Opinions neededAugust 7 2012 at 3:20 PM
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|Tripplebe (Login Tripplebe)|
I went in today for a CD2 baseline ultrasound and bloodwork. Results came back with a 9mm follicle on my left ovary and a 3 & 4 mm on my right. Bloodwork came back as fsh=14, e2=32. I didn't do any form of suppression prior to this cycle.
I was so hoping all my follicles would be below 6-7mm, so that I would have more even growth and go into retrievel with a better chance of having more then one mature. I really hate going through this process for only one egg when I ovulatre fine on my own.
Do you think it's any benefit to skipping this cycle and take the estinyl or estrace and try again next month?
FWIW, last ivf my fsh was 8, e2=32 AFC 3. Retrieved 4, only one mature enough to fertilize, transferred one. bfn.
That's a hard oneNo score for this post
|August 7 2012, 3:47 PM |
Hmmm, depends on what stims you are using and are you ok with spending the cost of the meds and monitoring? Thinking maybe you stim and if it looks like the E2 and the follicles sizes only show, based on your last IVF results, there will be only one mature egg, you could cancel at the last minute?
Even if you stim this cycle on very low doses, you could E2 prime for next month this cycle so you don't miss out on cycling again?
opinionsNo score for this post
|August 7 2012, 7:01 PM |
I hate to say it but I'd be tempted to cancel. You know I have no issue retrieving only one but I recall C.heck saying that pregnancy outcomes were poor if the retrieval date is too early in the cycle. I'd be concerned that your 9mm will be ready before CD12 and apparently that doesn't bode well. When I primed the cycle before I was able to get to CD14 for the ER versus the prior cycle where I had no suppression and my ER was on CD10. I didn't make it to an ET for that cycle. GL making your decision. It's a tough one.
dependsNo score for this post
|August 7 2012, 7:42 PM |
I think it would depend mainly on finances (for me, at least). A friend of mine just cancelled her own IVF cycle, because she had only 2 eggs. She is entirely self-pay.
If it lookedNo score for this post
|August 8 2012, 10:40 AM |
If it looked like I had a good chance at two mature going into retrievel I would definitely stick it out. After my call with the nurse last night she said I had a 9 and 5mm and a couple smaller ones. Those are close enough together I'd consider moving forward, or at least see what the next ultrasound shows but I didn't start meds last night so I'm afraid the smaller ones might start receeding already. That happened last time. I had 2 10mm on cd 2, but the tech put it in as centimeters and the nurses read them as 1.0mm. When the nurse called and gave me the size I tried to explain this must be an error. The nurse wouldn't take my word that the tech said there was two 10's. By the time I went back for my ultrasound I had a 14 and 7.
I am waiting for a callback now from one of the RE's. Hoping she will make me feel better about holding off.
updateNo score for this post
|August 7 2012, 10:54 PM |
The nurse called and they don't want to stim me with an fsh above 10. They want me to take Estinyl but I don't have the med so I will most likely cancel this cycle. I asked about taking Estrace in the LP but she was not giving me that option.
It was a complete fluke my last go around that my fsh was an 8. Otherwise my numbers going into this are exactly the same as last time. Not sure if my fsh will ever get that low again. Coming off of bcp and lupron suppression my fsh was always in the 13-14 range.
The nurse also said that my follicles showed a 9mm and 5mm. Plus a couple of other little ones. That gap isn't as bad as I originally thought. Maybe I should push to move foward this cycle? Is it possible to convert to a medicated TI or an IUI?
What to do, what to do??
Re: updateNo score for this post
|August 8 2012, 7:22 AM |
While Mrs. McIrish is correct that O earlier is not that great, I think it is fine if you have short cycles anyhow. I always have had short cycles so it it normal for me to O day 10-12. Also, Broodyhen did a femera round and O'd earlier I thought, and she had luck.
I would say try to stimm b/c you just never know! You can get the estinyl at a pharmacy relatively quickly I would imagine? But I found if I took it too long it suppressed me so I only took it for a few days in the first part of my cycle.
Also, you have to ask yourself if you would be ok with only two follicles and going to ER?
I take it backNo score for this post
|August 8 2012, 7:30 AM |
With FSH 14, I might opt out of this cycle - but you still might be ok with the slightly higher FSH?
If you want to E2 prime, you could take 2mg of Estrace from 3 days after O until a BFN then switch to the estinyl for a couple of days. There are a few ways to E2 prime. Woman on this site said to use progesterone too while using the Estrace. When you go off the Estrace is when you stop the progesterone if you have the BFN of course. Then you will continue on taking the estinyl for the first few days of you next cycle. I stopped on day 4 or 5 at the latest since it seemed to suppress me too much.
Re: I take it backNo score for this post
|August 8 2012, 8:59 AM |
I was hoping to take the Estrace/Estinyl combo with this cycle but when I called and left a message on the nurses line inquiring about it, nobody returned my calls. In total I left 4 messages with other questions and no one would called. Just kind of gave up and figured I'd see where I was at naturally.
Anyway, when speaking to the nurse last evening I told her that I don't like sitting any month out and I would like to do the Estrace in the LP this cycle. She said "we don't do that" she said we prescribe Estinyl. I kept re-asking the quesiton thinking maybe I was saying it wrong, she was adamant that they only use estinyl and that was all she was going to call a prescription in for. Estrace requires a prescription, correct?
The other thing that's bothering me is when I called to set this cycle up I was told we will just do a repeat of last time. Last time I started stims on CD 3 (this time she is saying I'll start on cd 5) and I used Menopur last go around. They are saying I won't need the Menopur. I get that the stim start date can change based on follicle size (although mine is identitcal to every other ivf I had done (9 or 10mm by cd2 even after suppression).
I don't understand why the meds would change when I haven't spoke to an RE inbetween the two IVFs. Plus I have all my records from the first go around and there is no notes about changing things up. I'm wondering who is making the changes.
I think I may try to get a Dr. on the phone today.
Are you atNo score for this post
|August 8 2012, 9:37 AM |
Dr. C's offices? If so they definitely do the E2 priming. I did it there - well, maybe on my own - cannot remember now. But I did have the Estrace and the Estinyl priming there. If you want to share your email address I can maybe help you out.
Sounds like they are not sticking to the same protocol, including timing and meds. Guess with a higher FSH to start, they think you need to start a little later in your cycle with meds. Makes sense in a way.
Re: Are you atNo score for this post
|August 8 2012, 9:42 AM |
Definitely ask to speak to a RE. I asked a couple of times (and sometimes I did not always ask) and still a RE called me back at Dr. C's offices. I found faxing my questions and monitoring call backs the best way to communicate there.
yes, that is where I am at.No score for this post
|August 8 2012, 10:33 AM |
I called the front desk this morning and am waiting for Dr. Co.hen to call me. Hoping she will give me a prescription for the Estrace. Does that need to be purchased from a speciality pharmacy?
Here's the other thing...When I'm not doing IVF, I see a local Napro Dr. who prescribes Letrozole to improve ovulation and luteal phase hcg injections to improve my natural estrogen and progesterone levels. My 7 dpo bloodwork has been coming back at E2=120 and P4=19. Pretty healthy numbers for a semi natural O. A Coop.er nurse told me not to take this the cycle before IVF but I did anyway. Well sort of. I took the Letrozole on CD2 (all 8 pills at once as prescribed) then I took the hcg 2000iu on 3dpo and 5dpo. Usually I would also take it on 7 & 9 dpo but I didn't want the hcg to be in my system at the start of my ivf cycle. Wouldn't you think that the hcg injections would sort of act as a form of estrogen priming?
My email is firstname.lastname@example.org.
Re: yes, that is where I am at.No score for this post
|August 8 2012, 12:08 PM |
No the Estrace can be picked up at a regular pharmacy. Not sure if the hcg would give you the E2 priming. I know that after an IVF cycle when there are multiple follicles, the follicles produce E2 and progesterone (together I thought) so E2/progesterone will be higher. Maybe using the femera/letrozole allows for more than one follicle, so that would give you some E2 priming sort of?
Your 7dpo bw looks great! I might stay away from 9dpo hcg though - just seems to close to the next cycle? I'm not an expert though! I like your idea of seeing the napro dr. Been thinking that if IVF does not work out next month, asking my RE to do just a couple of femera cycles with TI. Good luck to you and let me know what Dr. C.o.hen says. She is nice and understanding from the one time I spoke to her. I'll email you later.
Re: yes, that is where I am at.No score for this post
|August 8 2012, 12:10 PM |
The estinyl is from a specialty pharmacy, so that may take a little time to get. Wonder if Dr. C offices would have some for you.
updateNo score for this post
|August 8 2012, 1:29 PM |
Kim- I normally O Cd-12 myself but Dr. C.heck told me that an ER during that time had "poor pregancy outcomes". Can some get pg with an earlier ER date? Of course. But to get the best chance, I found that that the priming let me stim longer and get to an ER later.
Not sure Dr. C is correct (child ment.)No score for this post
|August 8 2012, 3:55 PM |
I have natural cycles that are short (24-26 days) all my life - used to be 24 day cycles almost exactly years ago. Dr. C told me too that I O'd early and that's not good (didn't want to offend him so I didn't drive home the fact I conceived my DD on 24 "exact" day cycles - and had a positive pregnancy test by day 21. I figured I O'd around day 10 - maybe 11 (as I always have at least a 13 day LP and sometimes 14 days). Maybe ER changes things about egg quality if too early, but I found the E2 priming lets me go too long like ER on day 13, 14, or 15 - which is unnatural for me. So guess it depends on your natural O. I just think the RE's should mirror your natural cycle length - what you had without high FSH. So if day 12 is your natural O day, then I would say try to mirror that. I could be wrong and am not an expert but it makes sense to me to mirror nature!
Now, I drive home the fact to all docs and RE's that my cycle have been and always will be short b/c that's what they were at 20+ years old. I had one local RE say... are you sure. I did not go into it with him. Sigh!
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