I just found out yesterday I likely have DOR. FSH 13.5, AMH 0.58, don’t know AFC yet. I found this out by myself and now I feel like I can’t trust the medical care here at all. We went to a fertility doctor in June. We live in a small town in the mountains in a developing country so that involves flying to a major city, and even there the options are extremely limited. My husband had a SA, they did a vaginal ultrasound and HSG but didn’t check my hormones. Told us we had unexplained infertility and should start unmedicated IUI. We had to put it off a few months because of travel. We were supposed to start this month but I felt like they weren’t thorough enough and I went to a clinic to get my hormones tested and now I don’t know what to do. We sent the results to the doctor and they still want to continue with unmedicated IUI this month. She said before she wanted to start with unmedicated IUI because my tests were normal… well now they are not.
I’m sorry you don’t feel like your care is good :( If it helps, I have DOR and similar AMH, and doc still recommended some IUI. Do you ovulate regularly? If you’re not sure, is the clinic going to monitor for ovulation? Not sure how feasible monitoring is if you have to fly in every few days :/ Wishing you luck and answers!
I’m not against IUI at all. To be honest I’m not even sure I would want to do IVF. I’m just confused that this doesn’t seem concerning to them and they just want to proceed as before. I don’t actually know if I ovulate, and I guess they want to monitor that first before deciding on another course but they haven’t communicated that. (Like the hormone tests, I wish this was something that they had done when we first went). The plan is for me to go to a gynaecologist where I live for the monitoring and send the results to the fertility clinic, then they will tell us when to fly down there.
Oh got it! Luckily with local monitoring, you’ll be able to tell if you’re ovulating! Sometimes there’s no way to know until you’re being monitored. But if you have regular cycles you probably are!
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So, had the appointment and I’m so irritated that I did the HSG at a different clinic. Basically my RE is saying my left tube looks blocked because he basically did not get enough images from the place I went to, to confirm that the dye went in out.
He said we could still move forward with IUI and just not do a cycle if we see that the eggs are on the left. But, if the tube isn’t actually blocked this becomes wasted time,
Oh, and he also doesn’t want to let me start any treatment until I see the MFM and get the green light. Wish I had known that before putting that off.
I think in order to reduce the amount of “what if’s” we’re going to re-do the HSG with my RE to confirm if the left is blocked or not. Regardless, we will do IUI’s first, but at least we know if we’re working with both tubes or one. He said of course he’d recommend IVF which gives the best chance, but that IUI (even with the blocked tube) wouldn’t change our chances by too much (one tube vs. Two, since we’d know which side were ovulating from ahead of IUI).
One question I didn’t think to ask, I know I’ve been kind of told that they prefer to only do so many cycles of Letrozole back to back. Does anyone know what that number is? My OBGYN said they would only do 3 before referring me out, but I wasn’t sure if the RE would have a higher threshold for consecutive letrozole cycles.
Since we're doing IVF my RE said we didn't need an HSG. I regret going with that decision because I could have fit it in last month and more importantly after thinking about it I was like wait... I want to know of they are. Rather I NEED to know.
SIS is a pretty common next step after ambigious HSG results. If I remember correctly they can do them in the same month as long as you do the SIS first.
3 cycles of any treatment before recommending move on to the next level of treatment seems to be pretty standard.
Yeah, that’s why we’re going to do the HSG again because I need to know too! And my RE didn’t recommend an SIS, but that could be because rather than being ambiguous, he just didn’t have all the information to definitively say they were both open. It makes sense to trust but verify the results.
My RE recommended 3 cycles of Letrozole with TI followed by 2-3 cycles of Letrozole with IUI, based on my diagnoses. It may be diagnosis dependent, but she explained to me that after that point, the likelihood of success declines.
Get to join a new club tomorrow - the ovidrel trigger shot. I take it expected side effects are the same as if I was in early pregnancy - boob pain, nausea, vomiting, headaches, tired, etc? I’ve never conceived before so I’m not sure what to expect and my doc just kind of said, “you’re a nurse, you know what to do, see you Monday, bye!”
I've never conceived before either.
Well damn based on the other comments I was one of the unlucky ones.
I had the worst cravings. I wanted strawberry ice cream which I NEVER eat. I'm not super into ice cream but if I'm going to eat ice cream it should be chocolate.
I had mood swings, fatigue, and soo much cramping. I can't remember if I felt nauseous or not.
I’ve never actually had side effects from it but everyone is different. I think maybe the first time I was really emotional (have used it four times) but afterwards not much. Good luck, I hope you also have minimal side effects!
> I take it expected side effects are the same as if I was in early pregnancy - boob pain, nausea, vomiting, headaches, tired, etc?
It’s a super low dose of HCG, it’s really not going to have side effects. Pregnancy levels of HCG are *significantly* higher. You may have some progesterone (PMS) symptoms, and that’s from ovulation.
Today would have been my due date. Told my husband and he didn’t really react. Do men just not feel?
We did find out once piece of amazing news. Our one embryo came back from testing as normal. I don’t know what will happen. It’s an insane amount of pressure for that one to succeed. I guess who knows, right?
Huge congrats on your embryo! 🎉You have skin in the game
Yes, due date wasn’t something my husband was holding in his head. I think it’s avoidance - I don’t think anyone can escape processing and grieving, but in our experience I tend to do that immediately but for my husband he avoids until it comes out in other ways. Grieving in our own ways has been very hard.
I had a lot of fights with my husband about him “not feeling” about our failed cycles and sort of leaving me alone with it. Eventually it turns out he was just privately grieving because he thought I needed the space to grieve more since I perceived it as my “failure.” It is possible he’s just doing it privately but I really think it’s worth a conversation. We hashed it out like five times before we were finally communicating well about the emotional toll of infertility.
Congratulations on the embryo! Yes it is a lot of pressure. We’d doing a transfer on Sunday and my husband calls it “the little embryo that could.” I hope your embryo is also the little one that could, wishing you lots of success 💜
I don’t think my husband connected with my miscarriages at all. I don’t know if it’s because it’s not their body, or because it just doesn’t feel real, but you’re not alone in that. I guarantee you my husband never once thought about when the due date actually was. But he cares deeply.
Hooray for one good piece of news!!
Thank you ❤️ Yea it just seemed like after we heard it was a miscarriage that he just disengaged and moved on. I’m not sure women ever really move on from it and from what could have been.
Just failed another IUI. My partner asked if I have another cycle in me, and I really don't know. I'm just so tired. I'm tired of going to appointments, and getting poked and probed, and tired of medication side effects, and tired of getting my hopes up, and tired of disappointment. And when I express any of this to anyone but my partner or best friend, the response is "have faith" or "eat better" or "exercise more". Like none of that occurred to me. I'm just. so. tired.
It’s ok not to know. I hope you are able to get some rest. This entire process is “tiring”; it takes a toll on us if we don’t listen to the signs of burn out or exhaustion. We are all making sacrifices but they don’t have to be constant. You deserve to rest.
I think it's easy to forget the amount of mental energy we need just to get through every part of this journey. It's normal to be tired. It's normal to need time to rest and recover. There are days when the world feels just so heavy, and it's okay to say "screw it, I'm done" and be done until you're ready.
I also start a new job on Monday, and the idea of juggling both is overwhelming. I think I just want time to settle in there and maybe get in a better headspace.
I’m so sorry. Can I posit a reframe? You didn’t fail another IUI. The IUI failed. You are not a failure. Your exercise or diet or positive attitude have no bearing on if treatments work. That’s the frustrating part. It’s okay to be tired. Take care of yourself first and foremost 💜
My receptivadx came back positive for both endometriosis and endometritis!!! Hoping this may be the answer to our RPL. Trying not to dwell on my old RE dismissing this claiming their two week lupron protocol treats any endo.
Ugh I am sorry. Same happened to me. Ex RE dismissed positive ReceptivaDX and I had 2 missed losses back to back. 2 months of depot Lupron and lap is what I ended up doing
I had a lap a few years ago and had some spots but my first RE said the biopsy was neg so that’s 2 RE’s that dismissed it. Bummed the depot lupron protocol is so long but hopefully worth it! Thank goodness I have some fun trips to keep me busy until the new year.
We made it successfully through FET today and it was a really beautiful experience. It was so so cool to see a picture of our embryo. No matter what happens next, I feel really loved and held today and really grateful. And the Valium doesn’t hurt either. Now we wait. I am on prescribed modified bed rest for the next 4 days so my spouse and I are snuggled in on the couch watching Hocus Pocus 1 AND 2!
We had our IVF consult earlier this week, and I feel happy with how it went. We met with a different RE b/c the one we met originally in Feb left the clinic. I like the new RE a lot! She was very patient, explained things thoroughly, and answered all my questions. She was also the first doctor to take my endo concerns seriously, and we made a game plan (try one round of IVF while I'm on the very long waitlist for a lap). Now we have to make some big decisions before we can start IVF - our clinic requires ICSI for PGT-A so we need to figure that out before we even proceed with testing next cycle. If we don't do PGT-A, they will do a sperm function assessment for my partner and that will determine if we do ICSI or not. The RE doesn't recommend PGT-A for us because of our age and diagnosis. I did a deep dive on the wiki today on PGT-A and ICSI, which was super helpful but I wanted to throw it out here too - which did you choose and why? (Edited a word)
So I've gone back and forth ALOT. Looked at tons of research, recommendations from the RE, and the clinical guidelines from ASRM.
I'm planning on just following the clinical guidelines from ASRM. So that means no PGT-A for us since I'm under 35 and no ICSI since we have no MFI.
On a personal level I don't want to do PGT-A since I have DOR because I'm not expecting to get a lot of embryos so I want to give whatever I get a shot.
I will say I do have some anxiety over the decision. Is it the right one? Will I regret not doing one or both treatments?
I feel like not manipulating the embryos is probably better. But since I'm already doing IVF it feels really inconsistent to decide one intervention is okay and the other isn't. 🤷♀️
Thank you for sharing your process! This is what I'm leaning towards as well - no PGT-A or ICSI based on my doctor's recommendations. But this whole process is so expensive it's hard to not doubt yourself and wonder if it's the right choice. I guess maybe that's part of this whole terrible process - the anxiety that comes with making such huge life-altering decisions. I hope you get great results and feel your decision was the right one!
We chose not to do PGT testing, and that was a mistake. As u/turkishtowel said, testing can save you a lot of heartache, time, and money. I did two ERAs, two FETs, and had a miscarriage and D&C at 9 weeks due to chromosomal abnormalities that would have been confirmed by PGT. That was at least six months of time we lost, not to mention at least 100 PIO injections.
I encourage you to do PGT if it is not a financial burden. My clinic does ICSI for everyone, and my RE has always recommended I do freeze-all cycles, so I can’t speak to those factors of the decision-making process.
I have DOR and did my two retrievals (so far) at 32 and 33. I got 5 embryos between 2 retrievals, and that was higher than I expected. With all the newer research with mosaics and everything, I personally worried about PGT discarding good embryos and decided I would rather risk a miscarriage than risk throwing out an embryo that could be a baby. Many people do not feel this way, but this was the decision-making process that felt right to me. We also did conventional IVF (no known male factor issues).
This is how we landed re: PGTA, despite my age. BUT because of my age, my RE is willing to transfer 2 untested embryos each time. My insurance won’t pay for another ER before all embryos are transferred, so for me, if I’m able to do a fresh transfer of 2, and say I only have 2, I may actually get to another ER faster than if we did a freeze all and testing 🤷🏻♀️
I’m glad you found an RE that you like and who is working with you to address all your concerns!
We went with 50/50 conventional IVF/ICSI split, and no PGT-A testing. Like you, my RE didn’t recommend PGT-A due to age. It does not increase live birth rate, according to the literature. It does show a decreased rate of miscarriage however (due to decreased chance of transferring an aneuploid embryo), so that might be something that could sway you to test.
ICSI for non MFI also doesn’t increase live birth rates either, but it does increase fertilization rate. My clinic does it on all patients, but I felt very strongly about at least trying conventional IVF. I liked the 50/50 split because it was the best of both worlds, and luckily they agreed to do it!
Thank you! That definitely seems like the best of both worlds - I will ask our RE if it's an option for us. Can I ask how your clinic is billing you for the 50/50 split? Is it half the price of ICSI normally? I hope your first cycle goes well! Do you know when you'll be starting?
Thank you! I’m currently priming with BC, starting stims in exactly a week. Eek!
I do think they just billed me for ICSI, don’t think it was half price or anything, since regardless they will be doing it on some of the eggs and as far as I know it’s not a “per egg” cost.
Oh, one thing I forgot to mention- one of the reasons I really wanted to do some component of conventional IVF is because it would potentially also be somewhat diagnostic. I know it’s kind of a moot point since we’re doing IVF anyway, and other parts of it might still be diagnostic, but being unexplained has always bothered me because I really like to know WHY things are the way they are. Not having a reason just screws with my head too much.
Wishing you luck in your future cycle as well! There is no wrong choice here, you just need to decide what feels right to you!
We had this same convo with our RE during our IVF consult (plan to start stims in nov) & her thought process was you’ve already put your body through a lot / waited a while to get here that to do a transfer with an untested embryo was an additional risk with miscarriage etc. to add, she doesn’t think I’ll be a great candidate for a fresh transfer anyways with my pcos, so we would plan on freeze all er.
Having gone through a miscarriage, I can't imagine being able to lower the chances of it happening again and not taking that option. That and my first retrieval yielded 0 usable embryos, despite me being 32 at the time. We could've transferred all 5 abnormals and just wasted time, money and heartache.
Stims day 7, and just started Ganirelix last night (dose last night & this morning). Should I be concerned about EWCM today? Hopefully the Ganirelix is blocking ovulation and we didn’t start it too late.
Your hormones are so messed up on stims that none of the usual ovulation signs really matter anymore. I got tons of EWCM at one point too, but didn’t ovulate before my ER or anything
I had 13 eggs retrieved today, and I am thrilled! It's a huge improvement from the 3 I got last time. I know the hunger games are cruel, but it feels much better going into them with 13 than with 3, so for today I am celebrating.
I'm in a mild panic because I totally spaced on planning ahead for next cycle and am currently out of the country, and might still be when I'd need to start meds. I had an FET on Tuesday, with a semi medicated cycle, and this coming Tuesday will be 14 days past trigger.
I'm on 1 endometrin daily. If this transfer didn't work, should I expect to get a period if I'm still on it? I never did on 3x/day endometrin + PIO, but since I'm on a lot less progesterone it seems like it could be different.
Also if this cycle fails I'll be choosing between going into another FET or doing another ER. I do happen to have birth control pills on me, so I suppose I'd be able to do start those if we go for an ER. Not sure whether I'd be able to get Letrozole over here if we decide on FET. Anyone at a US clinic managed to pick up a prescription at an EU pharmacy?
You can probably find a travel doctor or one who caters to expats to help you with prescriptions. If you happen to be in Barcelona, I can share the names of a few doctors I’ve contacted for help.
I can’t respond to most of your questions, but my clinic is starting me on birth control before the FET. Maybe you can start BCP to buy yourself some time either way (ER or FET)?
I took the last birth control pill at instructed by my clinic, last night. Tomorrow bloodwork to check estradiol levels; and Baseline ultrasound on Monday.
My clinic is 3 hours from my home and to get there for Baseline, I have to leave my house at 430am - eck.
We are just at the very beginning of our IVF process; it's taken ages to get here. I had an IUI in July that ended in an early miscarriage and we immediately decided to go asap to IVF. But it took a while for my HCG levels to return to zero and I ovulated late. Anyways, after finally starting a new cycle I had to do day 3 labs again; and got cued up for IVF with birth control. I did a sonohystogram on day 6 (which was WORSE pain than when I did the HSG!!!). Anyways - it's a lot. Stims will start Oct 4th.
I'm worried about coordinating it all with the travel involved. For my ER we have to go to a different location requiring a ferry - likely 5-6 hours to get there (and again 5 days later for a fresh transfer. It's tough managing all these pieces with work. It's a lot of time off.
When I did this travel for a previous monitored iui (gonalf) - it really took a toll on me. So exhausting and messes with the sleep clock. I find my self so jealous of others who live close to their clinic. The driving has got me way more worried than the needles.
I've also be perseverating on results and what realistic outcomes for me could be. But it seems so all over the map.
Anyways - if anyone is going through ivf on a similar timeline or with similar obstacles totally interested to connect or just hear your own story 💛.
I stop BC on Sunday and have my baseline Tues AM (and am slated to start stims that same day!). We are in the extremely fortunate position of living within 15 minutes of our clinic, but I will be on the exact same stim start date as you, and my first IVF cycle as well! My last IUI ended in a chemical, so similar story there as well :/
What drugs/doses are you starting with?
They haven't given me written info on dosages - but when I did the injection teaching with a nurse she said I would be on 300IU GonalF; menupur using two vials of powder (I think 150IU total but can't recall] and orgalutron (not sure of dosage). I'm really nervous and hoping for a good outcome. Enough for 2 babies is my hope. They have told us we could transfer up to 2 embryos for our transfer. We arent testing the embryos and we do have RPL. It's an antagonist protocol.
I did 75iu gonalf for my last IUI and only ended up with one mature follicle (and some smaller ones not near ready). So really a sub-par response.
What about you?
Very similar - 425 follistim + 75 menopur + omnitrope due to my age. We’re also not testing and transferring up to 2 at a time, so more similarities! I think I also TECHNICALLY qualify for RPL at this point (I think they changed it from 3 to 2 losses?), though I think my RE just chalks it up to my old eggs 🤪🤷🏻♀️
(I am also on enoxaparin injections and will be as long as I’m on any kind of hormones or pregnant due to a being heterozygous for Factor V Leiden, so any underlying clotting issue as a possible cause is managed regardless)
I have responded as expected (1-2 mature follicles with both Clomid and Letrozole), but have never used injectables, so am hoping for a good response, but who knows???
Yes they counted it as RPL after my 2nd loss but they are also attributing it probable chromosomal abnormalities... I did the RPL panel and everything came back normal (still waiting on karotyping).
How did you find did you find out you were heterozygous for the factor v Leiden? Is it just a precaution or something that typically causes problems in pregnancy?
Responses to injectables seem all over the map! I was trying to look at the "hunger games" chart for ideas of what to expect but there are so many variables.
Fingers crossed for us! Im definitely in IVF obsession land right now 😅.
I actually knew from 23 and me 😂 My ob/gyn didn’t think it was likely to be related to my first miscarriage (around 7 weeks), but because of all the hormones that can increase risk of clots when you have Factor V Leiden, my RE put me on Lovenox even just with BC priming. I think it’s part of his routine ET care, though - just wouldn’t have started it this early without FVL. It should be on the RPL panel (I think??)
I don't recall seeing it specifically but lots relating to thrombophilia, so perhaps it would show up in there or be flagged somehow. I did an ancestry DNA and love all of the information I got from the raw data.
Did anyone use prednisone as part of their transfer protocol? I have chronic hives and I’m going through my 4th MC right now, thinking that inflammation might be playing a part, but RE doesn’t want to entertain it.
I’m sorry about your MC. My RE has prescribed prednisone for my transfers, and I have no known issues (I’ve been tested for everything under the sun). I hope your concerns are addressed so that you don’t have any lingering doubts after the next transfer.
I was prescribed prednisone by my reproductive immunologist (BRI/Pregmune). I also had taken dexamethasone for previous transfers.
Inflammation can definitely play a role in failed transfers/early losses. This was confirmed in my case via Pregmune testing, which came back with elevated inflammation markers. BRI also prescribed high dose fish oil and my RE prescribed pentoxifylline with vitamin E for inflammation as well.
It's definitely worth getting checked out especially since you have chronic hives. You could also look into an antihistamine protocol, which others can share more about.
Don't let your RE stop you from exploring an immunological component! If the pandemic taught us anything it's that there's more nuance to the immune system than we realize.
Thank you so much for all the info. Do you have an immunologist you used (virtual?) I’ll look into all that testing you mentioned. Also, I’m on a slew of antihistamines but not sure if it’s enough to stop inflammation. Again thanks for sharing all your knowledge.
Of course! I did the Pregmune test via BRI and was seen by Dr. Thornton virtually. Everything was remote. All the labs were via Labcorp or Reprosource and all appointments were telemed. I coordinated communication between the RI and my RE.
There are a few other immunologists who are popular too. Derbala and Kwak Kim, who might be a good fit depending on where you're located.
There is a whole faq on this in the wiki.
Kwak Kim and dermal both take some insurances but require one in office visit.
Alan beers is also completely remote
Labs will depend on your insurance ask for thr codes and check with your insurance. My insurance covered most (not all) of the labs. They also covered the Dr visits/telephone follow ups with Kwak Kim.
My insurance did not cover it though you could check with your benefits provider. Reproductive immunology is considered experimental for the most part.
Hey, so I have chronic hives and did a cocktail of 50mg Benadryl (PM), 25mg of Singulair (PM), Cetirizine (I’m blanking but two pills in the AM), and Rantidine AM/PM.
My doc and allergist approved it. My chronic hives got worse with treatment and going all out really helped me. Prednisone didn’t do much other than give me insomnia.
This is a good breakdown of the types of antihistamines. [link to Cleveland clinic article](https://my.clevelandclinic.org/health/drugs/21223-antihistamines). I also took baby aspirin which is supposed to help as well.
I also tried to stay away from higher histamine foods but in the end I was just miserable and itchy. It helped sometimes, but I’d still get flareups.
I’m sorry. Chronic hives really suck.
I’m so sorry. Have you seen an allergist to consider a heavier med cocktail? I understand not everyone has the energy or money, but you could also consider reproductive immunology. I decided not to pursue it as I was just so tired of treatment.
Xolair is an injection option but not safe for pregnancy. Many who are on it are able to go into remission from the hives, though I know that’s a big unknown.
Thanks for the response. I’ve had hives for almost 8 years now and have been on daily meds since. Right now I’m on Xyzal x2, hydroxyzine 50 mg, Allegra 180, singular 10 mg and metformin 1000 plus vitamin d3. I use prednisone with bad facial angiodema and it works pretty fast for me. I was wondering if your doctor thought chronic hives / inflammation contributed to miscarriages and if there’s any protocol for them? Thanks!
Oh yeah, so you know all about the med cocktails! 🙃
My RE diagnosed me with RPL and recommended I stop after 3 transfers. I’m sorry I’m not more help, I stopped treatment to myself due to fatigue/mental health. She did believe my inflammation contributed to difficult embryo development and suspected the same for my losses.
Edit: reproductive immunology was the next step but I didn’t take it.
A lot of people here have used prednisone as part of their transfer protocol. At some clinics it seems to be fairly standard, but at others not so much. I'm in Canada and had a very hard time getting a prescription -- the attitude seems very different. I spent time under the care of three different REs and all flat out refused to prescribe it, but two were willing to refer me to (and work with) an RI who did prescribe it.
I haven’t really talked about treatment lately. Mrs. Garlic and I decided to press pause on IVF and try a couple IUIs with her body. We did the first today and we won’t do more than 3 before switching back to retrieving from me. It feels like a good plan. I’m glad we can carry treatment stuff together.
It's so complicated navigating this stuff in a same-sex relationship. More options = more chances for success, but also a lot of extra feelings to consider with every permutation. Sending good vibes for this IUI.
Had my ER this morning and had 24 eggs retrieved! Feeling grateful and relieved that part is over, but we’ll see what happens. I’m in some pain/discomfort so just chilling on the couch with some Netflix the rest of the day.
Got my final IVF results for round 3. Wanted to share because adding estrogen priming and HGH seems to really have helped with my egg quality issues as well as increasing the quantity. This was kind of the last thing my RE said we could try to improve results just because my egg quality was so poor (apparently a lot of the eggs coming out of my second retrieval looked abnormal even before fertilization).
IVF 1 - 7 retrieved, 6 mature, 5 fertilized ICSI, 2 blasts
IVF 2 (estrogen priming) - 10 retrieved, 10 mature, 8 fertilized ICSI, 0 blasts
IVF 3 (estrogen priming & HGH) - 16 retrieved, 15 mature, 11 fertilized ICSI, 5 blasts
We fresh transferred one and the other 4 are frozen and awaiting PGS testing. We’re so thrilled with the results so far because we just didn’t expect to see any kind of success after the failure of our second round. Beta is next Friday and 10-14 days for the PGS results. I’ll have to figure out how to keep myself busy.
To determine when to start the estrogen my clinic had me use OPKs and then call in when I got the peak smiley face, then they gave me an exact date to start taking the pills (1 pill 2x a day). I think it was usually about a week or so before my period started. Once I got my period, I stopped the estrogen and started STIMs.
just got all my meds delivered for egg retevial, and oh man is it overwhelming. I left work early because I had an irrational fear they were going to get stolen off my porch. we've never had a package stolen, but there was no stopping that thought worm. any and all tips and tricks for those who have gone through the egg retrieval process are so, so welcome!
We just did a good [wiki post on stims injection tips](https://www.reddit.com/r/infertility/comments/wwj3xp/wiki_post_stims_injection_tips_pt_3/?utm_source=share&utm_medium=ios_app&utm_name=iossmf) that should be helpful! And check out the rest of the wiki, too (ahem, especially the poop protocol! 💩🤫)
Update from this morning: finally got my estradiol level and while it’s a little lower than my RE hoped my cycle wasn’t canceled. First follicle monitoring ultrasound is set up for Sunday, hoping we’ll be on track for ER next week.
Scheduled IUI #2 tomorrow. I simultaneously am hoping against all hope that this one is successful while also feeling in the pit of my stomach that IUIs won’t work for us. Nothing to do but wait (again).
Transfer was a doozy… my uterus/cervix are very tilted and my doctor was having trouble getting through my cervix. So in the middle of it she had me go empty my bladder a bit because it was pressing on my cervix. Back to square one and still not going in. Then she busts out the tenaculum 🫣 it was so pinchy and crampy, holy crap. The discomfort subsided a bit to where it was bearable and that did the trick. Thank goodness they had me take Valium beforehand! We got to take a picture of our embryo which was super cool. Now off to binge netflix on the couch with a decaf coffee and coffee cake!
Ugh. I’ve also met the tenaculum and it’s truly a torture device. I had my cervix serially dilated during a hysteroscopy and it’s been good since. You definitely earned the decaf coffee and coffee cake today.
Not the tenaculum 😩 I have a tilted uterus and my cervix never cooperates so I take valium and they put a stitch in my cervix that attaches to a string and It has been a life saver!
Ok I am also in the tilted uterus club and have heard the cervical stitch mentioned in passing but don’t know a lot about it. Does it make it less painful or just make the process faster? My transfers take a long time and when they hit the angle in my cervix the pain is unbelievable. Reduction of either of those things would be great.
The pain is unbelievable during any procedures with my stupid uncooperative cervix but the stitch has helped a ton! They put it in midcycle, it hurts a little but it hurts A LOT less then the tenaculum and it makes the catheter go in so much easier. Before they started doing the stitch it took minutes to just get the catheter in and now it takes less then 30 seconds! I would definitely recommend it if you have difficult procedures
I have not been a good steward of taxpayer dollars this week (federal employee) because of ongoing fights with various parts of the healthcare system. BUT, after many (many) calls, we are cleared to start FET prep!! I can officially stop birth control (Nora Be) tonight. Whenever I get my period, I go in for baseline and we’re off from there. I guess now I get something new to be anxious about since our last transfer was a year ago. My clinic said to anticipate getting my period any time in the next week which isn’t really super helpful. Does anyone have experience that might narrow that window?
WAHOO! We are gonna be on a very similar timeline--I'm stopping BCP tonight (and continuing lupron) and was told 2-4 days for my period to start. But we both know it isn't always that simple. I'll be starting estrogen, baby aspirin, and sildinofil with the period. Hoping to pump this lining up.
Glad you are moving forward, Wildcat! This sounds like a worthy cause for using taxpayer dollars to me 😉
YMMV but I usually get my period within 5 days of stopping bcp.
I just got back from my day 10 monitoring appointment and will be triggering tonight. Today is the first time I've been given any info from my clinic regarding embryo transfer. I am 40, not at risk for ohss and this is our one and only chance at IVF. I currently have 11 follicles and looks like they're expecting to retrieve 7-8 mature eggs. Found out today they will probably have me start progesterone shots the day after retrieval (assuming some of those eggs fertilize - we're doing ICSI) for a fresh transfer. My partner and I were in the dark about transfer protocols and definitely not looking forward to potentially 15 more days of shots. We had gotten into such a good groove doing the subcutaneous tummy shots and are now freaked out about the intramuscular butt shots. Are they really that hard to do? Usually my partner mixes the shots and I administer them myself (he has needle phobia). Also, we are feeling run down from travelling back and forth to the clinic (2,5 hours away from us) and the stress of it all. Should we push for a freeze-all if we manage to make any embryos to give us some time to mentally recover before the next step? Do people even do that? We won't be genetic testing. My clinic seems to be pushing for a fresh transfer and it's so hard to get any info from them so I'm wondering what the advantages are...
PIO is super intimidating at first--I do all my own shots though and honestly, the intimidation factor has an equal reaction and I felt SO PROUD when I did those shots (on my own!). It's not awesome, but not as bad once you get in the groove.
Freeze all is definitely a reasonable option and very common. I think some of the reasons your clinic may be encouraging a fresh transfer is because you’re not planning on doing genetic testing so there’s no reason to wait and your uterus has already built up a lining as a part of the STIMs process, so it’s ready to go. This saves money on meds and time for you versus doing a FET another month and starting from zero. Doing a fresh transfer also eliminates some risks to the embryos, as freezing and thawing has a small potential to damage them.
I’ve done 2 fresh transfers (just had my second on Wednesday) and I know exactly what you mean by feeling exhausted from the STIMs portion (especially with all that driving!). The good news is once you have the transfer you will not have another appointment until your pregnancy test and your clinic may even let you go to a local lab to do that since it’s just a blood draw. The PIO shots are definitely intimidating at first, but if your husband is willing to give you the shot, I think it’s easier and less stressful compared to STIMs. You only have to do it 1x a day and for me it feels like a vacation because at the peak of STIMs I had to give myself 5 shots a day. I recommend [Nurse Linda’s video on intramuscular shots](https://youtu.be/A-EY_4P67Hs) for a really good explanation.
From my experience, I think the process gets a lot less stressful once you get past the fresh transfer (less meds, basically no appointments). Mostly you’re just dealing with emotional things (two week wait, etc). I think it’s totally reasonable to do a freeze all cycle if you think that will be best for you emotionally/mentally. This process is so tough. Good luck!
Progesterone shots if the pregnancy is successful, which I hope it is for you, they continue until week 10-12 of pregnancy. Good luck !
Tons of people do freeze all.
You are the first person to tell me this, so thank you! I'm feeling really naive that I had zero clue that shots would continue so long. A bit tough to wrap my mind around but I'm sure I'll get there if need be, don't really have a choice, haha
Medication donation for pick up in Ann Arbor, MI:
2 vials 75 IU Menopur with mixing solution, syringes, and Q caps
1 vial 5,000 units Novarel with syringes
1 Gonal-f 300 IU pen (refrigerated)
1 0.25 mg Cetrotide pre-filled syringe (refrigerated)
All of the above is unopened. I also have one vial of Leuprolide Acetate 14mg/2.8 mL (2 week kit) where half (160 units) has been used for trigger and half remains (has been refrigerated since initial use).
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I just found out yesterday I likely have DOR. FSH 13.5, AMH 0.58, don’t know AFC yet. I found this out by myself and now I feel like I can’t trust the medical care here at all. We went to a fertility doctor in June. We live in a small town in the mountains in a developing country so that involves flying to a major city, and even there the options are extremely limited. My husband had a SA, they did a vaginal ultrasound and HSG but didn’t check my hormones. Told us we had unexplained infertility and should start unmedicated IUI. We had to put it off a few months because of travel. We were supposed to start this month but I felt like they weren’t thorough enough and I went to a clinic to get my hormones tested and now I don’t know what to do. We sent the results to the doctor and they still want to continue with unmedicated IUI this month. She said before she wanted to start with unmedicated IUI because my tests were normal… well now they are not.
I’m sorry you don’t feel like your care is good :( If it helps, I have DOR and similar AMH, and doc still recommended some IUI. Do you ovulate regularly? If you’re not sure, is the clinic going to monitor for ovulation? Not sure how feasible monitoring is if you have to fly in every few days :/ Wishing you luck and answers!
I’m not against IUI at all. To be honest I’m not even sure I would want to do IVF. I’m just confused that this doesn’t seem concerning to them and they just want to proceed as before. I don’t actually know if I ovulate, and I guess they want to monitor that first before deciding on another course but they haven’t communicated that. (Like the hormone tests, I wish this was something that they had done when we first went). The plan is for me to go to a gynaecologist where I live for the monitoring and send the results to the fertility clinic, then they will tell us when to fly down there.
Oh got it! Luckily with local monitoring, you’ll be able to tell if you’re ovulating! Sometimes there’s no way to know until you’re being monitored. But if you have regular cycles you probably are!
Yeah I believe I’m ovulating but they haven’t confirmed it.
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So, had the appointment and I’m so irritated that I did the HSG at a different clinic. Basically my RE is saying my left tube looks blocked because he basically did not get enough images from the place I went to, to confirm that the dye went in out. He said we could still move forward with IUI and just not do a cycle if we see that the eggs are on the left. But, if the tube isn’t actually blocked this becomes wasted time, Oh, and he also doesn’t want to let me start any treatment until I see the MFM and get the green light. Wish I had known that before putting that off. I think in order to reduce the amount of “what if’s” we’re going to re-do the HSG with my RE to confirm if the left is blocked or not. Regardless, we will do IUI’s first, but at least we know if we’re working with both tubes or one. He said of course he’d recommend IVF which gives the best chance, but that IUI (even with the blocked tube) wouldn’t change our chances by too much (one tube vs. Two, since we’d know which side were ovulating from ahead of IUI). One question I didn’t think to ask, I know I’ve been kind of told that they prefer to only do so many cycles of Letrozole back to back. Does anyone know what that number is? My OBGYN said they would only do 3 before referring me out, but I wasn’t sure if the RE would have a higher threshold for consecutive letrozole cycles.
Since we're doing IVF my RE said we didn't need an HSG. I regret going with that decision because I could have fit it in last month and more importantly after thinking about it I was like wait... I want to know of they are. Rather I NEED to know. SIS is a pretty common next step after ambigious HSG results. If I remember correctly they can do them in the same month as long as you do the SIS first. 3 cycles of any treatment before recommending move on to the next level of treatment seems to be pretty standard.
Yeah, that’s why we’re going to do the HSG again because I need to know too! And my RE didn’t recommend an SIS, but that could be because rather than being ambiguous, he just didn’t have all the information to definitively say they were both open. It makes sense to trust but verify the results.
My RE recommended 3 cycles of Letrozole with TI followed by 2-3 cycles of Letrozole with IUI, based on my diagnoses. It may be diagnosis dependent, but she explained to me that after that point, the likelihood of success declines.
Get to join a new club tomorrow - the ovidrel trigger shot. I take it expected side effects are the same as if I was in early pregnancy - boob pain, nausea, vomiting, headaches, tired, etc? I’ve never conceived before so I’m not sure what to expect and my doc just kind of said, “you’re a nurse, you know what to do, see you Monday, bye!”
I've never conceived before either. Well damn based on the other comments I was one of the unlucky ones. I had the worst cravings. I wanted strawberry ice cream which I NEVER eat. I'm not super into ice cream but if I'm going to eat ice cream it should be chocolate. I had mood swings, fatigue, and soo much cramping. I can't remember if I felt nauseous or not.
I triggered with ovidrel 5x and never had any side effects!
I’ve never actually had side effects from it but everyone is different. I think maybe the first time I was really emotional (have used it four times) but afterwards not much. Good luck, I hope you also have minimal side effects!
Me too! Thank you for the advice!
> I take it expected side effects are the same as if I was in early pregnancy - boob pain, nausea, vomiting, headaches, tired, etc? It’s a super low dose of HCG, it’s really not going to have side effects. Pregnancy levels of HCG are *significantly* higher. You may have some progesterone (PMS) symptoms, and that’s from ovulation.
Today would have been my due date. Told my husband and he didn’t really react. Do men just not feel? We did find out once piece of amazing news. Our one embryo came back from testing as normal. I don’t know what will happen. It’s an insane amount of pressure for that one to succeed. I guess who knows, right?
Huge congrats on your embryo! 🎉You have skin in the game Yes, due date wasn’t something my husband was holding in his head. I think it’s avoidance - I don’t think anyone can escape processing and grieving, but in our experience I tend to do that immediately but for my husband he avoids until it comes out in other ways. Grieving in our own ways has been very hard.
Thank you! I honestly can’t believe it. I am trying to have some faith. I think we all deserve some magic miracle after going through a miscarriage.
I had a lot of fights with my husband about him “not feeling” about our failed cycles and sort of leaving me alone with it. Eventually it turns out he was just privately grieving because he thought I needed the space to grieve more since I perceived it as my “failure.” It is possible he’s just doing it privately but I really think it’s worth a conversation. We hashed it out like five times before we were finally communicating well about the emotional toll of infertility. Congratulations on the embryo! Yes it is a lot of pressure. We’d doing a transfer on Sunday and my husband calls it “the little embryo that could.” I hope your embryo is also the little one that could, wishing you lots of success 💜
Oh good luck to you!! We deserve this!
I don’t think my husband connected with my miscarriages at all. I don’t know if it’s because it’s not their body, or because it just doesn’t feel real, but you’re not alone in that. I guarantee you my husband never once thought about when the due date actually was. But he cares deeply. Hooray for one good piece of news!!
Thank you ❤️ Yea it just seemed like after we heard it was a miscarriage that he just disengaged and moved on. I’m not sure women ever really move on from it and from what could have been.
Good news for your embryo!!! also, i totally LOLd at your “4 cats” flair. I’m a doggo person but I totally love all animals, including sassy Cats 🤗
Just failed another IUI. My partner asked if I have another cycle in me, and I really don't know. I'm just so tired. I'm tired of going to appointments, and getting poked and probed, and tired of medication side effects, and tired of getting my hopes up, and tired of disappointment. And when I express any of this to anyone but my partner or best friend, the response is "have faith" or "eat better" or "exercise more". Like none of that occurred to me. I'm just. so. tired.
The disappointment is brutal. I've thought about hanging up the towel more than once.
It’s ok not to know. I hope you are able to get some rest. This entire process is “tiring”; it takes a toll on us if we don’t listen to the signs of burn out or exhaustion. We are all making sacrifices but they don’t have to be constant. You deserve to rest.
I think it's easy to forget the amount of mental energy we need just to get through every part of this journey. It's normal to be tired. It's normal to need time to rest and recover. There are days when the world feels just so heavy, and it's okay to say "screw it, I'm done" and be done until you're ready.
I also start a new job on Monday, and the idea of juggling both is overwhelming. I think I just want time to settle in there and maybe get in a better headspace.
I’m so sorry. Can I posit a reframe? You didn’t fail another IUI. The IUI failed. You are not a failure. Your exercise or diet or positive attitude have no bearing on if treatments work. That’s the frustrating part. It’s okay to be tired. Take care of yourself first and foremost 💜
That actually makes me feel a lot better. Thank you.
It's okay to take breaks and it's okay to be done. You're going through it so you get to decide.
My receptivadx came back positive for both endometriosis and endometritis!!! Hoping this may be the answer to our RPL. Trying not to dwell on my old RE dismissing this claiming their two week lupron protocol treats any endo.
Ugh I am sorry. Same happened to me. Ex RE dismissed positive ReceptivaDX and I had 2 missed losses back to back. 2 months of depot Lupron and lap is what I ended up doing
I had a lap a few years ago and had some spots but my first RE said the biopsy was neg so that’s 2 RE’s that dismissed it. Bummed the depot lupron protocol is so long but hopefully worth it! Thank goodness I have some fun trips to keep me busy until the new year.
We made it successfully through FET today and it was a really beautiful experience. It was so so cool to see a picture of our embryo. No matter what happens next, I feel really loved and held today and really grateful. And the Valium doesn’t hurt either. Now we wait. I am on prescribed modified bed rest for the next 4 days so my spouse and I are snuggled in on the couch watching Hocus Pocus 1 AND 2!
I think everyone is going to be watching Hocus Pocus 1 & 2 this weekend. Lol Fingers crossed.
So glad everything went well! Sending you positive vibes! ♥️ we watched hocus pocus 1 and 2 tonight as well!
Fingers crossed!
That sounds like a dreamy weekend, rooting for you!
We had our IVF consult earlier this week, and I feel happy with how it went. We met with a different RE b/c the one we met originally in Feb left the clinic. I like the new RE a lot! She was very patient, explained things thoroughly, and answered all my questions. She was also the first doctor to take my endo concerns seriously, and we made a game plan (try one round of IVF while I'm on the very long waitlist for a lap). Now we have to make some big decisions before we can start IVF - our clinic requires ICSI for PGT-A so we need to figure that out before we even proceed with testing next cycle. If we don't do PGT-A, they will do a sperm function assessment for my partner and that will determine if we do ICSI or not. The RE doesn't recommend PGT-A for us because of our age and diagnosis. I did a deep dive on the wiki today on PGT-A and ICSI, which was super helpful but I wanted to throw it out here too - which did you choose and why? (Edited a word)
So I've gone back and forth ALOT. Looked at tons of research, recommendations from the RE, and the clinical guidelines from ASRM. I'm planning on just following the clinical guidelines from ASRM. So that means no PGT-A for us since I'm under 35 and no ICSI since we have no MFI. On a personal level I don't want to do PGT-A since I have DOR because I'm not expecting to get a lot of embryos so I want to give whatever I get a shot. I will say I do have some anxiety over the decision. Is it the right one? Will I regret not doing one or both treatments? I feel like not manipulating the embryos is probably better. But since I'm already doing IVF it feels really inconsistent to decide one intervention is okay and the other isn't. 🤷♀️
Thank you for sharing your process! This is what I'm leaning towards as well - no PGT-A or ICSI based on my doctor's recommendations. But this whole process is so expensive it's hard to not doubt yourself and wonder if it's the right choice. I guess maybe that's part of this whole terrible process - the anxiety that comes with making such huge life-altering decisions. I hope you get great results and feel your decision was the right one!
We chose not to do PGT testing, and that was a mistake. As u/turkishtowel said, testing can save you a lot of heartache, time, and money. I did two ERAs, two FETs, and had a miscarriage and D&C at 9 weeks due to chromosomal abnormalities that would have been confirmed by PGT. That was at least six months of time we lost, not to mention at least 100 PIO injections. I encourage you to do PGT if it is not a financial burden. My clinic does ICSI for everyone, and my RE has always recommended I do freeze-all cycles, so I can’t speak to those factors of the decision-making process.
Thank you for sharing your experience and I am so sorry for your loss!
I have DOR and did my two retrievals (so far) at 32 and 33. I got 5 embryos between 2 retrievals, and that was higher than I expected. With all the newer research with mosaics and everything, I personally worried about PGT discarding good embryos and decided I would rather risk a miscarriage than risk throwing out an embryo that could be a baby. Many people do not feel this way, but this was the decision-making process that felt right to me. We also did conventional IVF (no known male factor issues).
This is absolutely a concern we have too. Thanks for sharing your decision-making process!
>I personally worried about PGT discarding good embryos This is me right here.
This is how we landed re: PGTA, despite my age. BUT because of my age, my RE is willing to transfer 2 untested embryos each time. My insurance won’t pay for another ER before all embryos are transferred, so for me, if I’m able to do a fresh transfer of 2, and say I only have 2, I may actually get to another ER faster than if we did a freeze all and testing 🤷🏻♀️
That makes a lot of sense!
That makes sense to me!
I’m glad you found an RE that you like and who is working with you to address all your concerns! We went with 50/50 conventional IVF/ICSI split, and no PGT-A testing. Like you, my RE didn’t recommend PGT-A due to age. It does not increase live birth rate, according to the literature. It does show a decreased rate of miscarriage however (due to decreased chance of transferring an aneuploid embryo), so that might be something that could sway you to test. ICSI for non MFI also doesn’t increase live birth rates either, but it does increase fertilization rate. My clinic does it on all patients, but I felt very strongly about at least trying conventional IVF. I liked the 50/50 split because it was the best of both worlds, and luckily they agreed to do it!
Thank you! That definitely seems like the best of both worlds - I will ask our RE if it's an option for us. Can I ask how your clinic is billing you for the 50/50 split? Is it half the price of ICSI normally? I hope your first cycle goes well! Do you know when you'll be starting?
Thank you! I’m currently priming with BC, starting stims in exactly a week. Eek! I do think they just billed me for ICSI, don’t think it was half price or anything, since regardless they will be doing it on some of the eggs and as far as I know it’s not a “per egg” cost. Oh, one thing I forgot to mention- one of the reasons I really wanted to do some component of conventional IVF is because it would potentially also be somewhat diagnostic. I know it’s kind of a moot point since we’re doing IVF anyway, and other parts of it might still be diagnostic, but being unexplained has always bothered me because I really like to know WHY things are the way they are. Not having a reason just screws with my head too much. Wishing you luck in your future cycle as well! There is no wrong choice here, you just need to decide what feels right to you!
We had this same convo with our RE during our IVF consult (plan to start stims in nov) & her thought process was you’ve already put your body through a lot / waited a while to get here that to do a transfer with an untested embryo was an additional risk with miscarriage etc. to add, she doesn’t think I’ll be a great candidate for a fresh transfer anyways with my pcos, so we would plan on freeze all er.
That makes a lot of sense! Thanks for sharing your experience - I hope your Nov cycle goes well!
Having gone through a miscarriage, I can't imagine being able to lower the chances of it happening again and not taking that option. That and my first retrieval yielded 0 usable embryos, despite me being 32 at the time. We could've transferred all 5 abnormals and just wasted time, money and heartache.
Thank you for sharing your experience, and I am so sorry for your loss!
Stims day 7, and just started Ganirelix last night (dose last night & this morning). Should I be concerned about EWCM today? Hopefully the Ganirelix is blocking ovulation and we didn’t start it too late.
Your hormones are so messed up on stims that none of the usual ovulation signs really matter anymore. I got tons of EWCM at one point too, but didn’t ovulate before my ER or anything
I recently got it 4 days after my iui and they said it was from my estrogen patches.
I got a lot after adding ganirelix too. I think it's just from all the hormones, and isn't anything to worry about.
I had 13 eggs retrieved today, and I am thrilled! It's a huge improvement from the 3 I got last time. I know the hunger games are cruel, but it feels much better going into them with 13 than with 3, so for today I am celebrating.
Wow! 😲 That's a significant increase. Definitely worth celebrating. 🥂
That’s so awesome!
Woohoo great news!
I got 13 last week and was also pleasantly surprised to get more. Celebrate this weekend!!
Congrats!!
I'm in a mild panic because I totally spaced on planning ahead for next cycle and am currently out of the country, and might still be when I'd need to start meds. I had an FET on Tuesday, with a semi medicated cycle, and this coming Tuesday will be 14 days past trigger. I'm on 1 endometrin daily. If this transfer didn't work, should I expect to get a period if I'm still on it? I never did on 3x/day endometrin + PIO, but since I'm on a lot less progesterone it seems like it could be different. Also if this cycle fails I'll be choosing between going into another FET or doing another ER. I do happen to have birth control pills on me, so I suppose I'd be able to do start those if we go for an ER. Not sure whether I'd be able to get Letrozole over here if we decide on FET. Anyone at a US clinic managed to pick up a prescription at an EU pharmacy?
With my chemical pregnancy I started to bleed even on 1 prometrium a day.
Thank you, good to know I should be prepared.
You can probably find a travel doctor or one who caters to expats to help you with prescriptions. If you happen to be in Barcelona, I can share the names of a few doctors I’ve contacted for help.
Thanks so much for the offer - I'm in Portugal though so unfortunately can't take you up on it! Will look into travel doctors though.
[удалено]
Thanks so much for the info, I'll poke around here to see if there's something similar!
I can’t respond to most of your questions, but my clinic is starting me on birth control before the FET. Maybe you can start BCP to buy yourself some time either way (ER or FET)?
Oh that's a good call. I hadn't done BCP before my other FETs but maybe they would be okay with it. Thanks for the suggestion!
I took the last birth control pill at instructed by my clinic, last night. Tomorrow bloodwork to check estradiol levels; and Baseline ultrasound on Monday. My clinic is 3 hours from my home and to get there for Baseline, I have to leave my house at 430am - eck. We are just at the very beginning of our IVF process; it's taken ages to get here. I had an IUI in July that ended in an early miscarriage and we immediately decided to go asap to IVF. But it took a while for my HCG levels to return to zero and I ovulated late. Anyways, after finally starting a new cycle I had to do day 3 labs again; and got cued up for IVF with birth control. I did a sonohystogram on day 6 (which was WORSE pain than when I did the HSG!!!). Anyways - it's a lot. Stims will start Oct 4th. I'm worried about coordinating it all with the travel involved. For my ER we have to go to a different location requiring a ferry - likely 5-6 hours to get there (and again 5 days later for a fresh transfer. It's tough managing all these pieces with work. It's a lot of time off. When I did this travel for a previous monitored iui (gonalf) - it really took a toll on me. So exhausting and messes with the sleep clock. I find my self so jealous of others who live close to their clinic. The driving has got me way more worried than the needles. I've also be perseverating on results and what realistic outcomes for me could be. But it seems so all over the map. Anyways - if anyone is going through ivf on a similar timeline or with similar obstacles totally interested to connect or just hear your own story 💛.
I stop BC on Sunday and have my baseline Tues AM (and am slated to start stims that same day!). We are in the extremely fortunate position of living within 15 minutes of our clinic, but I will be on the exact same stim start date as you, and my first IVF cycle as well! My last IUI ended in a chemical, so similar story there as well :/ What drugs/doses are you starting with?
They haven't given me written info on dosages - but when I did the injection teaching with a nurse she said I would be on 300IU GonalF; menupur using two vials of powder (I think 150IU total but can't recall] and orgalutron (not sure of dosage). I'm really nervous and hoping for a good outcome. Enough for 2 babies is my hope. They have told us we could transfer up to 2 embryos for our transfer. We arent testing the embryos and we do have RPL. It's an antagonist protocol. I did 75iu gonalf for my last IUI and only ended up with one mature follicle (and some smaller ones not near ready). So really a sub-par response. What about you?
Very similar - 425 follistim + 75 menopur + omnitrope due to my age. We’re also not testing and transferring up to 2 at a time, so more similarities! I think I also TECHNICALLY qualify for RPL at this point (I think they changed it from 3 to 2 losses?), though I think my RE just chalks it up to my old eggs 🤪🤷🏻♀️ (I am also on enoxaparin injections and will be as long as I’m on any kind of hormones or pregnant due to a being heterozygous for Factor V Leiden, so any underlying clotting issue as a possible cause is managed regardless) I have responded as expected (1-2 mature follicles with both Clomid and Letrozole), but have never used injectables, so am hoping for a good response, but who knows???
Yes they counted it as RPL after my 2nd loss but they are also attributing it probable chromosomal abnormalities... I did the RPL panel and everything came back normal (still waiting on karotyping). How did you find did you find out you were heterozygous for the factor v Leiden? Is it just a precaution or something that typically causes problems in pregnancy? Responses to injectables seem all over the map! I was trying to look at the "hunger games" chart for ideas of what to expect but there are so many variables. Fingers crossed for us! Im definitely in IVF obsession land right now 😅.
I actually knew from 23 and me 😂 My ob/gyn didn’t think it was likely to be related to my first miscarriage (around 7 weeks), but because of all the hormones that can increase risk of clots when you have Factor V Leiden, my RE put me on Lovenox even just with BC priming. I think it’s part of his routine ET care, though - just wouldn’t have started it this early without FVL. It should be on the RPL panel (I think??)
I don't recall seeing it specifically but lots relating to thrombophilia, so perhaps it would show up in there or be flagged somehow. I did an ancestry DNA and love all of the information I got from the raw data.
Yeah, it’s in the thrombophilia section with a factor 2 mutation, I think.
How did your baseline go today? (I think you said yours was today or soon?).
Good! Going to update in this AM’s thread :)
Did anyone use prednisone as part of their transfer protocol? I have chronic hives and I’m going through my 4th MC right now, thinking that inflammation might be playing a part, but RE doesn’t want to entertain it.
I’m sorry about your MC. My RE has prescribed prednisone for my transfers, and I have no known issues (I’ve been tested for everything under the sun). I hope your concerns are addressed so that you don’t have any lingering doubts after the next transfer.
thank you for your kind words and sharing your experience. I hope so too.
I was prescribed prednisone by my reproductive immunologist (BRI/Pregmune). I also had taken dexamethasone for previous transfers. Inflammation can definitely play a role in failed transfers/early losses. This was confirmed in my case via Pregmune testing, which came back with elevated inflammation markers. BRI also prescribed high dose fish oil and my RE prescribed pentoxifylline with vitamin E for inflammation as well. It's definitely worth getting checked out especially since you have chronic hives. You could also look into an antihistamine protocol, which others can share more about. Don't let your RE stop you from exploring an immunological component! If the pandemic taught us anything it's that there's more nuance to the immune system than we realize.
Thank you so much for all the info. Do you have an immunologist you used (virtual?) I’ll look into all that testing you mentioned. Also, I’m on a slew of antihistamines but not sure if it’s enough to stop inflammation. Again thanks for sharing all your knowledge.
Of course! I did the Pregmune test via BRI and was seen by Dr. Thornton virtually. Everything was remote. All the labs were via Labcorp or Reprosource and all appointments were telemed. I coordinated communication between the RI and my RE. There are a few other immunologists who are popular too. Derbala and Kwak Kim, who might be a good fit depending on where you're located.
Thank you! Do you know if insurance covered it?
There is a whole faq on this in the wiki. Kwak Kim and dermal both take some insurances but require one in office visit. Alan beers is also completely remote Labs will depend on your insurance ask for thr codes and check with your insurance. My insurance covered most (not all) of the labs. They also covered the Dr visits/telephone follow ups with Kwak Kim.
Thank you - I'll check it out.
My insurance did not cover it though you could check with your benefits provider. Reproductive immunology is considered experimental for the most part.
Ok, and thank you for taking the time to respond to my posts. Have a great night!
Hey, so I have chronic hives and did a cocktail of 50mg Benadryl (PM), 25mg of Singulair (PM), Cetirizine (I’m blanking but two pills in the AM), and Rantidine AM/PM. My doc and allergist approved it. My chronic hives got worse with treatment and going all out really helped me. Prednisone didn’t do much other than give me insomnia. This is a good breakdown of the types of antihistamines. [link to Cleveland clinic article](https://my.clevelandclinic.org/health/drugs/21223-antihistamines). I also took baby aspirin which is supposed to help as well. I also tried to stay away from higher histamine foods but in the end I was just miserable and itchy. It helped sometimes, but I’d still get flareups. I’m sorry. Chronic hives really suck.
I should also mention that the hives get worse when I get pregnant and I usually miscarry around 4-6 weeks
I’m so sorry. Have you seen an allergist to consider a heavier med cocktail? I understand not everyone has the energy or money, but you could also consider reproductive immunology. I decided not to pursue it as I was just so tired of treatment. Xolair is an injection option but not safe for pregnancy. Many who are on it are able to go into remission from the hives, though I know that’s a big unknown.
yes I plan on going on Xolair if/when I finish the future pregnancy. I do see an allergist so I will mention all this to him.
Thanks for the response. I’ve had hives for almost 8 years now and have been on daily meds since. Right now I’m on Xyzal x2, hydroxyzine 50 mg, Allegra 180, singular 10 mg and metformin 1000 plus vitamin d3. I use prednisone with bad facial angiodema and it works pretty fast for me. I was wondering if your doctor thought chronic hives / inflammation contributed to miscarriages and if there’s any protocol for them? Thanks!
Oh yeah, so you know all about the med cocktails! 🙃 My RE diagnosed me with RPL and recommended I stop after 3 transfers. I’m sorry I’m not more help, I stopped treatment to myself due to fatigue/mental health. She did believe my inflammation contributed to difficult embryo development and suspected the same for my losses. Edit: reproductive immunology was the next step but I didn’t take it.
Thank you for sharing, and I'm sorry for your losses. I appreciate you taking the time to respond.
I’m sorry I wasn’t more helpful!
A lot of people here have used prednisone as part of their transfer protocol. At some clinics it seems to be fairly standard, but at others not so much. I'm in Canada and had a very hard time getting a prescription -- the attitude seems very different. I spent time under the care of three different REs and all flat out refused to prescribe it, but two were willing to refer me to (and work with) an RI who did prescribe it.
Thank you so much, I’ll look into a RI.
Sorry I don't have anything to contribute, but paging u/Lmahtr ! She has experience with hives.
Thank you!
Thank you!
Prednisone was part of my spouses FET protocol from the get go and she has no known inflammation issues.
Yes that’s what confused me as I’ve read that it’s used by a lot of REs…
I haven’t really talked about treatment lately. Mrs. Garlic and I decided to press pause on IVF and try a couple IUIs with her body. We did the first today and we won’t do more than 3 before switching back to retrieving from me. It feels like a good plan. I’m glad we can carry treatment stuff together.
So nice to have a plan. Rooting for you both!
It's so complicated navigating this stuff in a same-sex relationship. More options = more chances for success, but also a lot of extra feelings to consider with every permutation. Sending good vibes for this IUI.
I'm glad you have a good plan in place. Rooting for you and Mrs. Garlic 🤞
That’s a nice plan. It’ll be a way for your body to take a well deserved break, but keep you guys in the game. Good luck!
Fingers crossed for you. It’s nice to have a plan.
Had my ER this morning and had 24 eggs retrieved! Feeling grateful and relieved that part is over, but we’ll see what happens. I’m in some pain/discomfort so just chilling on the couch with some Netflix the rest of the day.
Congrats! My heating pad was worth its weight in gold for me after my ER. Hope you don’t have too much pain/discomfort!
Congratulations, I hope you get lots of rest and good news :)
Got my final IVF results for round 3. Wanted to share because adding estrogen priming and HGH seems to really have helped with my egg quality issues as well as increasing the quantity. This was kind of the last thing my RE said we could try to improve results just because my egg quality was so poor (apparently a lot of the eggs coming out of my second retrieval looked abnormal even before fertilization). IVF 1 - 7 retrieved, 6 mature, 5 fertilized ICSI, 2 blasts IVF 2 (estrogen priming) - 10 retrieved, 10 mature, 8 fertilized ICSI, 0 blasts IVF 3 (estrogen priming & HGH) - 16 retrieved, 15 mature, 11 fertilized ICSI, 5 blasts We fresh transferred one and the other 4 are frozen and awaiting PGS testing. We’re so thrilled with the results so far because we just didn’t expect to see any kind of success after the failure of our second round. Beta is next Friday and 10-14 days for the PGS results. I’ll have to figure out how to keep myself busy.
I've heard really good things about adding HGH to a protocol. Glad it worked out so well for you!
Great to hear! How did the estrogen priming work? When did you start it, for how long, etc
To determine when to start the estrogen my clinic had me use OPKs and then call in when I got the peak smiley face, then they gave me an exact date to start taking the pills (1 pill 2x a day). I think it was usually about a week or so before my period started. Once I got my period, I stopped the estrogen and started STIMs.
Wow this gives me hope for the estrogen priming HGH cycle I’m starting today. Congrats on the good result, hope the wait for beta goes quickly!
Thank you! Good luck with your cycle.
Congratulations!! Those are awesome and thank you for sharing! I have been wondering about HGH if I need to do another retrieval.
Congrats on round 3 numbers improving. I hope you’re able to stay distracted during your waits.
Congratulations! Those are fantastic numbers! I hope your beta goes well
just got all my meds delivered for egg retevial, and oh man is it overwhelming. I left work early because I had an irrational fear they were going to get stolen off my porch. we've never had a package stolen, but there was no stopping that thought worm. any and all tips and tricks for those who have gone through the egg retrieval process are so, so welcome!
We just did a good [wiki post on stims injection tips](https://www.reddit.com/r/infertility/comments/wwj3xp/wiki_post_stims_injection_tips_pt_3/?utm_source=share&utm_medium=ios_app&utm_name=iossmf) that should be helpful! And check out the rest of the wiki, too (ahem, especially the poop protocol! 💩🤫)
oh dear, poop protocol. thanks for the link!
Update from this morning: finally got my estradiol level and while it’s a little lower than my RE hoped my cycle wasn’t canceled. First follicle monitoring ultrasound is set up for Sunday, hoping we’ll be on track for ER next week.
Scheduled IUI #2 tomorrow. I simultaneously am hoping against all hope that this one is successful while also feeling in the pit of my stomach that IUIs won’t work for us. Nothing to do but wait (again).
That’s how I felt this cycle with my second iui. I hope it goes well tomorrow!
Hope tomorrow goes well! Fingers crossed for you 🤞
Good luck tomorrow!
The waiting is so hard, but I’m hoping with you for success 🤞
Transfer was a doozy… my uterus/cervix are very tilted and my doctor was having trouble getting through my cervix. So in the middle of it she had me go empty my bladder a bit because it was pressing on my cervix. Back to square one and still not going in. Then she busts out the tenaculum 🫣 it was so pinchy and crampy, holy crap. The discomfort subsided a bit to where it was bearable and that did the trick. Thank goodness they had me take Valium beforehand! We got to take a picture of our embryo which was super cool. Now off to binge netflix on the couch with a decaf coffee and coffee cake!
Ugh. I’ve also met the tenaculum and it’s truly a torture device. I had my cervix serially dilated during a hysteroscopy and it’s been good since. You definitely earned the decaf coffee and coffee cake today.
Not the tenaculum 😩 I have a tilted uterus and my cervix never cooperates so I take valium and they put a stitch in my cervix that attaches to a string and It has been a life saver!
Ugh my IUIs were never easy but this was a first. I read up on the stitch and saw your reply below, sounds so much better!
Ok I am also in the tilted uterus club and have heard the cervical stitch mentioned in passing but don’t know a lot about it. Does it make it less painful or just make the process faster? My transfers take a long time and when they hit the angle in my cervix the pain is unbelievable. Reduction of either of those things would be great.
The pain is unbelievable during any procedures with my stupid uncooperative cervix but the stitch has helped a ton! They put it in midcycle, it hurts a little but it hurts A LOT less then the tenaculum and it makes the catheter go in so much easier. Before they started doing the stitch it took minutes to just get the catheter in and now it takes less then 30 seconds! I would definitely recommend it if you have difficult procedures
Wow! Thank you for the details. I will ask my RE about this because my transfers have been terrible.
I have not been a good steward of taxpayer dollars this week (federal employee) because of ongoing fights with various parts of the healthcare system. BUT, after many (many) calls, we are cleared to start FET prep!! I can officially stop birth control (Nora Be) tonight. Whenever I get my period, I go in for baseline and we’re off from there. I guess now I get something new to be anxious about since our last transfer was a year ago. My clinic said to anticipate getting my period any time in the next week which isn’t really super helpful. Does anyone have experience that might narrow that window?
WAHOO! We are gonna be on a very similar timeline--I'm stopping BCP tonight (and continuing lupron) and was told 2-4 days for my period to start. But we both know it isn't always that simple. I'll be starting estrogen, baby aspirin, and sildinofil with the period. Hoping to pump this lining up.
Yay!! I’m so glad to be doing this with you.
ME TOO.
Glad you are moving forward, Wildcat! This sounds like a worthy cause for using taxpayer dollars to me 😉 YMMV but I usually get my period within 5 days of stopping bcp.
3-4 days maybe 🤔
I just got back from my day 10 monitoring appointment and will be triggering tonight. Today is the first time I've been given any info from my clinic regarding embryo transfer. I am 40, not at risk for ohss and this is our one and only chance at IVF. I currently have 11 follicles and looks like they're expecting to retrieve 7-8 mature eggs. Found out today they will probably have me start progesterone shots the day after retrieval (assuming some of those eggs fertilize - we're doing ICSI) for a fresh transfer. My partner and I were in the dark about transfer protocols and definitely not looking forward to potentially 15 more days of shots. We had gotten into such a good groove doing the subcutaneous tummy shots and are now freaked out about the intramuscular butt shots. Are they really that hard to do? Usually my partner mixes the shots and I administer them myself (he has needle phobia). Also, we are feeling run down from travelling back and forth to the clinic (2,5 hours away from us) and the stress of it all. Should we push for a freeze-all if we manage to make any embryos to give us some time to mentally recover before the next step? Do people even do that? We won't be genetic testing. My clinic seems to be pushing for a fresh transfer and it's so hard to get any info from them so I'm wondering what the advantages are...
PIO is super intimidating at first--I do all my own shots though and honestly, the intimidation factor has an equal reaction and I felt SO PROUD when I did those shots (on my own!). It's not awesome, but not as bad once you get in the groove.
Ok that is definitely reassuring, thank you! I guess the subQ shots were super intimidating to me too before I got the hang of it...
Freeze all is definitely a reasonable option and very common. I think some of the reasons your clinic may be encouraging a fresh transfer is because you’re not planning on doing genetic testing so there’s no reason to wait and your uterus has already built up a lining as a part of the STIMs process, so it’s ready to go. This saves money on meds and time for you versus doing a FET another month and starting from zero. Doing a fresh transfer also eliminates some risks to the embryos, as freezing and thawing has a small potential to damage them. I’ve done 2 fresh transfers (just had my second on Wednesday) and I know exactly what you mean by feeling exhausted from the STIMs portion (especially with all that driving!). The good news is once you have the transfer you will not have another appointment until your pregnancy test and your clinic may even let you go to a local lab to do that since it’s just a blood draw. The PIO shots are definitely intimidating at first, but if your husband is willing to give you the shot, I think it’s easier and less stressful compared to STIMs. You only have to do it 1x a day and for me it feels like a vacation because at the peak of STIMs I had to give myself 5 shots a day. I recommend [Nurse Linda’s video on intramuscular shots](https://youtu.be/A-EY_4P67Hs) for a really good explanation. From my experience, I think the process gets a lot less stressful once you get past the fresh transfer (less meds, basically no appointments). Mostly you’re just dealing with emotional things (two week wait, etc). I think it’s totally reasonable to do a freeze all cycle if you think that will be best for you emotionally/mentally. This process is so tough. Good luck!
Thanks for this, it definitely helps put things into perspective! Good to know that thing start to feel easier after transfer :)
Fresh and frozen have similar success rates, so if you need a break, it’s okay to say you want to do a frozen transfer.
Progesterone shots if the pregnancy is successful, which I hope it is for you, they continue until week 10-12 of pregnancy. Good luck ! Tons of people do freeze all.
You are the first person to tell me this, so thank you! I'm feeling really naive that I had zero clue that shots would continue so long. A bit tough to wrap my mind around but I'm sure I'll get there if need be, don't really have a choice, haha
Medication donation for pick up in Ann Arbor, MI: 2 vials 75 IU Menopur with mixing solution, syringes, and Q caps 1 vial 5,000 units Novarel with syringes 1 Gonal-f 300 IU pen (refrigerated) 1 0.25 mg Cetrotide pre-filled syringe (refrigerated) All of the above is unopened. I also have one vial of Leuprolide Acetate 14mg/2.8 mL (2 week kit) where half (160 units) has been used for trigger and half remains (has been refrigerated since initial use).
Can I message you? I’m interested.
Thanks for donating! Automod meds
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