Frozen Embryo Transfer--Your experience?

[primipara]

Long time lurker, first time poster...

So, my first IVF cycle was just canceled due to the risk of Ovarian Hyperstimulation Syndrome (i'm 30 with PCOS). My estrogen crested above 12,000. On 12/2 they harvested 39 eggs and I had 32 blastocysts frozen on day 2. Sure enough, despite shots of Ganirelix & Cetrotide to bring down my hormone levels, I came down with a moderate to severe case of OHSS.I'm feeling much better now after 9 days of horrible bloating and passing out.

So now we are looking at a FET, feeling very blessed that we have enough in the bank for a few tries.

I'd love to hear from some women who have been through it--side effects? supportive and alternative therapies you used during the process? Success stories?

Especially like to hear the drug protocols used. FET I know is less intense in general, still, I'd like to come to my doctor with some less invasive alternatives for the next round after putting my body through all this.

[crazyrunningmama]

Hiya!!  I can't remember all the med info, but my first dd was the result of a FET and I remember it seeming sooooo much less intense.  I did find that accupuncture helped ( or did it?  hard to know ).  I had it weekly in the lead up to the transfer to prepare the uterus and before and after the transfer.  Good luck to you and pooh pooh on OHSS, that is some harsh stuff.

good luck :goodvibes

[Pearl1]

Edited by Pearl1 - 2/7/11 at 4:00pm

[Crunchy Frog]

Wow, what a lot of embryos!  Congratulations.

My twins were a result of FET.  I went through two rounds of IVF in my mid thirties specifically for the purpose of freezing all the embryos and keeping my reproductive options open.  They had been frozen for about 10 years when I did the transfer.  I had a total of 25 embryos from the 2 cycles, frozen at the 2PN stage (that's right after fertilization.

The process itself was a piece of cake compared with the IVF.  I don't recall all of the drugs or dosages, but they basically put me on the pill for a cycle and then started on a tiny dose of Lupron.  They then put me on estrogen patches to build up my uterine lining.  I never had to do the PIO injections.  They let me use a progesterone suppository instead.  Those were the major drugs and I didn't feel like I had any bad effects with any of them.  There were also antibiotics and a few days of Prednisone at the time of the actual transfer.  They also had me do baby aspirin.

At the time my embryos were frozen, the technology was not as good as it is now, so they on average have only about a 75% successful thaw rate.  We decided to thaw 8 of my embryos.  2 of them did not survive the thaw.  Of the 6 that survived the thaw, 2 of them never began dividing, but the other 4 did.  They originally wanted to do a 5 day blastocyst transfer, but decided to do a 3 day transfer instead due to the small number of embryos left.  On day 3 there were 2 really good looking 8 cell embies, 1 7 cell, and 1 6 cell.  The doctor said he could transfer all 4 if I wanted.  I really was afraid of high order multiples so I wouldn't allow more than 2; the 2 best looking 8 cell ones obviously.

Anyway, they both took and were born 31 weeks later to the day (6 1/2 weeks premature, but healthy). 

A few days after the transfer I got a call from the embryologist saying that one of the remaining embryos had grown out to a good looking blastocyst and had been refrozen, so I think I made a good judgement call in not doing more than 3.

I continued the estrogen patches and the progesterone suppositories through the first weeks of pregnancy.  They began weaning me down fairly quickly though and I think I was off everything by about 10 weeks.

I didn't do anything else other than the bed rest.  I kind of utilized the power of negative thinking; I was absolutely certain that it wasn't going to work.

Best of luck to you.  You might want to see if you can do the progesterone suppositories instead of the injections.  I honestly don't think I could have done it if I'd had to do the shots.

[primipara]

Thank you all for the information and good wishes!!!

I got my protocol from the dr. yesterday: birth control pills, then estrogen patches, then progesterone. No Lupron. My first baseline ultrasound will be 1/10 targeting a transfer on 2/1 or 2/2.

Crunchy Frog, that's an amazing (and inspiring) story. I swear I'm going to start recommending some of my single girlfriends to freeze either their eggs or their embryos after this. I know what you mean about the "power of negative thinking" :)

For Progesterone, my doctor is recommending the injections but I am planning on asking her (again) if I can do the suppositories, they seem sooo much easier. And for the entire 12 weeks, it's just crazy!

If anyone else is curious, I'm seeing an acupuncture/Chinese medicine specialist who is just amazing and in addition to what the doctor's doing, she's focusing on my blood and my liver. Floradix (liquid iron supplements), B12, cut alcohol, cut back on carbs...and relax.

Primipara

[Crunchy Frog]

Originally Posted by primipara 

For Progesterone, my doctor is recommending the injections but I am planning on asking her (again) if I can do the suppositories, they seem sooo much easier. And for the entire 12 weeks, it's just crazy!

Primipara

I would really push for the suppositories.  From what I know of the PIO, it is thick oil that is injected directly into a muscle, and the needle is something like a railroad spike.   At my clinic they base the dosage and length of administration on your blood levels.  From what I remember, the placenta begins producing estrogen and progesterone quite early.  I think by around 8 weeks my own production was skyrocketing and they were pretty close to completely weaning.  My RE apparently feels that the suppositories are just as effective for most women and that it reduces stress to not have to do the injections.  FWIW, I think my RE and clinic are considered to be close to the top in the country.  I can send you more info privately if you want.

Another thing they did was forbid all caffiene including chocolate for the entire pregnancy.  On the chocolate front, I avoided it for the entire first trimester but then gave myself permission to eat as much as I wanted.  There have actually been studies done linking dark chocolate consumption to a lower risk of preeclampsia.  It didn't work for me, but it was fun trying.

Please keep us updated on your progress.
 

[ratgrl]

I'm 12w5d with my snowbaby. Our first IVF cycle succeeded and then ultimately crashed and burned, but we had a bunch of frozen embryos (not as many as you though, holy cow!).. 

My experience with the FET in relation to the fresh cycle was that it felt. like. it. took. FOREVER. I felt like it was never going to end. My protocol was oral birth control, followed by estrace + lupron, then adding the PIO shots just before transfer. We transferred two and I have one healthy critter growing. Psychologically I found the cycle to be MUCH harder on me, even though the physical stuff is so much less intense. I just had a really hard time with how long it all took, whereas I felt like with the fresh cycle I was proactive throughout it with the bloodwork/ultrasounds/visits being so often. 

Good luck and I hope you get a snowbaby for a Valentine's day gift ;)

[BellyBean]

Thanks for starting this thread!

It looks like we will be doing our first FET cycle in Feb.  We were lucky to have a baby girl from our first fresh IVF.  We transferred two day 5 blasts, and had a singleton.  With this cycle, I am much more worried about twins, but don't really have the money to do multiple FET's.  How did you guys decide how many snowbabies to transfer?

My protocol sounds really easy (especially compared to IVF).  I will go in next week for an exam and start estrogen (he didn't give the brand name over the phone), then start progesterone suppositores a few days before transfer.  He didn't mention how long I would be taking those....so the whole first trimester thing comes as quite a shock!  I hope it isn't that long!  I wouldn't want to do the shots since it is the muscle, too bad it isn't like lupron, then I would take the shots over suppostitories because they are so gross and messy.

[blueyezz4]

Primipara-   Wow, 32 blast frozen - you go girl!!!!!  Sure glad you are over the OHSS... can't even imagine the pain you were in!!!   We are hoping to do a FET cycle either Feb or March and I'm thankful that you started this thread.  It is weird b/c I read all the posts and it looks like no one else, but me, is going to be on FSH for their FET cycle.  Hmmmmmm?  Weird.  My Dr. likes to have people on a low dose of FSH and get like 1 or 2 good follies and then trigger like you normally would and then do the transfer.  I guess it is suppose to be a way to trick your body into thinking you are going through everything like normal (or as normal as that can be, i guess).  Good luck to you and feel free to come join us in the "Winter - IVF forum".  There are several of us on there that are doing FET!!!

Ratgrl - good to see you!!!!  Hope you are doing well!!!

[Momsteader]

Primipara, if they were frozen on day 2, they're probably 2PN. They'll thaw and grow out to blasts. Or that was my experience. I did a fresh, then two FETs. Twins/lost one 15w/delivered singleton at term, failed FET of 3, and then FET 3 again twins/delivered at term as well.

As far as meds, sounds exactly what I took for both FETs though we did both Crinone suppositories and PIO injections. The injections really weren't all that bad! I did them myself, applied Arnica gel afterwards and didn't even bruise. They really were not all that bad. I did them in the hip rather than buttocks which some clinics push instruct. But, my shot educator showed me how to put my right thumb on my right hip, then spread the fingers back a bit. I'd then inject with my left hand into the space between my first/second fingers. I didn't jab it in like they did, I broke the skin and pushed it in slowly, then drew back to check for blood, then injected. I did mock/fresh with PIO in olive oil, but reacted to it on first FET (itchy welts at injection site), so I went with the PIO in cottonseed oil which I found easier to inject. I tapered off the PIO by 12 weeks, but continued the Crinone until 15w. 

Personally, I'd rather have done the injections than dealt with the discharge from the Crinone!!!!

[goldfinches]

I have heard really good things about acupuncture.  Glad you're doing it.

I just posted recently about PIO.  It's how I started, many years ago, and I am confident in it.  But, I've also used the supps, and they worked just fine.  It's a bit uncomfortable, though, to use them.  They dissolve a little while after they're inserted and the shell leaks.  It takes a lot of trust, though, to let someone else shoot you.  (My dh did mine...)

Btw, a "blast" is a 5 day old embryo.  Are you sure yours are blasts?

[BellyBean]

I am not sure if anyone else is intersted, but I found some statistics on singletons and twins via IVF and FET.  Being a "numbers" person, I liked their explanation....if only it made the actual decision easier.

Just thought I would share.  Glad to hear all the FET success stories!!!

"the overall success rate goes down from 80% to 50% if someone elects to do a SET. Which kind of makes sense: assume 100 women, 20 don't get pregnant, 80 do get pregnant, and of that 80, about 26 have twin pregnancies.

If you do SET with those same 100 women, 26 would become pregnant with one embryo no matter what (they were the twin group), 20 would be BFN no matter what (they are the group that didn't get pregnant with two embryos). The remaining 54 who had singleton pregnancies with the double transfer - with a single transfer, assume only half of them would get pregnant with a single transfer (because they transferred the 'best' two embryos which may have been indistinguishable). So 26+26 = 52% pregnant with a SET.

So... one way to think of it is
DET 80% pregnancy and 26% chance twins
SET 50% pregnancy and almost zero chance of twins (I don't know the stat, but in some ways I don't worry, because we have no way of controlling if an embryo splits)"

[goldfinches]

Originally Posted by BellyBean 

 I am much more worried about twins, but don't really have the money to do multiple FET's.  How did you guys decide how many snowbabies to transfer?

I read your research.

Interesting.

I had 1 successful fresh IVF and 2 successful FET's.  1 unsuccessful FET.

For the successful ones:

I became pregnant with a singleton for my fresh cycle.  Delivered one baby

I became pregnant with twins from a  transfer of 2 3 day embryos.  Lost one twin at 9 weeks.

I became pregnant with twins from a transfer of 2 5 day embryos and 1 3 day embryo.  I lost one at 5-6 weeks.

So, it was true for me.

The decision of how many to transfer for us was this.  We were okay with twins.  We would not reduce no matter what number of babies we ended up pregnant with, but we didn't want to be irresponsible.  So, we didn't want to transfer more than three, since we didn't figure all 3 would make it.  So, we thawed until we had 2 good looking embies, and transferred them each time.  The last time, we just had 5 left, 2 didn't thaw well, leaving 3, and we transferred all 3.

Hope this helps you with your decision.

[Momsteader]

You might also ask your clinic their rates of twins/triplets. The clinic we used hadn't had triplets in nearly a decade and so we were  pretty confident that transferring 3 in a FET wouldn't result in triplets. 

[colsxjack]

My wife and I are doing an FET in Feb. She took the pill for a month, now lupron, then next week she has a lining biopsy (which has shown to increase implantation in the month it is done) an ultrasound and blood work, then estrace, another ultrasound and PIO, then transfer. Continue on PIO and baby asprin until 12 weeks. We have never tried baby asprin before. We thought it was for people with clotting issues. Our RE said that newer research has shown that baby asprin for women even without clotting issues has shown to increase rates of pregnancy so he does it.

We have had 4 failed medicated IUI's. A failed single embryo IVF and a sucessful two embroyo FET. The last FET was pretty much the same protocol without the asprin. We transferred two and became pregnant with twins but one didn't grow a baby and was absorbed. We have a healthy 18mth old DD.  We have 7 blasts frozen and are going to transfer two. Hopefully two will thaw.

[lalalola]

I just did a FET in December, I was on superfact (sniffing drug, can't remember what it did).  Then I did estrace and started prometrium a few days before the transfer.  My clinic also has us on asprin 81 (baby asprin).  I transfered 2 embroys (day 3) and am pregnant.  One was a only 4/8 cells and the other was 7/8 cells.  I will find out on Monday how many are in there.

FET are so nice compared to IVF.  I thought I was a superstar (retreived 30 and fertilized 24) but you girlfriend are the superstar.  Can't even imagine how crappy you felt due to OHSS.  I didn't hyper stimulate, but was close. 

I had done 1 fresh and 1 frozen cycle before this one stuck!  I found that this time, I was more negative in my thinking.  I didn't really take it that easy like I did in the previous cycles.  I also did not take the baby asprin and took ASA 81 instead and my lining ended up being thicker.

I hope you have a successufl cycle. 

[primipara]

Thanks everybody for your posts, all the info, and messages of support!! CrunchyClark, you're right, my 32 little potentials are 2PNs (frozen on 2nd day) and will grow out to 5th day. Colsxjack,blueyezz4 best of luck to you. Blueyezz4

I will join you guys in the IVF forum as soon as I know my schedule--read on.

Ok curveball time. I took birth control pills for approximately 10 days and went in on January 10th for ultrasound only to find out that I had not sufficiently suppressed. I had an enlarged follicle and I had ovulated sometime in the past week judging by progesterone in the blood. Considering I have PCOS with oligomenorrhea, about a 45 day cycle usually, this was pretty suprising.

So instead of going straight on the estrogen patches I went on Lupron shots, plus Estrogen patches, plus progesterone suppositories (the last two were just in case I had happened to conceive on that random ovulation--wouldn't that be a cosmic joke.) So now I know what I'm getting into with the suppositories. They definitely are a bit messy!

This Wednesday the 19th I went back in for blood again. No BFP. The dr. wanted to test for something called "late-onset congenital adrenal hyperplasia" which is very rare, but can mimic PCOS and would explain the presence of progesterone. 

Right now I am doing daily shots of Lupron and waiting to get that test result back and to hear about what the new plan is. I am hoping this hasn't set back the schedule too far but I really have no idea.  Instead of the original 1st or 2nd of February we may be looking at mid February or even March. I am stressing because I have a ton of work travel planned in March. I will cancel if I have to but there's just no way to know for sure.

I am feeling pretty beat up after the interrupted IVF cycle, OHSS and now this! It is hard b/c we had just opened up to a bunch of friends about the process, back during Thanksgiving, and now we have to keep updating them with delays and bad news. 

From what everyone writes it sounds like there are almost as many protocols as there are doctors out there, but it is great to hear the success stories. Thanks so much!

PS> We are hoping to do a single embryo transfer, if the quality is good enough, because we have so many and I'm only 30.

[Momsteader]

I hope it doesn't set your cycle back too far either!   I think anyone who has even the slightest, even casual experience with IVF knows there are a million ups and downs and I doubt your friends mind hearing if you don't mind sharing :) 

And I think you're totally right about the protocols!  It's like 30 ways into the same spot in the city. Everyone has their favorite 'quickest' route, but you all get there at basically the same time! LOL  End result everyone desires is pregnancy, and I think all the protocols are roughly equal. Your doc has his 'fave' way to do it that works for him and his patients.

Once they find out if you are are adequately suppressed, they should be able to predict out your calendar fairly closely.

Good luck :)

[primipara]

Thanks so much for the encouragement--my blood yesterday looked good and I am going in for an ultrasound on Wednesday, hoping to start stimulation by Thursday.

[blueyezz4]

Originally Posted by primipara 

Thanks so much for the encouragement--my blood yesterday looked good and I am going in for an ultrasound on Wednesday, hoping to start stimulation by Thursday.

Awesome!!!!  Fingers crossed for you primipara!!!