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cherry / 120 posts
@AmeliaBedilia: I am so sorry, this is so hard. Take care of yourself.
pear / 1986 posts
@endymion4: Here is an interesting abstract for an article on its use in IVF for those without PCOS (for whom it is regularly used): http://www.ncbi.nlm.nih.gov/pubmed/20687400
It was added to my regime this time around during the fresh cycle (although I still have to ask if I will stay on it for the FET) in order to create a well-regulated hormone environment. I didn't have any indication that I have issues with insulin resistance, but I do have multiple unexplained failures so I think it is a relatively harmless addition that could have a big impact.
ETA: I think it is a lot about improving egg quality, which doesn't help either of us at this point, but I still need to ask my RE about whether I should stay on it for the FET.
apricot / 344 posts
@AmeliaBedilia: I am so very sorry I know how hard this is. While I know you want to jump right in again, I'm sure there's something to be said for giving your body a bit of time to heal. If it's an egg quality issue, definitely inquire about HGH. That was our issue and a very small amount added to our protocol made a huge difference in our embryo quality. We went from "ok" day 5 blasts to expanded hatching blasts this 2nd cycle. We were also put on a routine of vitamins (both hubby and I) for the 2 + months leading up to this cycle. Can send the specific list of you'd like
nectarine / 2192 posts
@waiting4you: Yes, please wall me the list. Did you do anything else differently?
Any ideas here? Here's a quick rundown since it's so hard to keep everyone's details straight.
DH and I are both 35 (almost 36), TTC#1 since 5/2013.
issues: 1. borderline prolactin treated with cabergoline
2. borderline TSH treated with synthroid,
3. low AMH (0.27), but FSH 6, AFC 15-20 (was 10 in August, then improved with melatonin, DHEA, vitamin D and acupuncure which I've been doing for 5-6 months prior.
4. natural killer cells were 34.9%- very high, normal is under 10%. This could have been falsely elevated by the elevated prolactin. RE recommended prednisone 20mg daily after retrieval. He didn't recommend intralipids but was fine with adding them. We did a double dose 8 days before transfer and again the day before transfer.
5. DH's morphology is 5%, other numbers are great. RE isn't too concerned about this.
Between the low AMH and elevated NK cells and some menstrual cramping, I suspect I have endometriosis.
Plan:
We did progesterone only birth control for 2-3 weeks, then 4 days of estrace, then started stims. I did menopur 75 and gonal F/follistim 375 units daily for 10 days. Ganirelix was added day 6 or 7. Day 5 ultrasound showed 6 good follicles and a number of questionable ones. My estrogen only got up to 1010 (47, 90, 285, 466, 865, then 1010- some of those were 1 day in between, sometimes 2). Trigger was day 11. Progesterone on day of trigger was 2.7 (he generally does a freeze all if over 3 but said he was "very comfortable moving forward.")
8 eggs retrieved, 6 mature, 5 fertilized with ICSI. Day 3- one looked great (better than all the others), one looked good, and 3 were behind so did a day 3 transfer with assisted hatching. Did acupuncture the day before. Transferred two, lining looked "perfect," and transfer went "exactly how it's supposed to." My doc does not have people lay on the table after transfer- he said when they stopped, their success rate jumped 10%. I did acupuncture again about 45 minutes later. RE had me do an ovidrel booster 5 days after trigger to improve ovarian secretion of progesterone and estrogen. Progesterone was prometrium 200mg vaginally BID plus PIO 0.5cc daily.
My questions for this very knowledgeable group of women:
1. What questions should I ask my RE?
2. Any thoughts on what went wrong and what you would do differently? My guesses are egg quality, NK cells, or the borderline progesterone.
3. Is there a point to doing laparoscopy?
4. When would you do another round if finances don't get in the way?
Thanks!
pomegranate / 3764 posts
@AmeliaBedilia: I am so sorry.
My first IVF didn't work, and I remember being so devastated because seemingly everyone else's DID work first go. Sometimes, it just doesn't. It's the worst.
The good news is, your doctor should be able to tweak things... so he might already have some good ideas in place for you. x
apricot / 365 posts
@GreenThumb: would love to hear what your RE tells you about the metformin! thanks for the link!
Meeting with our RE and another local RE in the next couple weeks
apricot / 344 posts
@AmeliaBedilia: for comparison sake...this is a pic of our best blastocysts from cycle 1 (left) and then our expanded hatching blastocyst from cycle 2 (right) we transferred 2 each time and the two were equivalent quality in the respective transfers. You can see there's a much more defined ICM in the ones this cycle. Hope any of this can help! Big hugs! You definitely have a great spirit and tons of determination. Your proactive efforts will surely pay off in the future!
pear / 1881 posts
@AmeliaBedilia: I so was thinking about you all last night - my husband was snoring, so I couldn't sleep
Anyway, these are some of my thoughts (assuming you will do another round):
questions to ask the RE: What does he forsee went wrong? Is there an egg quality issue?
So, if there is an egg quality issue, i would ask what he thinks you can do to help it. Are you taking CoQ10 or Ubiquonol? If not, I would def start, but the eggs won't show any changes from it for at least 3 months, unfortunately.
It's hard to say what went wrong since you had a day 3 transfer and although there are plenty of successes with those, getting to day 5 or 6 is definitely ideal. So, there must be some underlying reason why the embies didn't get that far.
I don't think that I would start immediately into another round. Plus, you probably can't if you need to take birth control for a few weeks. One of your posts mentioned that you could start stims next week? I wasn't sure if that was possible or not. Plus, you need to get your meds, which takes time (if you get them sent internationally again). If it were me, i would perhaps see if you can start the birth control once AF shows and then start a new round (unless you look into endo or need to save some $$). Unless, it's egg quality, then you might want to make sure you are taking all the correct supplements for 3 months. I don't know - it's such a crap shoot. I'm so sorry I was in your exact same position in November, except we were forced to have a 3 month wait because there weren't any earlier openings.
You had mentioned endo - why do you think that you have it? shouldn't that have been addressed earlier if it was a concern? If that is something you want them to look into, consider there might be a waiting period after surgery before you can jump into IVF.
After your transfer, were you on any sort of estrogen (patches or other)?
For DHEA, did you self prescribe that or did you get your levels tested prior to taking it? I ask because I had wanted to take it, but was too concerned without getting my blood levels checked. I am glad that I did because my DHEA levels were a bit higher than the normal range for my age. It was actually good because the levels start high as you are younger and slowly decrease as you become older. But, you don't want them too high. just a thought..
I'm just throwing random stuff out there that came to me last night, so feel free to ignore some or all of it. I know that I've said this before and I'll say it again - it might be worth it to listen to some of the Beat Infertility podcasts. You might learn a few things - I know that there are some on NK cells, hormone levels, endo, etc that might give you a few ideas of questions to ask. It's one of the best resources I've EVER found. Good luck! I'm working for part of the day, so I'll keep checking on here to see if you respond to this. Hugs..
nectarine / 2192 posts
@NorthStar: thanks so much! My doc called me last night and we talked for a half hour. He thinks the low beta was implantation, and less likely that I metabolize HCG slowly. He said under 5% chance that Monday will be better but he has seen it happen. He thinks more likely egg quality than NK cells. I'm already on melatonin, CoQ10, vitamin C, DHEA, and vitamin D for egg quality. RE doesn't want to add anything until we know Monday. I'm going to add PQQ (similar to coQ10)- he said this was fine. I have a few others I will ask him- Royal jelly, alpha lipoic acid, pycnogenol, N-acetyl cysteine. He said he would recommend we do next round in March/start stims 2/27, which sounds good, because I had many of your concerns starting sooner. He brought up adding human growth hormone, which I was going to ask anyway- the downside is he prescribes a higher dose, saying I would need 7 vials which is $2100 unless I can find it cheaper. We have an appointment 2/12 that DH will also come. I'm going to ask about the agonist/antagonist protocol with estrogen priming. It seems to be the best for egg quality. For the NK cells, RE thinks we have it under control, but has no objection to doing the intralipids sooner and more frequently, so we're going to do that. We've mentioned endo, but IVF wouldn't be significantly different knowing that, but I will ask. I didn't take estrogen after transfer/retrieval. It's not standard for him, plus I don't do well with estrogen.
I'm just so shocked. RE said both looked great, and one looked better than everyone else's, estimated 65% chance, DH and both my acupuncturists said they thought it was working, my mom thought I was glowing, and my symptoms were significantly different on the second week of progesterone than the first. I've also gotten so many weird signs from the universe. I just don't understand.
pear / 1881 posts
@AmeliaBedilia: I'm so sorry, but it sounds like you have a good plan in place. I start my stims on 3/1, so I will be right behind you if that is when you begin. I will also be doing an antagonist cycle as last time I did a Lupron cycle, which I believe affected the eggs too much. I've also heard about the antagonist protocol being better for egg quality, so hope it works for both of us.
Yes, this totally sucks and I'm so sorry
eta: just got my period - let's get this show on the road. It actually came on time this month, thank goodness! now to order meds, figure out when I need to start birth control, etc..
apricot / 344 posts
@AmeliaBedilia: have you thought about getting a 2nd opinion? I ask because the 7 vials of HGH seems extreme. Yes, every case is different, but knowing I used 1 vial for my 10 days of stims, 7 is A LOT. It also sounds a little like you're directing the dr, vs him "driving the bus". Maybe it's a good idea to get a completely new, fresh set of eyes on your case and see what another RE would say/do. Just a thought. Seems as if you've done a TON of research on all this. Going thru lots of medical issues with our family the last 3 years, I can't stress enough that you should "fight for your own health". If you are unsure about any details or something doesn't sit right, fight for another answer or confirmation. This is what saved my fathers life this last year. Just want the best for you and know how important, and EXPENSIVE, this is to try again and again.
pear / 1986 posts
@AmeliaBedilia: I agree that it might be helpful for you to get a second opinion since you are heading into another fresh cycle. @PurplePumps: might be able to offer some advice on this since I think she had a few remote consultations via phone if you don't have any other offices locally. Even if you don't actually intend to see another RE, some additional thoughts could lend some insight.
But, I also want to throw out there that there is only so much we can control in this process. Even if everything seems textbook, cycles still fail and this process is often heartbreaking. Looking for answers for next time is definitely important, but it is also important to realize that you will probably not ever know why this one failed. We've had a 50% success rate so far in the group, which isn't at all a surprise, and unfortunately you and I were on the losing side of the stats this time. I am incredibly sad and sorry about that for both of us. Let's hope next time around that isn't the case.
pear / 1986 posts
Definite negative on my beta this morning - so that's a good thing, haha. Nurse is checking with the RE to see if I should stay on the Metformin for the couple weeks before my followup consult with him. Hoping to get AF sometime next week so we can keep this train moving. I can't believe that I won't be able to have another try at this until April.
Also, devastating to see the lovely women who had her IVF transfer right after me (I saw her in the waiting room right before) come out of her beta this morning before me with a huge smile on her face and a spring in her step. Pretty sure I know her outcome. Happy for her, but why couldn't that be me...
persimmon / 1132 posts
@AmeliaBedilia: ️ It sounds like you are leaving no stone unturned, which is about all you can do. I really don't have much to add beyond what others have said. My only thought fwiw would be to try a more or different TCM-based acupuncture, though it sounds like you love and have confidence in your acupuncturist. While we can control some things in IF land, I do think it's a roll of the dice many times ...There are some studies out there that say that the odds are that most women will conceive within their first three cycles. Not that you want to think about cycle three before cycle one is officially over, but, like @jaguar said, your RE has more information about what levers to push and pull for next time. PS. You had asked me earlier if I did assisted hatching -- I hadn't. Sorry I forgot to reply to you about that!
Regarding buying more meds, I wanted to say I followed @AmeliaBedilia:'s advice and success with ivfpharmacy.com (the European pharmacy) and just ordered a bunch of Crinone (progesterone gel, inserted vaginally). With WinRx my order would've been $765. I can't imagine what it is at a regular pharmacy but usually WinRx is the lowest. With the Euro pharmacy, I paid $200!!! Now just hoping it arrives a little sooner than the promised 14 days as I just realized I am 1.5 days short with what I have on me now. If I get stuck, hopefully the RE will be able to help with samples!
Anyway, just wanted to share another med-buying experience in case it helps!
persimmon / 1132 posts
@GreenThumb: Oh, I imagine it was so hard to see her face. There is only one reason to be so buoyant at the RE. I'm glad for you that you aren't in beta hell and have clear direction on next steps. Take good care of you!
apricot / 344 posts
@GreenThumb: I so feel your pain as far as the other transfer beta in the office. When I had my fail last time there was a girl who was 42, had 1 follicle, got one egg, and had. 5 day transfer...and she got a positive beta. I was crushed. I'm 3, had 9 eggs, transferred 2 and...fail.
It definitely takes a special kind of strength to pick orselves back up, and keep smiling thru this all. hugs
nectarine / 2192 posts
@GreenThumb: thanks. I send you a hug- this all sucks!
As for getting a second opinion, I did before IVF and I felt better with my current RE. We are scheduled 2/12 for a wtf appointment. There is another RE in town, but I know several people who went to both (actually my RE broke off from the other option), and they all say how much better my current RE is. I also don't want to start from scratch, and my RE knows how I respond. As for seven vials, he starts it a few days before stims and continues. I'm also wondering if the vials he was referencing are the same size as @waiting4you: how many milligrams were in a vial? I think he said 2.9mg/dose but my brain is a little foggy. I looked at a research study that did 4mg daily from CD21 through trigger, so that doesn't seem too out of line. I'm guessing he means half of a 5.8mgvial for 14 days.
@Amorini: so glad my research saved you over $500! FYI I ordered Friday, I think they shipped it Monday, and it arrived the following Monday (10 days). This was also a week before Christmas, so I think the odds are good it will come in time. The tracking info didn't update a few days, then it was in NY and arrived later the same day.
apricot / 344 posts
@AmeliaBedilia: my dose was 2IU (12.5 units in an insulin syringe). The vial was 5.8 MG, which must be about 18-20 units since it lasted me 9 1/2 days. The 5.8 mg vial was $300 including overnight shipping.
persimmon / 1132 posts
@AmeliaBedilia: Yes, thanks to your research for sure! I mentioned the potential cost-savings to DH before ordering because I wanted to make sure he was on board with the Euro pharmacy (I mean, him being European and all, I didn't see him objecting but it's a big "overseas" purchase nonetheless), and he was all over it. U.S. drug companies are absurd! A nurse at my RE said cheapodrugs (Canadian) can be good, too, but it wasn't for the Crinone.
pomegranate / 3764 posts
It's so hard, because you want to be so hopeful and read into stats... but I am a bit cynical and don't trust stats at all anymore.
(After all, I'm the girl whose 28 year old eggs/30yo hubby swimmers with no genetic issues, produced a Down Syndrome bub.... who lost the baby after FOUR heartbeat scans - they always say after seeing a heartbeat, your miscarriage odds go down big time. And then the odds of having a repeat miscarriage the next cycle.. boom. Hit that too. And then again. Stats can suck it.)
Not to be a downer, of course - but yeah, we seem to hit the bad luck strikes constantly in this IVF game.
I really hope that you can get a good plan in place and I REALLY think it would be a great idea to see if you can get a second opinion. We are looking into this (again) in the next few weeks too. This journey is hard enough as it is, without throwing all eggs in one basket. Big, big hugs.
Commiserations on the positive beta lady at the RE. Happy for her, sad for you. That's the way this game always goes.
A friend of mine had her baby boy this morning. It was her first FET transfer that worked (like mine did/would have) and she had a boy... reminded me of what we "should" have had, and I shed a bucketload of tears today.
This whole thing is a mess.
apricot / 344 posts
Starting to get anxious about all this during the last few days of my TWW. Been feeling really nauseous at night and in the mornings. I have a feeling it's just the much higher E2 levels vs last cycle but it's definitely different. Got up in the middle of the night to pick up my hubby from a friends that was only a mile or two away and was reallllllyyyyy queasy the whole time. Feeling like i want to poas but know that's such false hope/negativity. Have some things planned this week to try and stay busy but Thursday at 7 am seems like a month from now!
kiwi / 538 posts
@endymion4: It's really just a mock cycle where they give you all the drugs that they would as if you are doing a transfer. On Day 5 of progesterone instead of a normal transfer you do a biopsy. I had heard that it was pretty painful but I took some prescription Tylenol an hour before and it actually was not bad at all. They send the results of the test out and you get an answer in about 2 weeks. You can start prepping for your next FET before you get the results since it doesn't really affect anything except the last week. The results tell you whether you are the most receptive to transfer on Day 5 or on an earlier or later day. The test cost about $850- I think the biopsy part was covered by my insurance. It seemed like a small cost in the grand scheme of things.
pear / 1986 posts
Man... I had a whole nice post and it just got eaten...
@jaguar: I'm going to be of the opinion that the stupid stats will be making a STRONG turn in your favor this cycle! Come on Olaf, STICK!!!!
@waiting4you: I know that Thursday feels like forever, but it will definitely come!
Alright you two... we need some more on this board!!
AFM: I was terrible to DH this morning. I hate coming off of all the hormones! Back to normal life (because normal is NOT pregnant) and I know April will come along at some point. Glad to have @NorthStar: to hang out with until then!
@NorthStar: You are slated for a March transfer, right? So glad AF showed... in a totally backwards way, it always feels like we are making progress when she does!
@endymion4: I know you are working through all the details of your next cycle now. When were you hoping to do another transfer?
@AmeliaBedilia: How are you doing, hun?
nectarine / 2192 posts
@GreenThumb: beta tomorrow that will almost certainly be negative. Emotionally, I'm hopeless and a mess. I know I need to do more packing (moving into a few rooms of the new house in 2 weeks) but I have no motivation. I'm nervous about doing all of this again- it's so hard! RE suggested doing the march cycle which starts stimming 2/27. It feels like not much time to get everything set, since i am hoping we can do the agonist/antagonist protocol or something with a different lead-in since I think I was over suppressed. We have our wtf appt 2/12 but I worry we need to get started sooner.
apricot / 365 posts
@dookie32: i have such a hard time coming off all the meds that the idea of taking them for a mock cycle is really hard. but we'll definitely be talking to the RE about whether it would be beneficial to do.
@GreenThumb: no idea! we'll be talking to our RE and a 2nd opinion from another local RE before deciding. Ideally spring, but we have some other stuff going on, so we'll have to see what additional testing we may need (or if we do the mock cycle), and how the timing all plays out.
I also have a hard time with the hormone fluctuations--the hubbies will never quite get it, but thank goodness for the support!
pomegranate / 3764 posts
@GreenThumb: I hope you're right. I am symptom spotting already and that is so dangerous. Always leads to false hope.
pomegranate / 3764 posts
@AmeliaBedilia: *hugs you*
@waiting4you: You've done well to get this far. Are you going to POAS at all or hold out completely? x
apricot / 344 posts
@jaguar: lol, I'm going to cave this time I think. As stupid as I know that is. I did the other day, 2dp5dt just to hopefully see a negative so I would know the trigger was out of my system. To my surprise, it was positive still. Did again on 4dp5dt and still positive, though a tiny bit lighter. So I kinda gave up on poas because I know it's so misleading. That being said, I still probably will this week.
What day is your beta?
pomegranate / 3764 posts
@waiting4you: Ah of course, those pesky triggers. What are you now?? I'm only 4dp5dt (I'm assuming I call it a 5 day emby, even though it was frozen at 4d) - but yeah... I will probably cave at some point too.
Beta is 9th - as if I could wait 9 more days!
apricot / 344 posts
@jaguar: Today is 5dp5dt and we transferred 2 expanded hatching (on own) blasts. My beta is on Thursday the 4th which would be 9dp5dt. This time around I'm feeling terrible. last cycle I felt nothing. not a twinge or a symptom or anything. I was confident it was negative. This time I'm SUPER queasy and have been since pretty much 2dp. To the point where I've tried to run errands and find myself sitting in the car, shallow breathing, wondering if I can make it in and out without getting sick. Though I'll note that I haven't actually gotten sick yet. Trying to drink some extra gatorade and eat light meals and soup broth but hasn't helped. Also, can't sleep and have pretty bad headaches not long after I take the estrace.The other thing is my stomach, from just under my rib cage to my hip bones, feels really tight. Almost like I ate WAY too much. Not fun. But keep reminding myself this is what being pregnant could very well feel like and I totally signed up for this.
pomegranate / 3764 posts
@waiting4you: Omgosh, you need to pee. I feel really positive for you!
The main thing I have right now is backache and twinges. Could just be progesterone.
persimmon / 1132 posts
@waiting4you: oh wow, those are some seriously suspicious symptoms! holding out so much hope for you! btw, my second beta was 1474 (168% in 48 hrs). I have another one Wednesday which will be a week after the last one. Honestly, I'm still having a hard time staying positive and thinking this is for real. I turn 40 next Saturday so the higher risks of m/c over the next weeks are very real, as much as I'd like to be happy-go-lucky and announce to the world!
@jaguar:
apricot / 344 posts
@Amorini: Yay for wonderfully increasing Beta's! When are you scheduled for your first ultrasound? I definitely understand being hesitant to shout it from the rooftops, but hopefully these fabulous numbers give you a little bit more reassurance. How have you been feeling?
pear / 1881 posts
@waiting4you: I'm holding out hope for you and those sound like wonderful symptoms! Since you said that you will cave and test, when do you think you will do so?!
@GreenThumb: Yes, i start stims on 2/29s, so will be doing a March transfer. I'm SO scared that we won't end up with a blast since last time, we transferred a morula and no others made it to freeze. The program we paid for allows three fresh cycles, unless they kick you out for not responding. I"m so scared that if this cycle doesn't work that they won't allow us to do a third. The only positive (if you would call this one), would be that we would get our $20+K back. But, I'd rather have a baby. only 4 weeks to go! We've got each other's back!
@jaguar: I hope your symptoms are of Olaf sticking and hanging on tight. I know how scary and frustrating this whole process is when all you want to do is give your little girl a sibling. It sucks and I hope that 2016 will finally allow us to give that to our daughters.
well, I start the dreaded BCP on Wednesday! I cannot remember if I posted that here or not..AF came on Saturday and we are all set to proceed. Thank goodness!
apricot / 344 posts
@NorthStar: I actually tested again this morning (I've tested 2dp, 4dp and now 6dp today). At this point each test has been equally faint positive (though not so faint that I have to squint at all) So while I'd love to read into it....I'm convinced it's probably just the trigger. I respond really well to small amounts of meds so it has got to be that. I've been using these cheap dollar tree ones that read 25units (or whatever measurement) of HCG. I have some first response early ones but haven't broken those out yet. Might test again tomorrow or hold off another 48 hours like I have been.
Update: took a pic, below
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