Friday 18 May 2012

The Post-IVF Specialist Appointment

This morning I met with Dr. F to go and run-through our first IVF cycle. (Have I mentioned how much I love this doctor? She's awesome. I turned up about 45 minutes early for my appointment, and she squeezed me in so I wouldn't have to wait around. How nice is that?)

She gave me her comments based on the notes from our first cycle:

  • 5 eggs - she wants this to increase to 10 next time. Not huge steps, but enough to have some to play with.
  • The 3-day transfer I had was something she was hoping we could avoid.
  • I stopped responding to 125 of Puregon at a crucial moment.
  • Out of my 5 eggs, only 3 were mature & healthy. 2 were 'black' eggs, meaning that they weren't formed properly. She wants to keep an eye on egg quality next time around.
  • That means, they only selected 3 eggs to actually take their chances with fertilisation. 2 fertilised, from the 3. That's not bad odds! I was so worried (thinking we'd only had 2/5 fertilise) and she thinks that ICSI wouldn't be beneficial just yet - with more eggs to choose from, we should still have good fertilisation.
  • She was worried about the pain I was in from my egg collection - sedation didn't seem to respond. She's made a note to give me a slightly higher dose next time, but is being cautious as she doesn't want me to have breathing/regulation problems.
So where do we go from here? As soon as I get my next period, we can go ahead for another long-down reg cycle. Meaning it's the full hog, again. We do have some new protocol changes for IVF #2:
  • Continue on Metformin & if I don't ovulate this cycle, take Provera to induce a period.
  • Three weeks of birth control pills... followed by Lucrin (an injection) rather than Synarel (the evil, evil nasal spray that I took last time)
  • I'm to take 175 Puregon for 4 days, reduce to 150 for 3 days - then monitor through bloods. She thinks giving my ovaries a huge kick at the beginning should see them produce better oocyte amounts.
  • Trigger shot is going to be pushed back to 38 hours before collection. She thinks that the standard 36-hour we went with last time, didn't give my stubborn ovaries a chance to fully mature the eggs before collection. 38 hours will give them a little more time to develop, but without letting them go too far.
  • I need more progesterone. I'll be on Crinone again, but with additional progesterone pessaries too. Oh joy!
Interestingly, she told me not to get my hopes up to have frozen embryos during my cycle. Frozen cycles have a great success rate with naturally ovulating women - but Dr. F reminded me that even if we DID have frosties survive the thaw, I would need to GET there by medicating. She thinks if I'm going to be medicating to induce ovulation, it's more beneficial for me to do the full stim cycles & see how we go. I kind of agree with her; except for the cost factor. But them's the breaks, I guess.
I'm happy to have a plan. Hopefully I'll ovulate this cycle & get a natural shot, but otherwise.. looks like late June.

14 comments:

  1. Sending good vibes as always !!!
    Love you

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  2. It's really great how detailed she is! It sounds like she's very confident she can make things work better with the changed doses.

    Best wishes!!

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  3. She sounds like a great doctor. Sounds like you've got a good grasp on all you've got to do and a great plan to go get it done! :) Sending all my love and hugs as usual ;)

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  4. Great that you have a plan and that she went through everything in so much detail with you... always so much more reassuring to know what they're thinking in this world of IVF where everything seems out of our control. Thinking of you as you move onto your next cycle xoxo

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  5. Have you asked the doc at all about skipping the bcp's? I didn't do them because my doctor thought they might over suppress my ovaries. They've all got different strategies and approaches though, it's such an inexact science. But those are actually better fertilization percentages than we had doing ICSI, so hopefully that's a good sign for your next cycle!! Thinking of you.

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  6. hey, I cant figure out how to reply to your comment.
    Thanks for update...very detailed. Good luck for the next couple of weeks I know they are busy times in the world of work.

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  7. Good news, my love. Sending so much love your way!

    xox

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  8. Love that you have a plan now! It sounds like the doctor is confident! Hugs friend :)

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  9. Two out of three fertilized does sound like very good odds. I'll be sending good vibes your way for the coming months!

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  10. Best of luck!! I hope this is THE cycle that works.

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  11. After our IVF failed, I was ready to quit, but our follow-up appointment filled me with hope again. I am SO happy that it has done the same for you. It sounds like you have a great plan, and I hope IVF #2 is your lucky cycle!

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  12. She sounds like a great doctor and I'm glad you've already got a plan for the road ahead - fingers crossed for you, lady!

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