Thursday, August 19, 2010

Planning ahead

Just got off the phone with my IVF doctor for the followup consult after our failed IVF 2.0. It was a good call.

Clearly ovarian reserve is an issue for us, since we've only gotten 2-3 eggs in our IVF cycles. I hadn't realized that the first cycle one of the eggs wasn't mature, but matured in time for ICSI and made a good embryo.

We know immunology is an issue, but we've been able to manage that successfully with Humira injections and Intralipid infusions.

So for this next cycle we'll switch to a different protocol. Both of my previous cycles were micro flare protocols: microdose of the antagonist Lupron, then adding FSH in the form of Gonal F (and Gonal F and Menopur in cycle #2). For IVF #3, we'll use estrogen priming towards the end of my next natural cycle (the one that starts mid-Sept) instead of doing birth control pills that cycle, along with Ganirelix to clear out whatever follicle emerges. After my period comes (mid October-ish), we'll start injectibles, and then add Ganirelix once the follicles get to 14-15mm to prevent a LH surge.

We're also going to go back to Humira to address my rising TH1/TH2 levels. We did Humira before IVF #1 and it worked great. For IVF #2, my levels were only slightly elevated, so we just did Intralipid, but my TH1/TH2 came back higher after the first Intralipid so I required another. To reset my immune system, I'll do two shots of Humira two weeks apart, probably starting next week.

And, bizarrely , since we'll need to know when my LH surge is, I get to use OPKs this cycle as a dry run for next cycle (since the estrogen starts 10 days after my LH surge). They want to be able to roughly predict the timing for retrieval/transfer. I haven't used OPKs for more than a year!

I'm really glad we're changing protocols. The reading I've been done about low ovarian reserve suggests that the estrogen priming can be really helpful. So hopefully I'll respond well!

I'm also really happy we were able to move this consult up (originally the clinic tried to schedule it for September 2). Since I need to be doing things this cycle, and my doctor wants the Humira done before the estrogen priming starts, waiting for the consult would have pushed things further back than October.


  1. So glad you have a new plan, one that both you and your doc feel confident in. That's hysterical that you're going to be using OPK's again - enjoy all that POAS!!!

  2. whoo-hoo! i'm glad you have a new plan set up in place, and that it's one you feel good about. :-)

  3. Your protocol sounds like a good one. I have heard of that protocol also and it sounds like you are at the Sher Inst. Is this true?
    I am wishing you ALL the best this next cycle.

    Take good care of yourself and keep moving forward :)

  4. Holy moly, I am thinking of you. You have such a great attitude and that will go so very very far. I feel so excited for you - although not excited about the needles, heh!

    Having been a success story for IVF, I have to say, it was something I will never regret. And I am glad you have it in you to do this again.

    I write this as my baby girl is sleeping in her crib, trying to eat her hands. :)

    Please come visit my blog. I write about IVF and what it is like to come out on the other side.

    Yours in motherhood,

  5. yayy :) Glad to hear that things are moving forward with the new cycle!!

    I'm following the exact same protocol this month! So excited for you and myself! :)

  6. Thanks for the kind notes!

    Baby bump bound: Not the Sher Institute, although they're also good for the immunology stuff. I'm working with Zouves.

  7. Getting a new plan in order is so important to feeling like you're regaining some control! I'm so excited to hear that you'll be doing a few things differently this round too - I know a different protocol would totally give me renewed hope!

  8. Wow, we really have been on the same path! I was so glad to hear from you today. The estrogen priming protocol has great results for women like us - I hope it is the one that brings you success! I will be keeping up with you here and keeping in touch.

  9. Thinking of you and hoping that the change in protocol does the trick!