Switching to a long protocol for my next ivf cycle

[Pep1952]

Hi everyone

Sadly my first ICSI cycle didn’t work :(

We collected 5 eggs (AFC 7) which were all mature but only 2 fertilised and 1 made it to a day 6 average quality blast. BFN.

Anyway, we did ICSI because we found out on the day before my egg collection that DH has dna frag of 32%, his SA was always fine. Incidentally he has bilateral varicoceles (diagnosed in 2019, he was told no intervention needed) which causes him pain / dull ache so he’s booked for a repeat ultrasound and will also see a urologist (Mr Tet Yap). Mr Ramsay is fully booked for the next two months.

The fertility dr is suggesting we try a long protocol next time we do a cycle. I wonder if anyone had a better experience with long protocol after trying a short one? I’m a bit concerned about oversuppression and I thought 5 mature eggs from 7 follicles in the first round was a good response but dr thought it’s worth trying a long protocol to see if we can get more eggs to mature.

Thoughts?

@BreakfastOats I'm sorry to hear you are getting so stressed that you're genuinely thinking of not going through with it.
Maybe if you start a new thread on here specifically for this you might get advice from others who have faced similar challenges?
For instance I'm not worried about general anaesthesia, although they don't do general anaesthesia with egg collection anyway, it's just sedation...
But you know what I mean. We all have different levels of anxiety when it comes to medical procedures / risks

Hope you get some reassurance and tips from others or from your clinic if they offer counselling?

@bubu24 Thanks for understanding. I find this so embarrassing and feel like I’m failing my husband although he keeps saying it’s up to me what we do. The clinic’s counsellor doesn’t have availability for another month. I found someone privately and hoping to book an appointment tomorrow. I spoke with a nurse today and she said that with a low AMH like mine, I have more chances of getting hit by a bus than getting OHSS. She also said that lots of women are scared of general anaesthesia but the consultant anaesthetist will stay with me during the collection. I will start a new thread, thanks for the advice.

@BreakfastOats lol the nurse's response made me laugh. But it's true...

I'm glad you found a therapist to speak to. There's nothing to be embarrassed about. There's lots of people with all sorts of anxieties and it's not always as easy as telling yourself to just get on with it. I hope the therapist will help you identify where your deep fears come from and retrain your brain to think and react differently when triggered,

For now I would strongly suggest you stop reading about all the things that could go wrong, otherwise it will all become too overwhelming.
I hope you'll get reassuring stories on the new thread that will help balance things out.

And you probably wouldn't realise it from my responses, but I'm also an anxious person, it's just that medical procedures is not one of my phobias 😄
But for instance I sometimes find myself worrying about what life will be like with a baby (from thinking about being tired and not having time to do anything else to what if I slip going down the stairs and drop the baby...). Then I start wondering if this means deep down I don't actually want a baby and I start feeling bad. So there you go, we all have our irrational thoughts that can feel rational to us in the moment. Putting this here hoping it makes you feel better.

Haha I know it was a good response, I needed that comparison to start getting back to reality! I appreciate you sharing your concerns @bubu24 you’re absolutely spot on saying that our irrational thoughts can seem rational to us. You are definitely a doer and this is how I want to be, I don’t want to give up! Thanks for your support 💜

Hello! Just checking in to see if any has any updates? x

Hi @BreakfastOats no updates as such from me. I am on estrogen pills atm and have a scan on Friday to check if my lining is thick enough to start progesteron, so hoping transfer will be late next week.

How are you? Have you decided to start treatment?

That’s great @bubu24! Not long now, I’ll keep my fingers crossed for you! 🤞

I’m going to see the nurse next week and I’ll start medication that will help me get my period on time so we can start treatment in the last week of March. Still waking up everyday and trying to shake off the unease I feel about the whole thing, trying to think about one step at a time basically!

Thanks so much @BreakfastOats.
Really pleased to hear you decided to go ahead. As you say, one step at a time and you'll get there. Wishing you all the best with your treatment ❤️

Thank you so much @bubu24 I appreciate your support! :)

Hello both… thanks for your updates! I am also gearing up for my next cycle. Eeek! Good luck to all of us! @bubu24 can I ask please if they do any monitoring during down regulation at all? I was wondering if I can squeeze in a holiday before stims when I know you’ll be monitored very often therefore should stay put. Xx

@Pep1952 no, there was no monitoring during downregulation for me. The first scan was when I got my period after stopping the pill.

This was my timeline:
Norethisterone from cd14 to cd 25
Buserelin injections from cd21 until my baseline scan
4 days after stopping Norethisterone I started my period
Baseline scan at cd2 and I then started stims

I would say definitely check with your clinic though to be sure. Hope it's all fine and you get to enjoy a nice holiday 😊

Thanks @bubu24 that’s really good to know. Yes I’ve got my nursing appointment next week but will call tomorrow for advice. I hope your scan goes well on Friday!

Hello @BreakfastOats @bubu24 how are things? :)
@bubu24 have you gone ahead with transfer?
Hope you’re both doing well! I’m starting downregulation next week! X

Hi @Pep1952. Thanks for checking in :)
Yes, I had the transfer last Thursday. My test day is April 3rd. This is 14 days post-transfer - longer than what I have seen others clinics do but I will try to stick to it anyway :)
All went really well.. It was just last night that I started having some mild period cramps and got worried but apparently it's common and nothing to worry about. Worrying won't do anything to help anyway so I'm trying to stay positive :)

Will you be using buserelin for downregulation?

@BreakfastOats I hope things are well with you too.

@bubu24 so pleased to hear it went ahead! Best of luck and good decision trying to wait for OTD.
I’ll be on synarel nasal spray. I’m a bit worried I’ll mess up doing the spray but dr said they’ve put lots on it and well tolerated apparently. I’ll speak to the nurse at my appointment which I’ve needsd to postpone to Friday! How were you during downregulation? I’ve read lots of women hate it!!

@bubu24 also re cramps yes very normal apparently! So try not to worry, I know it’s difficult x

@Pep1952 I get why you'd be worried but I guess unless you sneeze or blow your nose straight after, absorption shouldn't be affected.
I felt quite moody during downregulation but then felt better once I started stims. Also I had some bad headaches, might have even been a migraine but can't remember if that was before or during stims. Just make sure you drink lots of water throughout.
For the low mood if it does come, just tell yourself it will be better soon :)
That said, hopefully you have no side effects at all!

@bubu24 thank you! I had my appointment w nurse today and she actually gave me an option between spray or injection. I chose injection because I know myself too well - I’ll worry endlessly if I actually got the right dose from the nasal spray. 😅 No mention of norethisterone though. How long did you do sims? Did buserelin injection delay your period at all?
Not long until 3rd Apr. Best of luck xx

@Pep1952 no, buserelin didn't delay my period but not sure if that's to do with the cycle day you start. And I was also on the norethisterone and my period started after I stopped that, even while continuing with the buserelin injections...
I think for my clinic norethiterone is standard practice even on short protocols, or maybe just for people like me with endo. I didn't enjoy being on it, some maybe count your blessings there :)

I think with the long protocol I was on stims for 12 days, on short once I think it was 8 or 9.

When do you start the buserelin and how long did they tell you to take it for?

Hi @bubu24 I start it on day 21 of my current cycle then I wait for my period. I’ll then have a scan to see if I am ok to start stimming. It’s such a weird feeling seeing all these injections again but I know it’ll be worth it in the end. Xx