Dr. Che.ck wants me to start stims with an Fsh of 12.....wwyd?

Dr. Che.ck wants me to start stims with an Fsh of 12.....wwyd?

Sara Q
Sara Q

August 18th, 2012, 12:32 am #1

So my day 2 labs were not great, fsh 12, e2 32. This is a high fsh for me, even though I took estinyl for 4 days. I figured Chec.k would have me continue estinyl and wait a couple of days to see if fsh goes down and then start stims when number lower. But instead he said to start 150 Follistim tonight, while continuing to take estinyl once a day. I think he's trying to get more eggs, since we only had one last cycle. I really appreciate his tweaking things, I am concerned that the high fsh will lead to poor egg quality. I've already had 4 IVFs with many poor quality eggs, so I'm scared. Also, Dh and I agreed only one or two more low-stim IVFs before moving onto DE. But my DOR and immune issues seem to be getting worse quickly. What would you do? Advice?

Thanks!
Quote
Share

MargieD
MargieD

August 18th, 2012, 12:56 am #2

I thought there were numerous posts stating that high FSH did not necessarily lead to poor quality eggs - just harder to recruit??

If you don't have in your heart to continue the cycle this month, then don't. Wait until your FSH is lower.

With Dr. C, I have learned that each cycle is almost experimental. With my cycles, I am always learning something new and yes - it makes it harder to say "Ok - I've had enough - time to move on..." It's like - we're tweaking it until we get everything right so we can move forward with IVF. PITA... but I feel it will be ultimately worth it...

Are you having a bad month or are you really ready to give up?

Anyway - this is the way Dr. C operates.... and if it's already frustrating for you - then maybe it's time to rethink your game plan....maybe you need to switch REs....

As for FSH of 12, this isn't that bad. Many women have gotten pregnant naturally with those numbers.

Quote
Share

Sara Q
Sara Q

August 18th, 2012, 2:51 am #3

Hey Margie,

Yes, I think you are right that they about higher FSH making it harder to recruit, not necessarily leading to poorer quality eggs. (Although I think the jury might still be out regarding the the correlation between high fsh and lower quality eggs - many folks say it doesn't matter, and it may not. But my eggs haven't been so stellar, especially when we've used higher stims.) I do sometimes forget, however, that higher fsh doesn't mean poorer quality of eggs, especially when we're always trying bring the fsh down...

I don't think it's the fact the Che.ck experiments that is frustrating to me - I actually really like that. I wish my in-town RE had done more experimentation; maybe we'd wouldn't be here now if she did.

I think mostly I am frustrated because I had convinced myself that my issues weren't really that bad (such as Dr. C and other Dr.'s have said), that high stim was the major problem, and that when we switched to low-stim with the guru Dr. C, all would be okay. We would do the protocol, it work, we'd have a baby and then everyone lives happily ever after.

Believe it or not, I think I really convinced myself of that...it sounds so crazy written down, but not so much in my head. And I don't even think I realized that I had convinced myself of this until right now - if anyone asked I always say something like, "Well, we know it's not likely, but we're going to give it a try." In fact, most of the time I say to myself, "It will never work. What am I doing this for." But deep in my heart I always thought it would work. That something would work. I think I just told myself and others that it wouldn't work to try and ease the blow a little bit.

So I think my frustration comes from the reality of the situation not even coming close to the hopes I had for it and fearing that my vocalized expectations - that it will never work - are actually coming true. Instead of going "swimmingly," my AFC & FSH just keeps getting worse, and I've still never had implantation. Honestly, the path we've taken in last 2.5 years is beyond anything that I could have ever imagined when I was first diagnosed with DOR. If you would have told me my FSH would be 12 even after taking estinyl and my AFC would drop to 4, I would have been shocked beyond believe. And while I know plenty of women get pregnant naturally, with an FSH of 12, I'm really scared to pour more cash into a situation that will just bring more disappointments? Does that make sense?

I guess what I'm trying to say is that I'm frustrated to be here and that I thought working with Ch.eck would be different - that he has some kind of "magic" or something. Sounds silly, doesn't it?

As far as whether I'm really ready to be done - I honestly don't know. Part of me is so so tired, but at my core I want to do at least one low-stim IVF to say I've at least tried it. Part of me is also so damn stubborn and persistent - I think to myself, "Well, other people were able to do it, why can't I? Maybe it's just a matter of time." But I don't know how helpful that is...Even after giving up on IVFs, I can see myself timing ovulation right until the day I go into full-blown menopause.

But maybe letting go is more healthy? Maybe it's not worth it if our end goal is to just have a child? Sometimes I ask myself it's so important to me for this to work because I have a drive to have a genetic child or if I just want to "succeed." And honestly, I don't really know. What do you think? Do you ever thing about these things?

Sorry for the thesis...haha. Your post just made me think about a lot of things. Thank you so much for posting and being so supportive. I'm sure my flipping out the last couple months has been a bit exasperating...even (especially) to me.

Take good care,
Sara

Quote
Share

Sara Q
Sara Q

August 18th, 2012, 3:15 am #4

Long and somewhat philosophical post above ;) n/t
Quote
Share

MargieD
MargieD

August 18th, 2012, 3:50 am #5

Hey Margie,

Yes, I think you are right that they about higher FSH making it harder to recruit, not necessarily leading to poorer quality eggs. (Although I think the jury might still be out regarding the the correlation between high fsh and lower quality eggs - many folks say it doesn't matter, and it may not. But my eggs haven't been so stellar, especially when we've used higher stims.) I do sometimes forget, however, that higher fsh doesn't mean poorer quality of eggs, especially when we're always trying bring the fsh down...

I don't think it's the fact the Che.ck experiments that is frustrating to me - I actually really like that. I wish my in-town RE had done more experimentation; maybe we'd wouldn't be here now if she did.

I think mostly I am frustrated because I had convinced myself that my issues weren't really that bad (such as Dr. C and other Dr.'s have said), that high stim was the major problem, and that when we switched to low-stim with the guru Dr. C, all would be okay. We would do the protocol, it work, we'd have a baby and then everyone lives happily ever after.

Believe it or not, I think I really convinced myself of that...it sounds so crazy written down, but not so much in my head. And I don't even think I realized that I had convinced myself of this until right now - if anyone asked I always say something like, "Well, we know it's not likely, but we're going to give it a try." In fact, most of the time I say to myself, "It will never work. What am I doing this for." But deep in my heart I always thought it would work. That something would work. I think I just told myself and others that it wouldn't work to try and ease the blow a little bit.

So I think my frustration comes from the reality of the situation not even coming close to the hopes I had for it and fearing that my vocalized expectations - that it will never work - are actually coming true. Instead of going "swimmingly," my AFC & FSH just keeps getting worse, and I've still never had implantation. Honestly, the path we've taken in last 2.5 years is beyond anything that I could have ever imagined when I was first diagnosed with DOR. If you would have told me my FSH would be 12 even after taking estinyl and my AFC would drop to 4, I would have been shocked beyond believe. And while I know plenty of women get pregnant naturally, with an FSH of 12, I'm really scared to pour more cash into a situation that will just bring more disappointments? Does that make sense?

I guess what I'm trying to say is that I'm frustrated to be here and that I thought working with Ch.eck would be different - that he has some kind of "magic" or something. Sounds silly, doesn't it?

As far as whether I'm really ready to be done - I honestly don't know. Part of me is so so tired, but at my core I want to do at least one low-stim IVF to say I've at least tried it. Part of me is also so damn stubborn and persistent - I think to myself, "Well, other people were able to do it, why can't I? Maybe it's just a matter of time." But I don't know how helpful that is...Even after giving up on IVFs, I can see myself timing ovulation right until the day I go into full-blown menopause.

But maybe letting go is more healthy? Maybe it's not worth it if our end goal is to just have a child? Sometimes I ask myself it's so important to me for this to work because I have a drive to have a genetic child or if I just want to "succeed." And honestly, I don't really know. What do you think? Do you ever thing about these things?

Sorry for the thesis...haha. Your post just made me think about a lot of things. Thank you so much for posting and being so supportive. I'm sure my flipping out the last couple months has been a bit exasperating...even (especially) to me.

Take good care,
Sara
I can't write much tonight, but I wanted to say that I understand more than you think...

When I started with Dr. C, I was on a high - thinking - oh, he's the answer to my prayers - I'll do whatever he wants me to do and everything will work out.

Well... it's been more than a year and half since I started with him... and since then, we found out that I have a blocked tube, horrible endometrosis, LUFS (follicles don't always release), and probably something else that I've forgotten...

And then I wonder - "D&MN IT!! WILL IT EVER HAPPEN?!?!?!"

I got pregnant and m/c last Feb/Mar so I knew we were heading the right direction. I also knew I was under a lot of stress with the Ph.D. Not getting it done "in a timely fashion" was a like a huge black cloud following me around. So maybe the m/c was a blessing in disguise because I used it as an excuse to stop TTCing for a while to focus on the Ph.D. Now that I'm done... I feel different...there's no black cloud although there's a different kind of stress - but not like before...

And I'm back to working with Dr. C....

I'm not saying that you need to focus on the Ph.D. (although you should - smile)... and I'm not saying that you've been exasperating (not at all - smile)... but I do sense that you're being pulled in so many directions.... and when that happens - it's hard to give it your all...

Why not just do what Dr. C wants to you do for the next three months? (Is there any particular reason why you can't just do TI?) After you finish the Ph.D., you and DH can plan a trip to NJ for IVF?? Like you said - "letting go might be more healthy"...

Anyway - I need to get some sleep...

Quote
Share

AJ
AJ

August 18th, 2012, 3:51 am #6

Hey Margie,

Yes, I think you are right that they about higher FSH making it harder to recruit, not necessarily leading to poorer quality eggs. (Although I think the jury might still be out regarding the the correlation between high fsh and lower quality eggs - many folks say it doesn't matter, and it may not. But my eggs haven't been so stellar, especially when we've used higher stims.) I do sometimes forget, however, that higher fsh doesn't mean poorer quality of eggs, especially when we're always trying bring the fsh down...

I don't think it's the fact the Che.ck experiments that is frustrating to me - I actually really like that. I wish my in-town RE had done more experimentation; maybe we'd wouldn't be here now if she did.

I think mostly I am frustrated because I had convinced myself that my issues weren't really that bad (such as Dr. C and other Dr.'s have said), that high stim was the major problem, and that when we switched to low-stim with the guru Dr. C, all would be okay. We would do the protocol, it work, we'd have a baby and then everyone lives happily ever after.

Believe it or not, I think I really convinced myself of that...it sounds so crazy written down, but not so much in my head. And I don't even think I realized that I had convinced myself of this until right now - if anyone asked I always say something like, "Well, we know it's not likely, but we're going to give it a try." In fact, most of the time I say to myself, "It will never work. What am I doing this for." But deep in my heart I always thought it would work. That something would work. I think I just told myself and others that it wouldn't work to try and ease the blow a little bit.

So I think my frustration comes from the reality of the situation not even coming close to the hopes I had for it and fearing that my vocalized expectations - that it will never work - are actually coming true. Instead of going "swimmingly," my AFC & FSH just keeps getting worse, and I've still never had implantation. Honestly, the path we've taken in last 2.5 years is beyond anything that I could have ever imagined when I was first diagnosed with DOR. If you would have told me my FSH would be 12 even after taking estinyl and my AFC would drop to 4, I would have been shocked beyond believe. And while I know plenty of women get pregnant naturally, with an FSH of 12, I'm really scared to pour more cash into a situation that will just bring more disappointments? Does that make sense?

I guess what I'm trying to say is that I'm frustrated to be here and that I thought working with Ch.eck would be different - that he has some kind of "magic" or something. Sounds silly, doesn't it?

As far as whether I'm really ready to be done - I honestly don't know. Part of me is so so tired, but at my core I want to do at least one low-stim IVF to say I've at least tried it. Part of me is also so damn stubborn and persistent - I think to myself, "Well, other people were able to do it, why can't I? Maybe it's just a matter of time." But I don't know how helpful that is...Even after giving up on IVFs, I can see myself timing ovulation right until the day I go into full-blown menopause.

But maybe letting go is more healthy? Maybe it's not worth it if our end goal is to just have a child? Sometimes I ask myself it's so important to me for this to work because I have a drive to have a genetic child or if I just want to "succeed." And honestly, I don't really know. What do you think? Do you ever thing about these things?

Sorry for the thesis...haha. Your post just made me think about a lot of things. Thank you so much for posting and being so supportive. I'm sure my flipping out the last couple months has been a bit exasperating...even (especially) to me.

Take good care,
Sara
Hope you don't mind me barging in, but a couple thoughts in your post resonated with me. I don't think your feeling that C.heck would be the magic solution is silly at all. I too had the same feelings- if I do XYZ, this will work. Now here I am almost a year and a half later and nothing. And it's the longest I've ever gone without a BFP. And I think for many of us C.heck is a last stop so to speak, that the thought of giving up with him is really giving up. I'm doing TI cycles and is it sooo hard to give them up. Because I feel like once I do and I'm not doing anything to keep my FSH down it's just a matter of time before the big M. So not a lot of advice here, but just wanted to let you know that you're not alone with your feelings.

I don't want to minimize your anxiety about your FSH this month but I don't think it's necessarily worth canceling your cycle over. Yes, your AFC is lower, but your really just going after a couple of eggs anyway so I don't think that's an issue. But if it's really causing you stress then waiting until next month won't hurt either. It's all about what you're comfortable with.

I'm sending lots of positive thoughts your way in making these decisions and beyond:)
Quote
Share

Mrs. McIrish
Mrs. McIrish

August 18th, 2012, 2:03 pm #7

Hey Margie,

Yes, I think you are right that they about higher FSH making it harder to recruit, not necessarily leading to poorer quality eggs. (Although I think the jury might still be out regarding the the correlation between high fsh and lower quality eggs - many folks say it doesn't matter, and it may not. But my eggs haven't been so stellar, especially when we've used higher stims.) I do sometimes forget, however, that higher fsh doesn't mean poorer quality of eggs, especially when we're always trying bring the fsh down...

I don't think it's the fact the Che.ck experiments that is frustrating to me - I actually really like that. I wish my in-town RE had done more experimentation; maybe we'd wouldn't be here now if she did.

I think mostly I am frustrated because I had convinced myself that my issues weren't really that bad (such as Dr. C and other Dr.'s have said), that high stim was the major problem, and that when we switched to low-stim with the guru Dr. C, all would be okay. We would do the protocol, it work, we'd have a baby and then everyone lives happily ever after.

Believe it or not, I think I really convinced myself of that...it sounds so crazy written down, but not so much in my head. And I don't even think I realized that I had convinced myself of this until right now - if anyone asked I always say something like, "Well, we know it's not likely, but we're going to give it a try." In fact, most of the time I say to myself, "It will never work. What am I doing this for." But deep in my heart I always thought it would work. That something would work. I think I just told myself and others that it wouldn't work to try and ease the blow a little bit.

So I think my frustration comes from the reality of the situation not even coming close to the hopes I had for it and fearing that my vocalized expectations - that it will never work - are actually coming true. Instead of going "swimmingly," my AFC & FSH just keeps getting worse, and I've still never had implantation. Honestly, the path we've taken in last 2.5 years is beyond anything that I could have ever imagined when I was first diagnosed with DOR. If you would have told me my FSH would be 12 even after taking estinyl and my AFC would drop to 4, I would have been shocked beyond believe. And while I know plenty of women get pregnant naturally, with an FSH of 12, I'm really scared to pour more cash into a situation that will just bring more disappointments? Does that make sense?

I guess what I'm trying to say is that I'm frustrated to be here and that I thought working with Ch.eck would be different - that he has some kind of "magic" or something. Sounds silly, doesn't it?

As far as whether I'm really ready to be done - I honestly don't know. Part of me is so so tired, but at my core I want to do at least one low-stim IVF to say I've at least tried it. Part of me is also so damn stubborn and persistent - I think to myself, "Well, other people were able to do it, why can't I? Maybe it's just a matter of time." But I don't know how helpful that is...Even after giving up on IVFs, I can see myself timing ovulation right until the day I go into full-blown menopause.

But maybe letting go is more healthy? Maybe it's not worth it if our end goal is to just have a child? Sometimes I ask myself it's so important to me for this to work because I have a drive to have a genetic child or if I just want to "succeed." And honestly, I don't really know. What do you think? Do you ever thing about these things?

Sorry for the thesis...haha. Your post just made me think about a lot of things. Thank you so much for posting and being so supportive. I'm sure my flipping out the last couple months has been a bit exasperating...even (especially) to me.

Take good care,
Sara
I really feel like I could have written your post. Totally feel so many of the same things. I also believed low stim would be the answer and I still believe it can be for some. For others, the egg quality really is just compromised. Is it from the high FSH or from something else? Who knows. I did 2 low stim IVFs that yielded really terrible embryos and only one transfer. After a total of 4 IVFs that never brought a single BFP, I just couldn't keep doing it. If I had gotten a good looking embryo that just did not stick, perhaps I could have tried again. But that just did not happen. I felt like C.heck was Santa Claus at first and that it could happen and he'd give me a miracle.. Now I think he is just a nice old man who can bring joy to lots of people but he can't fix everything or everyone as Santa Claus isn't real. I truly hope you figure out how much you can handle before turning the page. Hugs.
Quote
Share

AJ
AJ

August 18th, 2012, 9:11 pm #8

I think there are a lot of positive things to say about Dr C.heck. His pricing allows women to do more IVF cycles, Estinyl therapy, I think he does use some creative approaches to stimming, but the main thing is that he gives us a chance. When it comes to TI cycles, I definitely think women could have success with their local REs if they'd offer the kind of monitoring C.heck does.

I dont think anyone is getting down on C.heck, but I've come to feel that for a lot of us being successful comes down to just plain luck catching the golden egg and timing. And he gives the luckiest of us the time needed to reach the point of success. Unfortunately there's just no rhyme or reason as to who the successful ones will be:(
Quote
Share

Mrs. McIrish
Mrs. McIrish

August 19th, 2012, 12:30 am #9

Don't get me wrong. He would let me cycle until the cows come home when no one else would. It's not his fault I have no golden eggs. I just can't look for it anymore as it may not exist in my body. Not every one has the golden egg.
Quote
Share

Mrs. A
Mrs. A

August 19th, 2012, 3:15 am #10

So my day 2 labs were not great, fsh 12, e2 32. This is a high fsh for me, even though I took estinyl for 4 days. I figured Chec.k would have me continue estinyl and wait a couple of days to see if fsh goes down and then start stims when number lower. But instead he said to start 150 Follistim tonight, while continuing to take estinyl once a day. I think he's trying to get more eggs, since we only had one last cycle. I really appreciate his tweaking things, I am concerned that the high fsh will lead to poor egg quality. I've already had 4 IVFs with many poor quality eggs, so I'm scared. Also, Dh and I agreed only one or two more low-stim IVFs before moving onto DE. But my DOR and immune issues seem to be getting worse quickly. What would you do? Advice?

Thanks!
as Dr. Ch.eck himself would say.

Those are completely acceptable numbers for cycling. Even at Cor.nell with Dr. D, that makes the cut-off for cycling.

If it makes you feel better, on my "only doing this to humor you, Dr. Che,ck" cycle my CD2 numbers were E2 less than 20, FSH 12.1, LH 4.6, P4 0.8. I barely had a single antral follicle. But by CD12 I had a 20MM follie. That follie's egg will be turning one next weekend. If that "high" FSH of 12.1 was supposed to lead to poor egg quality, I'll take it any day!

All kidding aside, I know you're a little down. You have every reason to feel bewildered and doubtful. But do not let these CD2 numbers be part of the reason. They are fine and it's the right call to start stims.
Quote
Share