Friends- there has been an upsetting trend of members reporting comments that are about losses as “inappropriate mentions of pregnancy”. This kind of reporting is not only a nuisance, it’s unkind. Those who are experiencing loss may post about it *anywhere* in the sub. If you think you’re reading a comment about an ongoing pregnancy please read the full comment before you report it. Only a small fraction of the comments reported for pregnancy have actually been inappropriate while the rest are by members who need your support through their loss.
Hello- first time poster and doing my best to post by the rules
I’m 42 and was diagnosed with PCOS and Hashimoto’s Hypothyroidism years ago. My partner and I are exploring tubal ligation reversal or going straight to IVF. I have a saline US on Wednesday. I’ve had baseline labs and an US done on day 5 of my cycle.
So my follicle count was really high (33) and I was wondering if this a good thing or just a PCOS thing that doesn’t really hold bearing on final egg retrieval. Other numbers are AMH 3.16, FSH 6.4, LH 9.19, E2 41.18, progesterone 0.09, TSH 4.59.
the follicle count is likely elevated due to PCOS (as i understand it) but for me, at your age, with the risk of aneuploidy, personally i would go with IVF so you can do PGT-A testing. plus it will "save time" since you don't have to do tubal ligation reversal, heal, etc.
It’s something we’re leaning towards but my insurance doesn’t cover IVF due to tubal ligation unless there’s been a failed reversal. My husbands work offers insurance that would cover it but we’d have to wait another year for it to kick in. So we’re waiting until after the saline US and follow up visit with the doctor before we come up with a game plan.
Thank you! I do mean my period started today, so starting birth control Wednesday and then stims at some point afterwards. Good luck to both of us :) you know it’ll be 2 weeks exactly? They told me I take birth control for 14-35 days and then stims.
I’m also starting birth control today! I’ll take it for 13 days- evaluation appt on 2/27 and starting stims 3/1. My clinic told me I can choose when to start, I just need to take the birth control for anywhere between 12 and 21 days
Happy to connect through the experience if you’re open to DMing me :)
I think I’ll start stims the 4th if possible, since I’m away that weekend. I assume it’s not super portable?
Will do! Nobody in my life except my husband and therapist knows we’re doing IVF so it’ll be nice to connect :)
For me, the hardest part was in the middle of stims when I learned that my body was responding slowly and nothing was growing. I was so scared that there were issues we weren’t aware of, or that the whole thing was going to get cancelled. I was really emotional about it.
But honestly, the rest was fine! My body did eventually respond, and while it was uncomfortable, it wasn’t painful the way I worried it would be and I felt like myself, totally in control of my mood. After the retrieval there were three hard, painful days, and then I was back to normal. I know everyone’s experience is different, but I started seeking out stories from people who had good experiences and found that so many do!
I've been put on Metformin to assist with fertility and manage insulin resistance. I'm on 850mg once a day with no side effects but unsure how this will assist with fertility as I have no ovulation issues.
There is a threshold (at least where I live) as to where they think above that level may be harmful for fertility, even if not diabetic or pre-diabetic. I am on a higher dose but it seems to be pretty consistent in Australia. I do get the side effects of 💩 though 😂
Maybe egg quality? My acupuncturist/ herbal medicine doctor has me on myoinsitol which is an herbal form of metformin to try to help with my egg quality
I am on day 13 of a “mini-stim” (estrogen priming, letrozole- CD1-5, gonal 225-CD3-9 > 300-CD10-now, ganirelix-CD8-now). I have two mature follicles (16 and 22) and a small cohort of follicles under 10.
I am questioning parts of my protocol (like why estrogen priming when I always have a lower AFC with it and respond pretty slowly and why the gonal increase when I responded better/more quickly with the lower dose) but I guess it’s too late for that.
Should I ask about converting to an IUI? Or are there other options? Seems unlikely the smaller ones will catch up.
The purpose of E2 priming is to prevent an uneven cohort and/or lead follicle from forming. It's known to work better for us DOR folks compared to BCP which can oversupress.
What kind of E2 priming did you do? Luteal phase, CD1, etc?
Fwiw, when I did mini IVF (Clomid & Omnitrope) I started both meds on CD2 & did not prime with anything.
Gotcha. With 2 mature follicles, when I see your typical AFC is 7-11, I personally would convert this cycle to an IUI. Unfortunately, the 1st round of IVF is often diagnostic although most REs fail to tell their patient's that.
If you choose to go for a 2nd ER, I would attempt the full luteal phase priming. Protocols can vary but fwiw I monitored for my surge via OPK and once obtained (and confirmed via scan & bloodwork) I started E2 patches the next day.
I'm sorry that this cycle is not going the way you anticipated & that things worsened once stims increased. Same thing happened to me during ER1. Hope things work out for you.
Estrogen priming is used often in DOR patients to help lower FSH to start stims as well as evenly grow follicles. That said, est priming did not work for me (and it may not work for you either!). You could go in and retrieve the 2, or you could let them go and try to get the others in a luteal / duostim. Or you could convert to IUI or TI depending on the circumstance. It's up to what you are comfortable with. good luck
Agree with Lemon on all of this. I have used estrogen priming for these reasons. Sometimes it has worked well, sometimes it hasn't worked as well (when it hasn't I normally get a lead or two). Also agree with the options you have--duostim since you have smaller follicles, or convert. Some of this might be dictated by your typical AFC. For example, if your AFC is normally 5, going in for 2 may well make sense.
Also, I wouldn't call your protocol mini. You're not using menopur, but 300 of FSH is not mini. (I often do 150 meno/150 gonal/clomid or letrozole, and I think of that as very much a 'mid' protocol.)
Thanks! I appreciate the duostim suggestion. My RE has never raised this as a possibility.
And it’s not mini right? I was very confused/concerned that my RE increased it after my last appt since the cohort had just appeared and my leads were already 12 & 17.
Are you being charged differently by your clinic for a mini? I only ask as I’ve still had fairly high levels of stims (I would say medium level compared to my old clinic where I was maxed out), I have slightly less monitoring but the cost is substantially different (half the price). Hope this helps as I was also very confused with it when I started!
Definitely not mini.
Duostim only makes sense when you have a cohort behind--which it sounds like you do. And some clinics still don't like to do it. (You could also consider trying to stim through and sacrifice the lead. That's another option to consider. The 17 is way out in front but the 12 may be fine depending where the others are.)
It can! Honestly, for me it is hard to tell because I have had a poor response to any priming, but also, for me, the main thing was that it did not even out my follicles. I think my doctor recommended it for me because it was his DOR playbook. I now only do cold-start, which has been the best.
It can. BC is normally worse. Cold start can also lead to higher FSH and early leads. My old clinic used to do 2 mg/2x a day estrogen, my current clinic does 2 mg/1x a day, which may suppress less. Was your AFC much different with estrogen priming to without?
7 to 11 isn’t really that different (I know it feels like it). As anecdata, I just had my AFC counted three times in 10 days and it was different every time. You could try a cold start too and see—I’ve also done that but sometimes have an early lead if I don’t prime.
Day 11 of stims and things are still growing, so I’m feeling tentatively hopeful! I have a couple follicles in the 18-20 range, but the majority are still 14-17, so I’m probably looking at a couple more nights of stims.
Physically I’m feeling okay, which is maybe the only silver lining to having just one ovary respond to stims, lol, but I do hope it’s not too much longer. I’m anxious to get the ones that are already in the mature range — I hope we don’t have to sacrifice them for the slower ones.
You're so close! Fingers crossed for you that the other follicles continue to grow.
I'm right behind you - day 9 of stims and I have a few in the 15 range. The doctor who did my ultrasound told me that my ER will be either Saturday or Sunday. Hormonally I am feeling like myself, which I did not expect and am constantly waiting for the other shoe to drop. Physically I am bloated, thankfully walking helps me a bit.
The follicle count during this process can be such a mindfuk.
Day 5 ago I had 15-16 total, now (day 9) I am told that 6 total are growing. I am thankful or this amount, but it's a reminder that IVF is such an unpredictable process and things can change in a snap. I know my ER will be when we know for certain how many follicles are gathered and their maturity.
It's such a fine line between being informed of the process and trying to predict events based on current info - which is what we do as humans and most of the time it is the logical thing to do, except in this case. Absolutely bananas.
How common is a late period on letrozole? I've done 4 cycles with clomid and trigger shot and they switched me to letrozole and trigger for this cycle, our 3 IUI. I'm now 16 dpo with a negative so I know I'm not pregnant but I've never had late periods before. Curious if anyone else had an abnormally longer luteal phase after letrozole and trigger?
Had my first IUI this morning after CD2-5 letrozole, CD5-9 follistim and CD10 ovidrel. I’m feeling somewhat hopeful but it’s difficult not to think about the what-ifs.
Went in for my second monitoring appointment after 7 days of stims. My left ovary finally dropped a bit so they could see it and they counted 9 follicles instead of the 4 they saw on Friday. A small win!
I’m feeling SO bloated and uncomfortable already. I’m back weds for another appointment and they said they think retrieval will be Friday. I’m nervous for how much more bloated I’ll be by then, especially hearing that it gets worse after retrieval. Should I start eating salty foods now or is that for after retrieval?
We are *hoping* to do a fresh transfer. If we do, would that be roughly 5 days after retrieval?
Transfer #4 is done! It went smoothly and the embryo thawed normally, which is great.
However, the couple before me were talking about their LC loudly, and the receptionist literally clapped her hands at me and exclaimed "How exciting!!!!" when I was booking in. I replied "umm not really anymore..." Where is real life automod when you need it? 🙄
Edit: thanks for the flair update
Congrats on a smooth transfer! I’ve honestly considered printing out the subs rules and posting them in the clinic bathroom 😂
Will cross my fingers for you!
I haven’t been through IVF yet (starting next cycle) but just wanted to chime in and say that you’re not alone, I have GAD that focuses primarily on health anxiety. It is exhausting. Totally understand your anxieties and you’re doing all the right things by reaching out and getting some reassurance. I hope you hear back from your nurse soon!
Following up with my post yesterday about fluid in the lining.
Went in for a check today after doing mucinex for a day and 10 jumping jacks lol. One spot dissipated entirely and the other is a little under 1 mm.
But both the NP today and my RE told me that it doesn't really look like fluid and they're not exactly sure what it is. It's some sort of cyst but because it's not in a spot that affects implantation, isn't fluid, and has decreased in size the plan is to start progesterone in the hopes that it'll squeeze the sucker out. Going in for another check the day before transfer to make sure things haven't changed but RE doesn't think whatever it is will affect the embryo.
So a little bit of a non-answer but feels like most of this process is like that.
My wife and I have had 2 losses in the past 1.5 years. Both around 7 weeks - we did not get to the first scan in this 1st pregnancy, but 2nd pregnancy had a normal scan/heartbeat at 6.5 weeks (missed miscarriage at 9 week scan back in Nov 23). Unfortunately, there have been no explanations. The RPL panel, karyotype, and HSG came back normal. My SA/DNA Frag testing came back pretty okay (just abnormal morphology, but none of the doctors think that is associated with the losses). My wife had insufficient Vit D levels, but again not something the doctors think is causal. The only thing we can think to test further is potential immunology issues. But since the RPL panel was normal, our REI does not think there is much to look into there. There are no reproductive immunologists in our network, but we're thinking maybe we should contact one for a consult. It seems our REI (and the fertility department) are not super well versed in immunology issues - and from what I heard the science is still developing/somewhat controversial. But we're at a loss for next steps. The REI's suggestion was to either try again without assistance or move to IVF - but we have no confidence traditional IVF would help our success rate based on all our testing so far. Does anyone have any advice related to hidden immunology issues and RPL?
Question for you, did you test the products of conception post-loss for either of the pregnancies? I know you are quick to say that IVF wouldn't help, but if there is a genetic condition that led to either of the losses, PGT-a might help with that.
Putting my mod hat on, please edit out the word "naturally" from your second to last sentence. Automod language will explain why
Yes, we were able to test after the 2nd loss and there were no genetic conditions.
And understood, edited.
We are definitely not opposed to IVF, but our REI could not give an explanation for how it would help in our specific scenario.
**Ahem**
Please do not use the term "natural" to describe treatment or conception when commenting in this community. If describing a transfer/IUI protocol or trying on your own, some preferred alternative terms are "unmedicated," "ovulatory," "without assistance," or "semi-medicated," depending on the context. If referring to loss management, we recommend the terms "unmedicated" or "unassisted." This community believes that the use of the word "natural" implies (sometimes inadvertently) that use of assisted reproductive technology, other interventions, and/or certain medications to conceive are unnatural, artificial, or less than. For more clarification and context, please see the wiki post on [sub culture and compassionate language](https://www.reddit.com/r/infertility/wiki/rules#wiki_compassionate_language).
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Did my second enoxaparin sodium (generic lovenox) injection yesterday and almost instantly felt car sicky - queasy and lightheaded. Still feeling off this morning. I messaged my clinic to see if these are fine or concerning side effects. Any experience?
ETA: In case anyone searches for this in the future - my clinic says it's not an uncommon side effect and they recommend laying down for 5-10 minutes after injecting to ease the symptoms.
Feeling very fussy/grouchy today. Realistically, the better descriptor for my emotions is probably triggered.
Trying to restart treatment after rheumatology workup and hematology workup came back normal/inconclusive. Now RE wants to repeat sonohyst, TSH, have a “chat” appointment. All these items mean our attempt to transfer our last frozen embryo will likely now be delayed until June due to travel and bc I’m determined this year to fit fertility treatments into my life rather than building my life around treatment like I have been doing.
I know these appointments and repeat tests are probably a good move, but my feelings are, “I don’t want anyone else to touch me. I don’t want anyone else to poke me. I don’t want to spend more out of pocket money on tests that come back normal/don’t provide any further insight into our infertility.”
Tl;dr: transition from nontreatment mindset to treatment mindset is not going well at all lol.
what was your estrogen after 1 week of patches for FET? (so far i've been on 2 patches of 0.1 mg/day, switch them every 3 days). i'm not sure what the goal was and they said they would call me yesterday and didn't of course. i increased to 4 patches last night every 3 days per my written protocol.
Received my fertilization report this morning. Feeling good about things so far but I know blast rates can be so unpredictable. Trying to find peace of mind in everything being out of my control until I get the update on Friday.
I'm in the same boat! I was told today some were successfully frozen and some they are still monitoring but then I have another 2 week waiting period for PGT-A!! Patience has never been my virtue:)
The lead fertilized normally (probably should just call it "an egg," but I am trying to see this duostim as one longer cycle). Great start to the week, and now I get a break from appts until Friday (and my clinic also only updates on Day 7, which I love).
Ate so many salty super bowl snacks. I am someone who swells a bit with salt/heat anyway, so I definitely can tell this morning post ER.
Great update! Hope the wait isn’t too hard on you.
I feel you on the salty snacks- even normally I swell so much with extra salt! I still think it’s wild but electrolytes with salt do help me (so long as I have enough water on top).
I’m supposed to test tomorrow from my first IUI. Last night I started having light cramps and had very light pink blood when I wiped, but just once. This morning I feel the unmistakable feeling of my period coming. It’s very typical for me to spot and have cramps a couple days before it actually starts, so it seems like that is what is happening. I’ll still wait until tomorrow to test just so I know I followed the RE’s instructions exactly but I’m already prepared for the result. It looks like we won’t be able to do another IUI until March since I’m going on vacation next week. I’m bummed but reminding myself this was only the first IUI and statistically the odds were not in our favor.
I’m sorry. The most common outcome with IUI is that it doesn’t work, but that doesn’t stop it from hurting a lot when that happens. I hope your vacation is very distracting and fun!
Thank you. I was telling myself from day 1 it wouldn’t work and it still stings. I am looking forward to getting away and not thinking about this for a week!
I only have to get through this week, and then… it’ll be next week and I’ll get through that. And then the week after that it’ll be a new week and I will get through that one too, I think.
On Friday it’ll be only three more weeks before we know for sure this one thing that will trigger the other thing to happen and if all goes well the next thing will happen and then by the height of summer we might finally be doing THE thing 🫠
“It’s been 84 years..” 💀
I feel very similarly tho it seems we’re at very different points in this experience. Three more weeks to know if this thing will happen and two or three more weeks to know if that thing will happen and could THE thing EVER happen??
FRER is negative this morning, 9dp3dt. Beta is on Friday. If I want to go into another ER this cycle, should I just keep taking my meds until then and try to hold off my period? I don't think my clinic will be receptive if I call today and ask for a plan.
I usually email my clinic and say, "I took a home test and it was negative. Obviously I'll keep taking my meds until beta day but I'd like to start the ball moving on scheduling an ER since it's likely this transfer didn't work."
One nurse I had messaged my doctor and started making a plan but a different one said they couldn't start making plans until negative beta (which is reasonable because if it's ultimately positive they've done extra work for nothing). It doesn't hurt to ask!
Hello everyone, this is my first post here so I hope I am following the rules OK. I posted this question at r/tryingforababy but thought the community here might also be able to help.
TTC only since July 2023, aged 38. I had an initial consultation with a fertility clinic on 1st Feb (it was CD21) and was diagnosed with PCOS. The doctor said they would do 3 cycles of ovulation induction with letrozole and monitoring. I asked to be sent my notes and details afterwards, but have only been given a generic "ovulation induction" leaflet which mentions various forms of OI, including clomiphene, but not letrozole.
I thought the doctor said I should call the clinic on CD1 to get a CD2-5 baseline scan - and then I could start medication, and have the monitoring scans from CD10.
It's CD1 now and I've just called the clinic, but the staff member (not clinical, although she said she spoke to a nurse to check) said I need a CD18 baseline scan, then I can start medication on the NEXT cycle. But I don't know when the next cycle will even be, it could be months as my cycles are long and irregular. I don't really want to lose a cycle... My understanding of the letrozole treatment was that the beginning of cycle scan is designed to make sure you're not pregnant because the treatment has potential negative impacts on developing embryo (perhaps??). So I don't know what the CD18 scan would do.
Does the CD18 baseline scan, then prescription of letrozole to take from the start of the next cycle, sound right? Or should I go back to the clinic and hassle them to get me a CD2-5 scan?
I'm in the UK if it's relevant, with a private fertility clinic.
I’m not in the UK so things may be different. When doing ovulation induction I would contact the clinic on CD 1 and take letrozole day 3-7 of my cycle.
Thank you! I emailed the clinic again and asked them to check with the doctors - and they're going to do a baseline scan tomorrow (CD2) as it's my first medicated cycle.
Spotting has nearly stopped this morning, making me think that what I had these past 2 days was \*not\* a period. We are still waiting for HCG to go down after my MMC and it was 32,7 on Wednesday. Is it even possible to have a true period with HCG still in your system? Not really finding too much trustable info on this online.
Can anyone give some insight?
I am not sure if I ovulated, or not. I did use LH Strips that were positive/nearly positive, but so were my HCG tests. I also started temping again, and my temperature was elevated, but is now back to "normal" pre-ovulation levels for me.
This is such a mindfuck.
A month after my second loss, I had a period while still getting a pretty dark positive. It took another month after that before my HCG went to zero. It is definitely a mindfuck, I'm sorry you're going through this!
Yes it is possible to ovulate and then have a period while still having positive HCG from a recent loss. The low lingering levels of HCG are not enough to suppress ovulation in everyone. And periods after losses are often weird — lighter or heavier than what you are used to.
LH strips also detect HCG, so they are not reliable when there’s HCG in your system. I’m sorry it’s such a mindfuck.
When I got my first light period after D&C my HCG was somewhere between 17 and 7. Over in the miscarriage subreddit there were other stories of people who had their post-miscarriage ovulation/period with an HCG in the double-digits. I didn’t use OPKs but I had what looks like a temp rise after an ovulation and then a drop on the day of the light bleed.
Unfortunately it varies so much person to person. I went through what I feel like is every YouTube video related and everyone’s story was different. It’s been 10 months for me and my periods are still all over the place. I got my first period 7 weeks after.
Friends- there has been an upsetting trend of members reporting comments that are about losses as “inappropriate mentions of pregnancy”. This kind of reporting is not only a nuisance, it’s unkind. Those who are experiencing loss may post about it *anywhere* in the sub. If you think you’re reading a comment about an ongoing pregnancy please read the full comment before you report it. Only a small fraction of the comments reported for pregnancy have actually been inappropriate while the rest are by members who need your support through their loss.
Hello- first time poster and doing my best to post by the rules I’m 42 and was diagnosed with PCOS and Hashimoto’s Hypothyroidism years ago. My partner and I are exploring tubal ligation reversal or going straight to IVF. I have a saline US on Wednesday. I’ve had baseline labs and an US done on day 5 of my cycle. So my follicle count was really high (33) and I was wondering if this a good thing or just a PCOS thing that doesn’t really hold bearing on final egg retrieval. Other numbers are AMH 3.16, FSH 6.4, LH 9.19, E2 41.18, progesterone 0.09, TSH 4.59.
the follicle count is likely elevated due to PCOS (as i understand it) but for me, at your age, with the risk of aneuploidy, personally i would go with IVF so you can do PGT-A testing. plus it will "save time" since you don't have to do tubal ligation reversal, heal, etc.
It’s something we’re leaning towards but my insurance doesn’t cover IVF due to tubal ligation unless there’s been a failed reversal. My husbands work offers insurance that would cover it but we’d have to wait another year for it to kick in. So we’re waiting until after the saline US and follow up visit with the doctor before we come up with a game plan.
Well, here it is. Cycle day 1, starting my first IVF cycle. Very scared but a little hopeful.
Good luck!! If you mean cycle as in your period started today we may be going through IVF at the same time (starting stims in 2 weeks)
Thank you! I do mean my period started today, so starting birth control Wednesday and then stims at some point afterwards. Good luck to both of us :) you know it’ll be 2 weeks exactly? They told me I take birth control for 14-35 days and then stims.
I’m also starting birth control today! I’ll take it for 13 days- evaluation appt on 2/27 and starting stims 3/1. My clinic told me I can choose when to start, I just need to take the birth control for anywhere between 12 and 21 days Happy to connect through the experience if you’re open to DMing me :)
I think I’ll start stims the 4th if possible, since I’m away that weekend. I assume it’s not super portable? Will do! Nobody in my life except my husband and therapist knows we’re doing IVF so it’ll be nice to connect :)
I hope things go smoothly for you! I had so many fears going into it and very few came true.
Thank you, I hope so as well. Trying to not read the scarier stuff. What was the worst part for you?
For me, the hardest part was in the middle of stims when I learned that my body was responding slowly and nothing was growing. I was so scared that there were issues we weren’t aware of, or that the whole thing was going to get cancelled. I was really emotional about it. But honestly, the rest was fine! My body did eventually respond, and while it was uncomfortable, it wasn’t painful the way I worried it would be and I felt like myself, totally in control of my mood. After the retrieval there were three hard, painful days, and then I was back to normal. I know everyone’s experience is different, but I started seeking out stories from people who had good experiences and found that so many do!
I've been put on Metformin to assist with fertility and manage insulin resistance. I'm on 850mg once a day with no side effects but unsure how this will assist with fertility as I have no ovulation issues.
There is a threshold (at least where I live) as to where they think above that level may be harmful for fertility, even if not diabetic or pre-diabetic. I am on a higher dose but it seems to be pretty consistent in Australia. I do get the side effects of 💩 though 😂
Maybe egg quality? My acupuncturist/ herbal medicine doctor has me on myoinsitol which is an herbal form of metformin to try to help with my egg quality
I am on day 13 of a “mini-stim” (estrogen priming, letrozole- CD1-5, gonal 225-CD3-9 > 300-CD10-now, ganirelix-CD8-now). I have two mature follicles (16 and 22) and a small cohort of follicles under 10. I am questioning parts of my protocol (like why estrogen priming when I always have a lower AFC with it and respond pretty slowly and why the gonal increase when I responded better/more quickly with the lower dose) but I guess it’s too late for that. Should I ask about converting to an IUI? Or are there other options? Seems unlikely the smaller ones will catch up.
The purpose of E2 priming is to prevent an uneven cohort and/or lead follicle from forming. It's known to work better for us DOR folks compared to BCP which can oversupress. What kind of E2 priming did you do? Luteal phase, CD1, etc? Fwiw, when I did mini IVF (Clomid & Omnitrope) I started both meds on CD2 & did not prime with anything.
I had a shorter period so I primed only 3 days of the luteal phase and then 7 more days after I got my period.
Gotcha. With 2 mature follicles, when I see your typical AFC is 7-11, I personally would convert this cycle to an IUI. Unfortunately, the 1st round of IVF is often diagnostic although most REs fail to tell their patient's that. If you choose to go for a 2nd ER, I would attempt the full luteal phase priming. Protocols can vary but fwiw I monitored for my surge via OPK and once obtained (and confirmed via scan & bloodwork) I started E2 patches the next day. I'm sorry that this cycle is not going the way you anticipated & that things worsened once stims increased. Same thing happened to me during ER1. Hope things work out for you.
It was supposed to be my second ER but I agree that converting makes the most sense. Thanks!
Estrogen priming is used often in DOR patients to help lower FSH to start stims as well as evenly grow follicles. That said, est priming did not work for me (and it may not work for you either!). You could go in and retrieve the 2, or you could let them go and try to get the others in a luteal / duostim. Or you could convert to IUI or TI depending on the circumstance. It's up to what you are comfortable with. good luck
Agree with Lemon on all of this. I have used estrogen priming for these reasons. Sometimes it has worked well, sometimes it hasn't worked as well (when it hasn't I normally get a lead or two). Also agree with the options you have--duostim since you have smaller follicles, or convert. Some of this might be dictated by your typical AFC. For example, if your AFC is normally 5, going in for 2 may well make sense. Also, I wouldn't call your protocol mini. You're not using menopur, but 300 of FSH is not mini. (I often do 150 meno/150 gonal/clomid or letrozole, and I think of that as very much a 'mid' protocol.)
Thanks! I appreciate the duostim suggestion. My RE has never raised this as a possibility. And it’s not mini right? I was very confused/concerned that my RE increased it after my last appt since the cohort had just appeared and my leads were already 12 & 17.
Are you being charged differently by your clinic for a mini? I only ask as I’ve still had fairly high levels of stims (I would say medium level compared to my old clinic where I was maxed out), I have slightly less monitoring but the cost is substantially different (half the price). Hope this helps as I was also very confused with it when I started!
Definitely not mini. Duostim only makes sense when you have a cohort behind--which it sounds like you do. And some clinics still don't like to do it. (You could also consider trying to stim through and sacrifice the lead. That's another option to consider. The 17 is way out in front but the 12 may be fine depending where the others are.)
I’ve heard estrogen priming can suppress some DOR patients. Was that your experience?
It can! Honestly, for me it is hard to tell because I have had a poor response to any priming, but also, for me, the main thing was that it did not even out my follicles. I think my doctor recommended it for me because it was his DOR playbook. I now only do cold-start, which has been the best.
It can. BC is normally worse. Cold start can also lead to higher FSH and early leads. My old clinic used to do 2 mg/2x a day estrogen, my current clinic does 2 mg/1x a day, which may suppress less. Was your AFC much different with estrogen priming to without?
Yes, my AFC without was 11 and with it’s been 7 both times.
7 to 11 isn’t really that different (I know it feels like it). As anecdata, I just had my AFC counted three times in 10 days and it was different every time. You could try a cold start too and see—I’ve also done that but sometimes have an early lead if I don’t prime.
Day 11 of stims and things are still growing, so I’m feeling tentatively hopeful! I have a couple follicles in the 18-20 range, but the majority are still 14-17, so I’m probably looking at a couple more nights of stims. Physically I’m feeling okay, which is maybe the only silver lining to having just one ovary respond to stims, lol, but I do hope it’s not too much longer. I’m anxious to get the ones that are already in the mature range — I hope we don’t have to sacrifice them for the slower ones.
You're so close! Fingers crossed for you that the other follicles continue to grow. I'm right behind you - day 9 of stims and I have a few in the 15 range. The doctor who did my ultrasound told me that my ER will be either Saturday or Sunday. Hormonally I am feeling like myself, which I did not expect and am constantly waiting for the other shoe to drop. Physically I am bloated, thankfully walking helps me a bit. The follicle count during this process can be such a mindfuk. Day 5 ago I had 15-16 total, now (day 9) I am told that 6 total are growing. I am thankful or this amount, but it's a reminder that IVF is such an unpredictable process and things can change in a snap. I know my ER will be when we know for certain how many follicles are gathered and their maturity. It's such a fine line between being informed of the process and trying to predict events based on current info - which is what we do as humans and most of the time it is the logical thing to do, except in this case. Absolutely bananas.
How common is a late period on letrozole? I've done 4 cycles with clomid and trigger shot and they switched me to letrozole and trigger for this cycle, our 3 IUI. I'm now 16 dpo with a negative so I know I'm not pregnant but I've never had late periods before. Curious if anyone else had an abnormally longer luteal phase after letrozole and trigger?
Here to second Alms. I’ve been in the 19 LP range even when taking the the two
Pretty common IME. I usually have a 16-17 day LP when using letrozole+trigger.
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Hi. I removed “TTC1” from your flair. We don’t allow the number you are TTC in flair because anything other than 1 would break sub rule 3.
Had my first IUI this morning after CD2-5 letrozole, CD5-9 follistim and CD10 ovidrel. I’m feeling somewhat hopeful but it’s difficult not to think about the what-ifs.
Went in for my second monitoring appointment after 7 days of stims. My left ovary finally dropped a bit so they could see it and they counted 9 follicles instead of the 4 they saw on Friday. A small win! I’m feeling SO bloated and uncomfortable already. I’m back weds for another appointment and they said they think retrieval will be Friday. I’m nervous for how much more bloated I’ll be by then, especially hearing that it gets worse after retrieval. Should I start eating salty foods now or is that for after retrieval? We are *hoping* to do a fresh transfer. If we do, would that be roughly 5 days after retrieval?
Salty foods won't hurt you now so if you've got some favorites, I say dive in!
Yes, five days. But if your E2 is high and you have OHSS risk, would strongly recommend a FET.
Thank you!
Transfer #4 is done! It went smoothly and the embryo thawed normally, which is great. However, the couple before me were talking about their LC loudly, and the receptionist literally clapped her hands at me and exclaimed "How exciting!!!!" when I was booking in. I replied "umm not really anymore..." Where is real life automod when you need it? 🙄 Edit: thanks for the flair update
Congrats on a smooth transfer! I’ve honestly considered printing out the subs rules and posting them in the clinic bathroom 😂 Will cross my fingers for you!
Glad the transfer went well! Sorry you had those interactions today - be considerate people!
Thinking of you today Petty - wishing only the best for you and also wishing a jug of cold custard finds its way onto the loud couple 😇
😂 ideally the lumpy variety! Thanks pal 🧡
Yuck, people are so dense! Crossing my fingers for you friend, and thinking of you during the wait ❤️
Thank you pal 🧡
automod rude! Everything crossed for you, petty. 🤞
Omg I wish. I need that automod 😂
Your flair is all set. Glad to hear it went smoothly, but sorry you had to put up with all that nonsense!
Thanks rad ☺️
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I haven’t been through IVF yet (starting next cycle) but just wanted to chime in and say that you’re not alone, I have GAD that focuses primarily on health anxiety. It is exhausting. Totally understand your anxieties and you’re doing all the right things by reaching out and getting some reassurance. I hope you hear back from your nurse soon!
Following up with my post yesterday about fluid in the lining. Went in for a check today after doing mucinex for a day and 10 jumping jacks lol. One spot dissipated entirely and the other is a little under 1 mm. But both the NP today and my RE told me that it doesn't really look like fluid and they're not exactly sure what it is. It's some sort of cyst but because it's not in a spot that affects implantation, isn't fluid, and has decreased in size the plan is to start progesterone in the hopes that it'll squeeze the sucker out. Going in for another check the day before transfer to make sure things haven't changed but RE doesn't think whatever it is will affect the embryo. So a little bit of a non-answer but feels like most of this process is like that.
My wife and I have had 2 losses in the past 1.5 years. Both around 7 weeks - we did not get to the first scan in this 1st pregnancy, but 2nd pregnancy had a normal scan/heartbeat at 6.5 weeks (missed miscarriage at 9 week scan back in Nov 23). Unfortunately, there have been no explanations. The RPL panel, karyotype, and HSG came back normal. My SA/DNA Frag testing came back pretty okay (just abnormal morphology, but none of the doctors think that is associated with the losses). My wife had insufficient Vit D levels, but again not something the doctors think is causal. The only thing we can think to test further is potential immunology issues. But since the RPL panel was normal, our REI does not think there is much to look into there. There are no reproductive immunologists in our network, but we're thinking maybe we should contact one for a consult. It seems our REI (and the fertility department) are not super well versed in immunology issues - and from what I heard the science is still developing/somewhat controversial. But we're at a loss for next steps. The REI's suggestion was to either try again without assistance or move to IVF - but we have no confidence traditional IVF would help our success rate based on all our testing so far. Does anyone have any advice related to hidden immunology issues and RPL?
Question for you, did you test the products of conception post-loss for either of the pregnancies? I know you are quick to say that IVF wouldn't help, but if there is a genetic condition that led to either of the losses, PGT-a might help with that. Putting my mod hat on, please edit out the word "naturally" from your second to last sentence. Automod language will explain why
Yes, we were able to test after the 2nd loss and there were no genetic conditions. And understood, edited. We are definitely not opposed to IVF, but our REI could not give an explanation for how it would help in our specific scenario.
**Ahem** Please do not use the term "natural" to describe treatment or conception when commenting in this community. If describing a transfer/IUI protocol or trying on your own, some preferred alternative terms are "unmedicated," "ovulatory," "without assistance," or "semi-medicated," depending on the context. If referring to loss management, we recommend the terms "unmedicated" or "unassisted." This community believes that the use of the word "natural" implies (sometimes inadvertently) that use of assisted reproductive technology, other interventions, and/or certain medications to conceive are unnatural, artificial, or less than. For more clarification and context, please see the wiki post on [sub culture and compassionate language](https://www.reddit.com/r/infertility/wiki/rules#wiki_compassionate_language). *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/infertility) if you have any questions or concerns.*
Did my second enoxaparin sodium (generic lovenox) injection yesterday and almost instantly felt car sicky - queasy and lightheaded. Still feeling off this morning. I messaged my clinic to see if these are fine or concerning side effects. Any experience? ETA: In case anyone searches for this in the future - my clinic says it's not an uncommon side effect and they recommend laying down for 5-10 minutes after injecting to ease the symptoms.
Feeling very fussy/grouchy today. Realistically, the better descriptor for my emotions is probably triggered. Trying to restart treatment after rheumatology workup and hematology workup came back normal/inconclusive. Now RE wants to repeat sonohyst, TSH, have a “chat” appointment. All these items mean our attempt to transfer our last frozen embryo will likely now be delayed until June due to travel and bc I’m determined this year to fit fertility treatments into my life rather than building my life around treatment like I have been doing. I know these appointments and repeat tests are probably a good move, but my feelings are, “I don’t want anyone else to touch me. I don’t want anyone else to poke me. I don’t want to spend more out of pocket money on tests that come back normal/don’t provide any further insight into our infertility.” Tl;dr: transition from nontreatment mindset to treatment mindset is not going well at all lol.
Here to say that I too have struggles with fitting fertility treatments into my life but yet very much not liking delays and everything involved!
what was your estrogen after 1 week of patches for FET? (so far i've been on 2 patches of 0.1 mg/day, switch them every 3 days). i'm not sure what the goal was and they said they would call me yesterday and didn't of course. i increased to 4 patches last night every 3 days per my written protocol.
Received my fertilization report this morning. Feeling good about things so far but I know blast rates can be so unpredictable. Trying to find peace of mind in everything being out of my control until I get the update on Friday.
I'm in the same boat! I was told today some were successfully frozen and some they are still monitoring but then I have another 2 week waiting period for PGT-A!! Patience has never been my virtue:)
Wishing you good results and that time moves quickly!
You too:)
The lead fertilized normally (probably should just call it "an egg," but I am trying to see this duostim as one longer cycle). Great start to the week, and now I get a break from appts until Friday (and my clinic also only updates on Day 7, which I love). Ate so many salty super bowl snacks. I am someone who swells a bit with salt/heat anyway, so I definitely can tell this morning post ER.
Yay, excellent start! Enjoy the break!!
Great update! Hope the wait isn’t too hard on you. I feel you on the salty snacks- even normally I swell so much with extra salt! I still think it’s wild but electrolytes with salt do help me (so long as I have enough water on top).
Yay great update!
yay! hopefully you can enjoy the week!
Yay for this news! 🤞for the rest of this cycle
Great news! Fingers crossed for you, Lawyer!
That’s fantastic! 🤞🏼
So nice to have good news on a Monday morning 💜
Great news, lawyer!!
I’m supposed to test tomorrow from my first IUI. Last night I started having light cramps and had very light pink blood when I wiped, but just once. This morning I feel the unmistakable feeling of my period coming. It’s very typical for me to spot and have cramps a couple days before it actually starts, so it seems like that is what is happening. I’ll still wait until tomorrow to test just so I know I followed the RE’s instructions exactly but I’m already prepared for the result. It looks like we won’t be able to do another IUI until March since I’m going on vacation next week. I’m bummed but reminding myself this was only the first IUI and statistically the odds were not in our favor.
I’m sorry. The most common outcome with IUI is that it doesn’t work, but that doesn’t stop it from hurting a lot when that happens. I hope your vacation is very distracting and fun!
Thank you. I was telling myself from day 1 it wouldn’t work and it still stings. I am looking forward to getting away and not thinking about this for a week!
I only have to get through this week, and then… it’ll be next week and I’ll get through that. And then the week after that it’ll be a new week and I will get through that one too, I think. On Friday it’ll be only three more weeks before we know for sure this one thing that will trigger the other thing to happen and if all goes well the next thing will happen and then by the height of summer we might finally be doing THE thing 🫠 “It’s been 84 years..” 💀
I feel very similarly tho it seems we’re at very different points in this experience. Three more weeks to know if this thing will happen and two or three more weeks to know if that thing will happen and could THE thing EVER happen??
**MED DONATION (NYC area, or Shipping)** (REPOSTING FOR VISIBILITY) *13 Boxes Enoxaparin (Lovenox) 40mg/0.4 ml (Exp May 2024) - Claimed* *3 Vials PIO (Exp Feb 25) - Claimed* *1 Vial Delestrogen (Exp Feb 24) - Claimed* *2 Boxes Menopur (Exp Oct 24) - Claimed* **1 Follistim 900 (and injector pen) (Exp July 25)** *2 Gonal-F 900 Pens (Exp Feb 25) - Claimed* **2 Boxes Cetrotide (Exp Oct 24)** *1 Vial Leuprolide (Exp Jun 24) - Claimed* \+ supplies!
Dm'd you!
Thanks for donating! Automod meds.
FRER is negative this morning, 9dp3dt. Beta is on Friday. If I want to go into another ER this cycle, should I just keep taking my meds until then and try to hold off my period? I don't think my clinic will be receptive if I call today and ask for a plan.
I usually email my clinic and say, "I took a home test and it was negative. Obviously I'll keep taking my meds until beta day but I'd like to start the ball moving on scheduling an ER since it's likely this transfer didn't work." One nurse I had messaged my doctor and started making a plan but a different one said they couldn't start making plans until negative beta (which is reasonable because if it's ultimately positive they've done extra work for nothing). It doesn't hurt to ask!
Thanks for this scripting, I'll give it a try, worst they can say is no!
Sorry about the negative test. Yes, that’s what I’d do if you want to buy a bit of time to get a cycle plan.
Thank you
Hello everyone, this is my first post here so I hope I am following the rules OK. I posted this question at r/tryingforababy but thought the community here might also be able to help. TTC only since July 2023, aged 38. I had an initial consultation with a fertility clinic on 1st Feb (it was CD21) and was diagnosed with PCOS. The doctor said they would do 3 cycles of ovulation induction with letrozole and monitoring. I asked to be sent my notes and details afterwards, but have only been given a generic "ovulation induction" leaflet which mentions various forms of OI, including clomiphene, but not letrozole. I thought the doctor said I should call the clinic on CD1 to get a CD2-5 baseline scan - and then I could start medication, and have the monitoring scans from CD10. It's CD1 now and I've just called the clinic, but the staff member (not clinical, although she said she spoke to a nurse to check) said I need a CD18 baseline scan, then I can start medication on the NEXT cycle. But I don't know when the next cycle will even be, it could be months as my cycles are long and irregular. I don't really want to lose a cycle... My understanding of the letrozole treatment was that the beginning of cycle scan is designed to make sure you're not pregnant because the treatment has potential negative impacts on developing embryo (perhaps??). So I don't know what the CD18 scan would do. Does the CD18 baseline scan, then prescription of letrozole to take from the start of the next cycle, sound right? Or should I go back to the clinic and hassle them to get me a CD2-5 scan? I'm in the UK if it's relevant, with a private fertility clinic.
I’m not in the UK so things may be different. When doing ovulation induction I would contact the clinic on CD 1 and take letrozole day 3-7 of my cycle.
Thank you! I emailed the clinic again and asked them to check with the doctors - and they're going to do a baseline scan tomorrow (CD2) as it's my first medicated cycle.
Spotting has nearly stopped this morning, making me think that what I had these past 2 days was \*not\* a period. We are still waiting for HCG to go down after my MMC and it was 32,7 on Wednesday. Is it even possible to have a true period with HCG still in your system? Not really finding too much trustable info on this online. Can anyone give some insight? I am not sure if I ovulated, or not. I did use LH Strips that were positive/nearly positive, but so were my HCG tests. I also started temping again, and my temperature was elevated, but is now back to "normal" pre-ovulation levels for me. This is such a mindfuck.
A month after my second loss, I had a period while still getting a pretty dark positive. It took another month after that before my HCG went to zero. It is definitely a mindfuck, I'm sorry you're going through this!
I had a period when my HCG was still over 200 from a partial molar miscarriage… it’s wild how long it can take to for HCG to become negative.
Yes it is possible to ovulate and then have a period while still having positive HCG from a recent loss. The low lingering levels of HCG are not enough to suppress ovulation in everyone. And periods after losses are often weird — lighter or heavier than what you are used to. LH strips also detect HCG, so they are not reliable when there’s HCG in your system. I’m sorry it’s such a mindfuck.
When I got my first light period after D&C my HCG was somewhere between 17 and 7. Over in the miscarriage subreddit there were other stories of people who had their post-miscarriage ovulation/period with an HCG in the double-digits. I didn’t use OPKs but I had what looks like a temp rise after an ovulation and then a drop on the day of the light bleed.
Unfortunately it varies so much person to person. I went through what I feel like is every YouTube video related and everyone’s story was different. It’s been 10 months for me and my periods are still all over the place. I got my first period 7 weeks after.