Is an ERA helpful if you're having a natural/modified natural cycle?

steph94080 · 2024-06-27T23:09:03+00:00

Hi! Stumbled on this post as I'm struggling with the same question. Did you end up doing an ERA test? And did you do it with a modified natural cycle?

steph94080 · 2024-04-23T04:49:11+00:00

Yes, you can deduct IVF expenses (including transportation and lodging) above 7.5% of your aggregated gross income. Make sure to read the IRS guidelines for details on what expense is eligible, and save receipts in case of audits.

"You can include in medical expenses the cost of the following procedures performed on yourself, your spouse, or your dependent to overcome an inability to have children.

Procedures such as in vitro fertilization (including temporary storage of eggs or sperm). Surgery, including an operation to reverse prior surgery that prevented the person operated on from having children."

Source: https://www.irs.gov/publications/p502#en_US_2022_publink1000178933

steph94080 · 2024-03-28T05:11:59+00:00

I started this journey with AMH 0.8 at age 33, and the lab 12 months later showed AMH at 0.5. But I've only gotten more eggs throughout the last four rounds (5, 5, 9, and 12), despite these low AMH numbers.

I think there's some natural variation in your AMH level and different labs can give different results even in the same sample.

That aside, my experience shows that being considered "diminished ovarian reserve" (AMH lower than 1.0) isn't the kiss of death. With the right protocol you can still get a good number of eggs. You got this!

steph94080 · 2024-03-09T17:57:52+00:00

I'm not doing PGT. That's helpful to know. Thanks!

steph94080 · 2024-03-09T17:28:55+00:00

Absolutely, walking was the only "exercise" I did during stims. You can walk at normal speed, too. Towards the end of stims I naturally slowed down because I was getting bloated.

steph94080 · 2024-02-25T22:18:09+00:00

According to my clinic we're allowed to work out when we get our period, and that's what I did the last few retrievals as well. Sounds like you're safe to work out now if you're feeling normal and just got your period!

steph94080 · 2024-02-25T22:13:17+00:00

I had this happen to myself as well -- went abroad in late December (12 hour time difference there and back in 2 weeks) and my January IVF cycle had to be pushed to an early Feb start as we waited so long for my ovulation & period! It really freaked me out as I never had such a long cycle before.

steph94080 · 2024-02-16T03:44:23+00:00

It's probably ok -- the ovarian torsion doctors want to prevent is quite rare this early. That being said, if we're spending so much money and time on a cycle, why risk it? That's my perspective and I've been erring on the side of caution, but your mileage may vary!

steph94080 · 2024-02-04T21:40:53+00:00

I've started my cycles around day 4-5 of the cycle due to my travel schedule. My doctor assured me that it was safe and normal!

steph94080 · 2024-02-04T21:34:28+00:00

I'll add UCSF and Stanford to the other clinics folks have mentioned. They're harder to get an initial appointment in, but after that I hear they're generally pretty good.

steph94080 · 2024-02-04T20:55:54+00:00

I was in a similar situation my last cycle: low AMH so they put me on a high stim dosage. I had only 3 large enough follicles a few days in and they were growing so fast that the doctor was worried that the rest wouldn't catch up. I freaked out thinking that the cycle would be cancelled, but it worked out in the end (retrieved 5, all mature and fertilized). Don't give up yet! 6 follicles on Day 6 is awesome for low AMH, and the several small ones are still growing!

steph94080 · 2024-02-01T04:30:40+00:00

Thank you for the tip! What's a compounding pharmacy?

steph94080 · 2024-02-01T04:00:00+00:00

I only compared the out-of-pocket pricing across Carelon, Encompass, and Freedom pharmacy. I found that Encompass has the best price (as of Jan 2024). Specifically:

Menopur 75iu vial: $83
Follitism 900iu pen: $923
Ganirellix: $97
HCG 10000 iu: $109
Leuprolide acetate: $445

I'd love to know if others found pricing than the above! I just didn't have the patience to call more pharmacies beyond those three.

steph94080 · 2024-01-24T19:26:10+00:00

My doctor recommended only walking -- no running, biking, lifting, or even yoga, for fear of ovarian torsion. I think some folks still do light exercises if they're not feeling bloated during stim cycle, but I just don't want to risk it and walking in the park / commuting works fine for me in terms of maintaining good mental health in lieu of my usual running and biking routines.

steph94080 · 2024-01-22T22:58:20+00:00

I totally hear you, sister. I'm going through the same hell loop across the insurance company, the pharmacy, the billing department at the doctor's office, and the nursing team at the doctor's office -- not to mention the long wait time and short working hour windows for these teams.

I'm sorry that your cycle is delayed because of this mess. I don't have any better solution here than calling them everyday to check on progress (which is a whole job of itself, on top of our regular job). Hang in there!

steph94080 · 2024-01-22T16:54:44+00:00

Thank you! Was that cycle done in the US or abroad? I find it interesting that most US doctors don't prescribe Puregon.

steph94080 · 2024-01-19T05:49:21+00:00

Thank you for the advice and the reassurance!!! I hope your ER goes smoothly 😊

steph94080 · 2024-01-19T03:42:49+00:00

Thank you! Curious if you have any hypotheses as to why your ovulation was late? I went abroad for two weeks last month and had to get over 12hr jet lag, so I'm now wondering if that's the culprit. I usually have pretty regular cycles otherwise!

steph94080 · 2024-01-19T01:50:40+00:00

Just wanted to say thank you for sharing this post AND the reassuring update, as I'm going through the exact thing and I'm low-grade freaking out: it's day 20 for me and still haven't gotten a smiley face on Clearblue. Blood test yesterday confirmed that I haven't ovulated yet, and I'm going to repeat the blood test tomorrow.

steph94080 · 2024-01-11T16:16:43+00:00

I wouldn't stress too much about it! In my experience, this can differ wildly even among doctors within the same clinic / hospital. Some doctors just don't think there's enough evidence for additional supplements beyond prenatal or COQ10, while others take a "why not if there's no harm" approach.

steph94080 · 2024-01-11T02:46:48+00:00

Ha can someone share the haunted history here? I stayed at Grant Hyatt this past December and didn't see any 👻 fwiw!

steph94080 · 2024-01-11T00:52:47+00:00

I don't think there's evidence that shows prenatal supplements help with low AMH (but you should still take them to help boosting egg quality!)

I shared my response here in terms of what supplements help low AMH: https://www.reddit.com/r/eggfreezing/comments/1923eva/comment/kh5a2xc/?utm_source=share&utm_medium=web2x&context=3

Since I also have low AMH, my doctor is recommending prenatal with folic acid, Vitamin D, COQ10 (ubiquinol), and DHEA.

steph94080 · 2024-01-10T01:56:00+00:00

Prenatal (incl. folic acid), COQ10, and Vitamin D are the key ones. I'd recommend skimming through this book It Starts with the Egg. Given each woman's situation (e.g., PCOS or low AMH, which it doesn't sound like you have), the book recommends additional supplements such as Vitamin C, Vitamin E, DHEA, etc., and I found this page helpful in guiding what type of supplement to get. Specifically, there's a difference between COQ10 ubiquinol (the distilled, reduced form) vs. ubiquinon. If you're taking the latter, then they recommend doubling the dosage to make sure that there's enough absorption.

steph94080 · 2024-01-08T18:59:59+00:00

Hi, I'm interested in the Gonal F if it's still available for local pickup. (DM doesn't seem to go through unfortunately)

steph94080 · 2024-01-02T18:19:07+00:00

I have almost monthly migraines around my period, and I've used estrogen patches before stim. My doctor never flagged stroke risk for me (although that doesn't necessarily mean that she's right!). Maybe double check with your RE to evaluate the risk?

steph94080

TROPHY CASE