Devastated... no eggs at ER for low dose IVF today (DD mentioned) X POST

Devastated... no eggs at ER for low dose IVF today (DD mentioned) X POST

Joined: March 28th, 2011, 5:51 pm

January 27th, 2012, 6:13 pm #1

Hi
Well, we decided to try low dose (i.e. Clomid) IVF. I knew that odds were that we would get very few eggs, but we knew that going in. Our IVF coverage expired so we paid up front out of pocket $10K for 3 retrievals and one transfer (because they bank the embryos).

On Wednesday, I was thrilled to have 3 follies all at 19mm and triggered that night. Yesterday, E2 b/w was 1567, so I was sure there were mature eggs in there.

Well, turns out the follies were empty. I'm so upset and also annoyed (not sure why or at whom) and don't know what to do. I'm waiting for the financial counselor at the RE to call me back. Apparently, while I was still recuperating from the anesthesia, the RE came out to talk to DH and me (though I don't remember a thing, apparently we had a conversation). He doesn't think another CLomid round is worthwhile (he's supposedly seen a couple of outcomes like this in the last 2 weeks alone).

DH says he thinks it makes more sense to either do a regular med IVF or DE. DE isn't an option for us; we also don't feel we need to go that route because we do have a DD so don't feel the need to do something that extreme. The problem is that during my first chat with the financial counselor, she said, no, if we do regular injects, then we forfeit this $10K and have to pay from scratch. What? I mean why would they care what meds I use, especially if we pay out of pocket for meds.

I hope they come back with better news on that front.

Any thoughts on all of this would be appreciated. Should I not be surprised at the outcome given the use of Clomid?

Thanks!

Me & DH: 38
Married at 32 and TTC right away
2/07: IUI #1 (Clomid only) BFP (No more hb at 9 weeks; D&C)
Through rest of 2007: Multiple IUI's (Clomid or Femara): all BFN
3/08: IVF #1 FSH: 11.6 (highest ever recorded for me) MDL protocol; BFP/chemical
10/08: IVF #2: BFP! DD born 7/09
5/10: Uterine polyp removal
8/10: FET #1: BFP/Chemical
11/10: IVF #3: Retrieval only; transfer postponed due to thin lining
1/11: FET #2: BFN
3/11: FET #3: BFN
12/11: Uh oh... FSH 16
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Joined: August 6th, 2011, 6:43 am

January 27th, 2012, 6:47 pm #2

I can understand how you would be so disappointed. I would have thought there were three mature eggs too. I've also had a retrieval where the RE could not get a couple of the eggs out and it is upsetting news. These are sometimes called "empty follicles" when really the eggs just don't come out.

I am not familiar with Clomid IVF, I didn't even know they did that. I don't know how sucessful that protocol is. But I don't understand why you would have to forfeit the $10,000 if you decide to change protocols and try a regular IVF cycle instead of using clomid. It does not make sense to me either if you are paying for your own drugs. The cost of their service is the same for retrieval and transfer. Maybe it requires more monitoring? But then you could just pay extra? I would want a detailed explanation as to why you should have to forfeit the $10,000 and not apply it to more services.

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Hadas
Hadas

January 27th, 2012, 6:59 pm #3

Thank you for your reply. So there is such as thing as empty follies. I wonder if perhaps I ovulated early (we didn't BD before ER), but that's just speculation, I suppose only 1 of a couple of possible explanations.

The RE is supposed to call me on Monday, but I don't know what he'll be able to say. All I know is that he doesn't feel this type of protocol is worth it. We wanted to try it because of cost and fewer and cheaper meds, and I don't know if this was a one off fluke and to try again with CLomid or not. If you ask the RE, he'd say no and to return to injects. It will depend on cost.

If you were me and if the answer on the cost was no, would you try another round of Clomid or is it just a waste of time and unnecessary use of meds for no result?
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Joined: December 20th, 2010, 7:38 pm

January 27th, 2012, 7:07 pm #4

Hi
Well, we decided to try low dose (i.e. Clomid) IVF. I knew that odds were that we would get very few eggs, but we knew that going in. Our IVF coverage expired so we paid up front out of pocket $10K for 3 retrievals and one transfer (because they bank the embryos).

On Wednesday, I was thrilled to have 3 follies all at 19mm and triggered that night. Yesterday, E2 b/w was 1567, so I was sure there were mature eggs in there.

Well, turns out the follies were empty. I'm so upset and also annoyed (not sure why or at whom) and don't know what to do. I'm waiting for the financial counselor at the RE to call me back. Apparently, while I was still recuperating from the anesthesia, the RE came out to talk to DH and me (though I don't remember a thing, apparently we had a conversation). He doesn't think another CLomid round is worthwhile (he's supposedly seen a couple of outcomes like this in the last 2 weeks alone).

DH says he thinks it makes more sense to either do a regular med IVF or DE. DE isn't an option for us; we also don't feel we need to go that route because we do have a DD so don't feel the need to do something that extreme. The problem is that during my first chat with the financial counselor, she said, no, if we do regular injects, then we forfeit this $10K and have to pay from scratch. What? I mean why would they care what meds I use, especially if we pay out of pocket for meds.

I hope they come back with better news on that front.

Any thoughts on all of this would be appreciated. Should I not be surprised at the outcome given the use of Clomid?

Thanks!

Me & DH: 38
Married at 32 and TTC right away
2/07: IUI #1 (Clomid only) BFP (No more hb at 9 weeks; D&C)
Through rest of 2007: Multiple IUI's (Clomid or Femara): all BFN
3/08: IVF #1 FSH: 11.6 (highest ever recorded for me) MDL protocol; BFP/chemical
10/08: IVF #2: BFP! DD born 7/09
5/10: Uterine polyp removal
8/10: FET #1: BFP/Chemical
11/10: IVF #3: Retrieval only; transfer postponed due to thin lining
1/11: FET #2: BFN
3/11: FET #3: BFN
12/11: Uh oh... FSH 16
which happened to me, my first high dose MDL (450 Follistim + 150 Menopur) resulted in empty follicles in half of them. Empty follicles happen in all sorts of protocols. It is just bad luck for that cycle.

Clomid IVF does require less monitor, and you don't need anaesthesia for retrieval which is a big saving. But you shouldn't need to forfeit the entire amount, it should be credited to whatever protocol you choose in the forthcoming cycles.
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B.
B.

January 27th, 2012, 7:23 pm #5

Hi
Well, we decided to try low dose (i.e. Clomid) IVF. I knew that odds were that we would get very few eggs, but we knew that going in. Our IVF coverage expired so we paid up front out of pocket $10K for 3 retrievals and one transfer (because they bank the embryos).

On Wednesday, I was thrilled to have 3 follies all at 19mm and triggered that night. Yesterday, E2 b/w was 1567, so I was sure there were mature eggs in there.

Well, turns out the follies were empty. I'm so upset and also annoyed (not sure why or at whom) and don't know what to do. I'm waiting for the financial counselor at the RE to call me back. Apparently, while I was still recuperating from the anesthesia, the RE came out to talk to DH and me (though I don't remember a thing, apparently we had a conversation). He doesn't think another CLomid round is worthwhile (he's supposedly seen a couple of outcomes like this in the last 2 weeks alone).

DH says he thinks it makes more sense to either do a regular med IVF or DE. DE isn't an option for us; we also don't feel we need to go that route because we do have a DD so don't feel the need to do something that extreme. The problem is that during my first chat with the financial counselor, she said, no, if we do regular injects, then we forfeit this $10K and have to pay from scratch. What? I mean why would they care what meds I use, especially if we pay out of pocket for meds.

I hope they come back with better news on that front.

Any thoughts on all of this would be appreciated. Should I not be surprised at the outcome given the use of Clomid?

Thanks!

Me & DH: 38
Married at 32 and TTC right away
2/07: IUI #1 (Clomid only) BFP (No more hb at 9 weeks; D&C)
Through rest of 2007: Multiple IUI's (Clomid or Femara): all BFN
3/08: IVF #1 FSH: 11.6 (highest ever recorded for me) MDL protocol; BFP/chemical
10/08: IVF #2: BFP! DD born 7/09
5/10: Uterine polyp removal
8/10: FET #1: BFP/Chemical
11/10: IVF #3: Retrieval only; transfer postponed due to thin lining
1/11: FET #2: BFN
3/11: FET #3: BFN
12/11: Uh oh... FSH 16
The financial stuff is so stressful...not to mention the whole process.

But I wanted to ask, what trigger shot did you use - was it HCG or Ovidrel?

Also - I'm confused about something. You said you paid for 3 retrievals and 1 transfer - can you explain just a little bit more - does that mean you have two more retrievals still left to do and this was the first one?

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Antonialisa
Antonialisa

January 27th, 2012, 7:42 pm #6

Hi
Well, we decided to try low dose (i.e. Clomid) IVF. I knew that odds were that we would get very few eggs, but we knew that going in. Our IVF coverage expired so we paid up front out of pocket $10K for 3 retrievals and one transfer (because they bank the embryos).

On Wednesday, I was thrilled to have 3 follies all at 19mm and triggered that night. Yesterday, E2 b/w was 1567, so I was sure there were mature eggs in there.

Well, turns out the follies were empty. I'm so upset and also annoyed (not sure why or at whom) and don't know what to do. I'm waiting for the financial counselor at the RE to call me back. Apparently, while I was still recuperating from the anesthesia, the RE came out to talk to DH and me (though I don't remember a thing, apparently we had a conversation). He doesn't think another CLomid round is worthwhile (he's supposedly seen a couple of outcomes like this in the last 2 weeks alone).

DH says he thinks it makes more sense to either do a regular med IVF or DE. DE isn't an option for us; we also don't feel we need to go that route because we do have a DD so don't feel the need to do something that extreme. The problem is that during my first chat with the financial counselor, she said, no, if we do regular injects, then we forfeit this $10K and have to pay from scratch. What? I mean why would they care what meds I use, especially if we pay out of pocket for meds.

I hope they come back with better news on that front.

Any thoughts on all of this would be appreciated. Should I not be surprised at the outcome given the use of Clomid?

Thanks!

Me & DH: 38
Married at 32 and TTC right away
2/07: IUI #1 (Clomid only) BFP (No more hb at 9 weeks; D&C)
Through rest of 2007: Multiple IUI's (Clomid or Femara): all BFN
3/08: IVF #1 FSH: 11.6 (highest ever recorded for me) MDL protocol; BFP/chemical
10/08: IVF #2: BFP! DD born 7/09
5/10: Uterine polyp removal
8/10: FET #1: BFP/Chemical
11/10: IVF #3: Retrieval only; transfer postponed due to thin lining
1/11: FET #2: BFN
3/11: FET #3: BFN
12/11: Uh oh... FSH 16
Just want to say that I'm very sorry you are going through this. It must be really disappointing.

I agree with the others on the financial side. Look at your contract but likely it says you forfeit funds only if you are successful, not if you switch protocols. No matter what your contract says, you should argue this in any case. (Pre-printed contracts that you don't negotiate are often not upheld in courts - at least in Canadian contract law.)
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Joined: August 6th, 2011, 6:43 am

January 27th, 2012, 8:01 pm #7

Thank you for your reply. So there is such as thing as empty follies. I wonder if perhaps I ovulated early (we didn't BD before ER), but that's just speculation, I suppose only 1 of a couple of possible explanations.

The RE is supposed to call me on Monday, but I don't know what he'll be able to say. All I know is that he doesn't feel this type of protocol is worth it. We wanted to try it because of cost and fewer and cheaper meds, and I don't know if this was a one off fluke and to try again with CLomid or not. If you ask the RE, he'd say no and to return to injects. It will depend on cost.

If you were me and if the answer on the cost was no, would you try another round of Clomid or is it just a waste of time and unnecessary use of meds for no result?
I would ask them to apply the remaining money to a regular IVF cycle, not clomid. I would do what your doctor suggests and try regular injectibles like Gonal F. It will be much more expensive than Clomid. Depending on the meds they recommend for you it could be between $4,000 and $6,000 for one IVF cycle.

Since I never used clomid and my doctor didn't recommend it for me at all I wouldn't use that drug. I have also heard clomid is hard on a woman's lining once she is older than 40.

I would ask for the RE's opinion as to why he/she thinks they were not able to retrieve the three eggs from the follicles. Most likely the response will be the eggs were bad and they stick to the sides of the follicle. But I would also ask could you have used a different HCG brand for the trigger shot or did you trigger too late? Was it the clomid that caused this?
Last edited by Raindrops1 on January 27th, 2012, 8:03 pm, edited 1 time in total.
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Hadas
Hadas

January 27th, 2012, 8:26 pm #8

which happened to me, my first high dose MDL (450 Follistim + 150 Menopur) resulted in empty follicles in half of them. Empty follicles happen in all sorts of protocols. It is just bad luck for that cycle.

Clomid IVF does require less monitor, and you don't need anaesthesia for retrieval which is a big saving. But you shouldn't need to forfeit the entire amount, it should be credited to whatever protocol you choose in the forthcoming cycles.
I was under anesthesia because other than the meds, it was a regular IVF but with Clomid.

I hope the agree to be flexible!
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Hadas
Hadas

January 27th, 2012, 8:40 pm #9

The financial stuff is so stressful...not to mention the whole process.

But I wanted to ask, what trigger shot did you use - was it HCG or Ovidrel?

Also - I'm confused about something. You said you paid for 3 retrievals and 1 transfer - can you explain just a little bit more - does that mean you have two more retrievals still left to do and this was the first one?
Ovidrel. I thought Ovidrel was HCG. Could that have made a difference? If so, I'm triply annoyed now!

Yes, on the package price. It's $8400 base for 3 retrievals and 1 transfer (because the assumption is that in total, not that many embryos result) plus miscellaneous fees for monitoring, anesthesia, and ICSI for a total of a little over $10,000.
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B.
B.

January 27th, 2012, 9:03 pm #10

Ovidrel has a certain percentage failure rate. I talked about this with Dr. Check and that's why he doesn't use it. some RE's prescribe two shots of Ovidrel in case one of them fails or in case there is a bad batch, but I would only use HCG having learned about these potential problems.

I read online about people losing 15k cycles due to the Ovidrel shot failing. It's really awful, everything that can go wrong. I can't advise you on the finances, it's too stressful and I am terrible at asserting myself in these situations. But you have two cycles left, and this time insist on HCG not ovidrel.
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