(Closed) 1 Year + TTC/TTC with Infertility– Part 29

posted 3 years ago in TTC
Post # 106
Member
2420 posts
Buzzing bee
  • Wedding: April 2014

vanike :  I was on 4 injections a day: gonal f and lupron in the morning between 6-8am, menopur and lupron at night between 6-10pm (I had to do the same time daily between those hours, though). You should get a calendar that tells you what time of day to take them.

Post # 108
Member
854 posts
Busy bee
  • Wedding: May 2013

vanike :  I did a microdose lupron flare protocol, and I had injections in the am and pm. I know I did lupron 2x/day, but I don’t remember if I had follistim am and menopur pm like Beverlygeese, or I had them each both am and pm. Hmm…interesting. I could go back and look at my notebook,  but basically it will depend on your individual protocol. 

Post # 110
Member
3564 posts
Sugar bee
  • Wedding: September 2013

vanike :  Ugh, that’s so annoying!  Can you plan to leave for lunch around the time the lady brings the baby in? Luckily I don’t have any female coworkers that could possibly have more kids, but there have been several instances at work dinners/parties where I get the side eye smirk from them if they notice I’m not drinking anything.  At that point I’m pretty much forced to say that no, I’m not pregnant, I just don’t want to drink. 

Post # 111
Member
523 posts
Busy bee

hollyberry4 :  I did two weeks of bc before my IVF cycle. I got AF, had a baseline ultrasound/bloodwork, two weeks of bc, had ultrasound/bloodwork and went off the birth control once the bloodwork results were back. Off bc for one night and then started injections the following night (so last pill Thursday, nothing Friday, gonal f/menopur started Saturday PM). Don’t be freaking out like I did, I got a withdrawl bleed on Sunday AM due to stopping the bc. It’s a lot of waiting but once you start stims, everything goes quickly until retrieval and then time stops again.

Post # 112
Member
523 posts
Busy bee

vanike :  Arg! I hear ya, my coworker just had a baby and at her baby celebration before she went on maternity leave one of my other coworkers said “your next” to me. They know nothing about my situation and in my head I told her “it better be me next!” Thankfully I’ve stopped thinking “I’ll be pregnant before xxx has her baby.” 

I wouldn’t go to lunch with the group either.

Post # 113
Member
516 posts
Busy bee
  • Wedding: May 2013

MrsLondon :  Congrats on the transfer! 

Post # 114
Member
516 posts
Busy bee
  • Wedding: May 2013

I was just rereading my email from my appointment from the RE earlier this month and I just noticed he indicated what protocol he’d recommend. This is what he said:

If it comes to IVF, I would recommend an ovulation induction protocol using a drug called letrozole to keep estrogen levels down, and then electively freezing the embryos and delaying embryo transfer to a later time when the fertility drugs are out of your system.

So as a IVF newbie, what does the first part mean?  

Post # 115
Member
854 posts
Busy bee
  • Wedding: May 2013

WillowB :  letrozole  (also called femara) is a lot like clomid (estrogen antagonist), and my understanding is that it is sometimes used in women they suspect would be hyper responders, and at a high risk for OHSS, like women with PCOS. I would say that is especially what he’s thinking given he suggested a freeze all cycle,  since OHSS is especially bad if you get pregnant wth a fresh transfer. 

Post # 116
Member
229 posts
Helper bee
  • Wedding: July 2011

hollyberry4 :   WillowB :  thank you!

How strict are the restrictions after transfer guys? I went to a company outing at a baseball game tonight (which my dr said was fine) and totally forgot about the not lifting more than 20lbs rule. I picked up my friends 2 year old since her hands were full and held him for a few mins before I remembered and put him down. He probably weighs 30lbs. I know it’s probably irrational but I didn’t just screw everything up did I? Ugh hard to not worry so much about every little thing! It was easier to remember these things when I did my fresh cycle since I was still physically sore from egg retrieval. 

Post # 117
Member
2420 posts
Buzzing bee
  • Wedding: April 2014

WillowB :  There is an IVF protocol called “Femara antagonist” which is often used as sort of a “last resort” for women who have DOR. It is used for women with very low reserve/AFC and who have failed to previously respond to other protocols. My RE said she was willing to try it on me this last retrieval, but that it usually only generates 2-4 mature eggs. In this protocol, you use femara/letrozole in conjunction with FSH (gonal-f, follistim). The femara will block synthesis of FSH/LH/E2 but you replace that with other stims. After 5-6 days of taking this, you stop femara and add in an antagonist to finish out your cycle. The reason you would do a freeze all is because femara will delay endometrial growth as you are blocking estrogen for over half of your cycle.

I have never heard it being used in someone with OHSS risk/high estrogen because once you eliminate the femara from the cycle (and add the antagonist) your estrogen will rise accordingly to how many mature follicles you are growing.

There is, however, an EPP that uses clomid in conjunction with stims. It works sort of opposite as femara, because you generally will get sky-high estrogen levels since you 1) begin priming with them and 2) clomid tricks your brain into thinking it has low levels of estrogen so you pump out more (while working as an estrogen receptor).

Now, if you were to use femara or letrozole in an IUI cycle, that is completely different. I have never heard of an IVF taking place with only one of these medications, because it is hard to stimulate consistant follicle growth/size without having a few leads jump out. Additionally, not all follicles will respond due to lead growth, and getting a dosage correct to stimulate may take a lot of trial and error.

Post # 118
Member
516 posts
Busy bee
  • Wedding: May 2013

BeverlyGeese :  does it seem weird he’s picking this as my first cycle then?  When he’s only speculating that I may have PCOS? My AFC is 35-40 so he did say he was worried about my estrogen being crazy high and my risk for OHSS. What should I be asking him at our next phone call in a couple weeks? 

Post # 119
Member
854 posts
Busy bee
  • Wedding: May 2013

WillowB :  I would clarify with your doctor, because while everything BeverlyGeese  said about the femara antagonist protocol is true (girlfriend knows her ivf protocols!), I think your doctor was referring to a much simpler femara/letrozole protocol, sometimes called a “minI ivf”, which is basically stimming with letrozole like you would for IUI, but adding ganirelix or cetrotide to inhibit ovulation of the lead follicle to allow other follicles to mature as well. Then trigger, retrieval, fertilization, etc. Similar name, but totally opposite uses (DOR/poor responder for femara antagonist vs PCOS/hyper responders for the femara only protocol).

ETA: I think you are right to question why he doesn’t just try starting you on a regular antagonist protocol with conservatively low stimming doses, and see how it goesx especially since this is your first IVF and only suspected PCOS.

Post # 120
Member
2420 posts
Buzzing bee
  • Wedding: April 2014

MattieK :  Mini IVF didn’t even cross my mind – good point! I immediately thought femara had to be for a regular protocol, which confused me as to why someone with possible PCOS would do it.

WillowB :  I agree with @mattieK, I would definitely question the reason for choosing this protocol, especially if you have not prevoiously done IVF/been on any of the medications and don’t know how exactly you will respond.

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