Could use your opinions and thoughts for plan moving forward!

Could use your opinions and thoughts for plan moving forward!

Erin
Erin

March 12th, 2012, 10:12 pm #1

Hi Guys- As you may have seen below, it was a BFN for me this month (with a couple pos HPTs along the way so I think there was a brief implantation that didn't work out). My husband and I talked about it and we both really want to try cycling this coming month and see what happens. This would mean no co-culture, but I honestly wonder if the co-culture did anything (3 of the 4 embryos still ended up with less than 6 cells) and this cycle would give us a chance to test that theory. I have insurance that covers cycles for another year (and then we're screwed), but if I only cycle once every 4mos or so, it really limits us. Plus, I turn 34yo in October and I feel like my age is the one thing I have going for me. I also will have had an E2 patch on for about a week by the time I get my period which should constitute "priming" since that's what I used in the past anyways.

I have some questions for you guys:

1) It appears the embryo implanted briefly as I caught faintly positive HPTs at 8 and 9dp3dt and beta was 0.8 instead of 0. Would this be indicative of immune issues? I've only had an "anti-phospholipid antibody panel" and all came back well within normal range. I also have an illness (Crohn's disease) that is widely believed to be autoimmune, but my ANA has come back negative every time it's been tested (it's been tested several times over the years).

2) I've never had an HSG b/c I've been told that with the illness and the tons of scar tissue and I have, there is a pretty good risk of infection for me with HSG. I've had laps and MRIs that found tubes are likely blocked but that I don't have hydrosalpinx. Would you go for the HSG to make sure given the very early chemical?

3) Our plan is to see if Dr. D is willing to run the same (or similar) protocol this month w/o co-culture and go with him if he will. If he's not, then we would go to C.heck or see if my local monitoring place would be willing to run the same protocol this month. We would potentially ask for immune testing asap so it could be processed while we're cycling. Does that sound like a decent plan to you all?

Sorry for the lengthy and somewhat rambling post. I would love to hear what you guys think on any or all of this. Thanks in advance!
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anna
anna

March 12th, 2012, 10:32 pm #2

Btw, keep in mind that the cycle before my IVF was IUI. And Cooper said since it was converted to IUI I should be fine. also I always make follicle on my left side and never on the right. So my left has always been working and my right never ever worked beyond 6 mm follicle. On my back to back cycle the left didnt work at ALL. Didnt even make one follicle and somehow magically the right one started making follicle. How and why?? I dont know!! but my theory for the left one which stopped working is that since the left one had made 3 folly last cycle it was tired and it didnt work this cycle . Because that was the only cycle the left didnt work. And I frankly have no theory on how the right one started working.

But if you take one month break to do the priming for the next cycle you should be fine and I am sure thats what Dr.D or maybe even cooper would recommend since you did the retrieval and touched the ovary.
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Erin
Erin

March 12th, 2012, 10:33 pm #3

Hi Guys- As you may have seen below, it was a BFN for me this month (with a couple pos HPTs along the way so I think there was a brief implantation that didn't work out). My husband and I talked about it and we both really want to try cycling this coming month and see what happens. This would mean no co-culture, but I honestly wonder if the co-culture did anything (3 of the 4 embryos still ended up with less than 6 cells) and this cycle would give us a chance to test that theory. I have insurance that covers cycles for another year (and then we're screwed), but if I only cycle once every 4mos or so, it really limits us. Plus, I turn 34yo in October and I feel like my age is the one thing I have going for me. I also will have had an E2 patch on for about a week by the time I get my period which should constitute "priming" since that's what I used in the past anyways.

I have some questions for you guys:

1) It appears the embryo implanted briefly as I caught faintly positive HPTs at 8 and 9dp3dt and beta was 0.8 instead of 0. Would this be indicative of immune issues? I've only had an "anti-phospholipid antibody panel" and all came back well within normal range. I also have an illness (Crohn's disease) that is widely believed to be autoimmune, but my ANA has come back negative every time it's been tested (it's been tested several times over the years).

2) I've never had an HSG b/c I've been told that with the illness and the tons of scar tissue and I have, there is a pretty good risk of infection for me with HSG. I've had laps and MRIs that found tubes are likely blocked but that I don't have hydrosalpinx. Would you go for the HSG to make sure given the very early chemical?

3) Our plan is to see if Dr. D is willing to run the same (or similar) protocol this month w/o co-culture and go with him if he will. If he's not, then we would go to C.heck or see if my local monitoring place would be willing to run the same protocol this month. We would potentially ask for immune testing asap so it could be processed while we're cycling. Does that sound like a decent plan to you all?

Sorry for the lengthy and somewhat rambling post. I would love to hear what you guys think on any or all of this. Thanks in advance!
E2 was only 47 on 7dpt so I started E2 on 8dpt and E2 went up to 140 at 9dpt but I'm wondering if it was too late at that point. Could insufficient E2 have been the problem? Either way, I plan to insist on E2 support from ET with the next cycle wherever I go.
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AJ
AJ

March 12th, 2012, 10:39 pm #4

Hi Guys- As you may have seen below, it was a BFN for me this month (with a couple pos HPTs along the way so I think there was a brief implantation that didn't work out). My husband and I talked about it and we both really want to try cycling this coming month and see what happens. This would mean no co-culture, but I honestly wonder if the co-culture did anything (3 of the 4 embryos still ended up with less than 6 cells) and this cycle would give us a chance to test that theory. I have insurance that covers cycles for another year (and then we're screwed), but if I only cycle once every 4mos or so, it really limits us. Plus, I turn 34yo in October and I feel like my age is the one thing I have going for me. I also will have had an E2 patch on for about a week by the time I get my period which should constitute "priming" since that's what I used in the past anyways.

I have some questions for you guys:

1) It appears the embryo implanted briefly as I caught faintly positive HPTs at 8 and 9dp3dt and beta was 0.8 instead of 0. Would this be indicative of immune issues? I've only had an "anti-phospholipid antibody panel" and all came back well within normal range. I also have an illness (Crohn's disease) that is widely believed to be autoimmune, but my ANA has come back negative every time it's been tested (it's been tested several times over the years).

2) I've never had an HSG b/c I've been told that with the illness and the tons of scar tissue and I have, there is a pretty good risk of infection for me with HSG. I've had laps and MRIs that found tubes are likely blocked but that I don't have hydrosalpinx. Would you go for the HSG to make sure given the very early chemical?

3) Our plan is to see if Dr. D is willing to run the same (or similar) protocol this month w/o co-culture and go with him if he will. If he's not, then we would go to C.heck or see if my local monitoring place would be willing to run the same protocol this month. We would potentially ask for immune testing asap so it could be processed while we're cycling. Does that sound like a decent plan to you all?

Sorry for the lengthy and somewhat rambling post. I would love to hear what you guys think on any or all of this. Thanks in advance!
so sorry about the BFN. Really, I'm so sorry:(. My knowledge of IVF is limited and I know absolutely nothing out immune issues, but- if you can cycle again right away I say go for it. I think if you have the insurance and know you are going to lose it at the end of the year, cycle as much as you can until you get your BFP!!

As for the HSG, you did IVF, so the tubes weren't involved anyway right? I don't see how the blocked tubes could correlate to the chemical, hence I don't see the need for an HSG. Are you worried that the embryo traveled up the tube after ET and got stuck?

Take care-
AJ
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Erin
Erin

March 12th, 2012, 10:46 pm #5

The tubes can fill up with a "toxic" fluid if they're blocked (called hydrosalpinx) and that fluid can drip into the uterus and cause implantation problems or m/c even if you use IVF to get the embryo there. The doctors think the MRI and laps and hysteroscopy I've had points to not having this, but I'm afraid they're wrong. The treatment would be to remove the tubes, but that would be very difficult given how much scar tissue I have in there.

Anyways, that's the issue. Thanks so much. Really, really hoping I get to see a positive HPT that becomes a 9mos-long BFP. I'm afraid I lost my only good embryo .
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Erin
Erin

March 12th, 2012, 10:51 pm #6

Btw, keep in mind that the cycle before my IVF was IUI. And Cooper said since it was converted to IUI I should be fine. also I always make follicle on my left side and never on the right. So my left has always been working and my right never ever worked beyond 6 mm follicle. On my back to back cycle the left didnt work at ALL. Didnt even make one follicle and somehow magically the right one started making follicle. How and why?? I dont know!! but my theory for the left one which stopped working is that since the left one had made 3 folly last cycle it was tired and it didnt work this cycle . Because that was the only cycle the left didnt work. And I frankly have no theory on how the right one started working.

But if you take one month break to do the priming for the next cycle you should be fine and I am sure thats what Dr.D or maybe even cooper would recommend since you did the retrieval and touched the ovary.
I'm going to have to see what the docs think about the back-to-back IVFs. I also have a bum ovary (although mine is the left one- the right one is the workhorse ). I thought that since both cycles are low stim, maybe it would be okay. I guess if I had to wait one extra month I might be able to deal with that, but I can't stand the waiting. I've managed 3 cycles in my almost 3yrs of TTC and I can't take it any more. Plus, with the insurance running out in a year, I feel the fire under my butt to get in as many cycles as possible, since I think ultimately it is a bit of a numbers game. Thanks so much for your input! It is much appreciated.
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AJ
AJ

March 12th, 2012, 10:55 pm #7

The tubes can fill up with a "toxic" fluid if they're blocked (called hydrosalpinx) and that fluid can drip into the uterus and cause implantation problems or m/c even if you use IVF to get the embryo there. The doctors think the MRI and laps and hysteroscopy I've had points to not having this, but I'm afraid they're wrong. The treatment would be to remove the tubes, but that would be very difficult given how much scar tissue I have in there.

Anyways, that's the issue. Thanks so much. Really, really hoping I get to see a positive HPT that becomes a 9mos-long BFP. I'm afraid I lost my only good embryo .
I just learned something:) Hmmm. Not sure what I would do in that situation. On one hand Drs. have been wrong before and you don't want to risk repeated implantation failures or m/c. But on the other hand, how great is the risk of infection from the HSG? And since you didn't mention it, I assume there's not a less invasive test to see if the toxic fluid is dripping into your uterus. Ugh! I'm so sorry that you have to deal with this on top of everything else....

And, FWIW, I think you still have plenty of time to find the one that sticks. This was not your last good one!!
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anna
anna

March 12th, 2012, 10:59 pm #8

E2 was only 47 on 7dpt so I started E2 on 8dpt and E2 went up to 140 at 9dpt but I'm wondering if it was too late at that point. Could insufficient E2 have been the problem? Either way, I plan to insist on E2 support from ET with the next cycle wherever I go.
1)I dont know much about immune therapy.
2)You did IVF so if your tubes are blocked or not is completely irrelevant. Unless your tubes have some liquid stock on them and it flows back to uterus and prevent implantations. I have open tubes but since I have endo I have been told that if I have endo in my tubes it could lick liquid on uteres. Do you have endo? Why do you have scars? For people who have this tubal problem cutting the tubes through lap surgery is a good idea.

3)Stick with Dr.D or cooper. No RE can copy other RE protocol. Its not like a cut and go cookie butter. The time of HCG depending on ur LH and adjusting the med and etc cannot be copied, the knowledge and experience is needed. I have tried to give my last protocol to 2 Res to copy for a friend of mine and none of them wanted to do the same nor they had the knowledge. If you can use ur local RE to monitor for cooper thats different story.

4) not sure about E2 for the next xyxle just take the E2 patch or pill after retrival. thats what cooper does.

BTW, how many IVF can you do with insurance, is there only time limit and no limit on the # of times you do the IVF?
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Erin
Erin

March 12th, 2012, 11:11 pm #9

On 2)- I have scar tissue b/c I have had 10-15 major abdominal surgeries for C.rohn's disease, so it's left me with a lot of scar tissue. This is probably why I have DOR as well, but that's another story.

On 3)- You're probably right about that. I guess maybe I'm a little apprehensive about C.ooper b/c when I was there I mentioned the concern about my scar tissue and problems with retrieval to C.heck and he brought in Dr. C.hoe who said she could do it, no problem. She then called me I think the next day and said she didn't realize I would be OOT monitoring and she "couldn't guarantee" she could successfully perform ER. That made me nervous. But I think you're right on not just anyone being able to work through a protocol.

On 4)- I will definitely be doing that.

On BTW- I have "unlimited" cycles until I reach the time limit. So, I will be covered for however many cycles until time runs out. So obviously, I'd like to get more in while I can!

Thanks for your good thoughts and for taking the time to respond- I really appreciate it!
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anna
anna

March 12th, 2012, 11:39 pm #10

In that case I say dont waste time and do as much as you can in the next year. And I hope you get ur BFP on ur next cycle and you and your insurance company will be both happy!!

Mr. A had the same problem. She had one year till her insurance would run out and I think she did total of 9 IVFs (many of them were canceled or converted to IUI, so not 9 retrieval, I think 4 ER ) in one year and she was swinging between cooper and cornel for each cycle. So dont think if you leave Davis for cooper you cant get back there. BTW cooper wanted to do ER for me and I am in CA but they had problem doing ur ER?? I am all confused!!
And also if for any reason some emergency thing happened and you start a cycle with cooper and couldnt drive there for ER, you can always contact Dr.D and he will do it for you. I mean thats what I did. I couldnt fly to NJ and did the ER with my ex local RE.
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