An update on my IVF cycle

Hi ladies,

 I've been so stressed out lately, and honestly- thought I'd jinx things if I posted...so I had been avoiding it.  Ha!  Well, I finally decided that things  weren't going too good as it was, so clearly my NOT posting wasn't helping me.  Might as well share, because at least getting the opinions of women who understand makes me feel better.

So you might remember, I had transferred 7 frozen embryos into our new clinic from our old one (that helped us conceive our daughter)...and long story short, only two were able to be biopsied, and we had one normal girl and no normal boys.  Boo.... but it just so happened the GSN results came in on the EXACT day I'd need to start a fresh IVF cycle, so I did, immediately.

 Lots has happened since then.  I got all my meds and realized they were different than one I'd used on my previous successful cycle.  I should have said something right THEN, but chose not to.  I figured they were probably just a different brand name for the same drug.  Wrong.  Doc had decided to switch me and protocol was entirely different, which would be fine if my results were anywhere near as good as they were last time, but so far, not even close. 

Three years ago, my AMH was .76 (low) and my antral follicle count was 10 (low).  We got 12 eggs on that old protocol, 10 were mature, all 10 fertilized normally and 9 made it to blastocyst!

Now, my AMH is 1 (improved to a normal range!?) and my antral follicle count was 18! (great!).  As of today, they're saying I'll only get 4-6 eggs at retrieval.  :-(

I NEED opinions!!!!

As of today, after 10 days of stims I have 1 follicle at 19, 1 @ 18, 1 @ 15, 1 @ 14, and 2 @ 13... and some smaller...  the plan is to stim today and tomorrow (total of 12 days) then trigger tomorrow night for a Saturday retrieval...though depending on my E2 level- they MAY ask me to trigger tonight instead.

Assuming we get 5 mature eggs, and they all fertilize  normally like last time, with my age of 33, I've been quoted that roughly half will be normal through GSN... meaning 2-3 normal and then we need to pray for a boy.  Sigh

My question to you ladies is this-  if you were me, would you go forward with this cycles 4-6 eggs and hope and pray it turned out, or would you cancel this cycle - lose out on the cost of meds only- and try again in a couple months with the OLD protocol, hoping to get more eggs?  I don't think I can afford to do this twice right now.  I'd have to wait until next spring to afford it again if I go forward with this cycle.

 I wish this weren't all so stressful.  :-(

 All advice appreciated.  Thanks ladies!!!

 I'm so sorry you didn't stim as well this time.  Have you considered batching?  That would at least save you the cost of paying for GSN twice.  I don't know.  There have been successes with just 4 - 6 eggs, but once you throw in GS it is an uphill battle.  My gut says cancel and try again.  Or batch if that is something you could handle financially.  But really you have to do what feels right to you. 

I am sorry about your low number of follicles, this happened to me for cycle #3, I came very close to canceling the cycle but then decided to batch we ended up with 5 fertilized which we froze, 4 of the 5 made the thaw and in the end none of the four were usable as they either had the genetic condition or results were inconclusive so at least I saved the $7500 for the PGD.

Can I ask why only 2 out of the 7 of the frozen embryos were able to be biopsied? I am considering doing a 5 day biopsy because we have three frozen embryos from an IVF three years ago but dont know if its worth it as I want to do a fresh cylce also and I was told today on day 5 they would all have to be blastocysts in order to be biopsied...

I would say cancel this cycle & start of with a new cycle with a differnet dose & different protocol. Even batching is not worth the ER & Embryologist charges with 4 - 6 eggs.

Also may i ask what protocol you are on now & what is the dosage of meds you are taking now?

Thanks for all the replies ladies!  So I just got off the phone with my nurse...poor thing- I had her on the phone for over 30 minutes with all my questions and waffling.

Number 1- they've decided to push my trigger to tomorrow night, and they feel fairly confident I'll get 6 eggs that are mature by doing so...so that's better than 4 anyway.

Number 2- this nurse was actually one of my nurses at CCRM when I went there three years ago, and she says the protocol I am on IS THE SAME as the one I was on there?  There I was on 300 iu of Gonal-f and 150 of Menopur, here I started off on 225 of Menopur and 225 of Bravelle, and have since been upped to 300 of each.  Apparently they're both versions of the MDL flare protocol.  She believes, as painful as it is to tell me, that I just have a classic case of diminished ovarian reserve (as evidenced by my 10.8 FSH and .76 AMH levels 3 years ago) and that I probably wouldn't get a better response next time. 

I guess, if this is the best I can do, I really have no reason not to go forward and do an awful lot of praying.  I did ask about batching, but since I'm trying to day a day 3 biopsy with day 5 fresh transfer, they strongly advise against it, as they'd have to freeze at day 3...and then biopsy as soon as they thaw which is not good for the embies.  If I do a day 5 biopsy, I could probably batch, but I'd have to freeze and do a subsequent FET...and I'm terrified of FET due to my previous bad experience with thawing frozen blasts (see next paragraph)

To the person who asked why they were only able to biopsy 2, your story sounds familiar to mine.  I had 7 blasts some were froze at day 6, some at day 5, from an IVF cycle that was successful 3 years ago.  They were slow frozen in vials instead of straws, and although they all survived the thaw, 5 of the 7 didn't "expand" and in order for them to do the trophoblast biopsy (which is what they do at day 5) they need to expand.  So we have a GSN normal 5BB xx blast frozen...the XY was abnormal with a duplication of chromosome 13.  [:'(]

It just kills me that I'm only 33 and have to go through this.  Unlike a lot of you ladies, I'd be content with just the children I already have (a 16 year old son, and three daughters ages 13, 7 and 2)... but my husband, he only has the 2 year old and wants a son so so badly.  The older three are from a previous marriage...so now here we sit- one tubal reversal, three IUIs, two ovarian cysts, a diagnosis of male factor, tubal factor (one tube is closed), MTHFR, Favor V leiden, diminished ovarian reserve, and soon to be two IVFs later... Sigh...

I guess I'm rolling the dice and will try to "let go and let God" as I often preach to my friends.  I'm sure you guys will be hearing a lot more out of me over the next couple of weeks...I just pray it's positive. 

I can understand what you going through.

After hearing the details. i think this is the best way to go.

Hoping this cycle will bring you success

KUP

I guess I didn't even think about doing fewer probes, figuring if it's GSN normal then I've got the best possible chances of a healthy delivery to term... but now that I hear about self correction and false abnormals and what not, maybe I should consider it?  I think my clinic automatically uses GSN...I wonder if GSN will do a lower probe if I specifically ask for it?  Maybe it would be cheaper?  Good questions to ask my nurse tomorrow I guess. 

 Thanks again ladies!!!

Well, here's my update for today.  As of this morning I had the following follicles

2 @ 20, 1 @ 19, 1 @ 17, 2 @ 15, 1 @ 14, 1 @ 12 and 1 @ 11 plus a few smaller ones that won't catch up without a miracle.

My E2 level today was 2010.

 I still had Menopur (300 iu) this morning and need to do my Bravelle (300 iu) tonight, and then trigger at 9:15 tonight. 

With that in  mind- we're anticipating 6 definitely mature eggs, possibly 7 or 8, depending on how much that 14 mm and 12mm one grow between now and Saturday between today's stimming and the trigger.

 My retrieval is Saturday morning.  Big deep breath.... maybe, just maybe this is my cycle. 

I think you should go ahead and finish the cycle.  6-8 eggs sounds good.

I am praying for you today!!!!!!!!!!