Vino
07-29-2003, 07:32 PM
If PCOSers are set up naturally to overstimulate with gonadotropins, then why would a dr. put someone with PCOS on a higher dose than one would normally start at?
Most people start on 75 ml, while my dr. is starting me on 112.5 mls. I am just so scared that this cycle will fail for producing too many follies we just can't afford it financially.
Anyhow, any advice would be great.
Thanks
Rose
Most people start on 75 ml, while my dr. is starting me on 112.5 mls. I am just so scared that this cycle will fail for producing too many follies we just can't afford it financially.
Anyhow, any advice would be great.
Thanks
Rose
Sponsor
adkins
07-29-2003, 07:42 PM
I am not sure how to answer your question about WHY doctors put women with PCOS on injectibles. However, I do know that women with PCOS who do injectibles have been very successful.
Unfortunately for me, I did injectibles (75ml) and I DID NOT overstimulate, However, I did not get pregnant either. So, I guess I was just unlucky on my first try at getting pregnant. But was pleased my cycle was not cancelled. Our insurance did not cover it, either. It is really difficult that is why we have taken a 2- month break. If I don't get pregnant by September, then I will do injectibles again.
I hope this helps and good luck. Remember that while on injectibles, they monitor you VERY closely and can adjust your dosage along the way.
Good luck to you!!!!
Pam
Unfortunately for me, I did injectibles (75ml) and I DID NOT overstimulate, However, I did not get pregnant either. So, I guess I was just unlucky on my first try at getting pregnant. But was pleased my cycle was not cancelled. Our insurance did not cover it, either. It is really difficult that is why we have taken a 2- month break. If I don't get pregnant by September, then I will do injectibles again.
I hope this helps and good luck. Remember that while on injectibles, they monitor you VERY closely and can adjust your dosage along the way.
Good luck to you!!!!
Pam
suki222
07-29-2003, 09:27 PM
I wish I had known as much as you do. I would talk to my dr. if I were you to be sure. My dr. put me on 150 of repronex and i produced 18 mature follies and went close to hyperstimulation. We had to cancel my cycle and we were out the $ we spent on the injectibles. Over $1000. Plus all of those shots in my rear were for nothing. I'd definitely double check with him. My dr explained (AFTER I had 18 mature follies) that this happens with PCOS patients, that we stimulate easy. Well why didn't they think about that in the first place? And what about all of those u/s and lab work? I was pretty upset at having to cancel that cycle. For this cycle, though, he cut the dose in half and then upped it a little half way through. I only had two mature follies. I go for the blood test on Monday. If it's a BFN I'm going to make sure I talk to the dr more and tell him my concerns as they come up. Injectibles are expensive. I hope this helps.
Good luck!
Good luck!
Vino
07-29-2003, 10:56 PM
Thanks Suki and Adkins for your reply.
I feel that being informed is empowering. It sorta gives me a false sense of control. LOL!!! :)
Anyhow, I realize that they do monitor you closely, and I go back on day 9 which is Saturday. I hope that everything will be alright.
Thanks again,
Rose
I feel that being informed is empowering. It sorta gives me a false sense of control. LOL!!! :)
Anyhow, I realize that they do monitor you closely, and I go back on day 9 which is Saturday. I hope that everything will be alright.
Thanks again,
Rose
Gr8fuldead69
07-30-2003, 01:29 AM
OMG, 18 follicles :eek: http://www.healthboards.com/ubb/wow.gif
I have PCOS and I've done four cycles with injectibles (follistim). They had my dosage up to 4 amps (300 UI) daily. One cycle I had 2 follicles, the other 3 I only had one.
Just make sure they have you going in for u/s every couple days so they can adjust the dosage if necessary. Good luck!!
~ Joelle
I have PCOS and I've done four cycles with injectibles (follistim). They had my dosage up to 4 amps (300 UI) daily. One cycle I had 2 follicles, the other 3 I only had one.
Just make sure they have you going in for u/s every couple days so they can adjust the dosage if necessary. Good luck!!
~ Joelle
amyttc
07-30-2003, 11:25 AM
I'm at the end of my second IUI with injectibles (Gonal-F) and I too have PCOS. My first cycle they put me at a fairly low dose, 112.5, and I had two follies, but that round failed. This time around, they tried a higher dose, 150, to give me more follies and a better chance, but I overstimulated. They monitored me really closely--brought me in every single day for six days for b/w and u/s! Even though they cut my dose back to 75, I had so many follies at once that my RE gave me a choice between cancelling the cycle outright or ovulating me a day early. Because the follies weren't quite mature, it was less likely that this cycle would work, but it gave me some chance as opposed to totally cancelling the cycle.
octobergirl
07-30-2003, 12:47 PM
The overstimulation happened to me my very first cycle of injectibles with DD back in '98. I was given the option of cancelling or going in and retrieving the eggs for a future cycle if I ever needed to do IVF. I chose to cancel, being that it was my first try ever and the thought kind of freaked me out a little. I felt I wanted to try more on my own, and at that time, it happened to work out, as I got pregnant on my next cycle. That might be an option for some people, though, to harvest from an overstimulated IUI cycle, as it seems as more people are trying IVF these days-it would be one step and one expense out of the way. Good luck.
suki222
07-30-2003, 01:04 PM
Hey Octobergirl! I asked if they could harvest the eggs and that we could switch to IVF but they said no b/c I hadn't gone through the proper paperwork, etc. I didn't think about harvesting them for a later cycle. Good thinking. If the next cycle (let's hope there's not one) produces too many, then I'm going talk to them about that! Thanks for the idea!
suki222
07-30-2003, 01:05 PM
Sorry. this was a duplicate.
[This message has been edited by suki222 (edited 07-30-2003).]
[This message has been edited by suki222 (edited 07-30-2003).]
Vino
07-30-2003, 05:22 PM
Thanks for all your replies.
I think the other thing that's got me a little freaked out is when they did the first ultrasound (on day 2) I had 18 follies forming on one side and 23 the other. No clue if that's normal or what. I never ovulate and never have periods on my own. I'm hoping that's normal. :)
Anyhow, that's a really good idea to harvest the eggs in case of IVF. Never thought of that. I'll have to inquire to see if that's possible.
As far as going in every other day, they're not doing that until day 9 which is Saturday. So from day 5-9 I'm on 112.5. I need to put more faith in them I guess, but this is my first experience with them and so far I don't have a very good feeling. I called 2 days ago to make sure that I was going to be taking the proper dose, and they have never called me back. That doesn't leave me with a very good feeling, plus on top of that, our first visit they told us that the doctors know us on paper only and that we will be dealing with their nurse coordinator 99% of the time. It's bad enough I have to travel 3 1/2 hours to this clinic and it's the closest one.
Anyhow thanks for letting me vent. :) And thanks for the advice. I really appreciate the support.
Rose
I think the other thing that's got me a little freaked out is when they did the first ultrasound (on day 2) I had 18 follies forming on one side and 23 the other. No clue if that's normal or what. I never ovulate and never have periods on my own. I'm hoping that's normal. :)
Anyhow, that's a really good idea to harvest the eggs in case of IVF. Never thought of that. I'll have to inquire to see if that's possible.
As far as going in every other day, they're not doing that until day 9 which is Saturday. So from day 5-9 I'm on 112.5. I need to put more faith in them I guess, but this is my first experience with them and so far I don't have a very good feeling. I called 2 days ago to make sure that I was going to be taking the proper dose, and they have never called me back. That doesn't leave me with a very good feeling, plus on top of that, our first visit they told us that the doctors know us on paper only and that we will be dealing with their nurse coordinator 99% of the time. It's bad enough I have to travel 3 1/2 hours to this clinic and it's the closest one.
Anyhow thanks for letting me vent. :) And thanks for the advice. I really appreciate the support.
Rose
Colleywobbles24
07-30-2003, 06:27 PM
Hello Rose,
I don't know how much help I can give you but I'd like to share my experience with you. I too have PCOS and do not ovulate on my own, we had tried Clomid but it did nothing for me, I am Clomid resistant. My first cycle of injections I did 4 amps of Follistim daily for 8 days and produced 9 mature follicles, we tried timed intercouse but it did not work.
Then I went for my second cycle and had 52 small follicles growing, I was put on 8 amps of Gonal-F for 3 days and then down to 4 amps daily for about 8 days, the reason for this being that the higher dosages of Gonal-F were given to start the "good" follicles growing and then when the meds were tapered off the "bad" ones died off and the good ones continued to grow. My RE has told me that women with PCO are likley to have poor egg quality so it's important to try and seperate the good from the bad. I was monitored every 2 days by vaginal ultrasound and blood work to make sure we didn't have too many follicles, your RE can control this growth by adjusting your dosage. I produced 7 mature follicles and am currently almost 20 weeks pregnant with twins. I would definatley talk to your doctor about any concerns you may have, I did hyperstimulate but only because I got pregnant and the HCG from the embryo tends to cause OHSS. I wish you the best of luck and hope you get a BFP really soon.
I would tell your doctor before you even start that you are concerned about producing too many follicles and having to bust the cycle, see how many follicles he will permit you to have to finish the cycle.
Best Wishes
Amanda
I don't know how much help I can give you but I'd like to share my experience with you. I too have PCOS and do not ovulate on my own, we had tried Clomid but it did nothing for me, I am Clomid resistant. My first cycle of injections I did 4 amps of Follistim daily for 8 days and produced 9 mature follicles, we tried timed intercouse but it did not work.
Then I went for my second cycle and had 52 small follicles growing, I was put on 8 amps of Gonal-F for 3 days and then down to 4 amps daily for about 8 days, the reason for this being that the higher dosages of Gonal-F were given to start the "good" follicles growing and then when the meds were tapered off the "bad" ones died off and the good ones continued to grow. My RE has told me that women with PCO are likley to have poor egg quality so it's important to try and seperate the good from the bad. I was monitored every 2 days by vaginal ultrasound and blood work to make sure we didn't have too many follicles, your RE can control this growth by adjusting your dosage. I produced 7 mature follicles and am currently almost 20 weeks pregnant with twins. I would definatley talk to your doctor about any concerns you may have, I did hyperstimulate but only because I got pregnant and the HCG from the embryo tends to cause OHSS. I wish you the best of luck and hope you get a BFP really soon.
I would tell your doctor before you even start that you are concerned about producing too many follicles and having to bust the cycle, see how many follicles he will permit you to have to finish the cycle.
Best Wishes
Amanda
Vino
07-31-2003, 02:03 PM
Thanks for sharing your story Amanda.
My fertility clinic will only allow us to do the HCG shot and IUI if I have 4 follicles or less. They said if we have intercourse anyways, then it's not their responsibility if I become pregnant with multiple births. I don't wan to have ten babies either, but to me it almost seems impossible to only have 4 follies with PCOS.
Anyhow, my hubby and I decided to do the BD anyways depending on how many follies becaus you aren't guaranteed to release even one follicle anyways.
You are so fortunate to have such a good RE. We don't even have those here in Canada. I don't even see a dr. when I go, I only deal with nurses.
As far as my egg quality goes, I have been pregnant before and now have a son. I was fortunate to get pregnant on 100mg of Clomid, but it didn't work this time, even with the metformin. I hope that is an indication that my eggs are ok. :)
Thanks again, and i will definately keep you posted.
How are you enjoying your pregnancy? I just loved being preggos. :)
Rose
My fertility clinic will only allow us to do the HCG shot and IUI if I have 4 follicles or less. They said if we have intercourse anyways, then it's not their responsibility if I become pregnant with multiple births. I don't wan to have ten babies either, but to me it almost seems impossible to only have 4 follies with PCOS.
Anyhow, my hubby and I decided to do the BD anyways depending on how many follies becaus you aren't guaranteed to release even one follicle anyways.
You are so fortunate to have such a good RE. We don't even have those here in Canada. I don't even see a dr. when I go, I only deal with nurses.
As far as my egg quality goes, I have been pregnant before and now have a son. I was fortunate to get pregnant on 100mg of Clomid, but it didn't work this time, even with the metformin. I hope that is an indication that my eggs are ok. :)
Thanks again, and i will definately keep you posted.
How are you enjoying your pregnancy? I just loved being preggos. :)
Rose
llama mama
07-31-2003, 02:09 PM
sorry- what is PCOS?
Vino
07-31-2003, 02:12 PM
llama mamma,
PCOS is polycystic ovarian syndrome :)
It's millions of cysts on the ovaries than inhibit ovulation and cause all kinds of other nasty side effects.
Take care,
Rose
PCOS is polycystic ovarian syndrome :)
It's millions of cysts on the ovaries than inhibit ovulation and cause all kinds of other nasty side effects.
Take care,
Rose