Anyone doing FET/IVF in Jan 2013 till everyone's BFP (Everyone Welcome)

[annmc30]

I was at clinic 2day at er is Monday Ive got 25 follices sizes 15-22

 

[L4hope]

Well looks like FET is going to be put back a week as blood test came back to say my estrogen and progesterone levels are too high to start taking the Oestradiol tablets at the moment but shows i'm due to have full AF in a couple of days. Fx'd ill get AF over the weekend and start tablets next week. Looks like I'm going to be doing transfer either 6th or 8th Feb. Fx'd no more delays xx

Sandy- we should be within days of each other for ET.. fx'd for you!

My transfer is Feb 8th. And Edamame a couple days later. There will be a lot of us in the tww together!

 

[alicatt]

I saw my REI Dr end of Oct/2012. He started me on bc right away, AF arrived end of Nov so the stims were started. I was on Gonal F, Menopur, ganirellix & then trigger.... In the middle of my meds (start of Dec) I was informed that my Dr was on medical leave in mid Nov. They would not give me any info of why or when he would return, all they said was that he was monitoring my meds... Nurse changed my meds (per Dr) ER was done 12/9 with 18 follies 9 fertilized & ET was on 12/14 with 2 (according to Dr) not so great embryos, non made it to freeze. The 2ww was very emotional because aside of the wait I had no Dr to talk too... Of course IVF was not successful = ( Then I find out my Dr past away 1/08/13 when he left mid Nov, he was not coming back due to terminal illness... He was a great Dr, I even attended funeral, but I'm calling clinic to find out who altered my meds & who monitored my cycle & I'm getting the run around from the office. Another Dr from the office did call me to ask if I'm ready for my next cycle..... What should I do??? I want answers, is there somewhere I can call? I already have an appointment to go to another clinic but I lost thousands of dollars....

angied1 - IVF is a difficult situation, and depending on your diagnosis the odds can be as little as 5% success. Did your FS Office do the right thing? Probably not. They should have told you who was monitoring you and you should have been seeing an alternate doctor through your cycle. Did you go in for ultrasounds? Who administered them? Who called you to alter your meds? My guess is that an alternate FS in the office was doing so. However they should have been up front about it.
With that said, IVF is not a guarantee, and you could have had the exact same response had your original FS been monitoring you.
If I were you I would waltz into the office and ask to speak with the administrator. Explain what you have said here, and see what she says. It is a lot harder for them to ignore you when you are sitting right in front of you. Once you have let her explain, if you feel that the explanation is still less than satisfactory I would ask for a discounted rate on a future IVF. That is the best you can hope for I think. I asked for a discounted rate on my first one and was given 10% off if I paid cash, and on my second one I got 15% off. Simply because I asked (and there wasn't anything that they did wrong).

Good luck!

Thank you so much for your response. I did have monitoring, all done by the nurse. My fertility problem is DH has low count (3mil), but I chose icsi for that reason. At one of my ultrasounds the nurse told me that my meds were being changed. Funeral was on a Sat & billing called me on Monday to ask if I wanted to start another cycle, I needed to make pay in full again prior to procedure. I explained the situation & asked if I can receive a discount. I was told not by her, I can make an appt to talk to a Dr but they had no appt available until mid Feb since no Dr was assigned to office yet.
I'm suppose to start new stims meds 1/25, according to nurse. I think I will skip this cycle & go to another clinic = (
Any recommendation for clinics in IL?

I think you are making a good choice. Starting a new cycle without a Dr in the office is ludicrous! Wait until you see my post in a bit about the detailed work my FS is doing with me. So I think finding another clinic is appropriate. Make sure that your old clinic sends their protocol to your new place so they can review it and use it in their plan for your next cycle.

 

[FirstTry]

I'm sorry if this has been asked 1000 times, but I'm trying to decide btw FET and a fresh IVF cycle. What is the protocol for FET?

I think for a fresh cycle, it's 3 weeks of bcp, followed by 2 weeks of stims, right? How much time does a FET save? And what are the meds for FET?

 

[alicatt]

Well looks like FET is going to be put back a week as blood test came back to say my estrogen and progesterone levels are too high to start taking the Oestradiol tablets at the moment but shows i'm due to have full AF in a couple of days. Fx'd ill get AF over the weekend and start tablets next week. Looks like I'm going to be doing transfer either 6th or 8th Feb. Fx'd no more delays xx

UGH.. sorry to hear about your delay, but it is only a few days right? It will be worth it as you'll be starting things at the right point in your cycle.

 

[alicatt]

I'm sorry if this has been asked 1000 times, but I'm trying to decide btw FET and a fresh IVF cycle. What is the protocol for FET?

I think for a fresh cycle, it's 3 weeks of bcp, followed by 2 weeks of stims, right? How much time does a FET save? And what are the meds for FET?

First -

In both fresh and frozen you may encounter BCP and Lupron, as well as the estrogen and progesterone support after transfer. The main difference is the stimulation meds. In fresh you need the stim meds, in frozen you don't. Also the cost is a lot less for a FET as you won't need to have as many ultrasounds or blood draws, and you don't have to do the ER or ICSI and most of the work has already been done by the embryologist. Once your body is ready for the transfer, they will defrost your embryos, most likely do assisted hatching and do the transfer. A FET is WAY easier on your system.

Most FS offices recommend using up your frozen before doing another IVF. However if the quality of the frozen embryos is in question or they've uncovered some odd reason why doing a FET would not be beneficial then doing another IVF would make sense. Personally I would go for the frozen. Also some women that have issues with implantation or MC could benefit from a frozen cycle. The main reason is that you haven't had the stim meds, and your endometrium is much more receptive to implantation and keeping it there.

I hope that helps!

 

[LotusBlossom]

First- my friend has done 9 IVF cycles, 2 were successful. She told me that in her experience, FET is better because it's shorter and your body doesn't have to go through as much. From what I've been told, it's easier to relax with a FET. I'm pumped about doing a FET. I'm still waiting for the nurse to call with my schedule, but I am starting BCP now and we are ordering the Lupron. My Dr gave me a basic overview saying it's BCP, Lupron (2 kits) and some pills. I'm not sure what the pills are, but I am thrilled to only have Lupron shots. Those are the easiest. You just have to prepare the lining and do the transfer. Woo! I started the BCP last night and Dr knows we have to leave the island by early March, so apparently we will do the transfer in Feb. I definitely vote for the FET, but you should see what your Dr recommends.

 

[alicatt]

Hello Ladies

I had my appointment with my FS this morning, and it went well. We have a tentative plan, and it follows. This may be more than you want to know, but I figure that it will be good for future women who are curious about NK cells!

1) Why are my NK cells elevated?

They are elevated because they are. There is no answer, at this point in my life they are elevated, but that doesn't mean that they will be for life. He used the democratic party and the republican party and their defense budgets as an analogy. Right now my immune system is high like it would be under a republican administration, but in a few more years it could be low as in a democratic party administration. Having an elevated NK cell count is normally a good thing as it fights the common cold, and flu and cancer. However for some women it also means it will kill your embryo.

2) What is your recommended plan?

We went back and forth on this. The test they did to determine if my NK cells were elevated included suppressing them with IVIg and Intralipids (the 2 options for suppressing NK cells) to see if my body would respond appropriately. My body did, and with the IVIg they dropped from 12 down to 8, and with Intralipids they went from 12 down to 9. Both would be satisfactory as we want the number to be under 10. The recommendation is to do an infusion before transfer, and if you end up pregnant do 3 more infusions (1 per month). The IVIg infusion costs $3000 per infusion and the Intralipids cost $1000 per infusion, not covered by insurance (of course). So my FS's recommendation (and actually my initial thought as well) was to do the first infusion with IVIg, and if I get pregnant to follow up with the Intralipids for the last 3 infusions.

3) Should we do further testing to ensure I don't have any uterine/entometrial issues?

He brought up a test that is brand new to the US, in fact he said I could very well be the first person to do it in the US. This is something that has been widely done in Europe and they have had great success with it. They are branching out to the US, and are setting up a lab in Miami, FL. My FS is going to be one of the Dr's that are working with them and continuing the testing in the US. I asked about what the procedures are and he said that we would do a trial cycle. So we'd just monitor everything and create the exact same environment for the transfer, but not actually do the transfer. During the cycle there would be 2 endometrial biopsies, timed around the implantation window. This would do 2 things. First it would determine the length of my implantation window (normal is 4-5 days), and second it would determine if there were any abnormalities that we would have to deal with. I asked him about cost as this sounded expensive. He said he would run all of the testing through my insurance, and they would cover it, except for the testing of the biopsies. He said that he would work with me and the company that is doing this testing to come up with a discounted rate since this is a new type of test in the US market. So I would have to pay a few co-pays, and the medications necessary for a FET, along with the discounted rate for the testing of the biopsies.


So with all of that said here is the cycle (well 2 cycles):

1) Call when I get my next period.
2) Go in and have base ultrasound on day 2-4 of my cycle
3) Be monitored via ultrasound and blood work to detail my cycle, and when the time comes do the biopsies (this is an in office procedure) not a big deal.
4) Get the results from the biopsy, and use the results to ensure we don't have endometrial issues and to pinpoint the best day of my cycle for implantation
5) Wait for my next period to arrive
6) Base ultrasound on day 3-4 of my cycle
7) Monitored via ultrasound and blood work until transfer day
8) Transfer
9) Wait to see if it takes

 

[BabyD225]

Hello Ladies

I had my appointment with my FS this morning, and it went well. We have a tentative plan, and it follows. This may be more than you want to know, but I figure that it will be good for future women who are curious about NK cells!

1) Why are my NK cells elevated?

They are elevated because they are. There is no answer, at this point in my life they are elevated, but that doesn't mean that they will be for life. He used the democratic party and the republican party and their defense budgets as an analogy. Right now my immune system is high like it would be under a republican administration, but in a few more years it could be low as in a democratic party administration. Having an elevated NK cell count is normally a good thing as it fights the common cold, and flu and cancer. However for some women it also means it will kill your embryo.

2) What is your recommended plan?

We went back and forth on this. The test they did to determine if my NK cells were elevated included suppressing them with IVIg and Intralipids (the 2 options for suppressing NK cells) to see if my body would respond appropriately. My body did, and with the IVIg they dropped from 12 down to 8, and with Intralipids they went from 12 down to 9. Both would be satisfactory as we want the number to be under 10. The recommendation is to do an infusion before transfer, and if you end up pregnant do 3 more infusions (1 per month). The IVIg infusion costs $3000 per infusion and the Intralipids cost $1000 per infusion, not covered by insurance (of course). So my FS's recommendation (and actually my initial thought as well) was to do the first infusion with IVIg, and if I get pregnant to follow up with the Intralipids for the last 3 infusions.

3) Should we do further testing to ensure I don't have any uterine/entometrial issues?

He brought up a test that is brand new to the US, in fact he said I could very well be the first person to do it in the US. This is something that has been widely done in Europe and they have had great success with it. They are branching out to the US, and are setting up a lab in Miami, FL. My FS is going to be one of the Dr's that are working with them and continuing the testing in the US. I asked about what the procedures are and he said that we would do a trial cycle. So we'd just monitor everything and create the exact same environment for the transfer, but not actually do the transfer. During the cycle there would be 2 endometrial biopsies, timed around the implantation window. This would do 2 things. First it would determine the length of my implantation window (normal is 4-5 days), and second it would determine if there were any abnormalities that we would have to deal with. I asked him about cost as this sounded expensive. He said he would run all of the testing through my insurance, and they would cover it, except for the testing of the biopsies. He said that he would work with me and the company that is doing this testing to come up with a discounted rate since this is a new type of test in the US market. So I would have to pay a few co-pays, and the medications necessary for a FET, along with the discounted rate for the testing of the biopsies.


So with all of that said here is the cycle (well 2 cycles):

1) Call when I get my next period.
2) Go in and have base ultrasound on day 2-4 of my cycle
3) Be monitored via ultrasound and blood work to detail my cycle, and when the time comes do the biopsies (this is an in office procedure) not a big deal.
4) Get the results from the biopsy, and use the results to ensure we don't have endometrial issues and to pinpoint the best day of my cycle for implantation
5) Wait for my next period to arrive
6) Base ultrasound on day 3-4 of my cycle
7) Monitored via ultrasound and blood work until transfer day
8) Transfer
9) Wait to see if it takes

Ali- Happy you have answers... this may seem like a dumb question.. but how would one know if they had NK cells to begin with? After a MC?

 

[alicatt]

Ali- Happy you have answers... this may seem like a dumb question.. but how would one know if they had NK cells to begin with? After a MC?

You would have to get tested. The lab that did my tests was called Fertility & Cryrogenics Lab and they are in Downers Grove, IL https://www.fclab.us/ They are the ones that tested me and then did the immune suppressing tests to see what type of immuno-suppression would work for me (IVIg or Intralipids).

This was a test that my FS suggested I do, and it was expensive $580, but it was helpful for me to do! It is something that some FS's consider for RMC (repeat miscarriage), or implantation failure. If you fit in those categories, then it would be something to discuss with your FS.

 

[Sandy83]

Ali, sounds like you have a plan in place. So happy you got some answers xxx

 

[FirstTry]

Thanks, Ali and Lotus! I'm leaning toward FET, especially if it will save us a couple weeks. In terms of cost, we bought an expensive insurance policy for 2013 that will cover up to $30k of treatment and $8k of meds. So, the decision will be based on other considerations.

I'm going to ask my RE for sample protocols to compare.

Ali: you are so knowledgable about all of this stuff. And on the cutting edge! I can tell that your kid is going to be very well educated!

 

[ttcbaby117]

firsttry - are you using donor eggs? Or do you already have eggs frozen for a FET?

Lotus - glad you have a plan.

ali - that is great information. thank you for sharing it. Also it is wonderful that you will be getting this test done. I go to a clinic in Miami and should I need it might have my dr do this test on me.

phantom - congrats to you and the new parents...that is such wonderful news!

wannabee - woohoo...congrats hun!

cali - are you ok hun? How are you feeling? Those are some wonderful numbers, I hope you have been able to keep OHSS at bay!

 

[FirstTry]

Ttc: we have 3 frozen embryos from our last cycle. We were going to do a fresh cycle to get as many as possible before I get older (DH's idea), but I'm rethinking that now that we're getting close to starting the cycle. FET sounds much easier on the body. And if it shaves 2 weeks off the schedule, that would be awesome! Does it? I'm still waiting for that answer from my doctor.

 

[ttcbaby117]

yes it does...as you dont have to do the stimming portion.

I can see what you are saying...bank your eggs while you can. Yeah thats a tough decision.

 

[alicatt]

Ttc: we have 3 frozen embryos from our last cycle. We were going to do a fresh cycle to get as many as possible before I get older (DH's idea), but I'm rethinking that now that we're getting close to starting the cycle. FET sounds much easier on the body. And if it shaves 2 weeks off the schedule, that would be awesome! Does it? I'm still waiting for that answer from my doctor.

Well.. I think it all comes down to your age and your AMH? Were you diagnosed with having diminished ovarian reserve? Are your embryos of good quality?

If you have insurance that allows you to do IVF, then maybe do another cycle in 2013 to get more eggs, then you can do more FET's if it doesn't work, or potentially have more embryos for 2014/15 to have a second shot?

I think you need to sit down with DH and your FS and look at your egg quality, embryo quality, DH sperm, your original infertility issues, the toll a fresh IVF cycle takes on your body, along with any other testing they may want to do, and come up with a decision.

FET does not shave time off your cycle, the type of cycle your FS chooses will possibly shave time. A cycle is either a long lupron cycle where you are on BCP and then lupron then followed by a typical 28 (or so) cycle.
If you skip the BCP and lupron, your cycle is still your normal cycle, that is somewhere around 28 days. The long lupron cycle or a normal cycle can be used in both fresh and FET. So there is no shaving off time (besides skipping the BCP and lupron). It just depends on what your Dr determines is the best protocol for you. His determination will be based upon your hormone levels and whether suppression is necessary prior to your cycle. Suppression is helpful if you have hormone imbalances (PCOS), or are apt to respond too well to stimulation. It is also used in FET, I think to help control your estrogen level so that it doesn't get too high to fast? (this is just an assumption as I have not researched this yet).

If I were in your shoes, and knowing that you have never done a full IVF cycle (that your last cycle was initially an IUI that got pushed into an IVF), and knowing that you paid for insurance for IVF for 2013, I'd go with a full fresh IVF, and get your FS to create a protocol that suits your current fertility issues. With that in mind, you will want him to tailor the cycle to improve embryo quality (if necessary) and improve total quantity (if possible) so you can then do a fresh transfer, and have embryos to freeze for future use! That being said, the final decision is yours, and one you should make with your DH and FS! Tough decisions, but I'm sure you will make the right decision for you!

I have spent many hours researching IVF, the ups and downs, and I have an analytical mind (I problem solve for a living) so I guess it lends itself to understanding IVF. Also, part of my jobs is to convey technical issues in a way that most people would understand. Plus I hope that my thoughts will aid you (and others who may read this in the future). If there is one thing I know, its that IVF is an amazing thing, but so difficult for couples as there is so much left unsaid. Plus there is so much research to do in the field to understand why IVFs fail, and how protocols can be further improved upon.

 

[Em260]

I finally got the pathology results and it's good news!! The margins are clear, meaning my doctor got everything during my surgery, and it's the same type of tumor I had last time which has a great prognosis. So no chemo necessary

 

[MoBaby]

First: I would like to know about that insurance plan!

 

[alicatt]

I finally got the pathology results and it's good news!! The margins are clear, meaning my doctor got everything during my surgery, and it's the same type of tumor I had last time which has a great prognosis. So no chemo necessary

Excellent news! So happy for you! So does that mean you will do another fresh IVF? Or will you just do a FET?


First - yes, I think I would like to know about that IVF insurance too!

 

[MoBaby]

EM !!! YAY!!! Sooooo glad!!!!