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Low AMH / High FSH Cycle Buddies - Part 6

155K views 2K replies 60 participants last post by  ShadyWheat 
#1 ·
#277 ·
Hello, dear ladies!

Mac: how are you?!

Shady: still holding out for a natural pregnancy for you! If not, I'd love to be cycle buddies next cycle--I'm hoping your lining will thicken beautifully in that "post-m/c is the most fertile time" sort of way.

susie: As for ejaculation timing, I must say my DP's anecdotal evidence points to "the least time between the last ejaculation and the sample, the better." I got that impression from other women on here, too... So perhaps (since we are all DOR here and even stims wouldn't get us quintuplets) the ideal thing would be BD'ing in the morning when a sample is due to be provided (which often is the morning of egg retrieval--so if they leave any eggs behind or if you ovulate too early you also have a chance). Most importantly, though, hurray for a successful and reassuring 20-week scan! Amazing!!! Wonderful news... How has pregnancy been treating you?

Blue: I'm so sorry about your bereavement... I'm glad you're slowly easing yourself back in--giving ourselves time and space to mourn is very important... It's been lovely having you along on this forum and I look forward to cheering you on if/when you decide to cycle!

katkat: I really want to hope you're pregnant but I'd wager you've tested already... Otherwise, yeah, cysts sometimes delay periods... Hang in there...

Helen: as Anna said, as long as your lining is ok, the exact timing of transfer is immaterial when your ovulation has been suppressed. That's one of the advantages of a medicated transfer: assuming your lining thickens well, the timing can be adapted to suit your needs. As for flying back, from one perspective I'd say the earlier the better--I'd rather fly before my embryo has even started to think of implanting. However, a transfer is a hugely emotionally intense event, so possibly you want to take it easy that day just so you don't pile even more stuff on top of that intensity. I'd say those are the trade-offs...

MA66: I have Brazil nuts quite consciously between when AF arrives and ovulation, to help thicken up my lining. I like them, so I have a lot more than two--I don't really think about how many. There is such a thing as too much selenium, but I'm not too worried that I'll be crossing that line. As for DHEA, I think the idea is that it converts to oestrogen, which yeah, is a problem for endo. I think you'd have to think about how bad your endo is and weigh that against how low your natural testosterone levels are (I've never taken DHEA, so please take others' advice on exactly what to test!)

queenie: Can't believe Lister told you they weren't doing this and then they did it anyway... So frustrating--I'm sorry...

tily: yes, from the moment I sought to understand why CRGH kept cancelling me for natural cycle IVFs even when I didn't have a cyst (FSH is too high), I've been entirely convinced that AMH and FSH are about quantity, not quality. Good to have even more evidence of that!

Anna: Don't feel ridiculous. It's natural to want to maximise your chances. You have to decide for yourself, but my personal approach has always been, for egg collections, the earlier the better, no matter my AFC. Well, in fact, it has been to keep collecting, through the ups and downs of my AFC. Because as we know, quality deteriorates with age... and as DOR women, chances are (unfortunately) that we'll need more than one collection... So for me, it's always been "just do it." But it is a hard choice... Especially because multiple collections mean lots of money, time, emotional investment, physical impingements--not to mention its effect on the couple... I hope another antral pops up in any case and makes your choice easy--but if not, good luck with whatever you choose!

AFM: Bleeding stopped a couple of days ago... I'm on norethisterone so I know roughly when AF should come. And then it starts again. It's been kind of nice to take a break, actually! On the other hand, I'm feeling quite impatient to have another transfer...
 
#278 ·
Hello ladies, wow what an amazingly supportive and knowledgable thread this

I've been reading your stories in awe - you're amazing.

I am hoping to pick your brains please... I have just had to cancel my third cycle due to poor response (only two follicles growing and the others extremely far behind)

My two previous cycles have been as follows

First cycle: long protocol, 300 menopur - 5 mature eggs (three of those matured in the lab) only one egg fertilised, 2 day transfer - BFN

second Cycle: short protocol, 450 menopur - four mature eggs, again only one fertilised, 2 day transfer - BFN

I'm 34, with AMH of about 10 pmol but AFC of 4 and we also have severe MFI due to my husband having undescended testicles as a child

Third cycle was short protocol with 300 menopur but two follicles so we cancelled

I'm now about to start again but having a tough time deciding what protocol and treatment plan I should go with

My clinic are saying it's kind of up to me what protocol we do as they don't think it'll make much difference and they hope that last month was just a blip

I wanted to please ask in your extensive wisdom what kind of protocol is worth exploring - antagonist, flare? (I'm not  sure I'm 100% on the difference tbh but will do research!)

I need to make a decision Fairly quickly as I need to sort meds so was wondering what you wise women think is best in your experiences

Thanks so much all, here for everyone in any way I can help

Take care all xx
 
#279 ·
Welcome, Lulu!

I have some questions for you, but based on what you've said so far (and on my own experience) I'd recommend a mild-dose antagonist cycle after oestrogen priming--something like:

previous cycle: estrogen patches starting one week before AF (on average, starting one week post-ovulation). Happy to give you more details about it, but if you happen to have endo (hopefully not!) then there are probably better alternatives...
CD 3-7: 2x50mg Clomid (evening)
CD 3 onwards: 225iu Merional alternate days
CD10 onwards: indometacin 3x/day

I'm not sure why your last cycle was cancelled. If they only manage to fertilise one of your eggs anyway, in practice it doesn't matter much how many mature eggs you start with...

Which makes me wonder why only one is fertilising. How mature is mature? How big were the follicles at trigger, and what was your oestrogen? Possibly waiting a little longer to trigger might help. Also, have you been using ICSI? If so, how good is the clinic's lab at it?

The oestrogen priming (or potentially norethisterone, or even BCP for a week or two) helps quieten your ovaries, which makes it easier for the follicles to all grow together when you need them to. So if you haven't been doing any priming or downregging before your short protocol, this is something to think about...

Also, I'll wager you don't need these high doses. A mild dose will probably get you just as many eggs, and the ovaries won't have been stressed by so many meds while growing the follicles...

In my case we avoided using an antagonist, because antagonists do make it harder for follicles to mature. We just watched LH like hawks--luckily on the above protocol it didn't rise appreciably for me before the follicles were really ready (ideally >20). But if it starts even thinking about surging, using an antagonist would be vital...

That's just my experience--I responded quite well to this, and my AFC is like yours though my AMH is much lower. Some women do better on flare. It's hard to know until you try... but yeah, like I said, I'd focus on (a) some sort of priming or down-regging in the previous cycle, (b) lower doses and maybe using Clomid to try to recruit as many follicles as possible and (c) trying to find out why you only got 1/4 or 1/5 mature eggs fertilised...

Good luck!
 
#280 ·
Hey Klik, that's very interesting regarding your LH surge. So on none of your stimulated cycles did you take an antagonist? Did you do daily bloodworks? In your opinion, how high is too high an LH, I mean what indicates a surge? For example my LH is between 4 and 8 to start with. So the times I measured it around days 10-12 it was about 5-9iu, except for the month before last where it was 25iu and I ovulated the following day. But I know others (briss for example) goes much higher before ovulation. By the way, it would have been an immaculate conception, but AF finally arrived anyway. Great to know your next transfer is around the corner

Welcome Lulu, there really isn't anything I can add to klik's mail. I agree with low doses vs high doses though too...

Anna really sorry to hear this. Why don't you just pick the one natural egg in the meantime...while waiting for your AFC to go up? This way you give this month a go and as you are with R. clinic it doesn't cost the world...

Helen, I think it doesn't matter when you do the transfer as long as your lining is good. Mine is usually thin so Id' be tempted to wait for a later in the month transfer,.

AFM, AF arrived and quite annoyingly EC would most likely fall on a day I have an important workshop/meetings. Exactly one year ago the same happened, and I had to call in sick in order to make EC. I really cannot do the same this year :/ so not sure what to do as I was quite keen to do EC and ET this month, as the next 2 months it's not possible due to work trips. But I cannot take any holidays and to do EC or ET I need 4 days off. I know it is all so unpredictable anyway, so as usual have to play it by ear and get super stressed out as I will not know until a day before if it will be EC, ET or both or nothing this month!
 
#281 ·
Hi ladies, Thank you SO much for such a quick and considered reply, I am so, so appreciative.

In answer to your questions... (thank you SO much for taking the time)

I've not had a decent answer to what they think about why only one has fertilised in our first two cycles - they've said it could be sperm, or could be egg. They don't know. We've used ICSI both times yes (need to as my husband has poor results across the board - count, morphology, everything is frankly terrible!) It's been frustrating in that we've had no real insight into what may be causing it and I was keen to at least find out if it was sperm or egg. So I did my own research into low fertilisation and came across AOA (artificial ocotyte activation) which is available in the UK but a stronger version of it is available in Belgium. It is primarily to overcome sperm issues but has been shown to help egg issues too but to a much lesser degree (I've have got lots more info on this if anyone is interested). Thought it may help to see if it's sperm or egg issue at least and thought it worth a try so we are cycling with a clinic in Ghent, Belgium.

On my first two cycles I had no bloods taken during stimms (we were at Guy's and is just how they do it) so unfortunately don't know my oestrogen levels were on those , if it's any use it was 4963 mpol on day 8 of stimms on the cycle we just stopped

And when I triggered my follicles were as follows:

Cycle 1: one at 19, one at 18, one at 16, three at about 12. On that cycle they collected 5 mature but three matured in the lab)

Cycle 2: one at 25 (think we lost that one), one at 23, one at 20, 3 at about 12/13

On my latest - They recommended I cancelled although I haven't got loads of eggs previously my follicles have at least been closer together in terms of size. This last cycle I had two race ahead very quickly (one was at 23 and one was at 20 by day 8 of stimms whilst others were 7 MAX). So they recommended trying next month. I'm not sure if that was the right decision but as we are paying now (last two were luckily nhs), I thought maybe we could get a couple more next month.

Your thoughts are unbelievable helpful - thank you so much. I'm a bit annoyed I didn't arm myself with this knowledge before the call I had with the doctor today (as the clinic is in Belgium it was over the phone) but I was also expecting her to have a slightly stronger plan of action for me - however it felt more like She would just do whatever I would most prefer which doesn't give me a great deal of confidence

So sorry to write such a huge essay that's all about me. I'm reading back on this thread a lot and getting a sense of everyone stories so I can help a lot more or at least be here for an ear and a sounding board. Thanks again for taking the time, it is so appreciated xxx
 
#282 ·
Hey, katkat! Yeah, an immaculate conception might have been difficult... Re. LH, I think a surge is defined by an increase, rather than a level. In particular, if your LH increases by about 50% from its baseline for that particular cycle, you need an antagonist. But that does mean blood tests every day from when your lead is getting close to being mature, so it can get expensive. I never used an antagonist in my natural cycle IVFs (only indometacin). At Cornell they always used an antagonist, as did CRGH 5 years ago when I did full stims. For these 3 recent mild-stim cycles at CRGH, though, we didn't use an antagonist for the first two. The third one, they didn't take an LH measurement until my lead was already 16, so we didn't have a baseline to compare it with and I used an antagonist just to be on the safe side... Real bummer about your timing... I'm hoping you get to have EC and ET this cycle despite your work commitments--as your AF is late, it's possible your follicles have already grown a bit anyway. If so, I'll hopefully be about a week behind you on the transfer!

Lulu: wow, if my oestrogen was that high with two mature, wild horses couldn't stop me from retrieving--it's a great oestrogen for 2 mature! I think you definitely need to prime with something--oestrogen is my personal favourite (100mcg patch, changed every other day, starting a week before AF--at AF, stop changing patches but only remove the last patch on the day you start stims; don't worry if it falls off, though), though norethisterone or BCP are also good contenders. I think you need to get your ovaries sleepy in the luteal phase of the previous cycle so you have a chance of getting all your follicles to grow together. Clomid is then particularly good, apparently, at encouraging those follicles to grow. So yeah, I'd totally try the oestrogen priming + Clomid + mild injectables protocol in your place... So you'd be cycling at a new place?! Hopefully they're better at ICSI than Guy's, though I would have though Guy's would have a good lab... Anyway, you'll be using artificial oocyte activation--what is that?! I've never heard of it! Hopefully that will help with the fertilisation rates and with, finally, getting a good embryo!
 
#283 ·
Hi lovely ladies - hope you are all staying warm and toasty in this crazy weather! I was supposed to go to Bristol for a girls weekend but can't get there with the snow.

Blue, so very sorry to hear about your bereavement. I'm not surprised that you didn't feel motivated to stick with healthy eating etc, it's tough at the best of times, let alone when you go through something like that. I'm glad that you're finding the thread supportive though as you gather your thoughts for next steps.

Lulu - welcome! Really sorry to hear about your three cycles so far and that your clinic are not giving you more advice about protocols. It's so hard to find a good answer as everyone's body responds differently, but sadly many clinics are very unimaginative when it comes to DOR and continue to advise high doses. I second Klik's advice, I would definitely try a lower stimms protocol, preferably with oestrogen priming if your Belgian clinic will let you do it. I have seen much better results on a lower stimms protocol, and also better fertilisation rates than with high dose. I would also be encouraged by your fab oestrogen levels last time - that's a really good sign! I would also have thought Guys would have better service and a good lab..... wishing you the best of luck on your next cycle! x

Klik - when is your AF due? I bet you are raring to go but I know what you mean about feeling tired. I'm totally preparing myself for disappointment/cycle cancellation as I can't afford to get emotionally invested this time.

KatKat, sorry to hear that timings are not going to work out with work - that is so frustrating, especially when you are going to be away for the next few months. However, one thing that this journey has shown me is that timings never are as predicted with regard to AF and ovulation, so there may still be hope this month!

AFM, so AF is 2 days late, typically when I'm sooooo impatient to get started and have been feeling symptoms of PMT for nearly 2 weeks now! Cramping is really bad so it must arrive soon, hopefully before tomorrow so that I can try and go for my first scan before going to Loughborough on Tuesday. Klik I'm 98-99% sure I'm not pregnant though!

I also want to ask your advice ladies..... so I received fab news this morning that I got offered a wonderful sounding job in Cambridge! I haven't received the official offer yet, but I have a ballpark figure in mind at which I think I'd take it..... but I just don't know if I should. I cannot completely figure out how I will cycle at the Lister and work in Cambridge if I do need to do more collections. Plus I would feel pretty crappy if I transferred this month, miraculously got pregnant and then disappeared 6 months after starting (completely assuming I wouldn't be able to start work with them until June as I think existing work would make me work out my notice). It's a small rare disease start up and I think they are completely about trying to find the right people to be on the team.... and the people were so lovely when I met them last week and it sounds like a really motivating atmosphere to work in that disease space and they're just closing on a massive amount of series A funding and expanding the team. However, they did also emphasise in the interview that they are very family friendly and all about work/life balance and that I could work from home sometimes as they have other people who are based in different countries even, so potentially it could work..... why is life never simple????? Obviously I need to discuss fully with DH, but I've been so miserable at my existing job that I literally cannot bear it anymore, I will also feel rubbish about my boss, because he has been massively supportive about the whole IVF thing - I'll feel a bit like I screwed him over....
 
#284 ·
Shady: my AF would be due around the 8th... lol, you know me so well! I'll hold out hope for your 1-2% chance of a natural pregnancy... but if not, I hope your AF does arrive between today and tomorrow, as presaged by your cramps... Re. the new job, ditch the guilt and take it! You're a lovely person for worrying about how your current boss will feel and how the new place will feel if you need to take maternity leave quite soon, but, really, just do it! He'll get over it, they will cope, everyone will understand you're doing the best for you. Please, get out of your hell and go to the new place, which seems lovely and understanding and--if I'm reading it correctly--flexible enough that you would be able to cycle at Lister and work from home when needed... I'm so glad you've got this in your pipeline! I hope it's the start of wonderful new things for you!
 
#285 ·
Just a quick one because I’m in India and internet isn’t great.
Shady... take the job! You cannot predict the future. Keep in the now. Ask yourself do you hate your old job? Would you love a new job? Are you excited about this new job opportunity? Don’t allow anything about babies, bosses, pregnancy, ivf, guilt etc get in the way. The decision will become impossible if you throw every single scenario into the equation. Keep it simple and trust that the future will be bright no matter what! Good luck xxx
 
#286 ·
Thanks so much for your very helpful response, can't tell you how helpful and reassuring I have found them. After feeling quite alone after lack of info from my clinic I feel much better

The clinic are recommending I use birth control pill (Microgynon) for two weeks before stimms (starting on day 1 of my period) is this a similar to estrogen priming - would you mind explaining what the difference is.

And sorry one (whoops two - just thought of another)  question from me 1) when you say 'low dose' what kind of numbers have worked? My clinic want to start me on 300 menopur. 2) in terms of clinic do you take this alongside stimms, I'm going to ask my clinic about this too but Interested in your thoughts

AOA isn't hugely available in the UK but can apparently help some sperm deficiencies so we were keen to give it a shot, here is a bit of a blurb. Do anyone please let me know if you're interested and I can send more info

'In order for successful fertilisation, your sperm must release a specific functioning enzyme called Phospholipase C zeta (PLCζ) when it enters the egg. This induces waves of calcium oscillations across the egg to ‘activate it’, allowing fertilisation to occur.

A deficient or abnormal PLCζ may be the cause of failed or low fertilisation. This can be overcome in some situations using a calcium ionophore solution to activate the egg artificially.'

Shady - I agree with the ladies here, take the job! I know the feeling, I've stayed in my current job and been completely miserable because I thought waiting it out whilst TTC was the sensible thing to do. I have actually just yesterday made the decision I am going to leave though - enough is enough for me and I need to feel other areas of my life are moving on. I think this job sounds wonderful, and I'm sure the change will be great for you.

Kilk, thanks so much for taking all the time you have to help, in very appreciative. I've read back a bit, I'm sorry to hear about your last FET, do you know when you'll try again?

Big hi to everyone else, hope you're all doing ok xxx


 
#287 ·
Shady take the job. You're missing out on so many things due to ivf that I think you shouldn't miss out on this opportunity. Had I not changed from my hated stressful Job 4 years ago then I would be stressed and miserable because of my work AND not pregnant. Now I am still not a mother but at least i am no longer stressed and miserable due to my work,  I love my job.
 
#288 ·
Shady, i agree with the other ladies about taking the job, the worst thing is having regrets and this new job sounds like an oppurtunity not to miss. Go for it!!

Lulu, totally agree with the other ladies re trying low stims, I had 3 cycles at high dose stims with low number/poor quality eggs and only ever have 1 fertilise, despite good sperm. Well then I moved to mild and I got 5 eggs and 4 fertilised, with a dose of 150 bemfola switching to 225 menopur from day 5. Estrogen priming i think you would only take the pill after ovulation for a week or so.

Afm, just waiting for AF. I only ever have a 11 day luteal phase that even cyclogest/lubion has never been able to extend, this is the first month ever that I’ve been able to extend it with cyclogest despite a few cramps when AF was due,  it has been a blessing as we have been snowed in for most of the week and would have struggled to get to Create. Have stopped the cyclogest for a few days now so also just waiting for AF. Wonder if I have a cyst now. Xx
 
#289 ·
Hello ladies, hope you’re all staying warm

Lulu: There is nothing I can add to these ladies comments, than wishing you luck.  Which centre are you with?
KatKAt: I understand the work/fertility balance saga.  Fingers crossed your timings work
Klik: wishing you all the best for your transfer, the break is nice huh?  Glad to hear the operation went well
Shady: Big congrats on the offer!! Cambridge is the new scientific hub, add the ability to work in rare disease and sounds like a great opportunity. If you can add a few working from home days, you can make this work.  I had the same feeling when I was recently offered a promo (and more hours and stress!) however I realised there is so much in our journey that we cant control, but job satisfaction and careers is something we do have a control over
Helenbeau: so very jealous of your trip to Goa.  When DH and I were there for Christmas (his family is originally from there) we actually said there was a market in ‘holiday’ ivf, as it would be great to head to somewhere warm for the last few days of stimulation and transfer.  Timing could be hard, but relaxing would have such a positive impact – enjoy!
Susie: interesting take on the EJ timing.  Interesting as started another IUI cycle (new clinic CRGH so they want us to do this before IVF) and they said the same thing, to not EJ in BD while stimming, I was blunt saying, clearly with stims and fertility treatments you guys cant get me pregnant, so there is no risk for me! They said well then think about the risk of multi’s and I had to laugh.  Congrats on the 20 week scan, exciting times
Tily: So sorry to read about your last cycle.  I’ll give an update below, but I feel like Ive just replicated yours but was able to use your learnings.  Hope you’ve figured out the next steps

Hi to everyone else!
So amongst all the travel, I thought I would do a baseline scan and AF just to check in, as it had been months.  My AF still remained low at 3 but my FSH had dropped to 15.  First time in a very long time.  Not sure if its diet, going back to exercising, or not thinking about it all! This chat really helped as I had  I’ve never really looked at LH before, but when you had highlighted it Tily  I reviewed my last few stimulated trials and it was on the higher side, this cycle it began a lot lower at 5.9.  As expected my oestrogen was low as I was letrazole and only 1 AF really responded to stimulants.  I considered your situation and I made sure the clinic let me go for a few extra days as I needed to let my oestrogen rise again.  Today I got my AF to 20 and oestrogen to 629, still not ideal but LH is starting to surge, so looks like IUI is tomorrow.  Then I fly out to Paris on Monday until Wednesday and then Thursday to New York.  So lets just see not really holding hope with 1 AF,  but it did really show how valuable this chat group is as a hands on resource – so thanks!

Keep warm 
 
#290 ·
Hi Ladies,

Sorry for the lack of messages over the last week or so.  I got struck down with gastroenteritis last Friday and a weekend of hell followed!  Cue then a busy week at work (not helped by all the snow) and today is the first time I'm getting a chance to catch up - this is such a busy thread to follow too!

Annakay: I'm so sorry to hear you feel ridiculous.  You've had such bad luck, I wish I could give you an answer how to improve things...sending hugs  ^hugme^

MA66:  I know it was a while ago you were asking about selenium now but I am just going to eat a handful of brazil nuts each day I think, would be interested to hear what you decided to do though.

Katkat2014:  Sorry I can't help with your DHEA question, I was advised not to take it by my doctor.  Glad AF appeared finally although sucks regards EC.  I feel your stress regards the not knowing until the last minute, as a control freak the lack of predictability of this process really gets to me!

Babyhopeful:  Glad your AMH results weren't too bad - what were they if you don't mind me asking?  I would be really interested to see what they said in your planning session as I too am a poor responder with what the doctor called low AMH but apparently isn't that low compared to lots (10.6).

Klik:  Sorry you had to repeat yourself with your doctor, communications are not always great are they?!  Good luck with your cycle, I too am feeling scarily optimistic this time round, I think it's because I'm doing a lot more in way of supplements etc. to help so can't help but feel something has to make a difference!

Mac78:  How you doing?

Shadywheat:  Still on downreg until 12th at least when I get first scan and decision on move to stims.  Hope AF arrives soon and FX for a nice thick lining too!  As for your job I would say take it, as you know you cannot predict what will happen with your cycle and there is never a good time to do these things, you cannot put your life on hold for it and, it sounds like it will make you a lot happier which can only be a good thing!  If your boss has been as supportive as you say he will totally understand.

Susie76:  That is really interesting about the sperm although I never believe a word written in the DM  ;D feel sorry for your partner though!  Do they not have locks on the doors?!  Great news about your scan, it's good to have some hope on this thread!

Bluedolphin:  Sorry to hear about your bereavement, hope you're managing to get back into it, any idea when you might start again?

Helenbeau:  Good work on booking a holiday!  Sometimes a bit of relaxation is better than any medicine!

Queenie123:  How you doing?

Tily:  Interesting article, unfortunately, as we need PGD, I can't try naturally :(

Lulu2017:  I'm sorry I can't offer any advice as I'm so new to this but good luck and I hope you find something that works for you!

Sunshine122:  FX AF appears for you soon!  Hope you don't have a cyst.

Cramer:  Wow you're so busy, I don't know how you have time/headspace for cycling with all that on your plate!  Good luck!

AFM:  I started downreg (Buserelin) last Sunday so almost a week in now.  So far injections have been a little easier than last time although they didn't give me enough needles so I had to get some from the GP which are twice the size and make me bleed a lot  :-[ ah well, could be worse!  Roll on 12th March for my first scan.  Oh and one quick question...AF is due tomorrow but I don't 'feel' like I usually do the day before, is it possible the Buserelin is suppressing symptoms or am I just overthinking things?  Love & hugs to all xx
 
#291 ·
Hi everyone,

I had a busy week as I finally decided to finish my Diploma, but  this time  I decided to do the 2nd semester in 2 weeks, rather then once a week for 4 months. So I had an  intense week of theory and tasting, one day I tasted about 50 spirits!! My mouth was literally on fire at the end of the tasting, but I am so glad I am  finishing something that I started 2 years ago and looking forward for the second  intense week  in April. It was  great to see how this Diploma is recognised globally as there were many students from all over the world attending the classroom, also, I realised that I have a lot to  catch  up if I wanted to have a successful career. I can' wait to apply all this knowledge that I am gaining and  I am feeling  excited about my future, so that brings to a quick note to Shady.

Shady- I agree with the ladies, if you feel so positive about this job take it. Helen is right and everything will fall into place, just trust that the future will be bright no matter what. This journey is so hard on us and feeling miserable or hating our work makes things ever harder. Don't feel guilt about your boss I am sure he/she will understand.

I will try catching up with everyone over the weekend. I hope all the UK ladies are safe and warm
Big  ^hugme^ to everyone.

 
#294 ·
Thanks ladies for your wise words and support - I think I'm going to take the job, I just have a good gut feeling about it. If this journey has taught me anything, it's that you can't control things or take them for granted, and if there is an opportunity to seize it with both hands. So in the spirit of saying 'yes' to more things this year, I will be going forward with positivity and hoping that this change is going to be a good one. I think not being surrounded by so much negativity and stress at work can only be good for the whole trying to conceive/IVF situation too. DH massively supportive of it too as he knows how miserable I've been, plus he really wants to be a stay at home dad, so if it comes down to it and we get this miracle pregnancy in the next couple of months, that's an option. It's just a bit hard to kiss goodbye to the very generous mat package where I am now after all the money we've already spent on IVF, but some things are more important than money.... like my sanity!

Helen, hope you are having a fab time in Goa and enjoying the warmth. I'm seriously jealous at the moment as we had a burst pipe this morning due to the snow/frost, water was pouring into the lounge when we got up -  can't get a plumber so we've just had to turn the water off, which means no water and no heating. I think the idea of a pre-transfer holiday and destress is a fab one!

Klik, we'll probably be looking at very similar transfer dates if everything works out, AF finally arrived this morning - hurrah!

Cramer, keeping everything crossed for you tomorrow and that this follicle is the lucky one. Thank you for the support about the job, I'm actually quite excited about the possibility of being in Cambridge again after so many years. I don't know how you manage all the travel but a huge well done for taking it all in your stride.

Mac - your week sounds like so much fun! My sister is doing a wine tasting diploma at the moment and loves it. I'm so glad that you are feeling positive and excited for the future, all these things help to ground us and realise that we can have a fulfilling life even while we are struggling to try and conceive.

Laura, exciting times! I found that being on busrelin did do weird things to AF, both times it came very early after starting busrelin, was very light and I had hardly any symptoms. So I wouldn't worry....

Happy weekend to everyone else, and hope you are all staying safe and warm xxx
 
#295 ·
Helen: hope you're loving being in India!

Lulu: oestrogen priming lowers your FSH, which means your ovaries get a bit sleepy and don't push any follicles to grow. The idea is, when you stop the oestrogen your FSH shoots up, your ovaries wake up, and all your follicles start growing together. BCP would have a similar effect, except (a) you'd be using it for 2 weeks instead of one, (b) it has progesterone as well as oestrogen, and (c) you'd be starting at the beginning of your cycle instead of in your luteal phase. (a) and (b) together mean that this "priming" will be more suppressive than oestrogen priming. As I've mentioned before, my AFC is not so different from yours, and one time I was put on 3 weeks of BCP and it oversuppressed my ovaries. Oestrogen priming is milder--personally in your place I'd be pushing for that, if at all possible... This is NOT to say that BCPs will oversuppress you--it's 2 weeks as opposed to 3, plus your AMH is actually pretty healthy, so maybe you won't be oversuppressed... but yeah, personally I find oestrogen priming safer, as it is milder, Even then it's sometimes oversuppressive for some of us...

A mild dose in my case was, as I posted above:
CD 3-7: 2x50mg Clomid (evening)
CD 3 onwards: 225iu Merional alternate days
(some point) onwards: indometacin 3x/day

the equivalent of Merional 225 alternate days would of course be a 112.5 dose daily. However, the Clomid boosts your natural FSH, so if you're not using Clomid you may in fact need more injectables to compensate. I'm quite loyal to my protocol because it worked well for me (and Clomid is known to recruit more follicles) BUT Clomid also thins the lining so it increases the chance that you might have to freeze than do a fresh transfer. Not using Clomid would probably imply using a dose of 225 daily rather than alternate days. Also, can you get your clinic to change Menopur to Merional? Merional has slightly better stats and is the same idea (FSH+LH). Some women do respond better to just FSH at the beginning and then adding LH towards the end of stims--I've never tried that, personally, but it makes good sense. Sorry, too many variables, but hopefully you get the idea.

I don't understand your second question: "in terms of clinic do you take this alongside stimms" -- ?. AOA sounds really interesting--hope it works out for you! As for my FET, hoping to try again in my next cycle.

katkat: hi!

Sunshine: fx'ed for no cyst!

Cramer: so nice to hear from you! Thanks! Oh, CRGH drives me bonkers with their many prohibitions against intercourse. Surely DOR women should be exempt. I've learned to make myself exempt unless there's a risk of infection (or in the 2ww, that whole story about an orgasm potentially knocking the embryo from its perch). Well done on waiting before trigger! I hope this IUI works for you!

Laura: here's hoping the supplements help! I do have smaller needles if you like (or your clinic should be able to supply them)--I think I can offer needles without any problem, as they're not drugs!

Mac: that's a wonderful development in your life! Well done!

Shady: hurrah for you probably taking the job! Shame about the great maternity package you're giving up, but it would involve another 9 months of madness at least... And I'm so sorry about the burst pipe--of course things break when you most need them... Awesome that AF has finally made an appearance! And yes, hurrah for hopefully being cycle buddies! FX'ed we can go on to cheer each other through successful pregnancies, too!

AFM: counting down to my last day of norethisterone (tomorrow). AF should be here soon after!
 
#296 ·
Mac78:  What course are you doing?  Sounds like fun!

ShadyWheat:  Glad you're leaning toward taking the job...sounds like a great opportunity.

Klik:  That's very kind but I'm in Edinburgh and think, unless I'm mistaken, that you're in London?  FX for AF arriving.

Hope everyone has a good Sunday! Xx
 
#297 ·
Hi everyone,

Lulu- Welcome and I am sorry to hear you having to cancel your last cycle. I don’t have much experience so I wouldn’t know how to adivise on your next protocol, but you are right on researching and the ladies here have tones of knowledge. I hope you find what is best for you.

Katkat- good that AF finally arrived, but annoying that dates might not work on your favour for EC because of work commitments. What have you decided?



Sunshine- I know had hard to wait for AF ( it;s the drama of my life!) hopefully it will arrive soon and try not to overthink about having a cyst.

Klik: I hope Af arrives soon.

Cramer- Good news on your FSH decrease and very  good that you were able to to track your LH and had some improvement. It seems like you are going to have busy days ahead of you and I hope you enjoy paris and NY.

Anna;  I know exactly how it feels when you get disappointed with only 3 antrals, but please don’t feel ridiculous . Have you considered Katakat’s advice?


Blue dolphin-  Good to hear you feeling like trying again, any idea when you might start again?

Helen- Good that you  decided to do something that is not IVF related. I know financially is hard to do IVF and keep doing things we like, but I am sure this will be very good for you. Well done!

Laura- Fingers crossed for beautiful follicles on the 12th. I am doing Diploma on Wines and Spirits and I know it sounds like fun but is hard! We have to learn all about beverage; history, Vinification/ distillation (all types of production methods) for each category, details of major wine/spirits regions around the wold (climate,topography, what they grow as raw material for beverage production and the laws of each region in terms of what they allowed to do), plus  global beverage  business & marketing. I wish it was just about tasting but there is so much information to take and my life will be all about writing Essays, at least until November. Nevertheless, I am enjoying it and once I am done I will be able to teach on the subject ,so I can’t wait.

Shady- Is you sister doing her Diploma in  London? do you know if she is on the first on second year?

MA66- I am having to read so much because of my Diploma, but once I am done with that I will read the book. Have you heard back from Create in regards to your TSH?

Hi to everyone else! How is everyone doing: Queenie, Babyhopeful, Tily?

AFM; I am still waiting (I am currently on day 54!!) I know it's scary and I try not to think to much otherwise I go crazy! I had an app with my GP doctor and she advised me on not taking  anything to start AF, as she will  refer me back to a gynaecologist in Kingston and she thinks would be better to  test my hormones as they are “naturally”. The only problem is that it might take some time for the app and if I take Primolout, as I did last time, I would probably be able to do an AF scan in the next 2 weeks and maybe it would be a better scenario than last time.. At the same time I want to have a proper  check on my hormones and see what HRT doctor would pescribe, then maybe give a go for 3/4 months and trying  a circle after.  On the plus side, I have been feeling good the last week or so, as I am not suffering with headaches or mood swings and the buzz in my years are not as intense as before. I don’t know  if this is because  I am taking a new supplement (Clean Marine) or because I am trying to focus in others things, might be a combination of both?? I woke up this morning with sore boobs and it’s been a long time since I had this feeling. I am not quite sure if this is good or bad, just praying that this a sign of period arriving soon. ^pray^

I am sorry if I've missed anyone.Big hugs to everyone. ^hugme^
 
#298 ·
Hi Guys,

Sorry I have been a bit AWOL.  Anyway - personals later.

I have had my first scan this cycle today (d3).  I have for once a fantastic number of follicles (7 between 1.5mm and 4mm).

I put myself on the pill last month after a failed cycle and for some reason my luteal phase didn't over-ride the pill so I was on it for 3 weeks. Which I suppose might be because the LH peak didn't lead to a good ovulation, so glad I cancelled it then. 

Anyway - really pleased with my AFC, gonna try and have a fairly relaxed cycle, just waiting for E2 and LH results to see if we do a mild or natural modified cycle.
 
#299 ·
Mac78:  Thank you, I really hope this one works out!!  Your diploma sounds very interesting but yes, I can see a lot of hard work!  Hope AF arrives for you soon, it must be very frustrating waiting.

Queenie123:  Great news about your AFC!  Good luck with your cycle!
 
#300 ·
Just a quick one ladies.  Queenie that's amazing results! Do you think it was estrogen priming , BCP or stem cells taking effect?
I'm tempted to try estrogen priming (just have to convince CRGH), but I believe you need to start a week before AF starts? Though if the progesterone post iui lengthens Luteal phase then if it's BFN I could potentially start immediately? Need to get more than one AF to respond to move to ivf banking

Mac: has your GP referred you to a menopause clinic (only thing they’d do for me).  Had my 6 monthly app last week and still pushing hrt but as my cycles are mostly present, no side effects and last bone scan was fine (though have to repeat) , they're happy to wait.  Saying that, they were looking at mild hrt to help with fertility treatment and increase estrogen.  Think if I'm in same position in 6 months time for next app I might consider it.  Nurse said no one she has seen with POI that has fallen pregnant naturally hadn't had some hormone support.  I'm hoping estrogen priming might be that for me in short term than full hrt.  Also said dhea is precursor for these hormones, so why is taking mild dose hrt for the end product you need such a big deal.  I guess for me once you start , how do you stop

Happy week ladies
 
#301 ·
Hi Queenie...
When I had BCP for 3 Weeks I found my AFC was higher... with the long protocol at Lister as ovaries have rested....
However Estrogen priming didn’t achieve this.
 
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