Hi, Cloudy, many thanks for setting up this thread. I had a recent miscarriage and am coping by trying to figure out what I can tolerate in terms of future OE cycles; my conclusion has been that I need to find an approach that is easier on my body. There seem to be multiple clinics in Czech Republic that offer natural and mild IVF treatment, and I am going to start contacting them next week.
AnnaMathilde, in your shoes I would go to egg collection, but that's because I know at this point that my DH and I have excellent fertilisation rates -- it sounds like you and your partner don't have that info yet about what your fertilisation rates will be. I guess the question is how much will you wonder about the what-ifs if you don't go to egg collection, vs. how much benefit will you get from being able to use the balance refunded from the current cycle to fund another go on a different protocol. It's a very personal decision, but if you feel strongly that you should give this egg a chance, you should do it. I followed my doctor's advice on my first cycle and didn't, and I regret that now.
Here's my situation:
- Preexisting issues: Age, low AMH, elevated FSH (not premenopausal levels, however), intramural and subserosal fibroids, presumed endo w/ tubal involvement (no lap performed, but long history of endo symptoms and tubes not patent on HSG). TTC naturally 5 years, never a whiff of BFP.
- IVF Cycle 1: "Poor response" on short protocol with 225 iu/day Gonal-F plus Cetrotide. 13 days of stims, 1 lead follicle on each ovary (one much further ahead that became a follicular cyst). No problems with side effects on Gonal-F and Cetrotide. Cycle cancelled and converted to IUI (a decision I regret, in light of my subsequent 100% fertilisation rate). BFN.
- IVF Cycle 2: 6 follies on long protocol with Buserelin and 300 iu/day Gonal-F. 3 weeks downreg, 18 days' stims (coasting last 3 days at 150 iu/day Gonal-F). Daily migraines from the Buserelin. 3 eggs, 100% fert. 2 embies transferred on Day 3, one good quality, one with small amount of multinucleation. BFN. 3rd embie cultured to blasto, but not suitable for freezing due to multinucleation.
- IVF Cycle 3: 3 follies on flare protocol. 3 weeks downreg on Yasmin (hormonal BCP) followed by 5 days of Synarel, 13 days' stims on 300 iu/day Gonal-F plus Synarel. Depression from the Yasmin, headaches from the Synarel (albeit less severe than from the Buserelin). 1 egg, fertilised. Good-quality embie transferred on Day 2, BFP. Miscarriage at 8w6d.
I have regular cycles (usually about 25-26 days long, occasionally shorter, very seldom a couple of days longer, but I've never had a "missed" period) and ovulate regularly as indicated by LH test strips and EWCM 14 days before my period. Basically, it's very difficult to persuade my body to deviate from its normal routine. When downregging on long protocol, I had to do a 3rd week at a double-dose to thin my lining out; when on Cetrotide, I still developed a very strong dominant follicle, and also had to take a double dose of Cetrotide one day to stop a natural LH surge.
I will never produce more than 2 or 3 eggs at a time on any protocol, but my egg quality is clearly good for my age or we would not have such a high fertilisation rate (also, one out of 3 embies put back so far resulted in pregnancy). I believe that my egg quality suffered from the lengthy stimulation required on the long protocol, and that's why we saw the multinucleation. At this point, I think we have to work on maximising egg quality, because higher quantity is off the table.
What I want to do is "natural" IVF with Cetrotide to control ovulation, and adding in low-dose Gonal-F or Menopur if the follicle does not seem to be maturing fully without additional stimulation. I'm aware that there's a risk of retrieving zero eggs on this kind of cycle, but I think we'll have a much better shot with any eggs that we do retrieve.
Currently I am working only part-time, doing consulting from home (or wherever I and my laptop are). At this point, I intend to continue this, even though I would like to have more face-to-face time with colleagues and actually grow my career -- but realistically this is my last year to conceive with OE. So I intend to keep my flexibility high to enable whatever travel I need to do to catch the egg each month.
Has anyone here had natural IVF at a clinic abroad? If so, at what points in your cycle did you have to travel? I'm sure I'll get some answers when I start calling clinics next week, but I'm very interested in what other ladies have actually experienced.