IVF protocol

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IVF protocol

Postby babydreams2 » Tue Jan 27, 2015 11:12 pm

Hi all,

I went to 2 different REs that gave me opposing IVF protocol advice and I desperately need help deciding what to do! I'm SO confused and stressed and hoping you all can share you protocol with me. I am 39, with normal hormone levels, AMH in normal-low range, and had 4 IUIs with clomid (50mg). Both docs suggested PGD. One doc (she's young, smart and not as experienced) advised a " low-dose estrace/clomid cycle with PGD and FET", preceded by 3 weeks of estrogen and testosterone. She's the one who did my IUIs and thought it was my best chance for quality eggs and without overstimulating. Second doc (22 yrs experience but doesn't know me well yet) suggested: a standard protocol of BCPs for 5 days, then injections twice a day with a fresh embryo transfer on day 6. My first doc said you can't do a transfer on day 6 and since PGD is done day 5, and that i'd have to wait a cycle and do FET the next one. So do I do the low-dose plan that the doctor who knows me picked, but will take 4 months for one cycle and it's $10k more expensive! Or do I go with the other doc who doesn't know me but is experienced and get it done in 1 month for much less $$?

Please answer if you'd be so kind:

What's your age:
Fertility challenges:
IVF protocol:
Suggestions for me:
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Re: IVF protocol

Postby Sunshinetex » Wed Jan 28, 2015 7:14 am

Babydreams, that is tough. I would look at success rates for both clinics. I am doing my first cycle of ivf and there is no re near me. But, there were several within 2 hours. I looked at their over 40 success rates and then chose. I felt like I did not have a lot of time to wasteland I wanted to work with a dr that didn't just work with young women. I hope this helps. Good luck!!

Oh, also, I have a blocked tube. I am 40. Df had motility issues, but after stopping his testosterone replacement therapy, he is back to normal. My protocol is a long lupron(bcp 3 weeks, overlap 1 week on lupron, then 2 more weeks lupron, then start stims and lupron). Conservative approach.
Me - 41
BF - 39
TTC #1 - Sept 2012

Hsg October 2014 - blocked tube. Straight to ivf
Ivf #1 - feb 2015 - bfn
Ivf #2 -may 2015 -
5/7 - 10 eggs retrieved, 9 fertilized
5/12 - et. 5 day transfer - 1 blastocyst and 2 morulas - bfn
7/2 - surgery to remove/repair tubes - tubes cauterized
Ivf #3 - sept 2015
9/10 - 13 eggs retrieved, 10 fertilized
9/15 - et 5 day transfer 3 blastocysts....
9/24 beta 152 9dp5dt
9/28 2nd beta 248 13 dp5dt
9/30 beta #3 468 15dp5dt
10/3 beta #4 1672 18dp5dt
10/9 u/s 1 baby
10/19 u/s 1 baby with heartbeat of 140. Due June 3, 2016.
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Re: IVF protocol

Postby marb » Wed Jan 28, 2015 11:51 am

Hi babydreams. I am so sorry for all that you have had to go through so far! It is tough to make the decision about IVF, and all the info can be a little much when all the other steps in the fertility game are fairly straightforward. The good thing is that we have choices!

I did all my IUI's with my OB, then met with her recommended RE and did research on other RE's in our area, looking at success rates, etc. I went with the first RE because I appreciated his scientific approach - he is the first one who was frank about our odds and didn't just say, "Don't worry, it will happen for you."

What's your age: 36
Fertility challenges:
Unexplained infertility; looks like DOR - husband is fine. TTC 4 years now. Tried it all; no BFP ever until IVF#2, which resulted in mc at 6 weeks.
IVF protocol:
Most recent cycle: 6 weeks BCP (so hard to wait!!), then Lupron 20 for 12 days, down to Lupron 10 3 more days. Stims started (end Lupron for me; this is unusual) with 450u Menopur and 450u Follistim (also unusually high doses for most). Then retrieval and a 5-day transfer.
Suggestions for me:
I think it is so important to work with an RE whom you trust (and their ultrasound techs and nurses - they are a huge part of it). Trusting them and getting good support from them makes a huge difference in your stress level through this whole thing. So, #1 piece of advice is get to know them as much as possible and decide if they will be helpful/detailed/trustworthy.

Also, I wanted to let you know about this clinical trial that was recently posted on the IVF boards. If this cycle doesn't work for us, we may pursue it. Helps with out of pocket costs for self-pay.
http://www.theivystudy.com/qualify.aspx

Best wishes and good luck!
Me: 36 DH: 34
Married 2010 (yay!) TTC - 4 years
Unexplained infertility, moving toward diminished ovarian reserve :( - DH is stellar
Clomid, Clomid w/ trigger, IUI's 2013 - all BFN
IVF#1 - June 2014 cancelled cycle due to low response to stims ("sluggish ovaries")
IVF#2 - Aug 2014 doubled stim meds, BFP w/ low but doubling HCG's, m/c ~ 6 wks, lingering HCG's - 2 snowflakes
IVF#3 - Jan 2015 one perfect embryo transferred, BFN
marb
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Re: IVF protocol

Postby Adventurer » Wed Jan 28, 2015 6:09 pm

Hi baby dreams. You are in a very similar situation that I was. I started IVF at age 39. I do not recommend the first protocol AT ALL. You need more conventional IVF. If your 2nd doctor wants you to do PGD, he probably means to do it at day 3 where the results will be back by day 4. You could even do a day 5 transfer. Does your DH have any fertility issues? If so, I'd recommend ICSI. I got it done on all my cycles even though DF doesn't have any issues. I wanted to make sure they fertilized. Dr. Sher in Vegas, my RE for cycle #4 routinely does ICSI on all his patients, male factor or not.

May I ask what is your AMH, FSH and antral follicle count?
Me - 41
DF - 35
AMH 23.8 pmol/L
Supplements: Ubiquinol 600 mg, Folate, vit D3, vit C, vit E, vit B6, Omega-3, royal jelly, L-Arginine, Chinese herbs
Acupuncture: 2x/week
IUI #1 (1/14): Femara 12.5 mg CD3-7, 3 follies, BFN
IVF #1 (2/14): 7 eggs - 5 fertilized with ICSI - 4 blasts biopsied for PGS/4 snowbabies - 1 abnormal, 3 no result
IVF #2: (4/14) 19 eggs - 13 fertilized with ICSI, 5 blasts/snowbabies
IVF #3: (6/14) 16 eggs - 10 fertilized with ICSI, 4 blasts/snowbabies
IVF #4: (8/14) 33 eggs - 27 mature - 22 fertilized with ICSI, 2 day 5 blasts transferred - BFN, 10 snowbabies, 4 remaining PGS normals
FET #1: (11/14) single embryo transfer - :bfp: at 5dp5dt
Beta #1 at 8dp5dt 134
Beta #2 at 10dp5dt 383
Beta #3 at 12dp5dt 955
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Re: IVF protocol

Postby babydreams2 » Sat Feb 21, 2015 9:14 pm

Thanks so much for the support ladies! I have not been able to check this board lately as so busy with work.

Adventurer - My AMH is 1.33, FSH is 5.5 and Estradiol 48, and AFC varies by practitioner from 5-8.

So after I posted here, my DH and I visited 2 more REs and got 2 other protocol suggestions! It amazes me how each experience is so different and that I can get so many different ideas from docs based on my same information. We decided to go with the RE that we liked best (was warm and kind) and had the most clinical experience. So my protocol is: 11 days of BCPs, had the sonohystogram and mock transfer, going to start meds on Monday 2/23 (SO excited to get this show on the road....and nervous). Meds are pretty heavy duty: Follitism, Menopur, Ganirelex, and then Omnitrope (growth hormone). I was watching a video on how to administer a couple of the meds and it's so involved!! I thought I'd just pull out a loaded neddle, insert and be done. But I have to mix up these things myself..seems like a lot of ways I could mess it up.
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