Winter IVF - Page 3

[FtMPapa]

New Mama - it's great you have some answers! Subclinical hypothyroid is a huge cause of infertility, and it's really easily correctable if you respond to medication appropriately. I would take this as a good sign of good things to come.


Just got my meds. every single package insert, except the Gonal-F, says "this medicine is typically administered in a hospital, doctor's office, or clinic..." we all know that's not true with IVF, but my insurance based their denial on not paying for it on the fact that they consider it a self-administered medication, and hence subject to the tiny little pharmacy limit they impose on us.

Even the Gonal-F says it's "sometimes" used at home. I wish I had known the details on the other meds, I could have made a stronger case for them to be administered at a doctor's office.

Eh. I'll file it with my appeal. I'm sure it will get denied, but I gotta try, right? I'm debating whether I should be calling my OBGYN to see if I can set up an injection appointment every day for the next week. I think they'll do that, and it's not far from my house, certainly close enough to save myself $100 per shot if the insurance appeal worked.


How are you guys handling work and post-IVF bedrest and such?

I have a somewhat unique problem in that I work a 20-hour per week contract as a teaching assistant, but I'm only required to be face-to-face at specific times about five or six hours a week. My employer already got cranky last semester because I missed a bunch of meetings and classes and wasn't as flexible as other TAs, and I kept moving my office hours around, because of my medical stuff. This semester, it's a new supervisor, but I expect the same uncompromising attitude, because this is the US, this is academia, and that's just how it goes.

Also, I don't know exactly when my ER or transfer will be, obviously, but I'm likely to be on bed rest for the first few days of the semester, so I'm not sure what to do, it's a bad time to miss a few days, especially given my spotty track record.

Any insights? I do plan to get a doctor's note, but I'm still a little leery.

I think the word "surgery" is taken more seriously than "fertility treatment" or "IVF." I've been making arrangements for care of my dogs and such post-IVF, nothing huge, I'm just checking in with friends about their schedules to see who might be available to walk the dog, or take one for a playdate or something, and they seem kind of surprised that I might need that kind of help, so I'm finding it useful to remind people that I am having surgery. It might be a minor outpatient procedure, but it's still serious, it's not a walk in the park, and it's not as casual as people (including me) seem to think.

[5terre]

Ftmpapa At my clinic most people stim for 8-9 days, but some places do it slower. I love the Gonal-F pen. At first I didn't like it. I'm a nurse and don't mind drawing up and it seems less confusing. But once you do the pen a hundred times it becomes your favorite. Mine seems to have just the right amount; I often have to prime twice, so I lose the extra, but I have enough left to give 4 doses at 225.

Momtoalexis Glad you had a nice getaway, that sounds awesome!! LOL about you locking yourself away and even the cat was scratching at the door, I SO understand!

wahine I just did 450 of Gonal-F so I am up there with you. If this is your only shot at IVF, I think it's great they're being aggressive with your stims, they can always decrease it or coast you if it's too much. Hope work went okay. No alcohol, not worth it. Do the Anji whenever you like. I try to do it daily. Did you get it yet?

Newmama OHSS only happens when you've overstimulated your ovaries, not possible without taking stims. Interesting about your thyroid.

My ER is tomorrow morning. I ended up with just 5 follicles, I'm disappointed, I thought this one would be better than the last, not worse. But I'm trying to keep hope, there's still a possibility that we could make it to a transfer this time.

[FtMPapa]

5terre - Good luck! Hope it goes well for you!

Five isn't a lot, but hopefully you've got enough for PGD and transfer.

I hope this is the start of a very happy and healthy nine months for you.

[FtMPapa]

Oh, and some good news for me for a change. . . my insurance finally approved cryopreservation of the embryos, if I have any to freeze, they'll pay for it.

They originally denied it, then said they wouldn't make a decision until the embryologist's report was ready...and that it might take 20 business days to make a decision.

But clearly common sense has prevailed.

[wahine5]

FtMPapa: Excellent news about insurance covering cryopreservation !!! Thank God they finally came through. I would most definitely try to get the injection at the clinic to save the $100. Do it if you can. About missing work... I'm just going to call in sick and hope the transfer is on a Saturday. I was told on the day of ER, you need to go back home and rest. ET, they say rest that day and the day after. Is it really bed rest? I would have walked your dogs if I were there . Can't wait to hear your news from your us tomorrow !!

5terre: Good luck tomorrow !!! I wish you a speedy recovery. How exciting !!
I did get the cd and listened to it yesterday. I'll listen again tomorrow. Somehow I am finding it hard to take 20 minutes to listen to it. Isn't that crazy. I loved it though.

New Mama: I'm glad you got some news on the thyroid and it's corrected and leads to a fab baby.

I had u/s and b/w today. No answer on the b/w, but I still have the 10 follies. No change since day 4. They are growing, but not so fast. Size is OK. He thinks ER will be next Wed. or Thursday. RE does not suggest PGD for us. That's a bit of a relief, as otherwise we would need to come up with another $5000. Heard y'all loud and clear on the alchol.

[MOMTOALEXIS]

5terre- Good luck tommorrow. They may only see 5 now but tomorrow you may get an extra surprise and have maybe one or two more. Fingers and toes crossed for you.

wahine-10 follies sound great, I ended up with 22 eggs my first cycle and only four survived, 3 transferred and 1 frozen. not sure how great the 3 were because the re had called on day 4 and said we should do a transfer and i was suppose to have my transfer on day 5. He never did say y he did that and just kept satiying everything is fine. I think I stimmed too fast and the quality was poor. I'm hoping to stim slower this time and have less high quality embryos in the end. I'm in the same clinic but have switched RE's. I used this Re for our FET and did get a BFP with only one embie transferred, even though it didn't last long, so I'm hoping he could do it again. The other Re didn't answer a lot of our questions, he even said during our fresh cycle that maybe he will do assisted hatching and when i asked him if he was doing it, he said don't worry about all that. Still don't know if he did. So I just feel more comfortable with the other doc in the office. Let us know when er is.

FtMPapa-Good news on the insurance. We have to pay out of pocket for the cyro, 1800.00$. But atleast IVF is covered up to 3 times. Everything will be worth it in the end when we get to hold our lil ones in our arms.

CRM-Stalk away, your always full of great advice. Very funny I do the opposite of consipated and go all the time. I must be from another planet.lol. But thanks for sending your love and sticky vibes our way. We need as many as we can get.

Tomorrow Night is last BCP. YIPPPPPEEEEEEEEEEEEE

[quelindo]

5terre, I'm crossing my fingers for you. Baby dust being thrown your way!

[poetgirl]

Quietly watching and cheering you all along!

5Terre, Sending you so much positive energy for a successful retrieval tomorrow. GL!

MomtoA, I had really high estradiol on my successful cycle. It wasn't OHSS per se, but the # was over 6000. My RE told me the high estradiol made the zona thick and it would be hard to hatch and implant so we added in the assisted hatching. When I look at my two embryo photos from the 2 different cycles, sure enough, you really can see that super thick zona. If your estradiol gets high again with this cycle (and I agree slow and steady is the way to go!), I would recommend making talking that over definitively with the RE a priority.

New Mama, how quickly would you see results with your TSH level? Does the RE want to bring that down for a cycle then start the IVF? GL!

Ftmpapa, Glad to see you got the green light. It's amazing how much of an advocate you have to be to wade through all this. I felt like I mothered myself through this whole process! Hope you have smoother sailing from here.

[MOMTOALEXIS]

poetgirl-- So good to see you, thanks so much for the support. My RE never told me my numbers from last cycle but they just said it was high and not to take any estradiol supplements. I actually still have them in the draw. Thanks so much for the tip because I ahd no idea about that, I will def be talking to him when I go for my suppression check on 1/11/10. I have much more confidence with this RE and feel much more comfortable. I'll let you know how it goes.

[FtMPapa]

Follie check this AM my first check, CD 6, fifth day of stims - ten were measurable or borderline measurable, plus some small ones.

The sonographer said "it looks like a juicy cycle!"

My endometrium is already up to 7.something, which is amazing for me.

I'm a little worried about my E2 levels - I have no signs of CM or anything else, but I guess I'll find out when I get my b/w results this afternoon.

I'm a little afraid that a few of the follies are pretty big, I had a 14 and a 15, one on each side, but the rest were all around ten and eleven, so I'm hoping we can hold the big ones steady, and keep growing the small ones, but I don't really know. Just waiting on that phone call with the blood test results. . .

[DaisyMae08]

Hi everybody,
I'm glad to see that there is a winter IVF thread happening. I've stayed away for a while as it just got too difficult to keep reporting crappy news. So, we had the 7 failed IUIs, and now two failed fresh IVF cycles and two failed frozen transfers. The first fresh IVF we did resulted in a chemical pregnancy. That was last June. Now it looks as though we'll be embarking on a THIRD fresh cycle.

We've had all kinds of genetic testing done on ourselves (all neg) and we've added assisted hatching. Is there anything else we can do??? We're another "unexplained" diagnosis. I respond VERY well to stims - we get a great amount of eggs (20, 22) and we have a good rate of fertilization. Our embryos are high quality. So what now? PGD? Should I volunteer for a laparoscopy?

It's nice to see that some folks have graduated since I was last poking around here. I hope the rest of us get to do that soon too!

[FtMPapa]

Welcome back - I know what it's like to be the old-timer on the TTC threads. :fingers crossed that this is it for you.

I'm assuming you've had some sort of evaluation of you uterus, either SHG or HSG or both?

PGD might be the next step.

Would you consider surrogacy?

Have you tried acupuncture?

It seems so unfair - with that many eggs and embryos and IVF, you should have something stick by now!

One thing that sticks out is whether you've been tested for any clotting disorders, like MFTHR (Is that right?) or Factor V leiden? (I might have the names a little wrong.)

Ask your RE about clotting disorders and the possibility of doing something about that.

[5terre]

Daisy Welcome back! That is so frustrating. I hope the third fresh cycle is finally it for you!

Good luck to everyone else this week.

Had my ER today. We got 5 mature oocytes. The embryologist decided to proceed with PGD so they are thawing the 5 from last time and they will all be biopsied on Saturday. Of course we won't know if the new 5 fertilized until tomorrow. I am so nervous. It's hard to be positive, knowing that some will die from the thaw, and 2/3 (in theory, probably higher in real life) will be abnormal due to our genetic issue. All I need is one beautiful embryo on Monday morning so I can have a transfer and have a chance like everyone else, is that too much to ask?

[FtMPapa]

5terre - that this is it!


I'm switching my meds up a bit, time to start the Luveris and Ganirelix, but I'm responding well to the Gonal-F, I had ten follicles today, and they're thinking maybe two or three more of the small ones will catch up, so somewhere around 11 or 12 is likely.

I'm on target for egg retrieval next Thursday! Obviously, a lot can happen between now and then, and I have another ultrasound date with the dildo cam on Friday, so I'll keep you all posted, but things are looking good so far!

(Excpet that I am so lazy. I can't seem to get out of bed. I've been having headaches in the afternoons, and I'm sluggish and tired all day, if I move around too much, my belly hurts, and my ovaries are twitching off and on...)

[MOMTOALEXIS]

Daisy- Welcome back. Sorry your still here like myself. Are you starting your 3rd fresh cycle now or are you trying to figure out if you should do laparoscopy. That idea has also crossed my mind, maybe scar tissue or something who knows. RE never brought it up so I didn't either. I have no signs of endo or anything else. Let us know what you decide.

5terre-

FtMPapa- Your moving right along, things sound great so far.

Got all my meds today. Only good thing about doing IVF a second time is I was not freaked out at all when I saw the meds. lol. Last time I almost pissed myself. Took my last BCP tonight. Thank goodness. DD just got her AF (first time last month. ) So needless to say things weren't pretty for dh. He's got the flu now so I'm being easy on him. Hmmm or maybe he's faking it to stay away.. Anyhow hope everyone else is doin good.

[DaisyMae08]

Thanks guys. It's nice to come to where people understand the frustrations I'm having.

I've done acupuncture - a lot of it. I don't think I've been tested for clotting disorders. My husband and I both had a crazy genetics panel done a couple of months ago. They took about 12 vials of blood from me, so I'll have to ask specifically what was tested for at that time.

I am most definitely considering surgery. It seems reasonable to at least check for those issues before wasting another fresh cycle (we are VERY lucky in that our insurance company will pay for 6 of them).

Right now we're just waiting to have our follow up appt. which is this Friday. We'll ask about PGD and the surgery then - and now clotting disorders also. So if anybody has other ideas, I'm open!

FTMPapa, good luck with the retrieval!!!

[wahine5]

DaisyMae08: Welcome back. Although I'm sure you don't want to be here !!
You must be so frustrated. You are a trooper, Girl. Thank God insurance is paying for 6 cycles. That is such a blessing. I have no suggestions. I'm a total newbie to IVF. What surgery would you have?

MOMTOALEXIS: Busy house !!!! What's your protocol?

FtMPapa: Wow... We're kind of on the same track What is the Luveris and Ganirelix do? I have dull headaches too. My back hurts too. Is that normal? Did you get the e2 results?

5terre: How are you feeling? Sounds like things went smooth. I have excellent thoughts going your way for the perfect embryo.

I'm a little nervous. Yesterday was my 1st u/s. This was day cd4 and after 2 nights of stims. The follicles weren't too big (10 total). I thing they ranged from 2 - 8. The e2 came in at 75. The RE was hoping for 100. They think it's ok and that I'm just a slow responder. It freaks me out, because my dose is so high already (600 gonalf). Also, I don't feel activity in the ovaries. I guess I feel fine, except dull headaches. I go in for another u/s tomorrow morning. This will be after 5 night of stims. I don't know where I'm supposed to be and Im totally psyching myself out. I better go listen to the Anji meditation before I fall apart. I'm trying to be positive, but it's just so easy to get down on the entire process. I always thought if we decided to go IVF, then it would be for sure. Now I realize so much can go wrong even before the ET. Sorry to be so negative. I haven't told but 1 friend and my mom about the ivf. This is my only outlet. Thanks for letting me vent.

[FtMPapa]

Originally Posted by wahine5

FtMPapa: Wow... We're kind of on the same track What is the Luveris and Ganirelix do? I have dull headaches too. My back hurts too. Is that normal? Did you get the e2 results?

Sounds like it!

Luveris and Gonal-F is the magic combination apparently. It's my RE's favourite, or so it would seem. Luveris is in the same family as Menopur and Repronex, and possibly Bravelle. I have lost track of all the drugs. The Luveris/Gonal-F combo is supposed to be really good for stims.

Luveris is about $40 for one 75 iu vial, compared to the Gonal-F which is $300 per 225 IU shot.

Tonight I managed to get an extra 75 out of the "empty" pen, and then I used a syringe to get another approximately 75, so I figure I saved myself about $200.

Ganirelix is usually started when the lead follicle is around 14 mm, which is where I'm at. Its role is to make sure I don't ovulate on my own before the retrieval, and it runs about $100 per shot, one shot per night.

The good thing about taking all three drugs is that the Luveris comes in powder in a vial, like hcG, but I can skip the water, and simply inject the Ganirelix and Gonal-F into the vial, and then it's still only one shot. A little more hassle than the pen, by the time you load the pen, and all three drugs and swirl, and switch syringes, and draw it up....it's a ten minute process to get it all arranged.

I have ten vials of Luveris and five Ganirelix, so I think I might have a few Luveris left over and be short a few Ganirelix...so hard to get this stuff right.

And you know, after all that waiting for the clinic's phone call, I didn't remember to ask for the actual E2 numbers. They're low, I know they are. I can feel it. I'll find out on Friday.


I'm doing the Anji meditations, too! I've had her sample downloads for a while, and I just got the IVF CD and the Fertile Meditations or something CD this week.


It sounds like you're right about where I am - 10 follicles, I'm a day ahead of you, I am on CD 6, and I had 4 days of stims. Does your RE do Menopur or Luveris or whatever? Maybe you could add that to the Gonal-F? I doubt they'll want you on more Gonal-F, it sounds like you're at the max. It does sound like you might be a slightly slower responder than I am, but not a low responder, you are getting somewhere. Just hang in there, it might take an extra day or two, but you'll get there. Remember that at that size, follicles are hard to measure.

My u/s clinic doesn't measure anything under 10, and my R/E's office sonographers don't measure anything under 12, my old R/E measured over 10. The measurements can easiily be off my a MM or so, too, because follicles aren't symmetrical, and different angles and such.

I'm waiting 'til Friday for my next wanding, I'm jealous you get to go back right away!



Do any of you guys have weird superstitions and habits for IVF? I wear lucky socks on days with appointments that require my feet in the stirrups. Today's were black with purple, mauve, and grey stripes. My donor/partner(in babymaking) and my friends who are in the know think the socks are hilarious. I have a whole assortment of novelty socks, the more outlandish the better.

[5terre]

Wahine Just a quick reply, if I can help decrease your anxiety. Two days of stims is nothing. My clinic doesn't do ultrasounds until day 6 or 7 of stims (but they do bloodwork), and that is the point where mine are past the 10mm threshold. Some people start off slower and don't have high E2 right away. Also feeling 'activity': my opinion is this means nothing. I start to feel it around the third day of stims and by the 5th-6th day I feel like I have 200 huge cramping follicles (but in actually I have only a couple). And then there are other people who get 30 follicles and feel nothing at all. So don't worry if you don't feel it, but if you do, look at it as 'they are growing'! As far as adding other drugs, Gonal-F, Follistim etc are pure FHS. Repronex is half FSH, half LH. I have been on it and there is a lot of debate about too much LH being bad for quality. I believe Luveris is pure LH. You are already on an aggressive protocol. It's good to be realistic, but I think it's too early for you to be worried.

[wahine5]

Hi Guys...
I had the 2nd u/s this morning. This test is after 4 days of stims. Seems 3 of the 10 follies stopped growing and now we only have 7. Looks like 2 of those are not going to get any bigger. So we might have just 5. That's fine with me. All we need is for just 1. I might have to be gonalF for a couple more days. We'll see on Saturday at the next appt. I don't have the results of e2 yet. Re thinks I'm doing OK, not great. I suppose I don't really have a choice in the matter. We're just doing the best we can.

5terre: Thanks for the advice and support. I kind of feel some movement in the ovaries today. How are you feeling? Are you sore at all? The ER hurt the next day?

FtMPapa: Thanks for the explanations.... I don't know if my clinic uses any of the other meds. I'm sure they do. Maybe I'm not a candidate. How do you like the Anji meditations? 1st night I listened they were great. I tried to listen again last night, but I couldn't relax into it. I have some crazy striped socks on today.