Hi all,

My husband and I are going thru our first IVF/ICSI cycle. My cycle is generally long--34-38 days. I started Lupron at day 21, got my period about three weeks later (normal for me...office said it would be more like 2 weeks), started gonal-f on the night of day 4, and now I am on day 13 of my cycle/day 10 of taking the gonal-f. My dr office says I am progressing slowly and they have bumped my gonal dosage a few times and now I am up to 450. I have asked if it might be b/c I have a long cycle and my body is doing what it is "use to.", but they haven't really given me a definite answer. I do have a number of follicles (17 one side, 8 the other), with the largest 16mm and the next is 12mm, all the others are around 8mm. Am I progressing slowly? Might it be b/c my cycle is normally long? I am assuming upping my dosage of gonal-f is supposed to speed things along.

Being that this is my first IVF I have a number of questions, but will stick to this one first. Any insight on lengths of IVF cycles and whether people with long cycles commonly have longer IVF cycles is appreciated.

Thanks,
Marie

Everyone is a little different, but usualy the doctors are the ones who create the protocol for their patients. I was on 450 gonal f from the get-go. Don't worry about how long this is taking for you. It sounds as though your doctor is taking it slowly to prevent you from becoming overstimulated. That....would be a bad thing! I've had a freind who got overstimed and it not only creates a very uncomfortable feeling (my friend gained almost 20 lbs!), and the risk of getting ill, but if the eggs are created too quickly they can become compromised and not be as healthy and strong as they will be if they develop more slowly.
Hope that makes you feel more at ease.

Hi & welcome. I agree w/ qt. Everyone is different, so try not to worry about how long your cycle is taking. If your dr doesn't seem concerned, then you don't need to be concerned. I know that's much easier said than done, but it sounds like you've got a lot of follies growing and some are almost at the right size! :) That's something to be happy about! I bet you will be doing the trigger shot in just a few days. Feel free to ask any of the other questions you have, there are quite a few of us around here who have been through IVF...some just went through e/r and e/t this past week. :) We are hoping to see lots of bfps in the coming weeks. Fingers crossed that yours will be one of them. :angel:

Holly

Thanks Holly and QT. I am quickly realizing how important it will be to have a support network as we work through this, and your responses help. Honestly, the thing that is making me concerned about my progress is that our dr is leaving for a fertility conference that is coming up the week after next. I won't go into any of the negative feelings my DH and I have had over why they would start me if there was a chance I wouldn't be ready before they leave (office says b/c it is my first cycle they didn't know). After speaking with the dr office yesterday, they say they are hopeful I will be ready to trigger Monday for a Wed retrieval. I can't help but think that if I had more time, I would have more follies ready than what I will on this schedule. I am pretty sure I will have at least one (the one that was 16 on Friday), but they generally want at least three for retrieval. Based on my u/s from Monday and Wednesday, my follies are only growing 1mm a day. Again, I am trying to stay positive, but wish I could feel like we were giving this the best chance we could.

Hi Marie, welcome to the boards. Hang in there sweetie it really sounds like you are in great hands with your doctor. Like Holly and Stace said everyone responds differently to the meds and every doctor has thier own protocal. Your eggs will also keep growing right up to retrieval and its sounds like you should for sure have more than three. Just try and relax if you can its really out of our control how we respond so we just gotta hang in there. There is a thread callled Sept/OCt IVF's you shoud join where you can post questions and also post your results. Its really a great support group. :angel: AimeeM

Hi Marie,

How did your appt go today? Are you ready for trigger? Can't wait to hear your results! :)

Holly

Hi Holly,

I had my blood work and u/s locally this morning and will hear from my dr later today. I didn't want to ask, but peaked at the screen and didn't see any sizes larger than 15mm. That was my left ovary and I know my big one last week was on the right. But from what I understand, that would be too small to trigger. I do have 18 follies on my left, but again, largest is 15. So, we will see what the dr says. I wouldn't be worrying about my progression if it wasn't for the conference that my dr is leaving for on Sat. I will keep you posted. Actually, I am about to go read the Sept/Oct chain and may chime in there.

Thanks for thinking of me.

Marie

Marie, does your dr work in a private practice, or are there other drs in the group? I guess what I'm asking is...if he has to leave for the conference before finishing your cycle, will there be another dr available to take over? I'm not trying to worry you w/ my question, I'm just curious if there is a back up plan in place. It does sound like your follies are still growing! :) Can't wait to hear what they have to say when they call you back. I bet you are almost ready!! :D

Holly

Hi Holly,

I have been worried about this since last week when they said I wasn't progressing like they thought. He is in a private practice and when I asked about what would happen if I don't progress, they said they gave enough time and have never had to cancel a cycle b/c of running out of time. However, when I read other people's results and timing, it seems I really need a few more days to trigger. That would not give us enough time, or at least seems like it would be compromising the potential time that an egg and sperm need to grow before transferring. I feel awful. It is awful to think that we wasted this cycle or didn't give it the time it needed. I phoned a few other clinics to check about continuing with me if needed and one is closed also for the conference and the other never phoned me back. I feel silly calling and saying hey can you take me for an E/R later this week? It will be interesting to see what my dr says when they phone later.

Just got a call from the dr and now they are going to try to stall me. Retrieve on Friday, transfer next week when they are back. I am not to take anything today and have another u/s and blood work tomorrow to see if this would potentially work. OK, I am not sure if this is better or worse...

Gosh Marie, you must be a nervous wreck. How many days will your dr be at the seminar? At least the eggs will have a better chance to grow if they try to delay things instead of trying to rush them. You will definitely have a nice number of mature follies by Friday. :D I guess it's impossible to plan for every possibility, but I am really upset that they scheduled the cycle so close to this seminar. It was definitely poor planning on their part & now you have all this uneccessary stress. Please know that I am pulling for you!! I'll say a prayer and cross fingers and toes that e/r and e/t go off w/o a hitch!

Holly

Thanks Holly. Your response and support helps. It was poor planning on their part. They say it was b/c it is my first IVF and they didn't know how I would respond, but they should have enough experience to plan and not put someone in this situation. It is stressful enough to suddenly feel like your body isn't cooperating with a conference schedule. It sounds like they will be back (there are two drs, both are going to the conference) on Wed or Thurs of next week. If I wasn't doing IVF, I would be ovulating on thurs this week, so this new IVF schedule might be better aligned with what my body is used to. For what that is worth. They will be in the office on Saturday. So, if they retreive Friday or Sat, that would be five days to transfer (assuming eggs can be fertilized--that is our biggest unknown right now). Is there any risk or potential negatives for a long time between retrieval and transfer?

Thanks again.

Marie

Well thank God it's not a long seminar! I can understand them not knowing what to expect, but you are completely right when you said they should have enough experience to know this was at least a possibility. Oh well, no sense going on about it, I suppose. It won't help anything.

Here's what I understand as far as transfers:

5 day transfers are generally more successful than 3 day transfers, and a lot of drs prefer doing 5 day transfers rather than 3 day'ers. The thing is, 5 day transfers are not always an option depending on how many embryos fertilize and how quickly they are growing. If you don't have a lot of embryos to work w/, then the dr will generally opt for a 3 day so that you don't lose too many before making it to transfer. I hope that makes sense. I don't really know how to explain it. How about this, the best place for the embies is in your uterus :) but if the embies are thriving in the lab, then they have kind of proven they are strong, and generally speaking, they have a better chance of implanting. It is NOT an exact science though, and there are plenty of 3 day transfers that work and plenty of 5 day transfers that don't work. So you just never know. All that to say, there are risks of waiting for a 5 day transfer (some of the embryos probably won't make it), but there are also benefits if you make it to a 5 day (better implantation rate). :D

Well, I hope that helped a little. Keep me posted w/ your updates. :)

Holly

Thanks Holly. That is VERY helpful. I had no idea why some did 3 day and some 5. That does make sense though. Let's hope for lots of eggs since it sounds like 5 day will be our situation. Maybe the extra time this week will be just the trick to turn some more of my follies into mature eggs. I did just post to the Sept/Oct chain as well, but will ask you another question....what about my estrogen levels? Can they let me go until late this week with my follicles growing potentially over 20 mm as long as my estrogen doesn't go too high? Right now it is over 1,000, but not over 2,000 (I can't remember the number).

Thanks again,

M

I'm so glad that all made sense. I knew what I wanted to say, but didn't know how to word it. I'm glad I could help. :)

I am sure the extra time will give some of the smaller follies a chance to catch up. I bet you will have quite a few by the time of e/r. I don't know as much about e2 levels as I do about transfers, but I am pretty sure that anything under 2000 is safe...and maybe even anything under 3000 (don't quote me on that though ;) ). They like to see a level of 100 for each follicle you have growing...do you know how many follies total are growing? If you stopped your meds, then your level shouldn't go up too much more & I think you will be safe.

Holly

Hi Holly,

I did a quick search online and found anywhere from 800-4,000 for estrodial at the time of retrieval (some have had higher levels though). Again, depends on how many mature follicles you have. One site said 250-350 per mature follicle. I couldn't find out how much for growing follicles (maybe that is your 100 number?). I have 18 follicles on my left and I am pretty sure 8 on my right (might be 7). The nurse definitely said my estradiol was at 1,000-something today on the phone. My first few days of bloodwork the nurse said my estradio was low. It made a jump last Friday to 300-something. The growth of my follicles seems pretty regular each u/s--about 1MM per night (which may be on the low side since I have read an average of 2MM per night). Anyway, my left ovary aches and I am nice and bloated. My right doesn't hurt. I feel good that this new approach of slowing the meds (and process) is the right one for us...I just hope my body responds!

I will go back and check past posts, but what is your situation?

M

Marie, I'm glad that you're starting to feel more comfortable about your cycle. :) This whole proccess is stressful enough w/o having to worry about scheduling issues w/ the dr. I think you are handling this very well!!! :D :cool:

We have been ttc for over 4 years now. I had a tubal pg from a previous relationship (lost the tube in the process) and never thought I would have problems getting pg again. Boy was I wrong! My BF and I took a long time to face the fact that things weren't going to happen naturally, and we first approached my dr the beginning of last year. In the summer of last year, I had a laparoscopy which showed that my remaining tube was completely blocked. I was referred to my RE, had another lap, and had the tube opened up...thought that would be the answer to our problem. While my RE was performing the lap, he noticed that my tube is misshapen and full of tiny polyps, which according to him were too small to be removed, but big enough to cause the sperm some problems in their journey. So, he recommended IVF...My insurance doesn't cover IVF though, so we started out w/ IUI, figured at least we would be doing something. First IUI, we got bfn. Then my dr asked me about doing the shared egg donor program where I would donate half of my eggs from my IVF cycle and the recipient couple would pay for a large portion of my cycle. We jumped at the idea and did our first IVF in May. It worked, and we were ecstatic. Sadly, my numbers didn't double, and I m/c two weeks later. We did a second IUI and got bfn again. We are currently waiting to start our second IVF in January or February. We were supposed to do it in November, but the recipient couple postponed it due to scheduling problems. So, that's where we're at now. Really looking forward to our next chance at IVF and praying for a healthy bfp this time around.

So sorry for the book!!! :D Let me know how your next monitoring appt goes. You go back tomorrow, right?

Holly

Marie.... I just read your thread and I just wanted you to know that I am praying this works for you!!! I am hoping to start my first IVF cycle very soon and I bet I will have the same questions you have!!!

I hope to see great things posted soon!!!

Crystal

Holly,

Wow, your story reminds me of how strong women (and couples!) are who go through IF. Thanks for sharing. I am glad that you have found a way to move forward and are continuing. My DH and I realize that this may be a long journey for us, and it is important to hear the stories of other couples who are persevering. We may learn this or next week (whenever we are able to try to fertilize eggs!) that his sperm is not viable and we need to try another option (b/c of the retrograde the drs have not been able to say whether or not his sperm can fertilize an egg). We are taking it one step at a time, but learning whether or not IVF/ICSI is an option for us is my biggest concern (fear) right now. It will be disappointing if there is fertilization but it doesn't "take" (we were going to try IUI, but the day of insemination the dr realized DH's sperm wasn't "workable" for that, and that was sad), but if we know it can work for us, we will be happy and we will continue. If it doesn't, we are not sure what we will do. DH not comfortable with donor sperm, I am not ready to let go having my own child and experiencing pregnancy. Again though, one day at a time. And hopefully tomorrow my cycle will have slowed (yes, blood and u/s in the AM)!

Crystal,
Thanks so much for your positive thoughts! We can learn together as we continue with our cycles. Keep me updated on your progress. The day my hormones arrived--I sat there thinking oh my, these are for me? And then the day I had to give my first shot (DH was giving them, but I travel for work), I wasn't sure I could do it, but now I can no problem. DH always says "you are so brave" and sometimes I like to hear that, but other times I don't want to hear it b/c it is easier for me if I think it is just par for the course--everyone is doing it. Finding this board makes me realize that there a lot of women doing it!

M

Marie,
I sure hope you get good news about DH's sperm. I know it won't matter if it's a low count or slow swimmers since the sperm is directly injected into the egg for IVF. I don't know much about any other sperm issues though. Since I'm single I had no choice but to use donor sperm. And this time around, I'm too old (ugh I hate that) to use my own eggs, so I had to use donor eggs. I wasn't happy about that, but had to think beyond it all.
It sounds like you will have lots of eggs on E/R day! Better to develop slowly than too quickly like I mentiond before. So sit back and relax - perhaps enjoy your big tummy now in hopes that it will be even bigger in a few months!!!!!!!!!!!!!!!!!!! :D And no, they shouldn't have scheduled a cycle when they knew they would have a schedule conflict. My office does their cycles every other month.

Wow Holly, I've never heard of being able to donate your 'extra' eggs for a discount on the cycle! wow girl! That is a terrific option for the costs!!!!! My insurance doesn't pay for it, at least they haven't in the past. I have a new insurance that will cover about 3 or 4K this time which is very helpful! My egg donor left me with 57 eggs, 49 of which fertilized and 20 of which were in tremendous shape that we transfered only 2, and 18 are in cryo. If this results in a bfp and a beautiful baby #2 in 9 months I will donate my embryos.

stace

Marie, you are right, there are a lot of us riding this IF rollercoaster. As much as I wouldn't wish this on anyone, it truthfully is helpful knowing I'm not alone in what I'm experiencing. That's one thing I love about this place so much. I hope things go well w/ your DH's sperm and the eggs being fertilized. I believe ICSI would be the way to go. That way the sperm doesn't have to swim at all, it is just placed in the egg to do it's business. ;) I have heard that ICSI can also aid in implantation. Well, I can't wait to hear how your b/w and u/s went. Let me know when you get a chance. :)

Stace, I was pretty surprised to find out a program like that existed as well. I know it's not available at all dr's offices, my dr just happens to be a participating dr. When I first heard about it, I wasn't sure if it was right for me, but after a few days, I came around, and now I am just thankful for the chance at doing IVF myself and the chance of helping another couple out in the process. It truly is amazing what they can do these days!! :D Good luck to you!!

Holly

Hi gals,

I just posted this on the Sept/Oct IVF, and wanted to share with you too.
The dr office just called. I am scheduled for trigger tomorrow night and E/R on Friday at 7:30AM. I have 18 follies on one side (largest 16mm) and 20 on my other side (largest 19mm). My DH goes in for PESA (sperm retrieval) on Thursday AM. They plan to ICSI Friday afternoon and do a 5-day transfer (RE will be a the conference), so if things go well, transfer will be on Wed Oct 17th. The feel good about the 5 day b/c of number of follies. I am so nervous I feel sick. My DH feels the same. He wants me to be with him when they do the PESA and I think I would be a nervous wreck. I guess they won't know if things will work for him right then and there. I will be there for him. They said he can be with me for the E/R too. Might be nice since I won't be awake for it.

M

Marie, that sounds like a good plan to me. I'm so glad you have so many follies growing. I bet there will be quite a few mature by the time Friday gets here. :) Try not to be nervous. Your dr is a professional, and I'm sure he's done this hundreds - probably thousands - of times. Also, we will be with you in spirit, cheering you on the whole way.

It sounds like you are on your way to that bfp. :D

Holly

Thanks Holly! It is hard not to be nervous. I will keep you posted!

M

Oh believe me, I know it's hard! :) And I'm sure you're extra concerned about how things will go w/ DH's sample. Just try to think positive. It really does go a long way.

Good luck!!

Holly

Yes, the results of DH's sample are what make us so nervous. I am being positive though. I haven't been feeling positive, but last night I had a dream that made me wake up feeling good. It was bizarre and had nothing to do with anything, but it left me feeling good and I am keeping that positive feeling.

Marie,
Keep that good feeling with you. Yes, easier said than done for us all, but we have to. I'm optimistic about my Hcg tests for Sunday and hope for a bfp, but, .....I have to be open to whatever comes. I know negative feelings can be a bad thing, so I stay positive.
It sounds like your follies are doing f a n t a s t i c!!! You've got quite a number of eggs little lady! Try to think of this.....I had only 17 eggs, only 9 good ones, and I have a beautiful boy! It can happen! It only takes one as they say!
Yes, ICSI does help in the implanting on the utereun wall. A layer of the shell is peeled back and it helps adhere itself to the lining easier. Definetly the way to go.

Hold on.....just a few more days!

-stace

Wow Marie!!! how exciting! That is great news..... what a great number! I am sending you extra prayers.... as this is such a big time for you and DH!!!!! Its great that he can be in there with you!

Come on BFP!!
:D :D :D