[Vaso]

Hello ladies,
I am new here - and I am already feeling quite pesimistic. I am 33 had 1 failed IUI and didn't respond to Clomid during the 2nd one. Dr said that because I have high FSH (12.5) and low ovarian reserve (60 instead of 200) I should go straight to GIFT so that I don't waste any more time (I have 1 good tube). He doesn't expect a great response from the drugs and hence prescribed the long protocol and put me on 450 units Menogon, which I understand is the max.

I have the following questions:
Dr told us that chances of success with ivf in our situation are as low as 2% (gulp) and that is why I am going to have GIFT. However, I don't see many people having GIFT here and I am concerned...

Dr said that he suspects that I don't have many eggs left and what I do have is of very poor quality. He told me to start considering donor eggs as the chances of success with present treatment (ie the GIFT) are very slim. I find this very very very hard to accept at the age of 33...Is Dr jumping the gun a bit?

I am also absolutely terified of the whole laparoscopy/general anaesthetic procedure...

I will let you know when I am starting the cycle (AF is due any day now) - hopefully I can find a cycle buddy.

Any (encouraging) advice would be very welcome. Haven't started yet and already feel that this is going to fail...
Thanks

 

[Vaso]

Thanks Elaine! I bet you felt real satisfaction when he apologised

 

[noodle]

Hi Vaso,

Just wanted to welcome you to ff, there is a lot of help & support here 
I can't really help either with your questions as I have never heard of GIFT  When are you having your laproscopy? & what are they looking for exactly?
I have had one of them to remove a cyst off my right ovary 
I know how you feel about thinking the whole thing may fail, that is always in the back of my mind too. I am due to start my 1st cycle of IVF next month, & I'm stressing too.(I hate the damn needles)
Hope all goes well for you, hope to chat soon
noodle xx

 

[Vaso]

Thanks for your message. I have been reading the boards for a long time, however I have just joined.

For GIFT you are prepared in exactly the same way as IVF, however they give you general aneaesthetic for the EC, do a laparoscopy at the same time, mix 3 good eggs with DH sperm(the procedure is not regulated by the HFA policemen) and put it all together in a good tube. The advantage is that you don't need to produce loads of eggs for GIFT (my Dr doesn't think I have many left), however I am terrified of the lap.

Dr said that GIFT is the most aggressive form of treatment, but he still doesn't think that our chances of success are good. However, he said it's worth a try.

How long did it take for you to recover after the lap? Were you in any pain after?

 

[fergie]

Dear Vaso

Hello and welcome. I just wanted to respond to your post.

I have heard of GIFT as that's what we were aiming for at our last attempt. My highest FSH was 11, and I have low antral follicle counts, so they didn't expect me to respond well to treatment. I was on what they call a suboptimal protocol at UCH- where you down reg but stop taking the Buserlin when you have AF. However, i didn't respond well, and only got 3 mature follicles, and they refused to even try GIFT, so we had another IUI there.
We have now moved over to the Lister in London. They will treat women with much higher FSHs than yours or mine, and they also seem to have a wider range of drug protocols to try. And they have reasonable success rates too- about 22% live births for women of my age (37-39) with FSH between 10 and 20, with average egg numbers of around 6  at collection. I am impressed with that statistic. I just feel much more positive about trying again- I was at the stage of thinking our only chance might be with DE. But we're about to start at cycle at the lister now- it involves being on the pill for one month, no downregulation, then start taking clomid and some stim injections, and then a few days later start taking cetrotide (to prevent early ovulation). SO we'll see how we get on I guess.
Anyway, my advice to you is definitely to get a second opinion, and I suggest you talk to the Lister or a clinic with more experience of treating women who have failed cycles elsewhere.

Good luck- let me know what you decide to do and how it progresses.

fergie

 

[Vaso]

Thanks for responding Fergie.

I am feeling relieved - and confused. I am at the UCH as well (Dr Ranieri is the Dr) and he did warn us that if I don't respond well, they will do an IUI, which sounds like a total waste of time. My antral folicle count was 8 and 4.

I am confused now, don't know whether to go ahead, I was under the impression that UCH was one of the best places to go and that the long protocol was the most aggressive way of stimulating the ovaries. Maybe not...

Good luck with your treatment
xxx

 

[fergie]

Hello again Vaso

I don't want to have confused you too much but I've been through the same thing at UCH. The reason they have such good results is that they refuse to go ahead with IVF unless they get good numbers of eggs- in effect they select the best candidates for IVF and so keep their results stats high. This won't help you or me as we're not exactly the best types of candidates. And I remain unconvinced that a protocol that involves any downregulation at all is helpful for women in our situation.

Anyway, your antral follicle counts sound OK- check out this link for more inof on this.
http://www.advancedfertility.com/antralfollicles.htm
Mine are much worse- 3 on each ovary so a total of 6.
Jaya is focusing on getting me to produce good quality eggs rather than big numbers. I got pregnant naturally about 16 months ago, and although that ended in a miscarriage, they say that is encouraging.

Anyway, please, please take yourself off somewhere else for a second opinion and give yourself the chance to hear alternative views. ANd if you decide to carry on with this cycle, good luck. If your AF is due, have you already been downregulating then? If not, you will probably only be starting that on day 21 this month, which gives you a little time to go for a second opinion anyway.

Take care Vaso, PM me anytime.
fergie

 

[Vaso]

Thanks fergie. I'll PM you as this conversation is heading towards clinic selection and as I understand it, we are not allowed to say bad things about clinics publicly.

 

[Plink]

Vaso

I had a GIFT at London Fertility Centre. It is Prof's 'baby' the GIFT procedure-he has reasonable successes. Mine didnt work (I am mid-forties) but Prof was pleased with his results in a small number of women.
They do not produce embryos during this procedure and so they can use ALL your eggs if you want. I had 6 eggs put back with the sperm.
This is the up-side
The down-side is that if it doersnt work, you have no idea why. ie did fertilsation occur/what was the embryo quality/did implantation fail etc etc.
Of course, even with ivf you often dont know the reason.

When chatting with another clinic, I found that many clinics no longer do GIFT -it is considered rather outdated. This is partly because ivf successes have improved and it is not thought to have anything over ivf AND you have to have a general anaesthetic (which you dont for ivf)
I was in quite a degree of discomfort after the procedure but this may not be usual.

I have an open mind about this. Either procedure can, potentially work.
The number of eggs is not rtegulated by the HFEA -so they can replace more. That is why Prof likes doing it for older women.

Love Plink

 

[Midge69]

Vaso

I also understood that down regulation for women with high FSH is not always a good thing. My FSH is 11 and I was put straight onto a short protocol for fear that having down regulated, it would be difficult for follicles to then be artificially stimulated.

Don't want to overburden you but I would query why long rather than short. I am not a medic so there could very well be a reason that I am not aware of. Maybe the choice is not as simple as I understand it to be.

Best of Luck

Midge

 

[Vaso]

Thanks for your posts.
I have decided to give it a go (the long protocol + GIFT) as the Dr's advised and see what happens. I have the attitute that the Dr must know something...

However, I have been encouraged by your posts as I have realised that there are other options should this cycle fails. I don't want to move on to donor eggs unless I am satisfied that there is no hope for mine.

Anyway, my stupid AF is late (day 35 today) and I am still having hot flushes from the Clomid 

I am in a real state, waking up every night soaked in sweat, make-up running down at work...
First time I actually want my AF to arrive so that I can start this treatment...I realise that I am going to get more hot flushes with the Tx, but at least a few days break from the sweats would be fantastic

Thanks for all your support
xx

 

[Rice cake]

Hi Vaso
I wondered how you can tell whether you a have  a low ovarian reserve (you mentioned 60 instead of 200).

Reason being I have an FSH blood test on Wednesday  but have not heard about the test

 

[Vaso]

Hello
on day 3 they do a blodd test and measure the FSH and the estrogen. Then they give you an injection of Gonal-F under the skin in your tummy (sounds worse than it is) and you go back 24 hours later for a repeat blood test. The estrogen level should rise in 24 hours by at least 200 after the injection.
As I understand it, together with the FSH level and the antral follicle count (how many follicles you have on day 3 in your ovaries) they estimate how well your ovaries are working, how likely they are to respond to the stim drugs, and how many eggs you have left. As my estrogen rose by only 60, they have decided to put me on the highest dose of Menogon when I start.
But I am no Dr, so I could be explaining this wrong...
xx