* Author Topic: Natural, mini, mild (etc) IVF chat thread  (Read 70259 times)

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Offline Cloudy

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I have noticed quite a few ladies recently have mentioned natural, mild, mini IVF so thought I would set up a chat thread for all the people who are thinking about, are planning on starting, or have started this type of IVF.

It's not intended to replace the Cycle Buddies, and not for pregnancy chat (as per the normal rules), but I just thought we could give it a try and see if there are any takers as I know that there isn't a specific "home" for this type of IVF.

I hope it's helpful, but if not the thread can slip into obscurity just like the amazing band that was Let Loose!  ;D


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    Offline AnnaMathilde

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    « Reply #1 on: 8/01/15, 09:22 »
    HI, thank you for starting the thread. Yes I would love to speak to more women considering/going through mild or natural IVF treatment. I am with IVI in spain, and started mild/modified (what is the difference??) IVF. The reason (I guess) why my DR choose this protocol, is that I only have 1 ovary and no tubes. So the idea is to do several rounds of EC & EF.

    I started taking Clomid daily with Menopur 150iu every 48hrs. At the first scan I had 2 tinny follicles. At the second scan I only had 1 left, but that one is definitely growing (currently day 14 of stimms, next scan tomorrow)

    I have asked for a meeting with my ER to discuss my treatment and "strategy". I am worried they want to cancel. But I don't want to cancel, because with this strategy it was never about quantity. I am worried that I am not thinking objectively/logically or being realistic because I am obviously a believer in miracles and feeling pretty hormonal.

    I want them to collect this one egg. My non-medically-educated brain tells me that this one must have more chance of being a "surviver" as it must be the natural dominant follicle which is growing. Going for quality over quantity, no?

    I don't actually want them to stuff me with more drugs, because with 1 ovary I will never get any serious quantities of follicles/eggs. I am thinking at most I could get 2 eggs (from 4 or so follicles). I don't want to stress my ovaries either and having to delay treatment. So I want to ask them if I should do a natural IVF with back to back cycles, after this current cycle. I fell pregnant naturally in August 2014, in September I had my only tube removed because the pregnancy was ectopic. Though this proofs that I can get pregnant, I know I ovulate, I know I have still (fingers crossed) a few eggs left. So would the best strategy possibly be: natural cycle, EC, ICSI and transfer, if BFN than go straight into the next cycle? Though it would have to be a cycle without Clomid, otherwise its best to do egg-freezing.  ????

    Anybody any advice, or am I just hormonally/stressed ranting???
    xxx   :-\

    Offline CrazyHorse

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    « Reply #2 on: 9/01/15, 14:52 »
    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. :)

    Offline AnnaMathilde

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    « Reply #3 on: 11/01/15, 22:11 »
    I completely agree and understand. I don't think that for some the full-on drugs is productive. I had my meeting at the clinic on Friday. The doctor was brilliant. Before I mentioned anything she already said exactly what I would have liked her to say. Wednesday they are going to collect my 1 follicle from this long-cycle (Japanese mini-IVF). She agreed that obviously the drugs don't do much to me (except for sweats and headaches, but I don't mind as its all for the cause!). So once this follicle is collected ( ^pray^that its a big fat wonderful quality egg), then for the next cycle we'll do a mild IVF. If that doesn't give me more than 1 follicle, then the third cycle will be just a modified-natural cycle. She also said, that no point in taking the drugs if the results are no different from a natural cycle. I always ovulate, have regular cycles and fell pregnant naturally twice in 2 years of trying (mc + ectopic, and now no more tubes).

    I was worried that the egg freezing has worse statistics than embryo freezing. Though she said that at their clinic they actually have better stats on egg freezing than embryo freezing. Fingers crossed this is true and true for me.

    Also to ICSI at each cycle, would be way too expensive, so egg collection a better option. I am thinking of doing another 2-3 cycles for collection and then going to transfer.

    About the travel for natural IVF, i am not sure. The doctor did say that there will be less ultrasounds with mild & natural IVF cycles, and that they will only use the drugs to control ovulation. I am with IVI in Spain (Bilbao).

    Let me know how you get on. I am very interested as well in hearing stories about modified-natural IVF. Preferably success stories!

     :) :) :)

    Offline Briss

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    « Reply #4 on: 12/01/15, 16:58 »
    ladies, I hope you do not mind me joining.

    Cloudy, thanks so much for starting this thread! I was looking for something like this but could only find very old threads mostly related to Create.

    CrazyHorse, hi! Thanks for the link! from reading your story I have a very similar response to cetrotide i.e. I also develop a very strong dominant follicle, and my natural LH surges while I am still on cetrotide.

    A little about me:

    I started my "IVF career" at Create, London. we had two cycles: (i) natural/modified and (ii) mild stims. natural/modified was probably the best cycle so far as we had a chemical pregnancy the closest we ever got to a real BFP. They were very supportive all the way. I was on 150 menopur from day 6 + cetrotide, trigger, and progesterone after ET. Our second mild stims cycle involved stimming from day 2 with Gonal F on 125 which was then upped to 250, we had 3 follicles but got only 2 eggs as the dominant ovulated early all eggs were of poor quality and did not fertilise. Opinions divided: some said we should go back to natural, others said mild stims is silly we should do proper stims.

    I have high FSH but was still eligible for the NHS funding in the UK so we decided to give full-on stims a go, spent a year waiting for our 3rd cycle but it was a complete disaster. I was on short protocol with 450 menopur from day 3 + cetrotide (which btw does not work for me and my LH goes up when my body wants to ovulate regardless), we had 4 eggs but it was the same story as mild stims all eggs of poor quality and none fertilised. it's something to do with maturation and cetrotide not working that in the end affects egg quality because on my natural cycles when I get 1 egg it's of good quality and it fertilises. unfortunately something also went wrong during EC and I started bleeding internally which I did not realise immediately as I was told pain is normal after EC (I had no pain with natural IVF), in the end I was hospitalised and was on morphine. I lost about a litre of blood which was trapped in my abdomen causing a lot of pain and it took 5-6 weeks to recover. Nobody tells you this can happen as IVF is considered safe. At this point we made a decision that we are going to stick to natural IVF but we need some help with sperm selection as ICSI is just not enough. Also, we started looking at clinics abroad as the cost of natural IVf in London is similar to stim IVF while in Europe you can do it so much cheaper. we are saving b/w 3-5K depending on the clinic on each cycle by going abroad.

    I am preparing for my 3rd back to back natural IVF cycle. the first two we had in Brno, Czech Republic and now we are moving to a clinic in Munich. the main reason is that they offer IMSI (we have severe male factor) and Brno clinic can only offer PICSI (but DH's SA was not suitable for PICSI so we could not do it). I know my body quite well so I like clinics that are prepared to be flexible. I really liked Reprofit in Brno.  I had all my scans in London and then just flew to Brno for EC/ET. The first cycle was a failure, I had 2 follicles growing  (naturally with no stims!) but they are most likely ovulated just before the procedure, they did not collect any eggs. I did feel I was ovulating but the procedure was delayed and I think that's why we lost them. For our second cycle our doctor agreed to have the procedure very early on, I was in the theatre before 8am! also, even though she personally did not believe in this she agree for me to take indometacin from the trigger to EC. since I have this issue of losing eggs to early ovulation I believe indometacin really helps because on the 3 cycles I was taking it we did not lose the eggs even the second time when my dominant follicle virtually started ovulating the egg was still inside and they got it. so I am a firm believer in indometacin. Our second cycle with them was very well managed and we got that egg. unfortunately sperm let us down, the sample was not suitable for PICSI so we had to rely on ICSI, it did fertilise but it was a BFN.

    I have to say that all the planning and travelling everything has to be booked the last minute cos natural IVf is very unpredictable all very stressful. If I could get success with stim IVf I'd rather do one stim IVF than many natural IVfs but unfortunately I cannot, stims just do not work for me. I am just happy a lot of clinics are prepared to go natural IVF route however painful it is and this is probably the only chance we got.

    here is a success story from a friend on B&B, very inspiring - http://babyandbump.momtastic.com/assisted-conception/1934573-7th-natural-cycle-ivf-w-o-meds-finally-bfp.html

    This post contains an unconfirmed link/information and readers are reminded that FertilityFriends.co.uk or its owners are not responsible for the content of external internet sites

    Offline AnnaMathilde

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    « Reply #5 on: 12/01/15, 20:26 »
    I am sorry that you are on such a roller coaster! I have no idea what to advice you on, as I am far from an expert. However I do agree with you, that just pumping lots of drugs into the system, doesn't really work for some of us.
    I am sure that the stress and travel doesn't help either. What is you next plan?

    Egg collection (only 1 follicle) for me on Wednesday and trigger tonight. Next round will be mild-IVF, and see how we go with that one...

     :) :)

    Offline Cloudy

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    « Reply #6 on: 12/01/15, 20:47 »
    Just popping in to say hello!

    Briss - im glad you joined up, I am a Reprofit thread stalker (its somewhere we may consider going in the future) and have been following your situation. Good luck with Munich x

    AM - good luck for EC x

    CH - hope you are ok honey, thinking of you  ^hugme^

    Good luck everyone xxx

    Offline Briss

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    « Reply #7 on: 12/01/15, 21:01 »
    Cloudy, thanks! I have only good things to say about Reprofit but you probably know that from Reprofit thread. I just wish they offered IMSI.

    AnnaMathilde, best of luck with your EC! I hope you will get that egg and it will be your lucky one. I strongly believe that you body knows best and it chooses carefully the right follicle to become the dominant one so you can be sure this is the best egg this cycle.

    Are you going to have any sedation? In CR and I think in Germany as well you can have EC without any sedation. I had it two months ago and it was actually fine, a bit painful but very quick.

    I have my scan tomorrow so we will see if we can try again this cycle. I already decided that we are going natural IVF route every month until we are lucky. I may change my mind of course and try stims again probably long protocol but at the moment I am sticking to natural IVF. It's much easier on the body.

    Offline Lizzie070

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    « Reply #8 on: 12/01/15, 21:36 »
    Hello,

    Do you mind if I join?

    A bit about me. I am on my third round of natural modified ivf at Create in London. I am having three rounds of collection, with (I hope) ET next month.
    I had one round on the nhs before age cut me off, and was on max Stims. I had three weeks down reg on burserelin, and then 23 days of 450 gonal f. It was quite hard going. I only have one ovary, have endo and a fibroid, so things are stacked against me. The nhs cycle resulted in 5 eggs, 2 were no good, but non fertilised as we weren't given the option of ICSI.
    The natural modified we have opted for ICSI, and the first round gave the exact same results with only 150 menopur, but two of the three ok eggs fertilised. My second round got one of two, and my third... Well who knows, as EC is sometime this week. It is so much easier on this protocol, and for me the results have been much better so far, but as still have not had any et, we cannot tell.

    Good luck to all out there what ever the protocol.

    Offline Briss

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    « Reply #9 on: 12/01/15, 22:03 »
    Lizzie, good luck with your EC! can I ask on what day after EC do they freeze your embryos? do they take them to blastocyst stage? how are they going to select which ones to transfer?