Link: Copy link
Sorry it took forever to respond to this, but I went in for a baseline u/s in the interim and asked Dr. T about the percentages for blasts specifically, and he said that their clinic statistics for my age group are that a blast has about a 25% chance of live birth (I'm assuming that's including the 40% implantation rate and the probably close to 40% miscarriage rate and that he meant a chromosomally normal baby, but I didn't ask if that included termination of abnormal pregnancies after CVS/amnio). I asked if it shouldn't be lower because of the only 1-2 normal eggs in 10 thing, but he said that by the time an embryo makes it to blast, the odds of it being normal are a little higher because it's already passed a number of significant hurdles to get to blastocyst stage. So given that, I think the numbers you got of 2/5 as opposed to 1/5 blasts being normal do make sense.Hi Di,
Happy to share the details. First of all I'll defer to you re: those statistical corrections. Thanks for challenging me on them. I didn't really check my facts thoroughly and was recalling off the top of my head just to give her an idea of the odds. I couldn't remember if it was 1 or 2 normal eggs in 10 for our age. I think 1/5 blasts turning out normal probably the stat, but I said 2/5 because that was how many normals I actually had out of 5 blasts in my last 3-cycle banking results (so I'm hoping for similar this time, though I know there are no guarantees). The 40% normal blast implantation rate was what Dr. T told me after I got a BFN with my 2 CGH normal blasts.
Here's what happened with my last cycle, where I got twice as many frozen blasts as any other previous cycle. I think it was part luck, part Dr. T's follistim dosing expertise/experience, well-rested ovaries, fortunate AFC, and part luck of the Irish:
Let it be known that I had an unusually high AFC this cycle. 8 were visualized at cycle start, but I have a history of more popping out later, especially on my more dormant left ovary (the one with the endometrioma). My lefty had a bumper crop this time, with 3 antrals at cycle start, but 8 mature follicles in the end. I had 6 good ones going on the left. Almost every follicle magically matured at a similar rate this time (very rare for me), so I had a very even cohort.
As for the Saizen, I was prescribed an 8.8 mg vial, which I reconstituted in 10ml of solution and injected 1ml per day from the 1st day of stims til it was gone.
The other meds were dosed as follows & I started injections on CD2:
Stim Day 1 & 2 375 follistim + 1/2 vial Luveris
Stim Day 3 & 4 225 follistim + 1/2 vial Luveris
Ultrasound showed bumper crop growing faster than is the norm for me, so Dr. T wanted to slow things way down.
Stim Days 4-9 150 follistim + 1/2 vial Luveris
Triggered on Day 9 based on bloodwork
11 eggs retrieved
10 fertilized (100%!)
10 embryos biopsied for CGH on day 3 (ranging 6-8 cells)
4 blasts frozen
My last cycle result(for comparison purposes. FYI: averaging 375 follistim per day and no saizen)
9 eggs retrieved
4 embryos biopsied on day 3 (6-9 cells)
1 blast frozen
Dr. T, needless to say told he was "very pleased" with my response this time -- LOL Mr. understated!!
Just goes to show, you NEVER KNOW!
I know GH is supposed to help with quality, but could it have made me more sensitive to the follistim? I can't figure out why I needed so much less of it this time to grow my follicles. In addition to GH helping the quality, I figure the lower dose of stims hopefully helped the egg quality.
So Di, I'm curious as to how my protocol was diff from yours? Do tell
Because overall SIRM in general seems to be SO anti androgen producing meds and SO anti-Femara.Di,
Cool! Glad to know my own personal cycle-derived, pasted-together stats are somewhat consistent with the percentages Dr. T gave you.
I really think 1 or 2 blasts per banking cycle is a good result for ladies in our age range (this was my own avg. prior to my last cycle) and if we have the resources to continue, we just may find success eventually!
You are one of about 4 ladies I've found recently to be on Dr. T's Femara protocol. I wonder if he perhaps started putting people on that AFTER I became his patient, but never switched me, since I was getting respectable results on simpler antagonist.
Heh, heh....I'm beginning to wonder what Dr. T would think about us comparing protocols online. I find all this info very insightful, but let's please don't mention each other when we talk to him directly. I have a good relationship with him don't want to stir up any "trouble!" I am, however, eternally grateful to have found out from you and Dee that he had you on HGH. I don't think he would have put me on that unless I asked him about it. He was all too happy to prescribe it when I asked, but never suggested it himself. Curious...
Curious why you are on estrogen priming? Are you cycles regular, do you ovulate? Is your lining good etc?Well, I'm at S.IRM in NY and unlike the other S.IRM clinics, the medical director there does use Femara protocols now. He has never had me do anything androgen-producing except for adding in a tiny amount of Luveris towards the end of my first, high stim EPP protocol as is standard with that protocol (Google LA10E2V protocol).
I honestly don't know how much this opens up the arsenal for the 45 and over crowd, though--I do have high FSH and DOR, but my AFC is usually around 8 and I'm only 41.6, and while this clinic in particular has had very good results in the 41-42 age group, like everywhere else those stats drop sharply in the 43+ group so I don't know if he'd be able to offer you much better odds than a few percent either.
All that said, I think he is very open minded and very receptive to tweaking individual protocols, and will definitely work with older patients. Dr. T does phone consults, but unlike the other S.IRM clinics it is not free to have a phone consult with him. Hope this helps!