AFA Discussion Forum

Elevated FSH @ 33

2009-01-06T18:10:33Z

I have had one cancelled IVF cycle with a day 3 FSH of 8.4. I did the Long protocol with 150mg of Bravelle 2x’s per day. The first monitoring appt had 5 follies. By the third, and final appt, three stopped growing and I was only left with 2. So the cycle was cancelled.

Second cycle we did the flare protcol with 225mg of Bravelle 2x’s per day. My FSH was 8.5. First monitoring started with 9 follies, gradually reduced to 5 on retrieval day. At the actual retrieval only two oocytes were obtained.

I tried to talk to my doc about DHEA, his response was he didn’t like how the study was managed. It was a control group instead of a blind study. Since follicle development isn’t a self reporting thing, I didn’t see why this was a problem. I also brought up ditching the BCP’s as they made me sick both cycles. (Til the day I die I will swear they dried out my skin and mucus membranes! I got nose bleeds and sinus infections to follow both times on BCP) He said they were necessary, kept me from getting cysts, although I have never had an issue with cysts… I also brought up antagonist protocol, he didn’t like that either. He wanted to do the flare again. I decided I need a new RE. I started acupuncture on my own, but didn’t bother to tell him…

Is there any hope any of this stuff about DHEA, ditching BCP in a flare protocol or an antagonist protocol can work for me??

I really don’t think I am bad off in terms of elevated FSH. If my ovaries are failing, I’m pretty early on in the process, right???

Another issue that may be important is that I have what has most recently been diagnosed as stage 2 endo. I don’t know if it should really be called that since this was the 4th lap I have had for it since 18. At 18 my left ovary was bound down to the abdominal wall and covered with so much adhesion material it was severely compressed. Is this ongoing issue with what my OB calls “aggressive” endo the cause of my FSH problem??

Thank you for your time.

Two consecutive chemical pregnancies

2008-10-13T09:28:04Z

Hello:

I am 29 years old and have been ttc for 21 months. My husband and I tried on our own for well over a year before we sought intervention. On my first cycle of Clomid, I acheived a pregnancy. I had a blood test that confirmed I was pregnant but my HCG levels were only around 8. Thereafter, my HCG levels rose but not appropriately. I experienced heavy bleeding with clotting which I thought was the miscarriage, but even after that, my levels continued to rise slowly. When my HCG levels were about 56, by OBGYN gave me methotextrate which ended up working and forcing my levels back to zero. After that, we sought the help of a specialist.

I had one cycle off because of the methotextrate and the following cycle we tried clomid again, with ovidrel and intercourse. I got pregnant again. I had a blood test which confirmed the pregnancy, but my HCG levels were only around 4. My HCG levels then rose to 8, then to 38 or so. I experienced heavy bleeding again with clots. I also had been taking Prometrium vaginally which my doctor switched to orally once the pregnancy was confirmed. I was taking two in the morning and two at night. I assumed that I had miscarried again, but my levels kept doubling up to about 240. I had a sonogram which slowed my uterine lining to be thin. The doctor said that it did not look good, but that they could not be sure. Today when I went back my levels had dropped to 45. So now I got back in two days to make sure they have dropped and then we start again. They said that I likely miscarried when I had all of the bleeding, but because my hormones were going crazy, my HCG levels continued to rise.

I have a few questions. First, I have had a full work up with no significant findings. Last week I requested auto-immune testing which I am now awaiting the results of. Are there any other tests that I should have?

Second, no one can tell me why this keeps happening. My OBGYN told me the first time that it probably had to do with a chromosomal abnormaility or there was also the possibility that it was ectopic. My tubes look good and are clear so I would think that would be the lesser of the two possibilities. This time, my fertility specialist said that it could be due to a weak implantation and that there are medicines that they can give me next time to try to help with this. What medications do you recommend in these types of situations?

Third, this cycle we are going to do IUI. I am wondering what the benefit of this really is if I have been able to conceive naturally with the clomid?

Mostly I am just confused and scared that the pregnancy will never work. Everyone, including my doctors, keep telling me that it will happen and to be positive. I just want to know if there is anything else that I can be doing to make a difference. I started acupuncture so I am hoping that that will help.

Thank you,

The Statistics on SART question from a newbie

2009-01-05T13:48:27Z

Hello there,
I am looking to DE. We are running numbers and looking for the best option. We have a limited amount of financial resources, though we are covered by insurance.

Here is my question:

Do you think it is better to go to a clinic with high stat on live birth.
or
to go to a clinic that is lower cost and success rate and we can afford several fresh tries at?

Thank you!!

Trying for second but haven’t ovulated since first

2008-12-18T18:54:04Z

I’m a 30 year old female. I stopped breastfeeding my 18 month old son 5 months ago. My periods have not resumed, I am still producing milk and I have a prolactin level of 43. My doctor has put me on a week of progesterone but has taken no further steps. I want to get pregnant again soon. It took us 2 years to get pregnant with my son. I was diagnosed hyperthyroid just before I got pregnant but all thyroid tests have since been normal. Could these things be related? Should I seek a second opinion? What should my doctor be doing? Thanks.

single parent sex discrimination

2008-12-09T16:28:13Z

I have known more than one woman, who wanted to parent, have sex and keep the pregnancy. Furthermore, one of them forced the father to financially support the baby by legal threat. Is there a means by which a man may control his own fate in such a way as long as he finds a surrogate? This would imply that the surrogate would not be able to cross examine the father as to how he plans to raise a baby.
Thank you,
John

Progesterone & Estradiol Levels??????

2008-12-03T22:38:41Z

I have been TTC for a few years now and a year ago tomorrow I lost a pregnancy at 15 weeks. That is I had a laproscopic myomectomy in July ( a success) and had the 3 month lupron depot shot on April 17th. Since then I have had a feeling that things have not been right. Did not have a period for 4 months ( because of lupron shot) and then had 3 periods in 6 weeks!!! Getting frusturated. Called my REI and he suggested I have my Estradiol and Progesterone levels checked on day 21 of my cycle( i did that with my health insurance not with him). Got the results back and my Estradiol is 44.3 pg/ml and my Progesterone is 1.25 ng/ml. I am not sure if these levels are good or low..... or what I need to do next.I have to make an ap. with my REI but funds have been so low that it may be a few weeks before I see him as fertility is not covered with my health insurance........ I am starting to worry as I am soon going to be 38 and the clock is ticking faster and faster....... Are these levels low??????

Cancelled IUI with 4 Follicles?

2008-08-12T08:12:18Z

Hello. I was wondering if anyone has had an IUI cycle cancelled with 4 good-sized Follicles (had approx. 9 in total)? My DR stated that I was “over stimulated” and cancelled my cycle without even discussing it with me. He told me that my husband and I need to abstain from intercourse for 10-14 days too! My question, should DH and I go against our DR’s orders and BD this week? (I’ve done research and learned that women my age are able to complete IUI cycles with 8 follicles safely!)

(Little background. I’m 28 & DH is 30. We have been TTC for over 2 years and recently confirmed that I have endometriosis. We did get pregant 21 months ago but ended in m/c. Because I was able to get pregnant once, my DR is being really cautious and I don’t understand. Throughout this process I’ve had a cancer scare, two surgeries, injections, labs, exams, ... and A LOT of “don’t worry, you’re still young.")

TIA!!

uterus didelphys

2008-09-08T19:53:48Z

I have been diagnosed with uterus didelphys. I have been told that if I can get pregnant, I can only get pregnant in the larger of the two horns, and that multiples were not an option. I have been told that IVF would most likely be required. What are the statistics with regard to success rates with this issue? Any insight or personal experiences would be greatly appreciated!

discomfort after ivf aspiration and transfer

2008-11-12T06:17:33Z

Hi Drs.

I understand that some bloating and discomfort can be associated to prometrium/estrace treatment post aspiration, but am wondering how much discomfort should be cause for concern. Don’t think i’m at risk for OHSS, since i’m 37, had only about 6 good sized follicles to be harvested, and have a naturally high FSH level, but since the day after the aspiration, i’ve had tenderness in my abdomen, especially on what seems to be each side of the uterus. This gets worse during the night, when my bladder is full, or when i’ve been lying on my sides. It subsides when i am sitting up. It reminds me a bit of the discomfort i had after my laparoscopy when they cleared out endometriosis adhesions etc. It’s not enough that it impedes my daily routines, but it does cause me to wake up frequently during the night to void my bladder and when i go back to bed, its sometimes hard to find a comfortable position. I haven’t needed to take any pain medication yet, but was just wondering if this reaction is normal. My gyno did aspire all follicles during my procedure, mature or not, and i understand this can lower risk of OHSS. I am on 2 prometrium intravag 3 times a day, and one estrace three times a day. I am day 1 post embryo transfer… We did do an HCG shot for maturation.

Another thing i’m wondering, is that if the endometriosis has come back (Laparo was feb 2005), since the prometrium/estrace treatment is meant to beef up the endometrial lining, could it be acting on endometrial tissue outside the uterus? would i feel that?

Lots of questions, but bottom line, should i call the clinic, or just wait for my poor ovaries to recover from all the wear and tear they’ve endured during this IVF cycle…

thanks....

hurtin’ hopeful mama!

first attempt at ivf….

2008-11-10T09:51:33Z

Hi Drs!

How much impact does embryo quality have on success rates of an IVF attempt?

We have been ttc for about 4 yrs now. I will be 38 in december. After an HSG showing that both fallopian tubes seemed to be blocked, a laparoscopy was prescribed in February 2005 and i was diagnosed with Endometriosis, and one of my tubes is “twisty” . The endometriosis was cleaned up, and we attempted 2 IUI’s with clomid etc, then 3 IUIs with injectables with no success. This is our first IVF attempt. My day 3 fsh is has been around 11-12 for about a year now, so gonal-f doses were pretty high. We got 6 good ovules, and only 2 managed to fertilize, but we are told they are of good quality, so we are going ahead with a transfer tomorrow.

Just looking for a little silver lining, i guess. I’ve been told quality is better then quantity in this case. Is this true?

Thanks for your time!

Briggie