Ivf anyone starting stimms next week?

[naty1]

Im starting stimns next week for icsi(dependent on blood test)?
Anyone at the same time want to join.

Hi :)

Poland was lovely, nice and warm, lots of street entertainers this time I feel like I have been on holiday.

Looks like we might be at the same stage after all Naty, egg collection won't be until some time next week now. Saw a different doctor and she was really nice so I feel more relaxed about it.

I'm having some very positive feelings so I reckon at least one of us will succeed this year :D

Sounds like you got some reassurance from that scan then Nat.
Now with 16 eggs, seems like you will have lots of embryos.
But I know from your history that it isn't the case.
So I anxiously waiting to see how it works out for you this time.

suzy, sounds like your IVF has the added benefit of creating a relaxing holiday mode; just what you need to alleviate the IVF stress.
Suddenly it's all happening for you!
Do you know how old the donor is?

16 is a great number, can't wait to see how many embryos you will get. It's always reassuring to have some spares to freeze :) I'm looking forward to hearing about your scan on Monday

My lovely donor is only 30 and already has two healthy children of her own. I have been reading that a pregnancy is mostly successful due to the genetic quality of the egg so fingers crossed this time it works.

Shellster, will you be having another round in September or do you have to wait till October now?

Its good you get a bit of a holiday with the trip.
30 and 2 kids already sounds really good donor.

Im a bit worried why the follicles are growing slowly (that the thyroxine has made my blood sugar higher.

Last time they grew fast and were immature but fertilised better.

Ivf#1 grew similar to this more mature but low fertilisation rate.

I could do with the follicle sizes.
They keep saying last time follicle sizes should have been mature, but maybe 4 were > 15mm and the other 4 collected were smaller but they triggered due to lots of follicles and rising oestrogen though i dont think it was that high.

Shell do you know how high your e2 has been each time?

Nat, if it's any comfort, I am doing the estrogen priming protocol because it produces more mature oocytes and increases good quality embryos. Research shows that these follicles grow slower. So there seems to be a positive correlation between slow and steady growing follicles with better quality embryos instead of growing them hard and fast. Here is one study:

On day 8, follicles were smaller in the E2 group compared with the control group. This was associated with more 16 mm follicles, mature oocytes and embryos in the E2 group
ivf.ca/forums/topic/13713-best-protocol-for-egg-quality/

With regards to estrogen levels, I don't have my results. Will have to ask my nurse. But I found this if it is any help:

To convert follicle size to estrogen levels:

There is no difference in E2 production between follicles measuring 14 mm and those that are smaller, nor between follicles measuring 17 mm and those which are larger (32). The authors devised an equation to determine expected serum E2 levels depending on number and size of follicles in both ovaries. Thus the serum E2 level on the day of hCG injection is:

E2 = 291 pg/ml + 180 (x) + 64 (y) + 18.7 (z)

where x, y and z represent follicles measuring >17 mm, 15 to 16 mm and

I think last time my e 2 was 4500 or so at trigger. But this was probably the little ones. They were quite small about 2 17s and 4 15s so only just big enough.

I will try the cal on these ones.

All going wrong :( i now have a lead follicle
So 1 18 1 about 15 and a 13.
She couldnt find the large one from fri on the right side
All of the rest are about 10 or under.
So looks like i may get 3
Or increase dose
Or cancel
I will most likely lose the largest one it has grown 4-6mm in 3 days but stopped the others growing.
They took bloods but expect them to be low. It may tell them if i ca. Increase dose.
But the smaller ones seem stuck.
But i would have to grow them quickly for a wed trigger (or if not go to sat for mon ec.
I cant go ahead with the 3 as i would then be incredibly luck to get 1 as at least 1 would be immature and then 50% fert rate.
Unless i trigger today that 1 will be lost

I think that makes about 700 e2 .
Will have to see what they say.
I just dont think the others will grow with this big one

oh Naty :( what on earth are you going to do?!

I wouldn't know what to do for the best but you know so much about how it all works I'm sure you will know the best course of action, although I guess that doesn't make it any easier a decision.

Hopefully Shellster will turn up soon as she is also really knowledgeable.

Thanks suzy
The clinic called e2 was 3500 i think.
They have put up menopur to 150 a day from alternating though this wont make a difference till tomorrow.
Now im worried even if i go for ec it would ideally fall next weekend when they dont do ops.
But first stage is to see if any more grow on wed.
Odd to think i did op on tues in jan

Only things i think could have caused this
Lost about 7lb (back to weight from 1st ivf)
Higher protein diet
Being on metformin since jan
Second ivf in 6m

I still must have a lot of small eggs to have a high e2 level so the pcos hasnt gone just not responding to the drugs.

Thanks for your vote of confidence in my but I don't know quite how knowledgeable I am Suzy. I have read every research article in the world yet I have probably had the worst IVF failure rate in the world with 7 failures!

Nat, it seems that this protocol just doesn't suit you as you start with so many follicles yet get so few mature eggs. I don't know if your clinic is open to suggestions but I would really recommend the estrogen priming protocol in your case. There are many research articles online that show taking estrogen from day 20 the cycle prior to IVF results in attenuated size discrepancies the following cycle for IVF. Here is one link:
humrep.oxfordjournals.org/content/18/12/2698.short
And there are many more research articles which back this up.
My first two cycles, I only got 1 then 2 mature follicles. The 3rd cycle I tried estrogen priming for the first time and I really noticed they grow at a more stead rate and I got 5 eggs - still not a lot, but a good effort considering I only started with 8 follicles on day 2.

In a normal cycle, by day 20 your body has realised you are not pregnant and starts growing the antral follicles for next cycle. So by day 2 the following cycle when you start the IVF meds, your body has already chosen the 2-3 strongest follicles and started growing them so they are bigger than the rest of the follicles. Starting estrogen on day makes your body think you have a mature follicle since these are what produces estrogen, and so your body doesn't start the process of growing 2-3 lead follicles for the following cycle. The result is that during the following IVF cycle, your antral follicles are at the same small size and they grow more consistently.

Of course, all this suggestion about what to try next cycle is no help to you in the midst of your current cycle. Over here it costs only $300-$400 if I cancel a cycle before egg collection so I chose to cancel my March cycle when I only had 3 mature follicles. How much are you out of pocket if you cancel now? I hope Wednesday brings some good news. It's going to be an anxious wait for you until then. Hope you can find some tactics to keep yourself calm and sane.

It got cancelled :(
The nurse thinks i have a hydrosalpinx on right side.
I only had 3 eggs all on left 1 22mm so we could have collected them but would have been a bit silly.
The consultant thought it was really small and not flowing into uterus but because of so few eggs...
So cancelled and im in 7 days of pill plus spray them stop then period as day 1 and start again worked out this would be EC mid oct.
So a bad day. Also not sure how thyroid will have changed in this time.
I would start again in slightly higher dose of 150 every day not 150/75
I really cant predict how id respond.
Also what has happened to that one ovary - not responding.
I may not get any more next time

oh what a shame, I'm so sorry :(

I hope it didn't waste too much money, I know how every penny counts in the game.

I'm glad your going again though :) have they recommended an exploratory lap or anything?

They said a scan between days 1-21 of next cycle. I presume its an ultrasound.
But im not convinced im wondering if i should have hsg as i think it would have gone down if it only appeared after all this stimming.
Was this why you had your tubes removed?
Not sure cons thought thats what it is (it wasnt there 2 days ago)

Both my tubes were hydrosalpinx so I couldn't conceive naturally and they wouldn't do ivf because of the risk of fluid leaking into the womb. I had an exploratory lap which was when they found them but afterwards they could see the via vaginal ultrasound. So if they didn't spot yours during a scan it can't be big or maybe it's some kind of swelling? Hopefully it's not a problem as it's a right pain having them removed although it doesn't effect your ovaries

Thats very interesting.
Im hoping it will go down as ive had so many scans 4 this time, 3 last time, 4 in 2011 plus 2 consultant scans previously.
The only thing i can think cause would be childbirth but then it would have been there in jan. Or brought on by the stimming. Or endo - that may explain why the ovary didnt respond
(,i had drunk a lot of water though so thought that could be it)

I feel terrible for you Nat.

I know the feeling of counting down until you hope the saga is over.
And you must be the same as you are already counting down to next EC.
Makes sense not to waste $$$$ on EC for three eggs.
Were you out of pocket a lot for the treatment so far?
What exactly is a hydrosalpinx in your tubes????
Do they have any idea why the right side didn't respond at all?
Are you keen to try a different protocol next time that gets them growing at more of a consistent rate?
Estrogen priming worked so well for me to get 5 eggs from 8 follicles, after two previous IVF's where I only got 1-2 mature follicles each time.

So I swear by it.
Hasn't worked as well since and I'm wondering if it's because I switched to soy milk and the estrogens in the soy are interfering with my bodies ability to absorb the stronger estrogen in the tablets.
Have cut it out from day 8 this cycle when I stumbled across that theory.
I started the estrogen tablets yesterday (day 20) so we shall see.
It all feels like forever away.
I just want to be past the point of egg collection so I can be out of my misery instead of all this build up.

No they just said each cycle is different.
I just hope its not been damaged by previous surgery, ECs.
I guess at least with a higher dose i might get more from the left even if the right doesnt respond.

I just heard from the clinic and only 1 embryo has made it to day 3 :(

They have graded it 8B saying its 8 cells and good morphology. In your opinion is that good? I'm slightly panicky now and have just spend £400 on flights and a hotel and I'm not convinced there will be an egg to transfer at this rate!!!

I think 8 cell is where it should be day 3. (Think i had a 8b and a 6-7 b/c)
So it would be a 5 day transfer.?
So there were more eggs and embies they just havent made it?
It seems odd as would have thought there would be more.. as i.think you had a couple at this stage with your own eggs they just didnt go further than day 3 or so except the blast.
Does it suggest sperm issue?

I wonder how the donors embies did.
When i was 32 i had 2 embies but only 1 good one and that worked, the younger the eggs the more chance i think 1 embryo under 35 was 20% chance at my clinic but i think that probably increases if you have a blast.
Also i think you said donor has kids so i would think that is a good sign.
Ivf is so unpredictable.

Fingers crossed
At least if youre going to blast you will know how its got on.

Yes, I too thought you had 4-5 embryos at day 3 with your own.

Weren't you guaranteed 5- 6 eggs?
So of the 5-6, only 1 fertilized, or they all did but the rest died before day 3?
As Nat says, IVF is so unpredictable.
I had one lone embryo fertilize well last IVF.
Immediately, I thought it was game over.
But then it was 10 cells at day 3, a morula at day 4 and I couldn't believe one embryo made it that far.

Sadly it died before day 5 transfer, but I would think that one embryo from a 30 year old has more chance than my one embryo from a 37 year old!
As Nat says, this woman is a proven producer.
And she would have only had her one lone egg make it all the way to day 5 and then implant each time she conceived.
Allow yourself to stress as much as you need to now. The embryo is out of your body and it's out of your hands.
One more day and hopefully you will be in 'ecstatic mode' when you are having a day 5 perfect embryo transferred.

She gave me 7 eggs but I thought with her being only 30 they would have done better and your right my own eggs were more successful!
Luck of the draw I guess, after the panic I realise I only need one to make it till tomorrow so it's not all bad. It's wiped us out financially so I don't know what we will do if it fails. Its a shame we have to worry about money when there is so much worry about the whole situation :(
I fly out tonight and I have an appt at noon to discuss the transfer before it happens, I am praying I don't get bad news then, would rather know before I set off.
I will be asking them what the eff happened as I think a fertilisation rate of 1 out of 7 is very poor for a donor.
Keep your fingers crossed for me ladies :D

Quick update before I jet off
It's now at morula stage a solid B with little fragmentation. I'm no expert but I reckon that sound quite good

Oh that sounds good.
Good luck.
With dd we initially had 1/7 fert rate and then they 'found ' another one so must have missed it fertilise so she could be either of these. (They also injected an immature one that didnt grow so 2/8 fert. But the next time we had 50-75% fert 2-3/4. But thats still low which could be the dodgy sperm or my pcos, or even a different lab tech who spotted better sperm.
Its odd the drs dont seem to think sperm does much with fert , but interesting all 3 of us needing icsi having issues.
I think as well it doesnt do eggs much good to have to be isci'd. As they need to be squished

Oh okay, so 7 eggs but only 1 fertilized. Geepers.
That must have been rough news to hear.
I did read one article that said if the eggs fail to fertilize, it generally points towards the sperm, where as if it is poor quality, it points towards the egg.
But there seems to be no scientific evidence to prove this and you could probably show me an article that says different.
However I have a friend who'se husband has terrible sperm parameters and she had 1 of 8 fertilise, then 0 of 10, then 4 of 25. But of the 5 that did, 4 made it to blast. Seems that if the egg had issues that caused such crap fertilization, then the eggs wouldn't have gone on to be such strong embryos.
So it certainly makes sense in this case that the sperm was the fertilization issue, but once they did their fertilization job, the embryos were top quality because that was the responsibility of the egg.
If it is the sperm, I wonder if the sperm preparation, incubation period and selection method is different over there Suzy because as you say, you did better with your own.
Anyway, here goes me trying to over analyze everything just like I do with my own IVF's.
Hopefully none of these questions matter and you will next be reporting to us that you have your little embryo safe inside.

so I'm back from my travels :)

Had my single embryo transferred and it was graded at 4AA which the doctor said was excellent. I remember that my first IVF also produced a perfect embryo at day 5 so it means nothing sadly. But fingers crossed eh

Hope your both ok