Appt with Dr. Ch.eck tomorrow after failed IVF- what to expect...?

Appt with Dr. Ch.eck tomorrow after failed IVF- what to expect...?

Jess
Jess

August 28th, 2012, 2:39 pm #1

Hi everyone.

Got the results yesterday that our first 1st IVF was unsuccessful I didn't have too much hope in it, but it still sucks. The secretary at Co.oper was actually very nice and squeezed me in for the wtf appt tomorrow since I want to come up with a new plan before my period begins in a few days.

We will not be doing another IVF this month, so I guess I will be talking to him about a natural, TI cycle. Does anyone know what his "protocol" is for this? Is it just totally natural with P4 support, or is there also meds/monitoring involved? Does Dr. Ch.eck go over why he didn't think the IVF was successful?

My history: Almost 29 years old. Been TTC #2 for about 20 months. FSH seems to usually be around 6-9, low AMH (.6) Dr. Ch.eck thinks if I do have DOR, it is on the "high end of low." Low progesterone (we just discovered this right before the IVF- so frustrating), but not that low that I need PIO shots. Tubes open, everything else seems to be normal (beh). DH is normal. 2 failed IUIs (at Co.rnell) and now 1 failed (low-stim) IVF.

My protocol was: 75iu Gonal-F along with 15iu Lupron every night (including night of trigger). Even with such low stims, they were still able to retrieve 6 mature eggs, but I think some of them may have been over-mature (guess I have to talk to him about that). Then we got the bad news that only 1 fertilized (we did not do ICSI since DH is ok, but maybe we should have). Put back 1 6-cell grade 2B. Lining at ER was 11mm and at 3dpt is was 16mm. Do you think it was too thick for implantation? Is there such a thing as that? Maybe the Lupron affected my egg quality? Maybe it was just bad luck? What would you do for a TI cycle?

I'm still kinda of a newbie with all this stuff, so if anyone has ideas/thoughts or advice, please feel free to respond.

TIA!
Jess

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Joined: November 8th, 2011, 3:54 am

August 28th, 2012, 3:13 pm #2

Hi Jess,
I'm so sorry to hear this. It's very scary and frustrating to not know why and wonder if it can ever happen. But I believe it is definitely too early to give up. You have alot going for you, based on the history you posted! Sounds like there are some changes to be made for next time and I'm sure Dr. C will have some ideas.

Having just experienced my first failed mini-IVF, nurses told me they don't even typically do consults until 2 failures-- because to a certain extent, it's just a waiting game, for the right egg/embryo. But it's great that you're talking to him, b/c you have some excellent questions.

Rooting for you
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AJ
AJ

August 28th, 2012, 3:13 pm #3

Hi everyone.

Got the results yesterday that our first 1st IVF was unsuccessful I didn't have too much hope in it, but it still sucks. The secretary at Co.oper was actually very nice and squeezed me in for the wtf appt tomorrow since I want to come up with a new plan before my period begins in a few days.

We will not be doing another IVF this month, so I guess I will be talking to him about a natural, TI cycle. Does anyone know what his "protocol" is for this? Is it just totally natural with P4 support, or is there also meds/monitoring involved? Does Dr. Ch.eck go over why he didn't think the IVF was successful?

My history: Almost 29 years old. Been TTC #2 for about 20 months. FSH seems to usually be around 6-9, low AMH (.6) Dr. Ch.eck thinks if I do have DOR, it is on the "high end of low." Low progesterone (we just discovered this right before the IVF- so frustrating), but not that low that I need PIO shots. Tubes open, everything else seems to be normal (beh). DH is normal. 2 failed IUIs (at Co.rnell) and now 1 failed (low-stim) IVF.

My protocol was: 75iu Gonal-F along with 15iu Lupron every night (including night of trigger). Even with such low stims, they were still able to retrieve 6 mature eggs, but I think some of them may have been over-mature (guess I have to talk to him about that). Then we got the bad news that only 1 fertilized (we did not do ICSI since DH is ok, but maybe we should have). Put back 1 6-cell grade 2B. Lining at ER was 11mm and at 3dpt is was 16mm. Do you think it was too thick for implantation? Is there such a thing as that? Maybe the Lupron affected my egg quality? Maybe it was just bad luck? What would you do for a TI cycle?

I'm still kinda of a newbie with all this stuff, so if anyone has ideas/thoughts or advice, please feel free to respond.

TIA!
Jess
about your IVF cycle:(. I have been doing TI cycles with C.h.eck and I can tell you that there isn't a set protocol, it really depends on your specific situation. Some women do low does of stims, some don't. He's been pretty adamant that I not do stim drugs because he feels it will compromise quality. Your a lot younger than me so he might think it's ok for you to take them, but he's not looking to create a lot of follicles. I does seem like everyone does progesterone support and I also take estrace daily in the luteal phase. Also, some women will use a trigger, but not everyone.

I don't recall if you've said before, but I assume you haven't done a monitoring cycle yet with Ch.e.ck? I think it's actually really helpful and you can learn a lot about your cycle. Be prepared for a lot of monitoring though. You'll do a baseline u/s and b/w, and depending on that you might not go again until CD 9, but maybe sooner. It just depends:). I've had cycles where I've done b/w and u/s 2 or 3 days in a row once I get close to O. Are you a local patient or out of town? I'm out of town and that does get tricky with all of the monitoring. But if your close and local it shouldn't be as difficult for you if you have flexibility in your schedule.

Hope this helps:) Good luck with your upcoming appt.!!
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jkl
jkl

August 28th, 2012, 4:15 pm #4

Hi everyone.

Got the results yesterday that our first 1st IVF was unsuccessful I didn't have too much hope in it, but it still sucks. The secretary at Co.oper was actually very nice and squeezed me in for the wtf appt tomorrow since I want to come up with a new plan before my period begins in a few days.

We will not be doing another IVF this month, so I guess I will be talking to him about a natural, TI cycle. Does anyone know what his "protocol" is for this? Is it just totally natural with P4 support, or is there also meds/monitoring involved? Does Dr. Ch.eck go over why he didn't think the IVF was successful?

My history: Almost 29 years old. Been TTC #2 for about 20 months. FSH seems to usually be around 6-9, low AMH (.6) Dr. Ch.eck thinks if I do have DOR, it is on the "high end of low." Low progesterone (we just discovered this right before the IVF- so frustrating), but not that low that I need PIO shots. Tubes open, everything else seems to be normal (beh). DH is normal. 2 failed IUIs (at Co.rnell) and now 1 failed (low-stim) IVF.

My protocol was: 75iu Gonal-F along with 15iu Lupron every night (including night of trigger). Even with such low stims, they were still able to retrieve 6 mature eggs, but I think some of them may have been over-mature (guess I have to talk to him about that). Then we got the bad news that only 1 fertilized (we did not do ICSI since DH is ok, but maybe we should have). Put back 1 6-cell grade 2B. Lining at ER was 11mm and at 3dpt is was 16mm. Do you think it was too thick for implantation? Is there such a thing as that? Maybe the Lupron affected my egg quality? Maybe it was just bad luck? What would you do for a TI cycle?

I'm still kinda of a newbie with all this stuff, so if anyone has ideas/thoughts or advice, please feel free to respond.

TIA!
Jess
Have to put a positive spin on it! Anyway, I thought all your questions were good ones, and definitely things you should bring up. Sounds like you are getting enough eggs, just a question of how to get more to fertilize. I always like to do something different on a subsequent try, you never know what will be the right protocol. Good luck!

jkl
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Jen
Jen

August 28th, 2012, 5:36 pm #5

Hi everyone.

Got the results yesterday that our first 1st IVF was unsuccessful I didn't have too much hope in it, but it still sucks. The secretary at Co.oper was actually very nice and squeezed me in for the wtf appt tomorrow since I want to come up with a new plan before my period begins in a few days.

We will not be doing another IVF this month, so I guess I will be talking to him about a natural, TI cycle. Does anyone know what his "protocol" is for this? Is it just totally natural with P4 support, or is there also meds/monitoring involved? Does Dr. Ch.eck go over why he didn't think the IVF was successful?

My history: Almost 29 years old. Been TTC #2 for about 20 months. FSH seems to usually be around 6-9, low AMH (.6) Dr. Ch.eck thinks if I do have DOR, it is on the "high end of low." Low progesterone (we just discovered this right before the IVF- so frustrating), but not that low that I need PIO shots. Tubes open, everything else seems to be normal (beh). DH is normal. 2 failed IUIs (at Co.rnell) and now 1 failed (low-stim) IVF.

My protocol was: 75iu Gonal-F along with 15iu Lupron every night (including night of trigger). Even with such low stims, they were still able to retrieve 6 mature eggs, but I think some of them may have been over-mature (guess I have to talk to him about that). Then we got the bad news that only 1 fertilized (we did not do ICSI since DH is ok, but maybe we should have). Put back 1 6-cell grade 2B. Lining at ER was 11mm and at 3dpt is was 16mm. Do you think it was too thick for implantation? Is there such a thing as that? Maybe the Lupron affected my egg quality? Maybe it was just bad luck? What would you do for a TI cycle?

I'm still kinda of a newbie with all this stuff, so if anyone has ideas/thoughts or advice, please feel free to respond.

TIA!
Jess
immune issues? The only reason I mention that is that you seem to have pretty decent numbers in terms of FSH and even AMH with no tube issues etc. I'm in the boat of exploring immune issues now, so that's been on my brain quite a bit. It might be worth checking to see if anything is affecting implantation or other areas.
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Jess
Jess

August 28th, 2012, 5:41 pm #6

Hi Jess,
I'm so sorry to hear this. It's very scary and frustrating to not know why and wonder if it can ever happen. But I believe it is definitely too early to give up. You have alot going for you, based on the history you posted! Sounds like there are some changes to be made for next time and I'm sure Dr. C will have some ideas.

Having just experienced my first failed mini-IVF, nurses told me they don't even typically do consults until 2 failures-- because to a certain extent, it's just a waiting game, for the right egg/embryo. But it's great that you're talking to him, b/c you have some excellent questions.

Rooting for you
Thanks so much! I know that you know how frustrating it is, but you're right that there's nothing to do but move on to the next cycle. I also hope he now gained a lot of info on how my body responds, so that's always good.

The nurses had also told me that after 2 failed cycles, you get a consult, but since we had only spoken about IVF and had not made a plan for after if it failed, I wanted to make sure I had a new plan for a TI cycle going into this month. I think I could have maybe spoken to him about it on the phone, but when the secretary said there was an opening tomorrow, I figured that's better than the 12am call

thanks again for all your support!

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Joined: August 23rd, 2011, 3:50 pm

August 28th, 2012, 5:51 pm #7

Hi everyone.

Got the results yesterday that our first 1st IVF was unsuccessful I didn't have too much hope in it, but it still sucks. The secretary at Co.oper was actually very nice and squeezed me in for the wtf appt tomorrow since I want to come up with a new plan before my period begins in a few days.

We will not be doing another IVF this month, so I guess I will be talking to him about a natural, TI cycle. Does anyone know what his "protocol" is for this? Is it just totally natural with P4 support, or is there also meds/monitoring involved? Does Dr. Ch.eck go over why he didn't think the IVF was successful?

My history: Almost 29 years old. Been TTC #2 for about 20 months. FSH seems to usually be around 6-9, low AMH (.6) Dr. Ch.eck thinks if I do have DOR, it is on the "high end of low." Low progesterone (we just discovered this right before the IVF- so frustrating), but not that low that I need PIO shots. Tubes open, everything else seems to be normal (beh). DH is normal. 2 failed IUIs (at Co.rnell) and now 1 failed (low-stim) IVF.

My protocol was: 75iu Gonal-F along with 15iu Lupron every night (including night of trigger). Even with such low stims, they were still able to retrieve 6 mature eggs, but I think some of them may have been over-mature (guess I have to talk to him about that). Then we got the bad news that only 1 fertilized (we did not do ICSI since DH is ok, but maybe we should have). Put back 1 6-cell grade 2B. Lining at ER was 11mm and at 3dpt is was 16mm. Do you think it was too thick for implantation? Is there such a thing as that? Maybe the Lupron affected my egg quality? Maybe it was just bad luck? What would you do for a TI cycle?

I'm still kinda of a newbie with all this stuff, so if anyone has ideas/thoughts or advice, please feel free to respond.

TIA!
Jess
I'm sorry. Hoping you get some answers and a new & improved plan.
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Joined: January 12th, 2012, 6:08 pm

August 28th, 2012, 5:54 pm #8

about your IVF cycle:(. I have been doing TI cycles with C.h.eck and I can tell you that there isn't a set protocol, it really depends on your specific situation. Some women do low does of stims, some don't. He's been pretty adamant that I not do stim drugs because he feels it will compromise quality. Your a lot younger than me so he might think it's ok for you to take them, but he's not looking to create a lot of follicles. I does seem like everyone does progesterone support and I also take estrace daily in the luteal phase. Also, some women will use a trigger, but not everyone.

I don't recall if you've said before, but I assume you haven't done a monitoring cycle yet with Ch.e.ck? I think it's actually really helpful and you can learn a lot about your cycle. Be prepared for a lot of monitoring though. You'll do a baseline u/s and b/w, and depending on that you might not go again until CD 9, but maybe sooner. It just depends:). I've had cycles where I've done b/w and u/s 2 or 3 days in a row once I get close to O. Are you a local patient or out of town? I'm out of town and that does get tricky with all of the monitoring. But if your close and local it shouldn't be as difficult for you if you have flexibility in your schedule.

Hope this helps:) Good luck with your upcoming appt.!!
Hi AJ,

I know that others have mentioned taking Estrace during the luteal phase. What is the purpose of this? Thanks so much for any info!

Jess, I wish I could give you advice, etc. but I am still so new to everything IVF related. It seems like you do have a great list of questions to ask the doctor.
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AJ
AJ

August 28th, 2012, 6:04 pm #9

Well, I think the primary reason is that it can help your body from recruiting follicles early in the luteal phase, which happens with high FSH. But I also think that in high FSHers estrogen can be low which can have a negative impact in pregnancy. Dr. Ch.eck is the only RE I know that checks estrogen along with progesterone in pregnancies. I'm not for sure on that, since I haven't had a BFP with Ch.eck, but it's what I've gathered from others on the board who have.
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Sara Q
Sara Q

August 28th, 2012, 6:19 pm #10

Hi everyone.

Got the results yesterday that our first 1st IVF was unsuccessful I didn't have too much hope in it, but it still sucks. The secretary at Co.oper was actually very nice and squeezed me in for the wtf appt tomorrow since I want to come up with a new plan before my period begins in a few days.

We will not be doing another IVF this month, so I guess I will be talking to him about a natural, TI cycle. Does anyone know what his "protocol" is for this? Is it just totally natural with P4 support, or is there also meds/monitoring involved? Does Dr. Ch.eck go over why he didn't think the IVF was successful?

My history: Almost 29 years old. Been TTC #2 for about 20 months. FSH seems to usually be around 6-9, low AMH (.6) Dr. Ch.eck thinks if I do have DOR, it is on the "high end of low." Low progesterone (we just discovered this right before the IVF- so frustrating), but not that low that I need PIO shots. Tubes open, everything else seems to be normal (beh). DH is normal. 2 failed IUIs (at Co.rnell) and now 1 failed (low-stim) IVF.

My protocol was: 75iu Gonal-F along with 15iu Lupron every night (including night of trigger). Even with such low stims, they were still able to retrieve 6 mature eggs, but I think some of them may have been over-mature (guess I have to talk to him about that). Then we got the bad news that only 1 fertilized (we did not do ICSI since DH is ok, but maybe we should have). Put back 1 6-cell grade 2B. Lining at ER was 11mm and at 3dpt is was 16mm. Do you think it was too thick for implantation? Is there such a thing as that? Maybe the Lupron affected my egg quality? Maybe it was just bad luck? What would you do for a TI cycle?

I'm still kinda of a newbie with all this stuff, so if anyone has ideas/thoughts or advice, please feel free to respond.

TIA!
Jess
First of all, Jess, I am so sorry that this cycle was a BFN. The first IVF BFN is brutal. (I remember it well.) My nice to yourself - take a bubble bath, eat some chocolate, have a glass of wine.

As far as the talk with Dr. Ch.eck, I'd focus on the lack of fertilization and the 6-cell embryo. I'd want to find out what he believes led to the low rate of fertilization. From my experience, it's very easy for REs to simply tell us "just keep trying and we'll get there." And while in some cases that may be true, it can prevent them from addressing problems that need to be addressed. Has your DH been tested for anti-sperm antibodies? My DH's sperm looked "perfect," but we only had 2 of 6 eggs fertilize during our first IVF (without ICSI). It turned out he had high anti-sperm antibodies. So we've done ICSI ever since and have had 80-100% fertilization every time, even with under and over cooked eggs.

That's about the only advice I have. Oh, except I agree with Jen, in that you may want to look into immunology issues as well. Dr. Che.ck is on the fence about some immunology stuff, but you can always get a consult and not tell him until later.

Sending you good thoughts.

xo,
Sara Q
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