Assisted conception after recurrent miscarriage part 5

[Mel3062]

Hope this is right ladies ...

brown I am 40, I tried SO with 450mls of gonal f and produced 4 follies

Crikey this thread moves fast sometimes! :)

mel I'm so sorry you've read bad things from some parents. I will say in my experience (from the parent's perspective) that some parents just like to whinge. I've found at DD's school, I will think everything's wonderful and great with her teacher and then be totally surprised to hear one or two parents in our year (who are generally really nice people) complaining about things that had never even occurred to me and I don't see as a problem at all. I think some people just like to complain/make trouble/have something or someone to whinge about. Try not to take it personally, and stay off that forum!

Interesting chats about IVF and responses. I can't comment on AFC vs AMH/FSH because my AFC was checked right at the start of my RMC investigations with Mr S and he said it was good (for my age presumably), but FSH wasn't tested until I think 8 months later and AMH has never been tested.

brown As far as I'm aware you don't get charged by Serum for cancelled cycles, and I can't do the package IVF deal as I'm using DE not OE, I think that '€4000 for 2 cycles in a year' is OE only.

With stimms bear in mind that clinics do things differently. I can't say what will definitely happen, obviously, but I know of several ladies who were at other clinics before they went to Serum and expressed surprise that on Serum's protocol for them they responded much better than they had at their previous clinics. I'd say the more info about previous history they can have, the better they can tailor your protocol to you personally.

mel I have had LIT, but it was at Serum (obviously) not over here. With that DH only had to go with me the once, they stored (froze I think) his blood for the second LIT. Missing KIR receptors - yes, that would be neupogen then. Welcome to the club! :) I don't know if I have missing KIR receptors or not, but I'm on neupogen anyway. It will be interesting to hear what Mr G says.

/waves to everyone

Thanks please can you tell me more about neopegen?
Got a meeting tomorrow with parents, I'd be sacked if I did that! Governors bought me a bouquet which was nice x

I understand people moan but when they publicaly talk about getting me out it becomes a different matter! X

Sorry you are having a crap time of it at the mo Mel and hope you get it sorted soon.

All the donor egg ivf talk is very interesting.

Waves to all.

Thanks I had some apologies today from those involved
Got the DNA fragmentation back please can anyone tell me if treatment is poss and what it will be?
Dfi- 39.1%
Hds- 15.5% = fair to poor integrity :( is this meaning poor sperm quality?

Ok mel.
Firstly you usually can improve this.
DFI over 25 percent is not good. Over 30 and there is low chance of live birth. My DH had 33 percent last aug 2012 & tested positive for a hidden urinary tract infection. A mth of strong dr g prescribed anti biotics and it came down to 22 by sep and 15.1 by jan 2013. Under 15 is excellent to good. it should say on attached sheet.
His hds was 4.8 anything under 25 percent is ok.

I also read up and visited zita west for antioxidants etc and he takes them now and eats tomato purée and olive oil lots of colourful veggies and fruit!

Thanks duggs that's how I understood it. This will upset him It was bad enough when he took antiobiotics for serum tests. Umm i think he'd best come with me to mr g follow up then so he can hear it from mr g himself :(
Interesting what you said about infection as hubby was in hosp with one so wonder if there's some still lurking though he was on antibiotic drip.
He's been on Marilyn Gardner vits and wellman before so hel be taking them again!!
Will he have to go through doing another sample?? Hel hate that :(

I just thought I'd share this info with you that I got from Serum. I can't believe how much time they are spending with me answering my questions when I'm not even a patient of theirs yet; they are amazing. I asked them about the effect of stimulation drugs on egg quality and they said:

'There was a study done a couple of years ago where they tried to compare groups of women with very similar characteristics, some of whom did minimal stimulation and some who did high stimulation. They checked the embryos for chromosomal problems using PGD, and the high stimulation group showed higher rates of aneuploidy (embryos with the wrong number of chromosomes) than the minimal stimulation group - but whether any of the errors found were triploidies, I'm sorry but I don't know.

We keep it in mind though, and we find with women who have a low response to stimulation, we see at least as good a pregnancy rate (often a better pregnancy rate) when we don't stimulate as when we use stimulation.

Another recent study didn't look at aneuploidies but just compared the pregnancy rates for older women with poor ovarian reserve using either a conventional (high dose) stimulation or a lower dose mixed protocol (clomid and FSH). The lower dose group had a significantly better pregnancy rate.

There is a lot that we don't know, but we do think that, particularly for some women, it is better to be cautious with the stimulation that we use and that the the stimulation protocol can have an affect on the egg quality and the implantation environment.'

This is interesting, as my NHS consultant told me that if I had treatment at the local private clinic they would use the maximum dose of FSH with me, and I'm wondering if that would be helpful after all.
Also, in case you're wondering about letrozole, she told me that would be considered mild stimulation, and therefore less of a risk to egg quality than high-dose stims.

That is interesting brown, and ties in with what I've read from women who've gone to Serum after doing IVF at other clinics and had better rates of embryos there on milder stims than they'd had at their other clinics. Is it Penny you're speaking to? I found, like you, when I was only going through them just for hidden infection testing, she was fantastic at answering questions even though then I couldn't imagine being able to do IVF. She works incredibly long days too, I've been on the phone with her before now at 10:30pm our time - I think Greece is 2 hours ahead. She also gave me her personal mobile and home phone numbers, and told me to call her at any time.

mel Great to hear you got apologies, and interesting what you're seeing with hubby's sperm results. duggs is the expert on that, as she's been through all this. What would you like to know about neupogen?

Just what it involves ari please, I know nothing about it!

brown thanks for the info. I have wondered if the high stimulation effects egg quality so it's reassuring to know there has been research done on it. Another reason for me to not try another cycle of ivf but use clomid or letrozole!

Just got my DHEA results: 610. The German lab that did them say these are in range (150 to 620) but everything I've googled suggests this is in fact high for a woman. Anyone else had their DHEA tested? I've only been taking 12.5mg so I dread to think what it was on 75mg, which I took for 7 months. What is really odd is that my hair has been getting thicker. I've got new hair at the roots. Presumably the oestrogen component.

I've had my DHEA tested brown but different range to the test you had done. I'm actually low - DHEA mean across 2 samples was 0.13 nmol/L where the ref. range is 0.30-1.00 and ideally you should be at 1.00. But mine are apparently tied to adrenal problems; I'm apparently in 'pre-adrenal exhaustion' state with low cortisol and DHEA results but high cortisol before bedtime which messes up my sleep (I wake up on and off throughout the night, much like being on pred).

It's a bit laughable when I consider I was worried while I was taking DHEA in case I was overdoing it. I now take 7-keto (so I avoid the hormone-altering aspect of DHEA).

What will you do then, stop taking DHEA as you're obviously not low on it?

mel Neupogen - well, for a start, it's bl**dy expensive; I think 5 vials would have set me back about £300 if I'd bought it here, a vial lasted me I think about 6 days. Standard dosing seems to be 1mcg/kg body weight; I think Mr G may prescribe higher, possibly 1.5mcg/kg. It's an injection; Serum provide a Puregon pen for this which makes injecting it a whole heap easier (this is the same sort of device as for the SO trigger shot if you've done that). If you don't have the pen then you can do it with a insulin syringe (very thin syringes) with ultra-fine needles. One injection every day. Neupogen increases your white blood cell count (off the scale for NHS testing, they do tend to get a bit twitchy if they look at your blood test results :) ) which in turn suppresses the killer cells. It's quite difficult to get hold of at times; Asda and apparently Superdrug are the cheapest, but my Asda couldn't get hold of it for me and I ended up buying mine when I was out at Serum, with a backup of Central Homecare (where Mr S uses for his SO drugs) being about £40 more expensive than Asda. Think Asda it was £263 for 5 vials.

Oh my days thanks ari how long do you have to have neopegen for? Starting when? Umm I'd def need a plunger rather than needle! Going to see dr g Saturday, sooner I go sooner I can start treatment ;)

I'm not sure how long Mr G's protocol has you on neupogen. Serum had me on it for just over 2 weeks before ET and then up to I think 12 or 16 weeks, I didn't get that far.

I would say that the insulin syringes with a very fine needle is really easy to use; if you go for something like a 31G they really don't hurt. And I am the world's biggest wuss when it comes to needles and pain! :)

You should keep an eye on your WBC, having it tested every so often to make sure the count is neither too high nor too low to be effective.

Yikes hope I won't need that then, don't think I'll tell hubby that bit ;)

If you have missing KIR receptors I would guess that it's possible you will be pxd neupogen ... ready that credit card! :)

Well ladies just on way back from dr g. Hubby is armed with 2 month supply of proxeed antidoxiants bless him, hel prob need a retest too. As for me I've got to ring mon to get a lit appointment but can use hubby's blood. Dr g said after that ill prob have an intralipid each month then when I conceive I'll need a blast of ivig and neopegen ouch!! Back to saving. Happy weekend x

Why would you need neopegen and ivig and lit? It just sounds like they all do similar?

mel Well you have to remember that not all things work for all people. LIT does something very different to IVIG, it works on your antibodies whereas IVIG works on suppressing your NK cells. Neupogen works differently again to increase your white blood cells which in their own turn stop so many NK cells being formed. They all work in different ways, basically.

Thanks ari feel much better now. Fingers crossed this is my answer, certainly doing all I can now! X

Yikes having lit on Monday, hubby being screened Saturday. Waving to all x