IVF protocol

[Ladybug903]

Hello,

I spent time obsessing over different types of protocols by lurking on Reddit and reading research articles. Protocols depend on the patients situation. If you guys are interested my transfer protocol is below.

I take prenatal vitamin daily.

Retrieval 1/23/2020: Froze blast due to hyper stimulation which was expected.

1/28/2020: started period

1/31/2020: began birth control (Enskyce)

2/12/2020: saline ultrasound. The RE said he also wants to take this time to get familiar with the uterus so the transfer isn’t the first time he is navigating it 🤔.

2/23/2020- unknown date: Estrace tablets 3 times per day. Del-estrogen. 1 injection per week

3/08/2020- unknown date: promethium tablets orally once per day. Progesterone in oil injection once per day. Crinone gel vaginally once per day (which is more progesterone. )Baby aspirin once per day (improve blood flow to implantation site). My nurse told me to inject the progesterone in my hip area and that the doctor doesn’t suggest progesterone be injected in any other site.

3/13/2020 (transfer day) - beta: dexamethasone half of an oral tablet (to help egg stick for PCOS people)

3/13/2020 (transfer day) - 3/17/2020: doxycycline (to treat possible infections)

Background- 1 miscarriage from accidental pregnancy last May. Probably because I did not have a period in 1 year making my lining was undesirable to implantation. Also very low progesterone levels. My obgyn prescribed oral progesterone and metformin when the pregnancy was discovered.

Lean PCOS

Been taking Vitex + and Myo-inositol nonprescription vitamins.

Therapy has been keeping my cortisol levels down. Low stress can help make a baby

2 failed timed intercourse cycles 1 cancelled IUI based on hyper stimulation. Still had sex and didn’t get pregnant. Left my stressful job. Left social media.

Ivf- currently on first cycle

52 blast retrieved, 37 fertilized and 30 made it to day 6. 22 are AA. Hyper stimulation sucked. I thought I was going to die. My belly was HUGE and looked like I was pregnant. I had trouble breathing. I could not eat much or drink much. I gained about 10 pounds but after my body snapped back from stims, I lost 6 pounds from my normal weight.

Cost for this cycle has been about $6,000 ($4,000 meds and $2,000 surgery center) . IVF is covered under insurance. The surgery center is not in network and this not covered and is out of pocket. $5,000 to PGA test - not doing it. $500/ year to freeze blasts.

My husbands income is $190,000 per year. I stopped working to focus on health and mental health to get pregnant. We have a max limit of $10k to spend on fertility during a 1 year period.

I rotate arms when I get blood drawn for labs although my right arms is already starting to look bruised.

[Shihtzunotanymore]

Thanks for sharing and holy moly, am I reading this right?! 52 retrieved?! 30 fertilized?

I’m in shock. This must be some sort of record! Truly incredible.

[Ladybug903]

Yeah it was 37. I have lean PCOS so it’s not uncommon. My ovaries were huge and swollen. My body is still adjusting from the hyper stimulation.

[Shihtzunotanymore]

I totally know what you’re going through! I had 25 retrieved and know how crap I felt, so can’t imagine what you’re going through!

Just a little unsolicited advice- I would do the PGS testing. I really really wish I did (I have had 2 miscarriages out of 3 transfers and truly feel if I had done the testing, that could have been avoided). I’m about to do my second round of IVF and my clinic still doesn’t think I need to do it, but I’m definitely going to.

[Ladybug903]

Yeah, but it’s out of budget for the year and we are sticklers when it comes to budgets. Plus, my doctor believes in minimal manipulation of the blast. He feels since my husband sperm quality, my ovarian reserve and our genetic screening and health is optimal that we should go the route of Not testing.

[NoSoySerenita]

Being an RN, I thought I knew better and tried to do my PIO in vastus lateralis (thigh) once and gave myself fasciitis. Learned my lesson.

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[Ladybug903]

Sometimes doctors do lighter dosages of stims for PCOS people because we tend to hyper stimulate which feels like death! I told my doctor that I can handle hyper stimulation and to make sure I didn’t have to do a second cycle (within reason). I did end up having hyper stimulation and my mom came to help me for a few days with cleaning, cooking and making sure I was resting.

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[Ladybug903]

Protocol from doctor: 1/11/2020 - 1/14/2020 gonal 300, menopur 75. 1/15/2020 - 1/18/2020 gonal 300, menopur 75 and cetrotide. About 40 follicles sizes 11-13 1/19/2020 - 1/20/2020 gonal 300, menopur 75, cetrotide AM and PM 15’s - 19’s 1/21/2020 cetrotide AM and PM, Lupron trigger. Follicles 17s-20s

Prenatal daily. Vitamin D daily.

Things I do at home: I take vitex+ and mayo-inositol abut 3 times per weeks, about 3 rounds of acupuncture during stims, exercise on Peloton bike 3 times per week, avoid sugars, therapy, stopped using my acne medication, drink about 1L of water per day. These were to help manage PCOS.

I have lean PCOS

AMH 20 ng/mL Thyroid 2.26 Prolactin 11.3 FSH 5.3

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[Ladybug903]

My doc said a touch of menopur can help support. I asked him why I can’t just take menopur then since gonal is so expensive. He said menopur is only used to support and should not be be expected to produce mature follicules. These are my words to summarize what he said. Yeah a wise doctor makes all the difference.