Anyone else doing injectables? Gonal-F, Bravelle, etc.?

[TTC First]

"just kidding! you ovulated days ago." Seriously....like this is a joke! I can't believe they would say that!

I know that when I had my first cycle with Gonal I was ready really early too.

I think that if there are no problems you should do Gonal again. I know I'm trying it again this month. I am on 75ui rather than the 150 last month. Not sure what they started you out with. I go for my u/s tomorrow for the first check. I am feeling a lot going on down there so I imagine something is happening. Even if they want to increase my dose, I will really be hesitant. I would rather stay low and have a longer cycle. I am looking for 7 eggs. Even if I get more I am going to ask for the IUI.

Were you BDing around the time of your O? There is still a chance that you could get a BFP if you BD. We ended up BDing and still didn't get a BFP, that scares me. I don't know how many I ended up Oing but I had about 20 in there and still didn't get BFP.

I am really frustrated too and would LOVE to jump to IVF. They asked me about it but I said I couldn't justify it right now. My first cycle at the clinic was on clomid and only had one follie, the second I was hyperstimulated. I want one good cycle.

I guess you aren't getting any OHSS symptoms. You may want to look that up if you don't know about it. When you have to many follies then it can turn into a messy health situation.

I wish you well in deciding what your next step is.

 

[pbl_ge]

Thanks, TTCFirst. Right now I'm thinking that we'll try Gonal-F one more time, then perhaps move to IVF if it doesn't work. Definitely if I overrespond again. But I keep changing my mind about things. Part of the reason for that is that Gonal-F with cycle monitoring isn't all that different than an IVF cycle, except that the chances of success approximately double for IVF. If the costs are the same, why not go to IVF? But it seems a little crazy at this point, so I'm still not sure. My OH wants to do IVF, which is one of the reasons I'm thinking about it.

It's interesting that we've had exactly the same pattern--one non-response, one over-response. I will be very curious to see how you do on 75 units! They started me on 150, but decreased to 75 after just three days. We were not BDing at the right time, but I suspect it probably doesn't matter, as I didn't have eggs much bigger than 14 mm, so anything I ovulated was probably not very mature.

I don't think they'd let me do insemination/IUI if I had 7 follies! They told me 4 was their outside limit. So far no symptoms of OHSS, so I think I'm fine.

So excited for you! Come let me know about your results!

 

[pbl_ge]

"just kidding! you ovulated days ago." Seriously....like this is a joke! I can't believe they would say that!

Oh, I forgot to say that they didn't deliver the news like that. My doctor is actually exceptionally gifted with his bedside manner, so he was great. That's just what I heard.

 

[TTC First]

Thanks, TTCFirst. Right now I'm thinking that we'll try Gonal-F one more time, then perhaps move to IVF if it doesn't work. Definitely if I overrespond again. But I keep changing my mind about things. Part of the reason for that is that Gonal-F with cycle monitoring isn't all that different than an IVF cycle, except that the chances of success approximately double for IVF. If the costs are the same, why not go to IVF? But it seems a little crazy at this point, so I'm still not sure. My OH wants to do IVF, which is one of the reasons I'm thinking about it.

It's interesting that we've had exactly the same pattern--one non-response, one over-response. I will be very curious to see how you do on 75 units! They started me on 150, but decreased to 75 after just three days. We were not BDing at the right time, but I suspect it probably doesn't matter, as I didn't have eggs much bigger than 14 mm, so anything I ovulated was probably not very mature.

I don't think they'd let me do insemination/IUI if I had 7 follies! They told me 4 was their outside limit. So far no symptoms of OHSS, so I think I'm fine.

So excited for you! Come let me know about your results!

I think it's pretty funny that we reacted the same. Last cycle I know they dropped my dose after the first couple U/S's although I had so many follies.

I have only had 3 injections this month and I feel it working. I forget what side effects I had last month but this month I am having horrible gas. DH is threatening to kick me out of the bedroom tonight. lol He should count his blessings that he just has to deal with gas, he doesn't have to go through all the u/s's and injections.

Because of my age they said I can do an IUI with more eggs than usual. I am just tempted to say go ahead as long as there is a couple, even if I'm over stimulated.

As for if this doesn't work...man...I don't know. I would have to agree with you on the IVF. Not sure where you are but based on what you said, IUI and IVF seem to be similar pricing. I'm in Canada and IUI is $350 and IVF is over $5000, so there is a major financial difference. I just don't want to get into doing too many IUI's when I could put that money towards a IVF.

I know that one of your issues with IVF was knowing how your child was conceived. I heard someone on here say that they had the same issue. What they decided was that they would make sure that they did plenty of BDing so they truly don't know if it was the IVF or BDing that conceived the child.

So I have my first U/S tomorrow so I am really hoping for a couple follies....but not TOO many. I will let you know how it goes.

 

[pbl_ge]

What's the word? Good numbers? FX for you!

Hope the gas goes away. Agree that OH has no place to complain. Can't believe how easy the men (or partners) in these situations have it compared to the women!

Turns out I didn't ovulate, so my dollar says I'm going to follow your path from last cycle, although I'll be frank--I hope to O before you did. I think I'm going to schedule an appt with the doc to have the WTF conversation and talk about the possibility of IVF. I'm extremely lucky in that my insurance covers it, so I'm considering going to it much sooner than I would otherwise. I've also noticed that the success rate for my clinic is almost 10% less than the national average, so I may need to consider going to the next-closest one, which is an hour away. It feels ridiculous to be thinking about it, but I like the idea of getting off this roller coaster sooner rather than later.

Okay, not to be an idiot, but if they harvest all the eggs during IVF, how would BDing possibly fertilize one?

 

[TTC First]

Oh, you're right about the fertilizing. Maybe they were talking about IUI then. oops lol

So I went for my u/s this morning. They said that there are 20 Antral Follicles that could come up at any time. They are leaving me at 75 ui unless my bloodwork comes back and tells them to increase it. I have to go back Friday for another u/s. They said they are taking it slow so that so many follies don't pop up at once.

Last cycle they kept saying that I Oed based on my symptoms. What made them think that you Oed already? I REALLY REALLY hope that you don't have a long cycle like I did. The only good thing is that maybe that was what allowed me to have a second round so quick. The problem with the situation is that they could force you to O with a HCG shot, however that would make the hyperstimulation symptoms come out.

If your insurance would cover IVF and it's not going to cost you much or anything I personally would go for it! At this point even if I have too many follies I am going to beg for IUI. I checked at my clinic and its $5800 for IVF and my insurance doesn't cover any of it. I'm just tired of this dragging on and on.

 

[pbl_ge]

20 follies sounds promising! FX they sort themselves out to a reasonable number by Friday. Have you asked them if they have limits to the number of follies for IUI? Some clinics are bound by regulations on those things. But I guess you could always do the old-fashioned method. I don't know your details--age, diagnosis, etc--so I don't know if that's something that could work for you. Not being nosy.

They thought I had O'ed because my estrogen *plummeted*--it went from ~1000 to 88 in four days, and I still had tons of follies, although they weren't really growing. I made an appt for Monday, so I'll ask about allllllllll this craziness. The first question on my list, regarding last cycle, is simply, "WTF?!?!"

That seems like a good place to start.

I'm eagerly watching your progress!

 

[TTC First]

Because of my age they will go with around 7 follicles, I will push even if it's more than that. I tried the old fashion method last month when I had 17 but it didn't even work. But then I also Oed on CD39. It kinda worries me because they haven't found anything wrong and still didn't get a BFP last month. I am wondering if there is an issue with dryness or something so I am hoping an IUI will fix that.

They assumed I was going to O based on my bloodwork too. Then a while later I had cramping and they said that was my O. Then later on I was bleeding and they said that was my O. Then I got my spike on my chart and knew that was my O.

So based on your chart, you haven't Oed. Are you still thinking about IVF? Are you planning to try "the old fashion way"?

I have to go back in the morning so I am hoping that I have a couple larger ones now but since they have me on a low dose I may not.

 

[Lawyer chick]

Hi girls. I'm supposed to start injects as soon as ready. I think my med choice as I'm in Canada is similar to follistim.

 

[TTC First]

Ohhhh pbl_ge...you've got me thinking IVF. I'm so frustrated! I went in today and they said that there is not a lot going on but one has started to grow. They are waiting for my bloodwork to come back this afternoon to determine what I should do and if I need to go back tomorrow.

I am just like you and so tempted to say lets do IVF and get it over with. If it weren't for the price tag, I would be there getting this all over with. I am so tired of going in every day and getting endless u/s and shots.

 

[TTC First]

Hi girls. I'm supposed to start injects as soon as ready. I think my med choice as I'm in Canada is similar to follistim.

Welcome Lawyer chick! I guess you can tell, we are a little frustrated in here. I am in Ontario too. What medication are you taking?

We have done Clomid and it didn't work and we have both over stimulated on gonal f. I am on CD9 and been taking the shots since CD3. I am hoping to do and IUI this month but we will see if my follicles agree on that one.

 

[pbl_ge]

Welcome, Lawyer! I hope the injectables work for you. Apparently fewer follicles is better than too many follicles, as we can both attest!

TTCFirst, so it sounds like you just have one lead follie? That's, if you don't mind my saying it, really annoying!!! How can the doctors take you from 20 to 1?!? FX if they keep you developing slowly that more will grow.

Nothing doing here. I just drafted the 20 billion questions I have for the doc about IVF in my journal. It's a little overwhelming to think about.

 

[TTC First]

"Apparently fewer follicles is better than too many follicles, as we can both attest! "



Yup....don't rush it!!!






TTCFirst, so it sounds like you just have one lead follie? That's, if you don't mind my saying it, really annoying!!! How can the doctors take you from 20 to 1?!? FX if they keep you developing slowly that more will grow.

That sounds about right. The last think I want is another cycle like clomid. Did you actually get anything on clomid? I have a normal cycle and I always O. When I was on clomid I still Oed but just one egg. Well he is checking bloodwork to see if they can up the dose. DH is telling me to just up it for one day no matter what they say. Good influence he is. lol


Nothing doing here. I just drafted the 20 billion questions I have for the doc about IVF in my journal. It's a little overwhelming to think about. [/QUOTE]

Ohhh IVF I so wish I could be doing that this month I swear, I will only do one IUI cycle then I am going to IVF. I just need the follies to fall in line for the IUI.

Did your get your appointment to talk about IVF?

 

[pbl_ge]

I'm exactly the same . I always O just fine on my own, and still only had one follie on Femara. (My docs use Femara, not Clomid.)

Part of me thinks it's ridiculous to move to IVF right now, as I've only tried one Femara cycle and one injectables cycle. But I have non-trivial barriers to conception (endometriosis, a non-functional tube), it's been a year since I've gotten a BFP, and I'm 36 next month. Sure, it would probably work *eventually* if I kept at injectables or something similar, but I'm leaning more and more towards the IVF. As you say, I really want to get this over with! That said, I think I may give Gonal-F one more shot, if for no other reason to have more data with which to guide the IVF protocol.

So my appt with my regular doc is on Monday, but then I want to make a second appt with the nearby clinic (much higher success %), too.

So this is your one and only IUI?

 

[TTC First]

I'm exactly the same . I always O just fine on my own, and still only had one follie on Femara. (My docs use Femara, not Clomid.)

Part of me thinks it's ridiculous to move to IVF right now, as I've only tried one Femara cycle and one injectables cycle. But I have non-trivial barriers to conception (endometriosis, a non-functional tube), it's been a year since I've gotten a BFP, and I'm 36 next month. Sure, it would probably work *eventually* if I kept at injectables or something similar, but I'm leaning more and more towards the IVF. As you say, I really want to get this over with! That said, I think I may give Gonal-F one more shot, if for no other reason to have more data with which to guide the IVF protocol.

So my appt with my regular doc is on Monday, but then I want to make a second appt with the nearby clinic (much higher success %), too.

So this is your one and only IUI?

If I have my way, this will be my only IUI. I'm just tired. I am also a foster parent with an 8 month old. Every morning that I have to go to the clinic it means getting up early and making sure she is ready. Dragging her and a heavy stroller with me. I may end up getting another foster child so that would mean dragging two little ones every time I go in. I want to at least try IUI to confirm that it is not working for me.

I just heard from my clinic and they said to stay on 75ui and come back tomorrow. It's great that they are working slow but I just hope that it doesn't backfire and have me end up with one follie.

I don't know what a good rate is but here is what my clinic says:

38 to 39 Years

Pregnancy Rate per Embryo Transfer
36.1%

Average Number of Embryo Transferred
2.1

Is that any good?

 

[Lawyer chick]

I will be on puregon. I'm west of Toronto. Def tough taking a wee one plus clinic.
I got one lead on clomid.

 

[TTC First]

Ok ladies I went for my u/s this morning and I am so upset! I have been on 75ui for 7 days and I only have one follicle. I am on CD 10 now and on my own I O around CD18.

The doctor said that I can try increasing the dose to 112.5 however there is no guarantee that I will have more than 1 follicle this month. He said that once the ovaries commit to the number of follicles that's what they are going to do for the month. He said that there is a small window of time that you can change medication in order to change what the outcome will be.

I was so upset with him. I went first month, one follicle. Second month over stimulated. Third month only one follicle. It upsets me because its a waste of a lot of time and money. Now they want to charge me a clinic fee for the treatment they provide. I can pay $75 per month or $300 for the year. I told him I would be no better off on my own.

Here is where the IVF/IUI comes into mind. Do I try and IUI if I only end up with 1 follicle since they haven't determined any issues related to me not getting a BFP? Do I skip this cycle and try again for IUI since they are closer to determining my dosage? Do I skip it all and go to IVF next month?

 

[pbl_ge]

(Was coming to catch up, and found your update!)

TTC - That really sucks! This is exactly why I'm thinking of moving to IVF! I'd ask the docs what your relative chances of conceiving on your own versus with IUI are, and see if that difference makes the cost worthwhile to you. I think it depends a lot on what your diagnosis is--or are you unexplained? IUI helps a lot more for some things than it does for other things. Here's one page with some stats (although I wish they gave sources):
https://www.advancedfertility.com/iui-success-rates.htm
Seems like at best you're about 12%. But I think you may be over 35?

I don't have any idea how frequently this sort of thing occurs, but I would definitely be looking around for other clinics. I would also be having a frank conversation with the doc about how much $ this costs you, and how frustrated you are to be paying for their repeated failure to calibrate correctly. Perhaps you could get a bonus cycle or a discount out of them?

As for the IVF success rates, those look good. In my journal, I showed the stats for average success rates nationally from 2008-2010. I did for those < 35 and 35-37 (my age group). The live pregnancy rate was 38.5% for fresh eggs and those ages 35-37--I didn't take note of the other age groups, but I'm sure it's lower as they decrease. So your clinic seems like it has pretty good numbers.

Are you doing foster to adopt?

Btw, I'm in Western New York State, so near Toronto.

 

[TTC First]

Hi pbl_ge

I am unexplained so there is no way to know the true odds. I just have a feeling that it has something to do with my CM that is preventing me from a BFP. This is the only reason I am thinking about trying IUI anyway. I just hate to pay $350 then get a BFN when I tried with 1 follicle.

Yes, I'm 37. I am starting to read stats and it's driving me crazy. Everyone is comparing different things and clearly...I'm not the norm!

I spoke with the doctor today and explained how upset I was. he said that I just react different than others and they have no way to know this. He said that the good thing is that they know what dose is too high and too low so next month they can go in the middle. I would be happy if they at least did a free IUI after all this. I just can't justify paying for their services when they have not even gotten me to a point where I have increased my chances. If they got me to O 7 eggs like the goal was and I didn't get a BFP...that's on me. But if you give me meds and don't increase my chances or you tell me not to have sex...how can I pay for that? My clinic has different doctors every day (it rotates among 5 or so doctors) I may end up talking to my doctor. I was looking for other clinics in my area but I didn't understand all the stats. I also dread having to go and start from the beginning. I would imagine a new clinic would want to redo all the tests this clinic did just to make sure it was done right.

I am not doing foster to adopt but it doesn't put adoption out of the picture. WHen you get a kid you don't really know where things will go. I know 2 couples that are doing foster to adopt and their kids seem to be going home. The one I have now seems to be going to adoption. The child we have now is mixed race and so are DH and I. They already asked if it came to it would we be open to adoption. I would love to adopt however more and more I really want to have one of my own.

Ahh...Western New York, you're not too far at all. I don't know what areas are considered "Western New York" but we do go to over the border every once in a while. I have family in Niagara Falls Canada so they are over there all the time. We tend to stick to the Buffalo/Niagara area mostly. We would LOVE to go to NY city but that's one long trip. It's kinda frustrating because with LO we can't go over the border if she is with us.

DH has been out all day so I haven't been able to talk to him since my appointment today. I have no idea where his head is.

 

[pbl_ge]

I'm sure you know this, but just in case: have you tried guaifenesin and/or something like Preseed for CM? I use both, just in case.

It's a hard decision to make about changing clinics. I'm really hoping the new docs WON'T want to re-do all those tests, but I guess one just has to see. It doesn't seem like they should need repeating, unless it's been a long time. But you never know what a new doc will say until you meet with them! I'd be most worried that a new doc would tell me that I have to keep trying other things for six months or so before I'm a good candidate for IVF.

That's great about fostering. If this doesn't work out for us (and possibly for #2, anyway), that's the road we'll take. Not sure how similar it is there, but I know people who have done foster-to-adopt and ended up with wonderful, permanent families. I also know people who had the children taken away after years. I can't even imagine that heartbreak. The whole race thing is very fraught here, too:
https://www.npr.org/2013/06/27/195967886/six-words-black-babies-cost-less-to-adopt
My OH and I (both v. white) would have no problems adopting a child of any race, although there are serious, legitimate concerns about trans-racial adoption (e.g., how to raise a minority child in a racist country), but I think those concerns are diminishing fast as our country becomes increasingly diverse.

So, do you think you'll be presented with the decision of adoption your LO? Would that change your infertility treatment thoughts?

I'm 30 minutes from Niagara Falls.