* Author Topic: Natural, mini, mild (etc) IVF chat thread  (Read 70005 times)

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Offline janieliz

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Natural, mini, mild (etc) IVF chat thread
« Reply #140 on: 31/08/15, 19:32 »
Hi Kat Kat,
I had my treatment at Serum. I did natural IVF with low stims. First round, had a scan on day 6, I had 3 follies, started 150 of merional, then I had scans every other day, cetrozide for 1 day and then triggered the next day. I got two eggs and I wanted to go to blast and Penny said that was fine. Had 2 blasts transferred but had a chemical. Next round I started stims on day 3, had 5 follies, got 5 eggs, 4 fertilised and I had 3 going strong on day 3. For some reason my gut was telling me to put them back on day 3, I think because I couldn't believe I had 3 embryos! Currently pregnant with a singleton. I found cycling at Serum a very collaborative process and I listened to Penny but she also listened to me. The girls doing the clomid were all banking as like crazyhorse pointed out, it can thin your lining. However, I had also asked about using letrozole and stims and penny said that was ok too. I think reprofit and other clinics use that protocol more though so may be more experienced in it. My embryos were always decent quality on the low stims and I would highly recommend Serum but I am a bit biased!!

X

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    Offline CrazyHorse

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    « Reply #141 on: 31/08/15, 19:43 »
    A lining of 8.5 mm isn't too bad, my concern if it were me would just be that Clomid would make it even thinner. Because Femara wasn't originally developed for inducing superovulation, it seems like not as many clinics use it as Clomid, but it does work well for that purpose.

    On the mild protocol, I had Cetrotide on Cycle Day 8, when the two lead follicles were 16 and 17 mm, and then a second dose of Cetrotide the following day, with EC on CD 11. I had another 4 smaller follicles at the time of the CD 8 scan, of which the largest was 13 mm. At EC I got 4 eggs, but only 2 fertilised, I believe because only the two from the lead follicles were fully mature (which was in line with my expectations for this protocol). Taking Cetrotide earlier isn't "bad", per se, it's just more in line with traditional short protocol where you take Cetrotide alongside the stims to encourage more even follicle growth. Unfortunately, the Cetrotide also slows follicle growth, and traditional short protocol didn't work well for me on a previous cycle. My AMH and AFC are pitifully low, though.

    I had a Day 3 transfer, although we could have done a Day 2 transfer on the Sunday if they'd suggested it. Because of my age (turned 41 shortly after EC) there was never any question that we'd put both back if there were 2 embryos, so there would have been no point taking them to Day 5 in vitro. We weren't doing PGD or an embryo banking cycle either. Some women do embryo banking with mild protocol cycles, and I think for that clinics do often culture embryos to blastocyst before freezing.

    Offline katkat2014

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    « Reply #142 on: 31/08/15, 20:12 »
    Thank you SO much! This forum is amazing and I really appreciate your help! Seeing some of you at a similar age to me with bfp's on a mild cycle is extremely reassuring  (this said we have an added issue of MFI too)!

    The only time when I felt any of my cycles going somewhere was my first time when a blast was transferred, the NHS never did a blood test but  considering the clotty heavy weird period I had it must have been a very early miscarriage or something similar (I was too naive a year ago to check it out). So what worries me about the mild or natural IVF is the early transfer as somehow I have it in my head that for me this doesn't work (which is silly I know). Janieliz, must have been a  tough choice if you get to this point, as it is equally scary to wait and then maybe have nothing to transfer.

    Considering I have had 4 failed cycles I may need to bank and do CGH per PGS or whatever, don't have much knowledge about it yet (and again, quite frightening if you find out none are genetically normal)...

    Scary but exciting, good luck with the follow up with Create - will be interesting to hear what they suggest


    Offline ScaryButExciting

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    « Reply #143 on: 31/08/15, 22:06 »
    Thanks KatKat and indeed also others - am getting to grip with understanding more of the mild protocol and it is so helpful!!! X

    Offline katkat2014

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    « Reply #144 on: 2/09/15, 20:16 »
    I have just had a consultation today with a new clinic and they advises me that as I respond well to stims and have normal FSH (about 8.3) and AFC (about 10-20) they do not suggest for me to do mild IVF. Is there anyone here who had similarly normal numbers than me but went ahead with mild IVF anyway? My issue is egg quality.

    Offline ScaryButExciting

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    « Reply #145 on: 3/09/15, 22:20 »
    Hiya - Well I am still considering it with a FSH of 8-11, AMH 16, AFC 11... For me it is about less meds, more natural and hopefully better quality eggs...

    Offline CrazyHorse

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    « Reply #146 on: 4/09/15, 08:25 »
    The less-meds aspect is worth considering, as lower stims translates to lower risk of OHSS for you ladies who are lucky enough to have good AMH/AFC. However, I think you're going to have a difficulty finding a UK clinic to do a truly mild cycle (and I don't mean a short protocol cycle with 225 or 300 iu / day stims, which I have seen some clients of Create report being described to them as "mild"!) if you have normal egg reserve, as the general thinking is very much that it's best to get as many eggs out as possible up to a maximum of 12 or so, and to assume that numbers will overcome any possible quality issues. And, given the exorbitant prices of UK IVF cycles, I can see why consultants feel this gives their clients with a decent egg reserve the best shot at pregnancy for their money. If you're keen on looking at protocols that use genuinely minimal amounts of stims, I would suggest having Skype consults with clinics abroad that specifically advertise mild and/or natural IVF as one of their treatment options (e.g., Serum, Reprofit). The thing about mild protocols is that, if you are not a poor responder, you will almost certainly get significantly fewer eggs per cycle, and even taking possible improved egg quality into account there is correspondingly a reduced chance per cycle of getting your BFP as a result. However, it *is* a lot easier on your body, and it makes it much easier to consider future cycles if one doesn't work.

    Offline Tigger99

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    « Reply #147 on: 4/09/15, 08:39 »
    This is a very interesting discussion! I have an AFC of about 6-10 and an AMH of about 5.4 to 7.4 (it's gone up ??? ). Last time I did IVF it was short protocol 300ius of menapur per day and I got 6 eggs. Outcome was a disaster as although I got pregnant it was a pregnancy of unknown location and took a long time to resolve. So would mild IVF be better for me do you think? I'm setting up calls with reprofit and serum. Where else would people recommend?

    Tigger xx

    Offline CrazyHorse

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    « Reply #148 on: 4/09/15, 09:22 »
    I wouldn't think egg quality would most likely be a cause of your PUL. Did you have any bad side effects (e.g., OHSS, major bloating, mood swings, etc.) from your previous protocol, or a low fertilisation rate and/or poor embryo quality? 6 eggs is a pretty good result! If I'd ever gotten that many and had 50% produce good-quality embryos from them, I'd probably have stuck with whichever protocol did that. Unfortunately, it's just almost impossible to predict in advance what kind of improvement you may or may not see when you switch protocol.  :(

    Offline Tigger99

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    « Reply #149 on: 4/09/15, 11:09 »
    Crazyhorse thanks for the reply. I got 6 eggs and 5 fertilised. 4 were still going on day 3 ( for a day 3 transfer). It was about 18 months ago at serum.  I had major bloating and felt very uncomfortable. I had 10 follicles but after egg collection they told me that4 of them were cysts.

    I've had 3 failed natural pregnancies and a lot of immune testing since!! Can't seem to get pregnant naturally now so thinking of IVF again.