I have a two year old boy and two frozen embryos.
Wow, that's awesome! I think part of the thing that really got me worried yesterday was when I talked to my nurse she said that they would trigger anything with E2 over 1800. From our last cycle with 12 eggs, we only had 4 embies which dropped to two embies by day 3 and I had this awful feeling this time that we'd get to EPU, only get a few eggs and none would be ok to put back in. However, now I am much more reassured that I'm just taking a bit longer to get going and I shouldn't have written things off quite so quickly.
So good to know that there is always hope, even if a cycle isn't looking too crash hot
Thanks guys. Just a quick update after my scan. We only have 5 follies but my E2 is hardly rising at all, even with my pumped up Puregon dose. Not feeling too confident. Has anyone else heard of a really good response one cycle, then no response the following cycle? I don't think its an egg reserve issue as my FSH is only 7 or so.
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