* Author Topic: Please share your successful FET Protocols.  (Read 1084 times)

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Offline taraeob

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I would love if people could share their protocols from their successful cycles, just as a way to learn about the different drugs used as some may suit people better than others.  I think it's important to have an input and not place all our trust in doctors who don't know us, especially after lots of failed cycles.  Please feel free to add other things you feel may have helped such as natural supplements.  TIA

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    Offline Cmcl75

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    Please share your successful FET Protocols.
    « Reply #1 on: 1/03/20, 04:38 »
    Hello...Iíve been on this site gathering valuable information for a couple of years but have never responded.  Now that Iím 14 weeks pregnant today with a precious little girl after two miscarriages (both twin pregnancies, one at 8 weeks, one at 6), I can list the changes I made in hopes of helping anyone going through this emotionally consuming process.  My husband and and I have two biological children of our own (18 year old son), but our daughter passed away at 21 after a long-term illness. That was three years ago, when we were 41...we started the FET process with donor embryos about two years ago...mainly because by then I had very poor ovarian reserve.  We started at Zlin...a fantastic clinic...great communication, quality clinicians, etc...but my protocol only included low-dose aspirin (81mg) once daily, estrogen (estradiol in the US) 2mg 3 times daily, and progesterone pessaries 400 mg, twice daily, and Synthroid 25mcg once daily.  They also transferred two embryos each time...both resulted in pretty difficult miscarriages...one in June 2018, one in January 2019.  Fast forward to May 2019, we decided to switch clinics...chose Gennet in Prague...I remember reading something very positive about their lab but canít remember what it was now.  We had a consult with Dr. Blahova and felt very comfortable asking a variety of questions and getting detailed answers to those...might have helped that my husband is a hospital pharmacist who understood the medical nuances of the consult.  We decided to keep the estradiol protocol the same, do the same progesterone pessaries (400 in morning, 400 at night)...clinic recommended only 200 in morning, 200 at night...our Dr. in US agreed to up dosage, added Lovenox injections (clexane in Europe) once daily, progesterone injections in early afternoon (25mg), Synthroid(25mcg) once daily, prednisone (5mg) once daily...

    Extensive immune testing confirmed nothing out of the ordinary.

    In addition, I had a uterine scratch the month before FET, chose to only have one high-quality embryo instead of two...prenatals, Vit.D, Vit.E...no other supplements...and diet is worse this go round than the previous two...I used to obsess with fish, salads, etc...this time, my transfer was Dec. 12 and during the holidays, so I had my fair share of fats and sugar and wine before transfer...my BMI is 29, so Iím on the heartier side. 

    One more thing...my husband is a military pharmacist, so when we began this, we were living in Guam and flying through South Korea to Europe...back in time...now weíre in the US and flew forward in time to Europe with this last transfer...so the uterine receptivity might have been off the first two times and spot-on this past FET.  Guam is about nine hours ahead of Prague...where I live in the US is 6 hours behind...so the timing gets tricky and Iíve never had a receptivity test, but it may have made a difference...basically I had five and a half days of progesterone...not just barely five...if that makes sense.

    In the end, my gut feeling for why it worked this time centered around taking the progesterone injections, but thatís just a feeling...we all know that this process is an absolute crap-shoot...emotionally and physically.  I write this with the intention of giving hope to anyone out there whoís reeling from a set-back or considering giving-up...this was going to be our last opportunity...we were throwing everything and the kitchen sink at it to make it work...the first two times, I was doing accupuncture regularly, this time no accupuncture.  I was jogging regularly...not long distances, but three or so miles three times a week...doing some strength training...nothing hard or fancy. 

    I went to Prague by myself for five days...had the transfer on a Thursday, at 11am...was wheeled back to my room for a thirty minute period to relax...actually felt our baby take hold inside of me...little pulling feelings in the top left portion of my uterus...walked two blocks back to my hotel...rested all day, night...Enjoyed Prague on Friday and Saturday before my flight...probably walked 5-6 miles touring the city.  Found out we were pregnant on Christmas morning...itís been like a dream...still canít believe we are receiving this special gift.  Sorry for writing so much...hope it can help someone.

    Warmly,
    Christine




    Offline AmberJ

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    « Reply #2 on: 1/03/20, 09:45 »
    Christine,

    Thank your for writing this.

    Firstly, I'm so sorry to hear about the loss of your daughter, I cannot imagine what a difficult time you must have gone through. 

    Secondly, thank you for taking the time to write this. I've just returned from a consultation at Gest in Prague which quite frankly consisted of the doc giving us the hard sell and when it finally came time for us to ask questions he responded by telling us we had to hurry up as time was pressing on. We are now considering Gennet (my s-i-l did OE ivf there after the UK clinic said her amh was too low and she has a little girl) and Zlin. Do you feel that Zlin did anything wrong? Or do you feel that you just needed more progesterone?

    Amber x

    Online Stacey10

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    « Reply #3 on: 1/03/20, 09:59 »
    Hi taraeob I went to zlin and had 14 days of estrogen, (2x1x1) then when I started progesterone, (400x200x400mg)  I also started low dose aspirin and 5 mg of prednislone, I transferred on the morning of day 7 of progesterone as my embryos were day 6 embryos, so I had 6 full days of progesterone before the transfer. I was on 50 mcg of thyroxine. Both fresh and fet were successful.
    I went to dogus in nov 18 and was on estrogen for 14 days, 15 mg of prednislone, of which I only took 10 mg And low dose aspirin from day one of cycle, then was on 600 mg of progesterone until transfer day and from transfer day 40mg of clexane daily and proluton depot injection was added to protocol once a week. Bfn.
    Will cycle at a clinic in Bratislava this year, very basic protocol of 11 days of estrogen then transfer on day 5 of progesterone, which is only 600mg per day..... suffice to say, Iím not doing this protocol and will follow my successful zlin one, 14 days of estrogen and with an adjustment of the days of progesterone, so I will up the amount to 1000mg and transfer on the morning of day 6 etc.

    Offline Cmcl75

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    « Reply #4 on: 1/03/20, 10:39 »
    Amber,

    Absolutely...a few months ago, I was struggling to find the answers too...this process if very individualized and to give each transfer your best shot requires taking a look at look at what youíve done and what you may be missing. Thank you for your kind words...we will never be the same...there really arenít words for loosing a child at any age.  We always wanted more children, but our thirties were rightfully focused on her care...so having this option when weíd run out of our own biological time was such a beacon of hope for us.

    No...I do not think Zlin did anything wrong...I felt like they werenít aggressive enough with the progesterone...but Iíve had to push that with Gennet too.  In the end, I still referred to my OBGYN back here who is a personal friend, and he gave me what I felt I needed within parameters...ironically, he was with us in Guam too and has luckily been stationed at the same hospital as my husband.  Heís been with us through the hard times and knows what weíve been through.  I know at Zlin, my progesterone for each transfer wasnít reaching great heights...over 50 but under 75 for both times on the pessaries. Gennet never measured progesterone but will if you request it.  I just figured it had to be crazy high bc my breasts were ginormous and sore...still are btw...and with the added progesterone injections on top of the same dosage of pessaries I was receiving before, it had to be much higher...

    Another downside for me about Zlin simply involved traveling logistics.  The flight from Guam to Vienna(3 legs with layovers to make it somewhat affordable), plus the Reggio bus to Brno then Zlin required 35+ hours. Getting to Zlin from the US mainland would not be nearly that long, but would still require a couple of hours on a bus.  Now, I can fly straight into Prague from Raleigh, NC or perhaps have one connection, so it was less stressful for me to go to Prague.  Also, I feel like Iíve got an amazing city to enjoy for days, whereas Zlin and Brno are very beautiful but small. 

    Iíve read other people who went to Gennet may not have had the most fulfilling consults...I think the Gennet page had a couple of those...but ours was a good one.  I feel like a big part of that was doing our homework and going in with questions that were relevant to my case.  We also werenít scared to ask follow-up questions to topics if we needed a more developed answer.  We also submitted our questions via email in advance about a week bf the consult so our dr was prepared for our concerns. I think if you go in without questions just to hear them talk, itís going to be a waste of your time and money.  You have to be your own best advocate. And again, I also think their lab is among the best in the Czech Republic.  So, yes that matters...especially with embryos.  At the end of the day, I could care less about their bedside manner as long as theyíre good at what they do.  With that said, the doctor that spoke you in that way was out-of-line.  As a consumer, you have the right to purchase services at another clinic.  And if you spread the word enough, Gest will feel the impact. Arrogance can mean a dr is so sure of himself/ herself that heís stopped questioning what he/ she could do differently...thatís not good medicine.

    I think Iím still holding my breath until we get well past viability, but weíre grateful to have made it to 14 weeks without incident.  Saw her kicking and turning her head yesterday with a strong heartbeat in the 160s...it was everything! Wishing you and everyone on here the success you all need to get your beautiful babies...

    Christine




    Offline taraeob

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    « Reply #5 on: 1/03/20, 12:32 »
    Ladies, I can't thank you enough for sharing. 

    Amber, stay away from GEST.  We had an absolutely awful time with them and if I can save just one more couple going through what I went through with them, I will be happy.  I almost ended up in hospital after being with them. 

    Christine, Congratualtions.  I will definitely take on board what you have said about progesterone plus I also worried about being a little overweight, stressing about eating greens etc.

    Did anyone do back to back FET or would you recommend a period in between?

    Offline taraeob

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    « Reply #6 on: 1/03/20, 12:37 »
    Sorry ladies, could I also ask what is thyroxine and Synthroid and what are they used for? What were the progesterone injections called?

    Offline Cmcl75

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    « Reply #7 on: 1/03/20, 13:19 »
    Hi Tara,
    Synthroid or Thyroxine (Levothyroxine in the US)...this is thyroid medication...not sure what itís called in Europe.  I know I had normal TSH levels for my age (44)...which was just under 3.  I think that for optimal fertility doctors like for TSH levels to be under two.  Iím only the lowest dose of my medication, Synthroid...25mcg and that has taken my level just below 1.  I know that having levels higher than 2.5 is not good for fertility and can lead to fetal development issues if not monitored during pregnancy.  Itís important to know where TSH levels are...I do not personally feel one iota of physical difference on or off of the Synthroid as Iíve taken breaks between cycles...so I never would have known unless I was told to get tested...Both Zlin and Gennet focused on thyroid testing as part of prescreening before giving a protocol.

    I personally wouldnít do a back-to-back FET...not to say it wouldnít work...who knows?  I just think when youíre spending so much money, starting with as fresh a lining as possible for a new round of meds could help...I had miscarriages where I really lost a lot of blood...the first took my hematocrit to 7.2...almost had to have a transfusion...my husband weighed-in when bleeding stopped to avoid transfusion and got me on iron and Vit C (Vit C helps bind to the iron to increase its efficacy) and with some rest over three-four months, I was back to normal...it takes 120 days for red blood cells to repopulate. 

    Offline Cmcl75

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    « Reply #8 on: 1/03/20, 13:36 »
    Oh, I almost forgot the progesterone...in the US, itís just called Progesterone injection or Progesterone in oil...I used Actavis brand...NDC is 0591-3128-79...itís a 500mg/10ml (or 50mg/1ml) vial...used two needles...the bigger one draws it out, then I switched needle heads to a smaller diameter to inject...itís very thick.  I did 25mg once daily in the afternoon.

    Offline taraeob

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    « Reply #9 on: 1/03/20, 17:21 »
    Thanks Christine, I'm going to get some bloods done first before going again.