Assisted Conception and the bits inbetween

[soosy]

Welcome to the new thread I only hope I can link it to the old one

Hi Kanuck,
Thanks for posting your message, I was very interested to read about your experiences particularly about your cons 'ageing' your ovaries at 36/37 based on response to stimulation. I am being treated at Oxford and about to embark on our 2nd IVF attempt in the New Year. Our first attempt resulted in m/c discovered at 9 week scan, I had mild OHSS and I had to reduce my drugs for a week before egg collection because my hormone levels were too high.
Last time I was at the clinic I had a short discussion with the cons who said he would like to talk to us about IVM treatment as he was worried about my hormone levels and considered that I would produce enough good quality eggs without the drugs next time (I am 38 on Monday btw).
I took it to be a bad thing that I overstimulated but in your experience am I right in thinking it could indicate a good future response do you think? I know your not a doctor or anything but I always find it useful to get the opinions of others. I do trust the clinic that they are doing the best they can for me but I'm uncertain whether the IVM will work and I just want to do the treatment that will work the best rather than save money on drugs etc.
If you have time to respond I would appreciate it in the meantime best of luck with your pregnancy.
Onion x

Hi Onion
I must say i do not know much about IVM. It is not offered at either of the clinics I was working with. Last I heard it was an Oxford development and they were the only ones using it - this likely has changed. I did once ask about it and was told i was too old and i never really bothered reading about it again.

There may be some motivation for Oxform to push IVM on you, as they are trying to get wider uptake of the therapy across the UK and abroad (read - RESEARCH). However I don't think they would do this if they didn't think you'd be a good candidate - remember they are trying to improve their statistics and increase their absolute number of success stories.

It wasn't clear to me whether you were an NHS patient. If so, they could be saving costs but again, they would not 'waste' money if they didn't think you had a good chance with IVM. If you are paying then there is no direct commercial incentive for them to push this on you obviously.

As for me this ovary 'aging' thing, as mentioned, was due to a high response to stimulation which, although can lead to negative OHSS symptoms, is definitely a good thing for you - you have lots of eggs.

Curious what your FSH doses were. A 40-year old typically gets more then 300iu apparently. Mine were:

#1 250iu (then lowered to 200) produced >20 follicles with 15 eggs. Transferred 2 embryos.

#2 200iu produced ~15 follicles with 11 eggs. Transferred 2 embryos.

#3 150iu produced 8 follices with 6 eggs (and this low dose is the only cycle that gave me OHSS). Transferred 3 embryos.

I have every confidence in Oxford. We started out there where my husband's situation was diagnosed but it was too far to continue with once we moved out of the area.

Best of luck.

Hi Kanuck,

Thanks for your reply sweetie, so quick as well, you are kind. Your right that IVM is really new that's why I'm a bit nervous about it, at least I know that IVF got us pregnant in the first place whereas this is an unknown area for us and I don't want to hang about trying things for the sake of it because of my age creeping up.

I know that Oxford having been carrying out the treatment on the under 37 age group and usually those with PCOS so as I am over the age group and not diagnosed with anything I'm curious as to why they may recommend it, I'm sure all will become clear when we have a chat with the cons. Hopefully they think the chances will be good to recommend it. We are private patients as I am too old for funding in the area in which I live (grr!)

I'm not sure what my FSH doses were, I only know from previous tests throughout my cycle that they have all always been fine apart from progesterone which has always been low. At my last treatment when I was coasted for a week I had 43 follicles which produced 13 eggs, only 2 were suitable for transfer and we got none to freeze.

Its really great to hear of your confidence in Oxford, I am very impressed with them so far and I like the people that I deal with on a day to day basis. What I also like about them is that they do not give false hope and often tell you things don't want to hear, I would rather they play it straight like that then you know where you are don't you. They said they thought we had a really good chance certainly after a few more cycles so I'm holding on to that for now.

Thanks again, happy new year and keep well.

xx

Kanuck that is interesting - the difference in dosage and your response. What do you think led to the OHSS the last time? Was it the same drug regime?
Mowmi, I'm not surprised you can't remember, like most traumatic, wallet-related event, your brain has blotted out the painful memory.
How are you feeling?
Do you think the quantity of drugs for the second cycle were comparable to doing a regular, high stimulation IVF?
I have been hitting the websites to try and find out more about the drugs/costs, procedures, because I was feeling a bit panicky. I can see the consultant's face when I whip out my print-out from Babycentre IVF forum. They love that don't they!!
Lottie, how's tricks? Have you been for a run?
I'm still recovering from this cold/bronchitus thing and have been outside about 5 times all week, luckily the TV is good so at least I'm not watching 'Murder She Wrote' all day.
I have found a cool thread about IVF diet and the benefits of increasing protein in the diet to improve egg quality. So of course I have only eaten tuna and eggs all day.
Onion I have just searched on IVM at Oxford and almost fainted at the £95 drugs cost!

morning ladies...I'm trying to type lying down in bed with the pup lying on my shoulder!

RB the last cycle i was on 225 so i think this might count as a regular cycle but not really sure - i now it was higher than Geeta expected me to need (learnings from the 2 other cycles).

Lottie - that's a really good point - my first cycle drugs were prescribed by my GP, she had to take it to the practice meeting but they approved it! I should have gone back again for the subsequent cycles but I thought they would only do one - should have tried harder!!
My first cycle was abandoned (I did long protocol but my ovaries didn't wake up after being shut down) then did 2 antagonist cycles (no down regg) the 2nd of which resulted in BFP.
Scan is on wednesday - I went for the other blood test because I had a bit of spotting but they told me not to worry about it. Sill worried that it could all go wrong at the scan next week - then when I relax and try to get in to it I worry that I'm setting myself up for a big fall.

Go for the course! you might regret it if you don't! I also think an IVF site would be great - everything is so all over the place - not one resource tells you everything you need to know!

Had anyone seen anything of Flibberty on the other threads?

rowingboat - the docs don't have any idea why i got the OHSS this last time with such a low dose. It was mild at first and went away for 5 days or so. But then when i got pregnant it reared its ugly head in a much more severe manner. This was 8 days after transfer or 10 days after aspiration, which would have lined up perfectly when implantation took place.

I was always on Puregon for FSH (the other drugs don't matter for OHSS but were also the same). The reason the dosing was lowered in subsequent cycles was because i produced too many follicles and they told me i was overstimulated the first two times. They never want to see =>15 ripe follicles by Day 8. My consultant always told me, "I only want to see 5 or 6 ripe follicles" which is exactly what i got the 3rd time (6) when i got pregnant.

Also on that note, there is an unproven theory that overstimulation produces an endometrium lining that is too thick. The theory is that if the lining is 14mm or greater before aspiration, it has passed the stage at which the ideal secretions for implantation are present. Both my consultants told me this could have been a problem in my first two cycles but also stressed that it was only a 'theory'.

Kanuck, I did see something about OHSS sometimes being linked to pregnancy, can't remember the details though.
I was wondering about the FSH, because I noticed that some people have different kinds of FSH for each cycle or a mixture of two and get different results.
Your consultants comments about number of follicle are very interesting. Just anecdotal, but I have noticed that lots of eggs doesn't seem to mean success, when you look discussions on forums, it seems better to have lower numbers of eggs fertilised for success. That is just my observation when people post their stories.
Mowmi, glad to hear you are doing well. Are you still listening to the relaxation CDs?
Lottie, I'll let you know when I start my running thing. I could help you get set up if you like, not that I know very much.

Hi ladies,
Hope you all had a good weekend, did you see the article on the front of the Independent on Saturday about frozen embryo transfers? I think there is some kind of fertility conference on next week so I guess there will be lots more stories in the press over the next week or so.

Just checking in with you have nothing new to report.

Lottie - I'm desperately seeking a career change and was also considering counselling, my local college offers an intro course for 8 weeks that I might enrol for. Let me know if you need any help with your website I would love to be involved in something like that and I think it would be very useful for others like us.

Onion x

The Independent article that Onion refers to:

Frozen embryos: the future for IVF
www.independent.co.uk/news/science/frozen-embryos-the-future-for-ivf-1222839.html

I know what you mean Lottie. I have become quite suspicious as this whole process is so costly. I worry that the clinic wouldn't make much effort to freeze embryos because there is more money in a fresh cycle. I don't know if that is even true, but I like to frighten myself once a day.
Good going with the early start as well!
Onion and Lottie, you would make great counsellors IMO, just based on your posts here.
Right I have my second opinion at the ERI at 10:45 this morning - the one about the HSG. Then we have an initial appointment at 1:45 with the IVF people, so back to the ERI.
And I took DS round to nursery this morning, to find they didn't actually start back until Wednesday. Oh well, it's good practice for him to get used to getting up earlier.
Better dash, will report back later!

Hi all, just popping in to say that I have been to see the first doctor - very delayed, almost an hour and she didn't apologise. That's OK, I don't have anything else going on in my life!
She reckoned that she could offer a laparoscopy (sp?) to investigate the tubes, but wasn't sure whether it was worth it. Also didn't actually have my notes so couldn't give me a conclusive answer. I don't think it is her fault, the system just doesn't seem very joined-up. She will phone me or write to give me her opinion after checking my records.
Off to appointment number two now....

Hi ladies,

Its my birthday today!! I'm now 38 and very surprised that I have woken up very positive, there hasn't been snow on my birthday for some years now and this morning there was some and it was so pretty I'm taking it as a sign things will be different for me this year and we'll get some luck!

I know what you guys are saying about the story on the Indy, my DH brought a copy to me when we were doing our shopping, I thought he was so sweet, we bought the paper but when I read it I was surprised it made front page. We attend the OFU and I think they are fantastic so far but this article didn't relate to us as we had no chance with NHS funding due to my age - GRRRR

Spook - hope your downregging is going OK
Mowmi - good luck for scan sweetie
Rowingboat - hope your appointment goes well

Lottie, I'm in marketing at the moment (in the loosest sense of the word as the company I work for don't really do it property) and I would love a change to do something that actually helps people for a change. I'll drop you a line sweetie! I have also had a productive day today, been sorting out stuff in the house and getting rid of some clutter, like a detox, can't start the healthy eating til after my birthday though :-)

x

Lottie - agree with your comments on the article

1. Oxford does a good job at PR definitely. Although they are good with research, they are in fact a very small facility and it is probably expected of them to be more leading edge and publish their finding any chance they get.

2. It sounds to me like they are trying to 'innovate' the way statistics are collected by including the FET cycles. I think there would be a lot of dispute against this as there are so many different FET protocols, storage methods and other technicalities that might make comparison between clinics and patients a very 'apples and oranges comparison'. Some patients opt for no drugs, for example. My clinic actually treated frozen embies a bit like bonuses or 'throwaway cycles', believe it or not.

3. It also sounds like the PCTs are not funding FETs and so media attention is one way for the clinic to fight that battle - publicly.

I tried a few different FET protocols and they did not work but i know some clinics have good success with them. As age was a factor for me, I was told not to piss around on the FETs and waste valuable harvesting time. For younger people, it is certainly more economical and more healthful for the patient to do all the FETs possible.

I was quite interested in FETs and read a few threads on various forums and obviously, the posters were all people for whom they had worked. I was struck by how so many on the threads said they were happier and a lot more relaxed doing the FETs because their bodies hadn't been put through so much by the drugs.

Hi everyone. Happy Baby Making New Year to you all! Sorry not been around much. We've had guests and the boys haven't gone back to school yet
Anyway....Kanuck. Thanks for your story and wahey for your pregnancy!! Fantastic news. I hope your cysts aren't too awful ...
Onion Happy Birthday
Sounds like you and Lottie have really welcomed the New Year in with a burst of energy. I would love to be decluttering and cleaning but its hard with DS's around. God I'm soooooooo ready for them to go back to school. They broke up on Dec 11th ffs!
Fantastic news about your course Lottie. I bet you feel better now having made the decision. I think you'll be an amazing counsellor (and fwiw I think an IVF website would be brilliant. I can't abide FF because of all the tickers and bloody smileys!)
Mowmi-its so exciting that its your scan on Wednesday! You see-the time did pass.
I can't quite believe I've got my scan in the morning then hopefully start my stimms on Wednesday. Finally the injections are here!!!! DH is going to do them because he's a pharmacist so I reckon he'll be better with needles and hysterical women
RB-that sounds like a very frustrating appointment this morning. I must admit I came away from some of our early appointments feeling like nobody really gave a shit. I still get that feeling tbh. Watch this space....I'll see how they treat us tomorrow. I am under a prominent consultant and I have never met her after 4 visits.
How did your second appointment go today???
Wish me luck that I'm all switched off for the morning....

Hi to all of you on this thread! If you look back far enough, I dip in and out of this thread over the last year.

Briefly, to introduce myself to the many many new faces around here - I'm 39 (just!)and have a 2 year old DD through IVF, and have had two unsuccessful cycles in the last 12 months. I was due to have another cycle last October, but didn't downreg properly, so it got deferred by a month, and then we ran into Christmas...so have really only started this cycle in January. At least I managed to downreg properly this time around! I've had 4 days of stims now, and the first scan and blood test were fine and results as expected today.

Lots of new names on this board. Lottie, I love the idea of having a new improved routine for the new year! Sounds very similar to the way I usually hit January.

And Mowmi, good luck for your scan this week. And Spook, good luck too and hope you get to start your stims this week.

Will catch up with the rest of you soon I hope. Nice to be back on the board, especially with all the good news on here recently

Hi Spook and Onlyaphase!
Things are hotting up around here aren't they!
Spook, I saw the monkey today for my IVF appointment- cat's on keyboard so random symbols and letters may ensue- I didn't see the organ grinder either. I can't say I was bowled over.
He told me about what was involved in IVF and that was it really and we were given reams of paper to take away. I did ask about the prices and he said the £640 was what I would be charged for the drugs 'package' regardless of what I used, which seems quite reasonable based on what you guys have told me.
The annoying thing was that he said they would be unlikely to transfer three embryos on a first attempt, regardless of my age. I told him we might only make one attempt because it is so expensive, but it seems it is not his decision and the main dude would have the final word. He did say he would put our case to the head IVFer, but it might be something that is decided at the transfer.
How frustrating!
Mowmi, I asked him about low stimulation IVF and he said he had no idea what that was, said all IVF is the same.
He also mentioned the FET article of today fame and said he was nonplussed by it.
I would love to stay here and have the treatment rather than plod off with DP and DS to another country.
He told us the treatment would start in July, but we are on the cancellation list so they could contact us any time if somebody else cancels.
So that is it for now with the ERI
I plan to make an appointment on Wednesday with the GP to let them know what we are doing and try to find out whether we can get any help with the drugs side of thing.
Now really must take down the Christmas tree....tomorrow!

Hi LondonLottie, sorry to butt in on your thread but just wanted to let you know that I decided to go ahead with the IVF at NURTURE. Forms all posted so waiting for first appointment. Really sorry your attempt didn't work, hope you have better luck next time. Thanks for your help.

Hi all,
just popping in to say hi.
Happy Birthday Onion, sorry I missed that! Still not really firing on all cylinders. Back at work and they must think I had a lobotomy over Christmas, kept leaving things lying around.
The IVF at ERI is very NHS, I think they are accustomed to people with no choice and the presentation leaves something to be desired.
The timeframes are rather vague, as the IVF bloke thought we had a good chance of being offered a cancellation before the 'official' date, but obviously he had to give us a date of some sort whilst we were there. It is very vague.
The Hungarian clinic is looking very appealing, since they can get started immediately and there is no issue with three or even four embryos.
I think that if ERI came back within the next month or so we would just go with them and then if that didn't work out we would try Hungary if we can raise the extra cash.
FETs for me are important because we are on a limited budget lots of fresh cycles isn't an option and having the FET option if the fresh cycles don't work is quite reassuring. And the lack of hassle with FETs appeals.
We are considering the cost of storage and FETs as part of the overall picture because it is important when cash is tight regardless of age.
The bloke at the ERI said they would be happy to put back three frosties?