Monitored cycle / HCG trigger / timed intercourse

[hopingforapeainapod]

Hi all,

A niche one but I wondered if anyone else is doing / has done a monitored cycle before? I’m currently having an unmedicated one with a HCG trigger to time ovulation, timed intercourse and then progesterone support. Going in tomorrow (CD14) for another scan and hoping follicles look ready for the trigger 🤞 if it doesn’t work this month will do the same but with Letrozole next month. Would be interested to hear from anyone in a similar boat!

I've not done this yet but the next option on my journey is a monitored cycle with letrezole 2.5mg and trigger shot. I have PCOS so I think they just go straight to letrezole.

Why did they suggest natural cycle first? I've never heard of this being offered with trigger shot. Interested to hear how you get on. Are you going private?

Good luck!

I did something similar. This month was my first month taking 2.5mg letrozole with a follicle tracking scan cd14 trigger shot cd15 and I am now 3dpo. I don’t ovulate naturally and consistently hence the need for letrozole too. I didn’t get any progesterone though. Wishing you lots of luck!

@CatmumTTC I think they suggested I try this first because I fall into the ‘unexplained infertility’ bracket - all signs suggest I already ovulate naturally and so this is partly a diagnostic cycle (see if anything comes up through my scans / bloods etc) and partly hopefully to give my ovulation an extra ‘boost’ (I always spot before my period, so I’m hoping the progesterone pessaries will help with this!) Follicle and lining looked all good at my scan this morning so will be doing the trigger shot tonight! 😬 quite nervous as I have never done an injection myself before!

@UserL95 best of luck to you too! How did you find the trigger shot? Are you going to test it out or wait?

hi@hopingforapeainapod , good to hear you’re getting this option!

I took trigger shot for first time yesterday as part of a letrozole round, with two big follicles shown on scan yesterday and positive LH test.

I think I’m experiencing mild OHSS as I’ve got a lot of pain on the side I know I’m ovulating from, and bloating. Feel quite lousy! I was warned about this given my AMH level. I hope I’ve ovulated already as not sure we’ll be able to DTD if I feel like this tomorrow. I think I will have given I had positive LH before the trigger.

How are you feeling after your shot?

Can I ask when you were told to start your progesterone?

I have some but my doc didn’t tell me when to start it. She actually suggested seeing how the trigger helps this month, then adding progesterone next month. Sounds similar to your doctor, getting you to try the trigger without the letrozole! But I think I’m just going to do it as I’m impatient (and I’ve read it can help with OHSS).

🤞🏻🤞🏻

I’m testing out the trigger shot which is so bittersweet. I’m 6 days post trigger today (cd21) and still testing positive for hcg! The line has gotten more and more faint over the days though so something is happening for sure. First ever positive hcg test.

hope you are both doing well xx

@UserL95 i tested today to see how strong it would be (2days post trigger) so also experienced my first ever line on hcg test. Will probably do one every couple of days until it fades so I can see what’s happening

@Sierra26 so I did the shot on Thursday night about 9pm, no side effects or anything yesterday but have woken up this morning with quite bad ovulation pains and feeling quite bloated and tired - I also weirdly have quite a metallic taste in my mouth and am producing lots of saliva, so no idea if that’s a side effect of the hcg?! How are you feeling?!

I’ve been told to start the progesterone tomorrow evening (so 3 days after trigger). I’ve been told it’s important to get the timing right and not start the progesterone too soon as it can increase the risk of ectopic pregnancies otherwise? My progesterone results have actually always been fine on day 21 but I’m just really curious to see if it finally stops the spotting…

Not sure whether to test out the trigger or not. I’ve never seen a positive pregnancy test before so it sounds silly but I think I need to psychologically build myself up to it a bit!!

I’ve also come down with a terrible cold which is a) making me really not feel like DTD and b) worrying me that it’s not gonna work this cycle cause my body feels pretty run down - need to try and get in a more positive mind frame! 😂 here’s hoping that this finally does the trick for us 🤞

@hopingforapeainapodthanks for the update! I feel a LOT better today, normal except for the occasional dull ovary pain. Nothing like yesterday - I went for a walk in the evening and regretted it as every movement felt like it was bashing my ovary. Then slept for 10 hours!

Ive been reading up and will start my progesterone tomorrow (day 3 post trigger) too.

When I saw the positive hcg line part of me was like “oh so this is how it would feel” and the other part was like “shut up you know exactly what it means” 😂. I want to be able to monitor it reducing as if the progesterone stops AF arriving, i want to be able to test at day 14 and know for certain what the deal is. so I can decide whether to stop the progesterone or ask for more if pregnant.

Hope you start feeling better, can you have a very gentle DTD session? 😳 I know how disappointing it is if you feel like you have to miss the ideal time.

TMI but my other symptom is I’m drowning in EWCM 😂 honestly so much more than normal!

@Sierra26 glad you are feeling better! I had really weird ovary pain too yesterday so I assume it must just be a side effect of the injection!

out of interest have you been told to do a day 21 progesterone test? I’ve been told to do one 7dpo but I feel like it will just be artificially high because of the progesterone supplementation - but maybe I guess they just want to see if it’s working? I was reading last night that progesterone can apparently help with implantation and make the lining nice and ‘sticky’ - here’s hoping!! 🤞🤞

Haha @hopingforapeainapod i was honestly just googling this exact thing, wish I could share my search history with you to prove it 😂

I’m booked in for a day 21 test too but only because we’d discussed me not starting progesterone this cycle and testing on day 21 to see what effect the trigger has on my levels. Then to add it next month if not successful.

But I’ve gone ahead and started the pessaries today as this might end up being our last cycle pre IVF and I want to throw everything at it. So I’m wondering whether to go for the test or not, as it will surely be artificially high, and also now wondering if there can be such a thing as too high!

I think I’ll go as any data is interesting. If I do get pregnant this month I’d be able to assume it was likely due to the higher progesterone level, and know what that level was? And I suppose if one has NOT ovulated the level would still be low despite the pessaries, so good to know that? These are my rookie theories… any data is good data!

Fingers crossed it does the trick for both of us!! Keep me posted

I’m 8 days post trigger shot and 7dpo and am still getting a vvvvfl on easy@home tests! Surely this is still far too early to be getting bfp’s though? I wonder if this shows I have a slow metabolism or something?

@UserL95 ive been looking at this as im curious, someone on here or another thread posted a link to a calculator that works out how much would be left in your system each day.

this is based on 10,000IU dose, but I’m not sure which half-life it has! So 8dpt you’ll still have at least 39IU in your system and I THINK most cheap pregnancy tests are 25IU sensitivity? So likely to still pick that up for 1-2 more days, assuming the 24hr half life

@Sierra26 this is so interesting! And actually helps me to feel a bit “normal” if that makes sense. Maybe tomorrow or by Wednesday at the latest there won’t be a trigger shot line. I’ll keep praying for a bfp line instead x

@UserL95 keep us posted! My hcg line was super faint even day after trigger. I’m only 4dpt now. Going to need to place an Amazon order to keep testing 😂

@Sierra26 i keep telling myself that I’ll stop testing as soon as trigger line is gone… but I wonder if I’ll just keep testing until AF comes this month oops!

I’ve got tingly crampy feelings going on in my lower tummy region and I’m hoping/praying that’s a good thing… but not an unusual thing for me.

Amazon to the rescue!!

@Sierra26 yes that all makes sense! I agree it's always better to have more data to go off! My progesterone levels have always been fairly borderline (I think first test was 25, second test was 33) so I will be interested to see how much of a difference these progesterone suppositories make! I'm just really hoping I don't get too many side effects with them!

@UserL95 I think 7dpo might be too early for a bfp just yet as I think implantation normally happens between 6 and 9dpo? I've read online that the trigger can take ages to fully leave your system (that's why my clinic insisted I should wait until 14dpo to test) so I don't think it's your slow metabolism! I've unfortunately read lots of stories on MN of people still getting remnants of the trigger as late as 10 or 11dpo, which seems mad! The TWW is so hard... I always become a crazy person during it but I think this month with all the added stress and effects of the hcg trigger and progesterone is going to be particularly hard! Best of luck!

@hopingforapeainapod no side effects yet for me, and haven’t had any of the ‘messiness’ yet I was warned about! My progesterone levels have previously been either 33ish or 55ish, and I’ve had over several medicated and unmedicated cycles. I be read progesterone is released in to your body in bursts so levels can vary a lot. Very curious to see what the cyclogest does for us both!

@UserL95 you’re a few days ahead of us so we’ll live through your testing until our time comes 😆

Really hoping for a few positive stories! Xx

8dpo and I had a temp drop this morning so I’m most likely out. Still need to test the remaining hcg but I think it’ll be gone today. I told myself this whole time to not get my hopes up after over 2y TTC but I feel crushed each and every time!

Aw @UserL95 im sorry to hear this. What dpo does your temp usually drop/ how long is your luteal phase? My temp normally drop either sharply on the day AF starts, or in two steps starting the day before.

You’re not out yet, but I know how it feels to be faced with the data suggesting it’s going in one direction, and not want to get your hopes up.

Sometimes I feel like time is just running away faster than I can process, and wish I could just pause it while we work all of this out xx

@UserL95 did you have a progesterone test this round? If your temp has started to drop it usually indicates your progesterone has already dropped, as progesterone is what keeps temp high, and id say 8dpo is quite early for that to happen. So could be a good data point to use to ask for progesterone test/support?

sorry if you already know all of that, just thinking what I’d do next!

@Sierra26 im 8dpo today and my luteal is usually 9-12days so it can be quite short. My temp usually starts to drop 2-3 days before AF shows up.

I really agree with that time thing, it’s scary where time is running off too!

I’ve never had a progesterone test but I sometimes think mines on the lower side, especially as I do experience anovulatory cycles. I tend to supplement with b6, vit c d e as well to help. So that’s data I don’t have unfortunately!

This is a pic of my hcg starting from 2 days post trigger to today at 9 days post trigger - still the faintest line there!!

@UserL95 I don’t want to give you false hope but I wouldn’t panic just off the basis of one temperature - I think it’s normal to have random one-off peaks and drops - if it continues to fall then that may be a sign af is on its way but I have also heard that you can have an implantation drop (due to a late surge in estrogen) so if it goes back up tomorrow you may still be in the running! I also agree with @Sierra26 that you should definitely get your progesterone tested if possible - 8dpo is quite early for temps / progesterone to drop as implantation normally happens between 6-9dpo! I think ideally you therefore want progesterone / bbt to remain high until about 10/11dpo to give plenty of time for the egg to stick?

I’ve woken to some light pink spotting this morning… really hope it’s just an effect from the cyclogest as I’ve read that can happen. I’m only 5dpo so would be insanely early to be seeing my usual spotting (tends to start any time from 9 to 12dpo).

@Sierra26 at the risk of TMI are you inserting the pessaries through the front door or the back door?! I’ve definitely heard if you put them in the front door they can cause spotting (which seems ironic as I thought that’s what progesterone is meant to fix!) so could try another mode of entry?!