Stim and PCOS

[yarnista]

Does anyone have experience with stim and PCOS? I just started 3 days ago and on ultrasound today and already responding, the doc wants me to do bloodwork again tomorrow which had me a little concerned. The other thing is the nurse practitioner said there is potential for 20-30 eggs based on what she saw but that's not what they would want. Any help would be appreciated!

[kandice]

one of my blood tests came back towards the beginning of my cycle and the dr said I had some symptoms of pcos but not everything. they still put me on metaformin 2x a day and as you can see from my sig- everything went great! I have 29 embies sleeping in the lab waiting for me on 3/8/07!

and 20-30 eggs, you'll be uncomfortable- trust me! but everything will work out- just try not to worry- easier said than done I know!!

[Michellyn8]

Hi,
I have PCOS and I will soon be starting my 2nd IVF cycle. I was put on Reponex and Gonal F and I was starting to overhyperstimulate. They continued me on gonal F and had me take only 7 out of the 10 reponex. Even though I made 23 eggs (15 fert) they were not great quality and could not be frozen. I had 2 (1 was excellant quality) transferred but it didn't work. I drank lots of fluid and gatorade to help w/ the OHSS. Egg quantity does not always equal quality. My next stim protocol will be gonal F only as they are going to try to make fewer eggs to improve the quality. Sometimes if you are OHSS they will just freeze the eggs and wait until your body normalizes.
Additionally they tested my blood every day, not pleasent but very necessary as OHSS can be a very serious thing. I was very bloated and uncomfortable. What is your stim protocol? Can they lower it as it seems you are possibly overresponding? If you have any questions you can contact me. Good Luck.
Take care,

Michelle

[ssalgado]

GOOD MORNING!!

LET ME START SAYING THAT I DO HAVE PCOS FOR MORE THAN 15+ I WAS DIAGNOSED WHEN IWAS 15 YRS OLD BUT THE FAMILY DR SAID NOT TO WORRY TILL I WAS MARRIED YEAH RIGHT!!! AND THAT'S WHAT HAPPEN!! ANY HOW I HAVE TAKE IN THE PAST METAMORFIN TO CONTROL MY SUGAR LEVELS WHICH GETS REALLY CLOSE TO THE DIABETIC POINT SOMETIMES..
TRY #1 -I DID MY IVF-ICSI FOR 1ST TIME IN 2003 AND IT WORKED I DO HAVE A WONDERFUL HEALTHY BOY WHO IS 2.50YRS OLD! THAT TIME I PRODUCED 17 EGGS 9 FERTILIZED FROM THOSE 3 WENT THRU THE WHOLE 3 DAYS I GOT PUT BACK 2 AND FROZE ONE, GOT PREGNANT WITH TWINS BUT ONE WAS A VANISHING TWIN AND DIDN'T RESPOND SHORTLY AFTER 2 MONTH.

TRY# 2- FET ON DEC 06 OF ONE FROSTIE LEFT FROM 2003 - NEGATIVE RESULTS.

TRY #3- FRESH CYCLE ON JAN-FEB - PRODUCED 35 EGGS YES VERY UNCOMFY- 17 FERTILIZED- 11 SURVIVED- GOT 2 PUT BACK ON FEB 8/07- 9 TOOK THEM TO THE BLASTOCYST STAGE 6DAYS - 3 SURVIVED AND FREEZE ON BLASTOCYST STAGE, NEGATIVE RESULTS ON FEB 22 FOR THE 2 PUT BACK IN ON FEB 8- (UNFORTUNETELY I FELL ON THE STAIRS 4 DAYS BEFORE MY TEST AND WE THING THAT DID IT) . , BUT

TRY #3- FET SCHEDULE FOR MAR 16*07 TRYING TO GET ALL OF MY 3 SNOWY BABIES PUT IN SO WILL SEE THIS TIME NO STAIRS FOR ME

I HOPE MY STORY HAS HELP UNDERSTAND A LITTLE BIT MORE...

SUSETTE-

[kia1973]

hi yarnista,

i have POCS (bad case) and about to start stimms on monday all going well with my scan, i have had 3 diffrent protocols so far,

1st - started stimming and had lots of eggs so i ended up coasting for 5 days before ER. clinic said i was over responding. 8 eggs only 2 fert in the end.

2nd - they reduced stimms and i produced 6 eggs of which 3 fert.

3rd - Tmt in Germany high dose of stims, produced 40 eggs of which only 17 fert. froze 12.

this cycle (UK) low does stims haven't started yet but will keep you posted.

its all in the quality not quantity. what is your protocol?? hope all ends well for you.

[yarnista]

Thank you for all of your kind replies. The doc said everything is going well, I've been on 225 follistim, they just lowered it to 175, starting ganirelix tonight. He said at some point I will take lupron too. It's exciting to see the changes on ultrasound. The nurse pract. had me write down the sizes of the follicles this morning. I'm wondering about having massage therapy done to help relax me.
I have PCOS, but had a healthy boy 10 yrs ago, am now 32. Ours is also male factor, my son is from a prev. marriage. My husband has very low sperm count and morphology, possibly due to variocele. Thanks for all the encouragment.

[sharon2007]

hi
I have pcos . after 6 days of stimulation my RE cancelled the cycle because of high E2 levels and large number of follicles in my ovaries.
Going to start a new cycle soon .

[HLD]

I have PCOS too and bad. Didn't respond to Clomid but do respond to pure pituitary hormone. 2 failed IUIs and husband does have low sperm count too. First round of IVF produced 39 follicles and many were really good. We did ICSI and got something like 13 fertlized eggs. So, we were happy. On transfer, because of high risk of OHSS, did one follicle and froze the rest. I am pregnant in the 6th week now.

So, so much luck to you. It can happen, even despite some serious setbacks! Keep up the hope!

[ssalgado]

CONGRATULATIONS HLD- THAT IS GREAT!!

I TOO HAVE PCO'S HAD A SUCCESS IVF-ICSI AS WELL ON 2003 MY SON IS 2.5 YRS OLD, NOW WE HAVE DONE A FRESH CYCLE AND2FET ON THIS LAST ONE WE GOT A BFP AND ON THE 3ERD BETA WENT DOWN AND WE LOST THE PREGNANCY VERY DEVASTATED, NOW TOMORROW THE DR WILL HAVE A MEETING TO SEE WHAT THEY CAN DO BETTER I PRODUCED ON MY LAST FRESH CYCLY 35 EGGS 17 FERTILIZED END UP WITH 11 TRANSFER 2-BFN/ THE OTHER 9 WENT TO BLAST 3 SURVIVED DID A FET IN MAR 2 BLAST- BFP AND THEN LOST PREGNANCY , 1 BLAST FROZEN, WAITING FOR DR'S MEETING TOMORROW TO SEE WHAT WILL BE NEXT STEP...

PCO'S IS VERY SERIOUS BUT WE CAN WORK WITH IT, IT'S JUST VERY FRUSTRATING SOMETIMES....

SUSETTE

[HLD]

I'm so sorry for your losses, ssalgado. That has got to be such an up and down and very trying. I hope it works out the next time! If you don't mind me asking, at what week did you lose your BFPs? I worry about that happening. I've got my fingers crossed for you that it works this time for you!!

[ssalgado]

Good Morning HLD-

Thanks for the good wishes i am expecting the call from the Dr's today to see what the plan will be and see if we are ready for another emotional round i still shaken from this, i lost them at 5weeks and they were blast beanies, You have PCO"S also? for your cycle have you been on your metmorfin or clomid while in the cycle besides the ivf meds? they think that contributed to the loss since i was not taking it while i was cycling something to do with the blood flow on the uterus, PCO'S and this pill, but there are no proven evidence of this just few situations like mine they have seen before and they put them on metmorfin or clomid for thenext cycle and it works! So will see what happen...

Please don't worry about what happen to me.. ENjoy your Pregnancy... every body is different... and seems to me that you are in a great step..

You should be due for you us soon....


Susette

[Michellyn8]

Hi PCOS Ladies,

Good luck to everyone and congrats to HLD on your BFP.

I had a couple of questions for everyone. What were your drug protocols? Did you take aspirin? Accupuncture? 3 day or 5 day transfers? How did you take your progesterone? How much Metformin? Did you use repronex?

Sorry to ask so many questions but it is so hard to find info about PCOS and the types of cycles that actually work...and don't work. I am switching to an antagonist cycle...but I have a weird feeling about that. Has anyone used an antagonist cycle (gonal f and cetrotide only).

Thank you and take care,

Michelle

[MarciaL-OurHope4Baby]

Hi there

I there I've also got a bad case of PCOS but luckily I'm Non IR.
The main problem with PCOS women is most of us tend to respond really well too quickly and when it's trigger time there isn't enough mature eggs in the follies, and triggering just brings on OHSS3-4 days after the Egg Retrieval as it's the trigger shot that kicks that all off. If you're on Metformin like I have been since Sept, it's said to combact OHSS and prevent you from the effects of OHSS. I only found that out last week as another girl I know said if I wasn't already on it, to get some as it stopped her from OHSS this time, whereas before she ended up in hospital.

The best it to try and get a good enough number of mature eggs over a longer period of time so that you get a good quality and not so much a really high quantity. So 6-10 eggs to work with are good numbers for us.

This is our first IVF and I' did my trigger shot today, and I've been stimming for 16 days. I'm a slow responder to Menopur and started off on 150iu's, then on my 8th day of stimming I had my baseline scn, and I've had to go up to 225iu, and then 300iu's that I'm now since Friday to get a decent amout of big follicles that I've never had before on Injectables. The last time I stimmed for 16 days on 150iu's of Menopur was in 2005 and I had stims for OV with BD, and I only Ov with 2 eggs. This was my stats from my journal.

CD15 - Tuesday 27th March,

1st Follicle tracking scan.

Slow progress -

Left Ovary = 6 follicles, measuring 5-6mm

Right Ovary = 3 follicles, measuring about the same.

Lining = still really thin

Possibley 9 eggs growing, measuring the biggest follies, as there were smaller ones surrounding them.

I have been told that I have to go from 150iu's on Menopur to 225iu's until Friday's scan.

CD18 - Friday 30th March,

2nd Follicle tracking scan.

Better progress -

Left Ovary = 3 main follicles, measuring 10.2mm and 2 at 8mm

Right Ovary = 3 follicles, measuring 8-9mm

Lining = 4mm

Possibley 8 eggs, measuring the biggest again, as there were smaller ones surrounding them and one of the follies from Tuesday is flagging.

I've been told to up my dose from 225iu's to 300iu's untill the next scan on Monday. This dose should boost them over the weekend. With any luck everything might be able to keep me on track to some degree.

Feeling more Ovary pain on my right side now as well as the left now.
Now I'm hoping to Trigger by Wednesday, ER 2 days later and then a 5dt sometime around Next week Monday 9th if all embries made it through fertilisation woo hoo.

Today's scan was even better . I'm in even more discomfort than Friday's scan and with good reason to.

CD21 - Monday 2nd April,

3rd Follicle tracking scan.

Much better progress -

Left Ovary = 5 follicles, measuring:-
3 are 13.2mm, 1 is 12.2 and the other is 10.3mm.

Right Ovary = 3 follicles, measuring
11.8mm, 11.2mm and 10.8mm

Lining = 7.1mm

Possibley 8 eggs as follies are now growing nicely, these are biggest ones at the moment. Still have lots of smaller ones surrounding them not sure how big.

I've been told to carry on with the 300iu's of Menopur until Wednesday's scan at 8.15am

CD23 - Wednesday 4th April,
4th Follicle tracking scan.

Fantastic progress -
Left Ovary = 12 follicles measuring:-

1) 20
2) 14.3
3) 20.5
4) 21
5) 16.1
6) 15.7
7) 14.7
13.2
9) 12.6
10) 12.5
11) 11.5
12) 16.2

With smaller ones around 8mm.


Right Ovary = 12 follicles measuring:-

1) 15.32) 9.8
3) 13.3
4) 11.8
5) 8.5
6) 14.5
7) 11
9.8
9) 11.9
10) 15
11) 13
12) 8.2

Plus some smaller ones around 8mm

Lining = 9.2mm

E2 = a whaooping 6182

They said that the lining is great as they like it to be anything over 8mm at this point. I've highlighted the main follicles they're concentrating on for maturity.

So the plan now is, to carry on taking my Buserelin for today and tonight, being the last one.

[MarciaL-OurHope4Baby]

PS. I've always had Acupuncture just before any treatments to help with the cycle lengths. But after my EP in 2003, I had some crazy cycles for 5 months and it was getting me down, so I had Acupuncture again in 2004 and my cycles have been great ever since.

Hubby and I've started preparing my bodies for the IVF since December 2006, nd then I started having acupunture again in preparation to for the IVF since January. I've been having one or two a cycle, but this time it's all part of the IVF protocol as the therapist I go to specialises in Acupuncture & CraniolSacral Therapy with Relaxtation techniques for IVF and Fertility.

This woman is amazin, and I've been going every 2 weeks, and I'm supposed to have one Friday morning before ER, but as I've triggered a few days early, I'll see if I can have it in tomorrow and then Friday evening as having Acupuncture around ER and ET is supposed to be really good to promote the right blood flow to the womb and aids implantation. Otherwise I'll see I can have it on Friday and Saturday the the week after that.

As for the Metformin, I started off taking half a 500mg tablet when I started taking them in prearation for the IVF last September. I didn't know how I was going to respond to it, so I wasn't about to take the 1000mg a day like I as supposed to. The doc said there was no probs seeing what worked for me. In November I went up to 500mg a day and that was fine; then I tried one and half tablets for 3 days and they gave me tummy ache. Went back to one 50mg tablet a day, and I was fine again, so I watced what I ate again and 1 and half was fine. I had a runny bum when I tried 1000mg in December so went back to one tablet.

Now that I've doing the IVF this week, I started alternating the days and having one tablet then one and half the next, to make sure I have a good build up in me, and then from tonight I'm taking the 2 tablets so that I'm taking the 1000mg as I'm quite full of follies now, and have nearly 41 in there. I don't want to OHSS, so upping the metformin dose over the next few days should help things out.

Ideally, it's best to start it a month 2-3 months if not longer before your IVF so that your body has storage of it. As long as you take it a mont before you should be ok if you're on the full dose.

Good luck to all, and sorry for those of you that have had losses.

[MarciaL-OurHope4Baby]