Femara plus TI

Femara plus TI

Amy
Amy

May 25th, 2012, 2:57 am #1

Sorry...I know this has been asked before, but anyone here trying Femara with timed intercourse, and just using OPK rather than a trigger? I'm just looking for some "low-tech" options right now that might give a slight boost over just TI alone.

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BroodyHen
BroodyHen

May 25th, 2012, 5:23 am #2

sort of. i'm trying femara for the first time this cycle, followed by follistim (only 75IU day). TI, but with monitoring and trigger. i kinda think the trigger is important if you are trying to get more than one follicle. i worry that without it, you might not ovulate them all and then have a cyst for the next cycle. i don't know how big a risk, but i'm not willing to take it. i think you could do a trigger without monitoring if you are using OPKs carefully. i'm still using OPKs for sure because i don't want to miss the surge and just generally want to know what is going on and to help with timing. i'm using both CBEFM and cheap internet OPKs and i have found on a few occasions that the CBEFM misses the surge, but i catch it on the OPKs in the afternoon, so i think frequent testing is helpful whatever protocol you're doing.

sorry, this isn't actually helpful information! i don't know what the difference is between doing femara alone and femara with low-stim. i only ended up doing two days of follistim and i got 2 follicles out of it. we'll see if i get lucky. anyway, from my very limited experience i think a simple femara plan could be a good low-tech boost over plain TI. you might also search recent posts about c.heck's tiny boost protocol, which i believe calls for a couple of days of very low-dose follistim around the surge (antonialisa posted about it). again, something you could probably do at home without monitoring. i'm thinking about trying that, too. although what i ended up with this cycle is kind of a hybrid - 5 days of femara followed by 2 days of low-doses of follistim. i might be able to do this on my own without monitoring for future cycles. that is if i can get my hands on the drugs. my RE only gave me a single, non-refillable script for the femara.

good luck!
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anne
anne

May 25th, 2012, 3:46 pm #3

Sorry...I know this has been asked before, but anyone here trying Femara with timed intercourse, and just using OPK rather than a trigger? I'm just looking for some "low-tech" options right now that might give a slight boost over just TI alone.
but i would still trigger because depending on what stage of peri your ov's are in, you want to be sure and have a strong ovulation.
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Joined: August 23rd, 2011, 3:50 pm

May 25th, 2012, 6:51 pm #4

Sorry...I know this has been asked before, but anyone here trying Femara with timed intercourse, and just using OPK rather than a trigger? I'm just looking for some "low-tech" options right now that might give a slight boost over just TI alone.
I've been doing generic Femara with TI for 4 cycles now. I took a break inbetween for a Lap.

My instructions are to take 8-25mg tabs on CD2. I pinpoint a surge (opk & CM) and then I take 2000iu of HCG subq on 3,5,7 & 9 dpo. They do bloodwork on 7 dpo. They like to see my E2 above 100 and P4 above 15. My numbers have been really strong with my P4 being in the mid-twenties range. It has definitely helped my body to have a strong ovulation at the right time (cd 12-15). I have been known to O on the early side, plus I tend to have very low P4 numbers without the hcg support.

This protocol (for lack of a better word) comes from a Napro Dr. The odds of conceiving naturally aren't much better for me then with ivf so I am trying to make the most of my ivf break cycles.
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anne
anne

May 25th, 2012, 8:41 pm #5

that's unusual and really interesting. i may look into finding a napro doc just because i think they focus on hormone balance, has that been your experience?
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BroodyHen
BroodyHen

May 25th, 2012, 10:38 pm #6

I've been doing generic Femara with TI for 4 cycles now. I took a break inbetween for a Lap.

My instructions are to take 8-25mg tabs on CD2. I pinpoint a surge (opk & CM) and then I take 2000iu of HCG subq on 3,5,7 & 9 dpo. They do bloodwork on 7 dpo. They like to see my E2 above 100 and P4 above 15. My numbers have been really strong with my P4 being in the mid-twenties range. It has definitely helped my body to have a strong ovulation at the right time (cd 12-15). I have been known to O on the early side, plus I tend to have very low P4 numbers without the hcg support.

This protocol (for lack of a better word) comes from a Napro Dr. The odds of conceiving naturally aren't much better for me then with ivf so I am trying to make the most of my ivf break cycles.
thanks, tripplebe. helpful info about femara. i had asked my RE about taking the femara all at once but she said no. i wonder what the benefit is of taking it all in one does vs. taking it over the course of 5 days?

also, i was really worried about my E2 after taking femara. i had a 20mm and a 23mm follicle and my E2 was only 109. i tried to find info about it online, and only found a few references to E2 being low when on femara. one woman said her RE told her they are looking for an E2 of 30-50 per mature follicle, and that if there is no egg in the follicle the E2 won't rise. though anecdotal, this made me feel a lot better. sounds like the napro docs concur.

are you on P4 support in addition to the HCG shots? again, why space out the shots instead of taking it all at once?
thx
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Amy
Amy

May 26th, 2012, 3:20 am #7

Thank you everyone for the advice.

I have some leftover femara and might take it, but don't want to spend the money on monitoring. I agree that if some follistim is added, then monitoring and a trigger is probably wise. Thanks!
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Joined: August 23rd, 2011, 3:50 pm

May 26th, 2012, 2:51 pm #8

that's unusual and really interesting. i may look into finding a napro doc just because i think they focus on hormone balance, has that been your experience?
Napro is all about regularating your hormones, surgically correcting things and a whole lot of patience.

When I first started seeing this Dr. last Nov she had me do a unmedicated hormone workup which consisted of Cd3 BW and ultrasound and then they did BW every other day the entire cycle. They also did a 7 dpo ultrasound to check for a ruptured follicle and tri-phasic lining.

I thought my numbers appeared pretty normal that month. My cd 3 fsh was 7, my e2 rose to 264 at O.
Somehow based on all my numbers she could tell that I was having a sub-optimal ovulation. They also rechecked my fsh and lh at 7dpo. Haven't figured out what that shows, maybe it's a resting fsh/lh ratio thing, not sure. What it did show was that my progesterone levels peaked at 8 on 5 dpo and then quickly fell. She referred to it as a Type 3 luteal phase deficiency.

There's a book called The NaPro Technology Revolution: Unleashing the Power in a Woman's Cycle, I read it recently which explained the different LPD types and a number of other fertility tests in detail. A lot of the information was old news since I've been through years of this already, so I wouldn't pay money for the book but I was able to get it on an Inter-state library loan.



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

May 26th, 2012, 7:23 pm #9

thanks, tripplebe. helpful info about femara. i had asked my RE about taking the femara all at once but she said no. i wonder what the benefit is of taking it all in one does vs. taking it over the course of 5 days?

also, i was really worried about my E2 after taking femara. i had a 20mm and a 23mm follicle and my E2 was only 109. i tried to find info about it online, and only found a few references to E2 being low when on femara. one woman said her RE told her they are looking for an E2 of 30-50 per mature follicle, and that if there is no egg in the follicle the E2 won't rise. though anecdotal, this made me feel a lot better. sounds like the napro docs concur.

are you on P4 support in addition to the HCG shots? again, why space out the shots instead of taking it all at once?
thx
No additional P4 support. The hcg apparently helps the ruptured follicle produce better e2 and p4 on it's own.

I don't know why she has me taking the Femara all at once. I think maybe it has to do with trying to only recruit one mature egg as opposed to trying for two or three but I really don't know. The other reason might be in us older patients our e2 levels don't bounce back as quick from Femara as maybe somebody younger. Since I've been on Femara she hasn't tested my E2 levels near O but I'm pretty sure they are low. CM is next to almost always non-existent. She recently switched me from cd 3 to cd 2 for taking the Femara. Which is another reason I think it has to do with low estrogen.

I forgot to mention this earlier but along with the Femara she has instructed me to take Mucinex cd 6 thru O. She has also prescribed Amoxil which is suppose to help CM but I stopped taking it because I really didn't see an improvement and it was making me feel under the weather.

Spreading the hcg out is just to keep my P4 high enough through implantation. I read in the Napro book that depending on the type of deficiency you have you might only take it on days 3 and 5 dpo. Some start taking it later. My numbers are low to begin with and drop off drastically at 7 dpo.

I did femara with an IVF cycle once. It was a while ago but I think it took 5mg a day over a couple of days and then added in 600iu of follistim. My estrogen stalled at 400 with four folicles. Lowest my estrogen has ever been on a full-stim IVF. Everything ended up being inmature. Not a protocol I would use for IVF again.
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BroodyHen
BroodyHen

May 28th, 2012, 9:30 pm #10

thanks, tripplebe n/t
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