And one..

And one..

BabyDance
BabyDance

September 20th, 2011, 7:27 pm #1

So I have a lead follie, and we are going for one.. Dr. T seems to be recommending I stockpile and may not do meds, and do natural. Still deciding on that. I'm wrapping my head around it, apparently the freeze fees are included in the package, which I did not know before. Follie is at 12, looks like ER will be Sunday or Monday. He wants 5 day freeze, which scares the crap out of me, since I've never gone that far before, but I'm willing to try. He seems to believe if it doesn't make it to 5 day, it's not going to make it.. I sent an email to see if there is any use in trying Clomid to get 2 eggs, if my lining has a chance to heal before transfer. I'm tired of the meds for one egg. That's where I'm at. A bit down, but glad my FSH no longer really matters, if I'm doing natural IVF, as long as I ovulate, it just doesn't matter anymore, does it?
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Joined: December 20th, 2010, 7:38 pm

September 20th, 2011, 7:48 pm #2

According to Kato clinic's 40,000-sample research study, while on their mini-IVF stimulation, d2 transfer yields the highest success rate for 40+ age group. And this result is based on Clomid protocol which thins out lining, still, d2 fresh outperforms d5 vitrified blast. Kato only does d2 fresh transfer, d2 vitrified FET and d5 vitrified blast FET. Nobody ever achieved live birth with d2 vitrified FET.

At least for the Japanese older women, clomid didn't thin out their lining enough to cause a concern. On average, each patient goes through ~10 mini-IVF cycles.
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Joined: April 23rd, 2010, 9:38 pm

September 20th, 2011, 8:11 pm #3

Do you have a link to that study? Fascinating!
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Joined: December 20th, 2010, 7:38 pm

September 20th, 2011, 8:20 pm #4

the title of the paper is:
Minimal Ovarian stimulation with Clomiphene Citrate - a large scale retrospective study

Author is Teramoto, the guy who invented the mini-IVF clomid protocol. This study draws on Kato clinic's own cycling data from 2001-2005.
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DeeinNYC
DeeinNYC

September 20th, 2011, 8:41 pm #5

According to Kato clinic's 40,000-sample research study, while on their mini-IVF stimulation, d2 transfer yields the highest success rate for 40+ age group. And this result is based on Clomid protocol which thins out lining, still, d2 fresh outperforms d5 vitrified blast. Kato only does d2 fresh transfer, d2 vitrified FET and d5 vitrified blast FET. Nobody ever achieved live birth with d2 vitrified FET.

At least for the Japanese older women, clomid didn't thin out their lining enough to cause a concern. On average, each patient goes through ~10 mini-IVF cycles.
You shouldn't freeze embies too soon. Day 2 is too soon and they are more fragile. The earlier they are frozen..the less likely they are to survive the thaw....vitrified or not and if they do survive..they will be much weaker than if you had never frozen them on Day 2 in the first place. It doesn't make sense to me that Day 2 transfers would outperform Day 5 embies....maybe vitrified Day 5 embies are different..but still...we know that there is a much higher success rate when it comes to Day 5 transfers than Day 3 transfers. Did they compare fresh Day 3 embies to fresh Day 2 embies?

BD, if it were me and if you decide on a fresh transfer, have him do it on day 3. That seems like a no-brainer to me. Maybe Day 2 if he will do it. BTW...isn't there something to be siad for allowing embies to grow in the proper pulture? We hear all the time about the storied lab at CCRM and their culture which seems to perform miracles on some embies. SIRM has a great lab. If on the other hand you decide to batch and do a FET later...go to day 5 although it's a risk. IMHO...I don't think you would be doing your embie/embies any favors by freezing on Day 3. They will be too weak. You might as well do a fresh transfer on Day 3. I could be looking at this all wrong...but that's what I think.
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BabyDance
BabyDance

September 20th, 2011, 8:57 pm #6

So I have a lead follie, and we are going for one.. Dr. T seems to be recommending I stockpile and may not do meds, and do natural. Still deciding on that. I'm wrapping my head around it, apparently the freeze fees are included in the package, which I did not know before. Follie is at 12, looks like ER will be Sunday or Monday. He wants 5 day freeze, which scares the crap out of me, since I've never gone that far before, but I'm willing to try. He seems to believe if it doesn't make it to 5 day, it's not going to make it.. I sent an email to see if there is any use in trying Clomid to get 2 eggs, if my lining has a chance to heal before transfer. I'm tired of the meds for one egg. That's where I'm at. A bit down, but glad my FSH no longer really matters, if I'm doing natural IVF, as long as I ovulate, it just doesn't matter anymore, does it?
Transfer this cycle on day 3 (although that is NOT what Dr. T recommends - he wants to freeze 5 day), sign up for the package deal, freeze the next two cycles, and use Clomid cycle. I'm tired of all the meds to get one, and something in my gut all along has said to try Clomid. Aren't their nightmare stories, though, of Clomid screwing up cycles (not the lining issue). I'm concerned about that. I will probably then have to sign up for another 3 cycle deal after that, and go from there. I'm a bit concerned about doing anything Dr. T doesn't recommend. I trust him. He is a good egg in a biz full of rotten ones. He also said he has never had someone over 41 get pregnant with IUI, and didn't put too much stock into it working for me (asked if I should just do this, given that I only get one egg).

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BD
BD

September 20th, 2011, 9:01 pm #7

Do 3, freeze three, and transfer 3, and keep doing that. That probably makes the most sense. Now I just need 36,000 to do this 9 times... but will think if it as 3 at a time.. ugh..
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DeeinNYC
DeeinNYC

September 20th, 2011, 9:19 pm #8

Transfer this cycle on day 3 (although that is NOT what Dr. T recommends - he wants to freeze 5 day), sign up for the package deal, freeze the next two cycles, and use Clomid cycle. I'm tired of all the meds to get one, and something in my gut all along has said to try Clomid. Aren't their nightmare stories, though, of Clomid screwing up cycles (not the lining issue). I'm concerned about that. I will probably then have to sign up for another 3 cycle deal after that, and go from there. I'm a bit concerned about doing anything Dr. T doesn't recommend. I trust him. He is a good egg in a biz full of rotten ones. He also said he has never had someone over 41 get pregnant with IUI, and didn't put too much stock into it working for me (asked if I should just do this, given that I only get one egg).
Did he really say that Day 5 is the way to go even if you have one embie? I'm surprised by that. I guess he really just believes that if you can't make it to day Day 5 you will not make it period. He wanted a Day 5 transfer for me for my first cycle but I was too scared and asked him to do Day 3. He let me do Day 3...no problem..but his argument for me was not only his belief that Day 5 is the way to go...but he wanted to select the best embies and as he said..so much changes from Day3 to Day 5 and I've come to see that he was right. Also...that was the only BFN cycle I had with him...likely having more to do with the quality of my embies that cycle however...but who knows. In your case....I don't get it. What's the reasoning to wait around until Day 5 with one embie? I do trust him greatly...I'm just not getting the rationale here.

Second..did he say he never had IUI success with an 41 year old or over or with a 41 year old with your stats...FSH, ovarian reserve etc? I did an IUI with him at 43 because the insurance company made us do it and while he said the chances were slim...he said it could happen. Maybe I didn't ask the right question!!
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BD
BD

September 20th, 2011, 9:29 pm #9

I guess I have to discuss this further with him, but he made it sound like he wanted me to do 5 day, and if it didn't make it, it won't make it. He said he would transfer earlier if I wanted. I'm confused. Really. If it were up to him, I think he'd have me stockpile 5 day, and go from there. This is just a huge investment and I don't know anymore...

He said he never had anyone over 41 get pregnant with IUI, that's it, nothing about FSH or stats at all.

I don't know about any of this.. I really don't.. This sucks. I really probably need to hang it up, but I won't, and I will end up bankrupt. This is just crazy.
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Joined: December 20th, 2010, 7:38 pm

September 20th, 2011, 9:38 pm #10

You shouldn't freeze embies too soon. Day 2 is too soon and they are more fragile. The earlier they are frozen..the less likely they are to survive the thaw....vitrified or not and if they do survive..they will be much weaker than if you had never frozen them on Day 2 in the first place. It doesn't make sense to me that Day 2 transfers would outperform Day 5 embies....maybe vitrified Day 5 embies are different..but still...we know that there is a much higher success rate when it comes to Day 5 transfers than Day 3 transfers. Did they compare fresh Day 3 embies to fresh Day 2 embies?

BD, if it were me and if you decide on a fresh transfer, have him do it on day 3. That seems like a no-brainer to me. Maybe Day 2 if he will do it. BTW...isn't there something to be siad for allowing embies to grow in the proper pulture? We hear all the time about the storied lab at CCRM and their culture which seems to perform miracles on some embies. SIRM has a great lab. If on the other hand you decide to batch and do a FET later...go to day 5 although it's a risk. IMHO...I don't think you would be doing your embie/embies any favors by freezing on Day 3. They will be too weak. You might as well do a fresh transfer on Day 3. I could be looking at this all wrong...but that's what I think.
It may also have something to do with the early stage vitrification technology. It was just put in use (first commercial embryo application was in 2001), so the technology was not as mature as today, and could destroy some d5 blasts.
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