TTC for 18 months or more. Moving onto iui/ivf/icsi.

[lucieloos]

We have relocated from the conception board where we were previously chatting under the thread 'ttc for 10 months or more'. A lot of us are now long term ttc-ers and are going through infertility treatment or looking to take steps in this direction so we feel this might be a more suitable home for us!

Feel free to stop by and say hi and hopefully we can share the journey together and make it a little easier along the way!

Hi all,

Hope the weekend has been treating you well, I started spotting yesterday so AF is definitely on her way, I'm currently on d33 which is unheard of for me!

Banana you reminded me I have not done stats.

MrsRen - 32
DH 30 (nearly 31)
TTC no 1 for 15m (again another sneaker from the last thread)
All my initial tests ok
May have a mild sperm problem, we are awaiting a repeat result.
GP says we will get a referral but it will be June 2017 before we are eligible for IVF here and will only get one NHS round.
We are happy to try naturally until then but we want to make sure my tubes aren't blocked first so we aren't wasting time.
I started drinking dandelion/red clover tea last month in the run up to ovulation and we started using pre seed as one of the issues may be mobility (anything we can do to help them!)
I've also got raspberry leaf tea this month as I'm convinced as my periods are light in not making a very good home

Basically I try to solve everything with a cup of tea!

Hi all,

Banana i really hope it all works out for you this time, you deserve it after all you have been through xx

Lucie all the best for tomorrow, fingers crossed you will be all good to get going again x

MrsRen sounds like you are preparing well, i really hope that it all works out for you and that you won't even need your NHS round next year!

MPP thats great news that you got nice lines on your OTD, i hope the next two weeks go by quickly so you can have your scan!

It is very hard working in a nursery, some days are harder than others, i have run a baby room for 13 years so thats where all my experience is but my manager has been really good and said anything i need just shout. She is clueless, excited and presumes that IVF = a baby first time round but she means well!

Hope everyone is having a lovely weekend!

Xxx

Banana! So so lovely to hear from you and what fab news about the wash working and not having to have the IUD! So pleased you managed to get the viagra too!

MPP great news about the tests and also the nicer house not being too far from where you are now - hope the process goes smoothly and quickly for you!

Hope it must be so hard for you glad your manager is good though it really helps (except the IVF = babies thing!).

AF came yesterday so will call the hospital tomorrow and do the obligatory preg test. I'm hoping we can get going with the next round of IUI ASAP.

Could I have some advice please ladies though?? I'm sure that my lining is / part of the problem - it was 5.8mm last time but they still did the IUI anyway they seem to think it was the clomid that thinned it and whilst I don't disagree I do think it's been thin before as my periods are so so light since coming off the pill / never had a bfp.

They did suggest half dose of clomid (so 25mg) or injectibles the next time round - I'm going to ask for injectibles I think but if lining is still thin, is it oestrogen tablets I should be pushing for? Want to go in and sound like I know what I'm talking about and not get fobbed off!

Am trying raspberry leaf tea, Pom juice, liquid iron a la sammy, Brazil nuts etc this cycle to see if it works haha!

Banana, what's the difference between John Bowen pessaries and the super expensive ones? I really just want to boost my lining by an extra mm or so. It's so frustrating as all the times I have done egg collection only my lining has been perfect but now I have started transfers it's not quite there or not quite where I want it, the docs have been happy enough but I would like it a bit thicker. I joked with DH that this would probably happen as soon as we wanted a transfer!

Hope, I can imagine it must be very difficult working in a nursery especially when having treatment. I'm glad you have an understanding boss though.

Maple, so sorry af has arrived and hope you can get started with the next IUI asap. Clomid is well known for thinning the lining so I think it would be good to try injectables next time instead. I think you can possibly add in estrogen on a fresh cycle but I'm not sure on the timings with iui. Banana would be your best bet as I think she may be looking at doing this. I would also be interested in the answer as it's something else I would like to try.

lucie well the thing with the John Bowen ones is that we don’t really know exactly what is in them - they’re bought from a random bloke with a gmail address, can we really be sure that the appropriate dose of sildenafil is in there, and if the formulation is appropriate? All the studies are based on them in a pessary format, made up by regulated pharmacies who ensure the exact dose goes into the right format for optimal vaginal absorption. I would hope that John Bowen’s v-cream is pukka, but the fact is we don’t really know. The studies are all for 25mg pessaries x 4 times daily - so whilst John’s might be as effective, there isn’t any way of knowing. For you, I’m sure they’re more than enough, given you don’t have major lining issues.

Hope big hugs

Maple Right. 5.8mm is deffo not thick enough. It’s accepted in pretty much all the literature than the minimum for IVF transfer is 7mm - with 8mm+ being preferable, and 9mm+ being ideal. The benefit of injectables is that it doesn’t thin your lining - the down side is that they can be more unpredictable and you could end up being told to cancel a cycle if your ovaries go off like rockets. Clomid’s effect on the lining is cumulative, so I’d personally go for injectables too. They can add in oestrogen tablets later on in the cycle, once the follicles are sufficiently well developed - you can’t add it in too early or it’ll stop the follicle from growing.

We did a more complex version of ovulation induction using Cetrotide (ovulation blocker used in IVF) so we could add in the oestrogen tablets earlier, for the ovulation indiction FET just gone - but this is probably overkill for an IUI. Main thing is that you’re aiming for a 7mm+ triple line endometrium at the time of trigger.

When they’re doing dildocam, ask if they can check your uterine blood flow too. My consultant checks it every time, just flips a switch to bring up the colour doppler which shows blood flow to the endometrium. Don’t know if your clinic will do that but worth asking

Other vitamins to take are 6g l-arginine and 1000iu Vitamin E xx

lucie for a fresh cycle you can add in oestrogen tablets or patches as soon as your pituitary is switched off - so with me it was within about 36h of having started the Cetrotide. Not sure how it works on a short flare - not sure at what point the buserelin switches from flare mode into suppression mode. You only want to add them in once your pituitary is switched off, otherwise the oestrogen will interfere in the FSH / LH feedback loop

Ah right ok yes I see what you mean banana. I asked John about the formula and he said there is 2ml of cream in each applicator and 100mg of sildenafil. He recommends 1-2 a day but I see penny recommends 2 so will probably try that. It's worth a go for me anyway.

So on a fresh IVF it's ok to add in the estrogen anytime after Cetrotide? I asked dr Sher about it and he seemed to think that estrogen shouldn't stop the follies growing if gonatrophins were used as well but I wouldn't want to risk it by adding them in early. I normally start Cetrotide on day 8 so I'm thinking go to first scan on day 7/8 and if lining is looking a little thin add in estrogen from day 8/9 rather than wait until after EC again as dr sher says that's a big no no as even though the lining might thicken it will just be down to secretion of fluid from the glands plumping it up rather than the base layer actually getting thicker which is what's needed.

Also I dont know whether to take l'arginine whilst stimming? I did last time and I did ok with (well actually best cycle yet) it but I've since read it can affect embryo quality. I only took 1g though.

I was told the same lucie - the doses are completely different to the pessaries doses, and I don’t know how the gel actually gets absorbed. It’s supposed to be 100mg split 4 times a day in all the studies, but with John’s Penny says you use one twice daily. Deffo worth a try - and until my pessaries arrive I’m using them right now!

On a fresh IVF my consultant said we wouldn’t add the oestrogen in before the Cetrotide for two reasons:

• if the levels of oestrogen are too high then the ovaries may not respond well to the stims - unless the pituitary is shut down
• if the follicles are large then the oestrogen could trigger premature luteinisation without the Cetrotide

So we only started it as soon as the Cetrotide had kicked in. In my second cycle I was only just above 7mm at trigger - which wasn’t really enough (although I did get pregnant, I also miscarried a healthy embryo). My lining was 8.5mm by transfer, but this was the lining become secretory (as you describe) - post EC it’s switched from the proliferative phase, and that’s when you want the oestrogen to exert its influence. So deffo important to start it well before EC.

I wouldn’t take l-Arginine on a fresh cycle for the same reason as you, but might on an ovulation induction cycle where you’re just looking for one or two good eggs. I didn’t take it in my fresh cycles, but have switched over to lining supps for a FET. They’re like bloody horse pills!!

Damn I wrote a post and it disappeared!

Thank you Lucie and banana!! Read it through a couple of times.

So next appointment (I'm hoping they will have me in for a scan this week):
a) ask for injectibles
b) ask to check uterine flow
c) ask for oestrogen tablets if lining is still thin later on in cycle and follicles are developed enough

For the supplements do you take them everyday throughout the cycle? Can I take them alongside pregnacare conception which is what I currently take? Finally where is the best / most cost effective place to purchase them??

Thanks so much!

Ok thanks banana, I will give it a try and see what happens. Have you ever tried it with the terbutaline that Dr Sher recommends?

Thank you Maple, Lucie and Banana!

I wish i could also add some advice on lining etc....however being a newbie and not having done a round of IVF yet i am completely clueless and will be no help at all!!!
You ladies know so much about it all and what to try and take i certainly know who to ask if i need any advice when i start treatment!

Goodluck to you all xxx
Xxx

Scan today at 12:15! Have to sneak away from work - a bit worried as could be potentially gone for ages as they said if all looks well they will get me to go to pharmacy to get prescription (which could have a long wait) and then back to them for them to show me how to do the injections eep!

Hey maple, I'm also sat waiting for my baseline scan and have sneaked out of work too. I arrived about 30 mins early so didn't time it very well. There are another 2 couples here waiting so they must be before me. Hope they aren't running too late. Just want to get it over with. I have no idea what to expect doing the cycles back to back like this and whether we will be ok to go ahead this month or not. Good luck with your scan. Let us know how it goes.

Good luck Lucie! Is it far from work? It takes me about 30mins. Hope it goes well and keep us updated!

Same here maple about 30 mins each way!

Good luck maple and Lucie! Fingers crossed x

Thank you to everyone for your kind welcome. I really do appreciate it.

I'm just doing a lot of waiting at the moment for my next appointment but I have a nice holiday soon so hopefully that might take my mind off things a bit (fingers crossed!).

Good luck Lucie and Maple for your scans.

That is great news about the wash Banana.

Best of luck Lucie and Maple.

We managed to DTD last night, courtesy of a viagra pill, then this morning again courtesy of DH feeling more confident. Looks like the SA is on for wednesday still. AF due wednesday or thursday, so next cycle is looking more promising (we still have a few blue pills kicking around just in case).

It all went well! I was nervous as starting again so soon but the lining was nice and thin and where they wanted it to be and she counted 5 follicles on each side so 10 there altogether. Obviously we don't know if all 10 will respond to the medication and grow yet but it's a good start. Last time we went there were only about 7 altogether, 3 of which didn't really respond so it's a good start and she said 10 was good so I'm pleased so far and onto the next step.

My next scans will be this Friday and bank hol Monday which is good as I'm off work for both of those days so no sneaking about! I'm thinking EC will be a week Friday if everything goes well but they will let me know that after the scans. Phew.

Catch up with everyone later x

Great news Lucie! Lucky you don't have to be a sneak next week! What are the next steps now for you? Sorry, I'm clueless!

I've just had my scan too - they have prescribed me injectibles which I'm just waiting to collect and then back to the nurse for her to show me how. They poo pooed my request to check uterine blood flow banana and then said vitamin e, baby aspirin etc was a myth but they have said they will supplement me with oestrogen pessaries (are these the famous leaky fanjo bullets?!) if my lining is still thin! So some progress at least!

Yay maple glad everything went ok and good news they are prescribing the injectables! Next steps for me are the 2 scans to measure the sizes of the follicles and then hopefully by a week Wednesday I should be ready to trigger and then egg collection a week Friday. That's if everything goes to plan.

Just had my first shot - it stang better get used to it though and I think it will be harder doing it myself the first time! Hopefully I'll be shooting up like a pro in a few days! Next scan booked in for next Tuesday. I'm on 75iu of Merional.

Lucie hope you get lots of follicles over the next week!

Brilliant news lucie -10 follies is a great start! Are they putting you on short flare again?

At a punt I’d guess my EC would be a week on Fri or possible Mon 5th if he wants to give my lining a bit longer - we’re not worried about the egg quality so doesn’t matter so much if they get a bit overcooked (as long as I don’t overstimulate, we’re all good)

Mine’s a bit of an odd FET hybrid, as obv I’m having an EC, but we’re not actually doing any IVF. Would be so lovely to be able to be cycle buddies, really really hope I’m able to join you in having a transfer.

Brenna great news about the DTD and SA! I fessed up to my consultant to having pretended to be a bloke to get viagra pills from the Superdrug online Dr service to self medicate for my uterine lining (oral viagra does naff all, but some clinics prescribe it because they can’t get the pessaries). He didn’t even bat an eyelid - think he’s basically heard it all from me! Glad the little blue pills did the trick

City holiday sounds fab, hope you’re off somewhere nice

maple great news about the Merional and the oestrogen tablets - honestly that is WAY more important and will do way more than vitamin E etc. Oestrogen will likely just be oral tablets - fanjo bullets are the progesterone pessaries, they are a treat, I can tell you! Sounds like you’re all set, hurrah! You’ll be a stabbing pro in no time

Hope I knew absolutely sod all at the start of my journey - have accumulated knowledge over the course of several cycles. TBH I think sometimes know too much…

Maple, good luck lovely. You will soon get used to the injections and be a pro before you know it.

Banana, thank you, I'm really pleased so far although I know it doesn't mean they will all grow but at least it's a start. I'm being very naughty and kind of doing my own protocol this time. The NHS don't realise how many ECs I've had as I'm only allowed to tell them about one before it affects my allowance on the NHS so they don't know how I've responded previously. They want me on short antagonist this time which is fine but on 450iu Gonal which I wasn't very happy about months back when they first suggested it as seems very high and my last high stimms protocol with dr Sher didn't turn out very well so I've taken it upon myself to do the mini again with out telling them I had as good a response with that as I've ever had and so I don't see any reason for pumping my body full of high stimms which could potentially affect egg quality. I know no 2 cycles are the same and just because I did well on the mini last time doesn't mean I will this time but if it doesn't work out I will still have enough meds left over from the NHS to do another 3 private mini ivfs so I think that's what I've decided! Eeekkk will be great if we can be cycle buddies! Fingers crossed.

Brenna I missed your update on dtd! Glad the little pills helped and fingers crossed for Wednesday!

Banana he said oestrogen pessaries which is why I wondered about the fanjo bullets! Hmm I would prefer tablets personally!
Really hope you get to transfer soon!

I could do with another holiday city!