Follow-up with RE

Follow-up with RE

Violet
Violet

May 25th, 2012, 5:01 pm #1

Hi,
We had our follow-up. So tired of the follow-ups!
Anyway, my RE does not think I have an immune issue. He thinks that if we have a high quality embryo, I will get pregnant. He thinks these were not the best embryos. We looked at the quality of the remaining vitrified embryos and he thought they were very good and they developed well however it was clear that they are not the best as they were early blasts on Day 5 and my RE said he would have preferred a solid blast on Day 5. He will test me again for the standard immune panel. Clearly people get pg all the time without the most perfect embryos so why can't I?

I am keeping my appt. with Dr. Braverman and will look into costs of that in the next week.

Also thinking about changing from Crinone 2x per day to PIO. Does anyone have any thoughts on this.

We are also planning on doing a scratch biopsy the cycle before the FET.

My thyroid jumped up to 3.4 when I had my beta. My RE said it could have been from the increased estrogen however he does want me to see an endocrinologist about this as we all know it need to be under 2.0, estrogen or not.

Does anyone have any thoughts?
thanks,
Violet
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DeeinNYC
DeeinNYC

May 25th, 2012, 5:51 pm #2

Hi Violet,

My thoughts are...keep your appt with Dr. Braverman. Most Dr.'s not well versed in immune issues say what your said. Of course, he may be correct, but what if he's not? If it turns out that you do not have an immune issue..fine. No harm..no foul except for of course that you will be out of pocket some money. I think it's money well spent however to get answers. As far as Crinone vs PIO shots, there have been lots of posts on this so you may want to do a search on several of the boards here. I know I have seen many on the regular High FSH pregnancy board about this issue. I think many think that the PIO works better than Crinone. In my experience, the Crinone did not hold off AF as well as the PIO. I know of people that take PIO, crinone AND endometrium. The studies however show that they work equally as well I believe. Definitely look into the elevated TSH levels. Good luck.
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DeeinNYC
DeeinNYC

May 25th, 2012, 5:57 pm #3

Darn auto-text!! - Sorry...I know you are not Di n/t
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Hopeful7608
Hopeful7608

May 25th, 2012, 6:08 pm #4

Hi,
We had our follow-up. So tired of the follow-ups!
Anyway, my RE does not think I have an immune issue. He thinks that if we have a high quality embryo, I will get pregnant. He thinks these were not the best embryos. We looked at the quality of the remaining vitrified embryos and he thought they were very good and they developed well however it was clear that they are not the best as they were early blasts on Day 5 and my RE said he would have preferred a solid blast on Day 5. He will test me again for the standard immune panel. Clearly people get pg all the time without the most perfect embryos so why can't I?

I am keeping my appt. with Dr. Braverman and will look into costs of that in the next week.

Also thinking about changing from Crinone 2x per day to PIO. Does anyone have any thoughts on this.

We are also planning on doing a scratch biopsy the cycle before the FET.

My thyroid jumped up to 3.4 when I had my beta. My RE said it could have been from the increased estrogen however he does want me to see an endocrinologist about this as we all know it need to be under 2.0, estrogen or not.

Does anyone have any thoughts?
thanks,
Violet
For my failed de cycles in boston, it was crinone. However we are now at ccrm and they will only use pio. They have good success rates..... the studies say there is no real difference.
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Violet
Violet

May 26th, 2012, 12:06 am #5

toward PIO because I have only used Crinone. Also, from what I have read, it seems like CCRM and RBA and other clinics that have higher stats than my local clinic (also in Boston)are using PIO. I know I should not correlate PIO with more success...because there are so many variables.

I think I am ready for the kitchen sink protocol. Can it really hurt?

How are things going at CCRM? Are you using your own donor or egg bank?
Thanks,
Violet
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Violet
Violet

May 26th, 2012, 12:10 am #6

Hi Violet,

My thoughts are...keep your appt with Dr. Braverman. Most Dr.'s not well versed in immune issues say what your said. Of course, he may be correct, but what if he's not? If it turns out that you do not have an immune issue..fine. No harm..no foul except for of course that you will be out of pocket some money. I think it's money well spent however to get answers. As far as Crinone vs PIO shots, there have been lots of posts on this so you may want to do a search on several of the boards here. I know I have seen many on the regular High FSH pregnancy board about this issue. I think many think that the PIO works better than Crinone. In my experience, the Crinone did not hold off AF as well as the PIO. I know of people that take PIO, crinone AND endometrium. The studies however show that they work equally as well I believe. Definitely look into the elevated TSH levels. Good luck.
I appreciate your input. I am taking the steps for Braverman and we'll see where I am in a few weeks when the appt is scheduled.

I am ready to try more things because I feel my RE was of the less is more approach as he thought I would get pg with ease using DE. So, now that we have 4 blasts left, I want to go for bust.

Also...I think if you feel like all the other parameters for your donor add up at RBA, I would deal w/ the height. Not everything added up for our donor however we thought overall she was a lot of what we wanted. It's a hard decision.
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hopeful7608
hopeful7608

May 26th, 2012, 12:32 pm #7

toward PIO because I have only used Crinone. Also, from what I have read, it seems like CCRM and RBA and other clinics that have higher stats than my local clinic (also in Boston)are using PIO. I know I should not correlate PIO with more success...because there are so many variables.

I think I am ready for the kitchen sink protocol. Can it really hurt?

How are things going at CCRM? Are you using your own donor or egg bank?
Thanks,
Violet
We thought we were old pros having been through DE in Boston however we walked out of CCRM overwhelmed at first. Totally different atmosphere, more intense, way more testing, etc and I really like the fact it is approached as "when you are pregnant" as opposed to our clinic Boston who basically told us "flip of a coin". Currently we are doing a mock cycle with endometrial biopsy for beta integrin. We have not decided on egg bank vs fresh although if you use their vitrified eggs you basically get a new vitrified donor for free if you don't get pregnant with your first.....not a bad deal.
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Joined: September 7th, 2011, 4:55 pm

May 26th, 2012, 12:58 pm #8

Hi,
We had our follow-up. So tired of the follow-ups!
Anyway, my RE does not think I have an immune issue. He thinks that if we have a high quality embryo, I will get pregnant. He thinks these were not the best embryos. We looked at the quality of the remaining vitrified embryos and he thought they were very good and they developed well however it was clear that they are not the best as they were early blasts on Day 5 and my RE said he would have preferred a solid blast on Day 5. He will test me again for the standard immune panel. Clearly people get pg all the time without the most perfect embryos so why can't I?

I am keeping my appt. with Dr. Braverman and will look into costs of that in the next week.

Also thinking about changing from Crinone 2x per day to PIO. Does anyone have any thoughts on this.

We are also planning on doing a scratch biopsy the cycle before the FET.

My thyroid jumped up to 3.4 when I had my beta. My RE said it could have been from the increased estrogen however he does want me to see an endocrinologist about this as we all know it need to be under 2.0, estrogen or not.

Does anyone have any thoughts?
thanks,
Violet
Without doing genetic testing there is no real way to know if your embryos are actually good. Even genetically flawed blasts can progress to pregnancies, at least that's the common explanation for incidental miscarriage. I have heard this number can be 50% but many factors influence this statistic. I could believe that failing with 2 good looking DE embryos is bad luck, but not say, four. That's my gut feeling, not a medical perspective.

I prefer PIO because I alway have breakthrough bleeding on supps and I never have with PIO, however this is not the case for the majority of patients. I also have no issue with injections and appreciate being able to quantitatively evaluate P4 levels. It's a personal decision in the end as they both are effective for the majority of women, and if you are not experiencing breakthrough bleeding then you don't have a specific issue with Crinone that would necessitate the change, but if you're into it then it's not going to hurt you at least. Just a warning, I've had to do PIO 2x a day which is really rough for a lot of people.

We are also going to do a scratch biopsy and I see a ME for elevated thyroid levels.

You are doing a lot to advocate for yourself. Thanks for the update.
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Violet
Violet

May 29th, 2012, 2:11 pm #9

We thought we were old pros having been through DE in Boston however we walked out of CCRM overwhelmed at first. Totally different atmosphere, more intense, way more testing, etc and I really like the fact it is approached as "when you are pregnant" as opposed to our clinic Boston who basically told us "flip of a coin". Currently we are doing a mock cycle with endometrial biopsy for beta integrin. We have not decided on egg bank vs fresh although if you use their vitrified eggs you basically get a new vitrified donor for free if you don't get pregnant with your first.....not a bad deal.
I am so glad that you are feeling better with CCRM. To be honest, I am pretty frustrated with my RE right now. I feel like he does not want to do anything different. We just have to "wait for the right embryo" and then I'll get pg. He is sure of it. Uggh.

So, you are doing an endometrial biopsy now. Does that mean you'll transfer next month? I have been reading about endometrial biopsies and that they help with implantation the following month.
Also, what is beta integrin? Just curious.

If things do not work out for us locally, I am thinking about CCRM as our backup. I want to feel like we are getting the most proactive care and I don't feel like that is happening now.

Hope you are well.
Thannks.
Violet
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