Ghost Need answers

[colesmom]

Thanks for helping us girls. I just got another bfn on my last attempt with a FET. I would like to know if you have any light to shine on all this for us. I have endo. and pcos. My hubby A+ sperm. Here is my Fresh cycle.
28th started 20 units lupron in a.m. 2mg estrace 2x a day.
3rd last day of oral contraceptives. Stop estrace.
6th decrease lupron to 10 units.
8th baseline u/s lining 15
10th follistim 100 units a.m. 25 units p.m. 1menopur
13th follistim 75 units a.m. no p.m. 1 menopur
16th change to 50 units follistim
18th trigger with ovidrel @ 9:15
20th aspiration 24 follies 17 embies
26th transfer 2 blast 4made it to freeze lost the rest..BFN

Frozen cycle
24th stopped oral contraceptives. 2mg estrace 2x a day
11th baseline u/s lining start crinone a.m. vaginally pio in p.m. took 5000 units hcg in p.m.
13th started medrol 8mg in a.m.
14th medrol 2x aday
16th transfer 2 blast
17th last dose medrol
25th BFN

We live in Pa and go to a smaller clinic and want to change to a top notch clinic for the next cycle PA, NY, NY all O.K can you help shine some light? Is it my lining being to thick? Meds cyst? Thanks Ghost

[Ghost]

Your fresh cycle protocol is very typical, although we never do them that way. Too much playing games with the stim too avoid OHSS risk, and to much OHSS risk. Reducing the stim does not reduce risk very much and can harm the oocyte cohort.

Your FET protocol is a bit unusual, and again, we'd never do it that way. First off, we stopped using Medrol 5 years ago because it was no help (and even seemed to hurt). Second, we never use hCG in an FET. Not sure why they are giving you the hCG, the PIO, and the Crinone. Triple protection I suppose. The timing looks correct, though.

You were quite the pincushion, weren't you?

Many clinics would do your fresh cycle like that, but few would do the FET that way.

Based on their reputations for research, some clinics I'd recommend in that region:

RMA in Morristown NJ
Cornell in NYC
University of Connecticut (Lawrence Engmann)

U of Connecticut won't screw around with your stimulation to avoid OHSS because they know and use a *much* better technique.

[colesmom]

Thanks Ghost.
Can you tell me what Medrol is and why it is attempted to be used in ivf? Also what would they use hcg for? Sometimes I wish I were a DR. or a Scientist. My OBGYN also is likes RMA Morristown NJ. I should had listened and not of went to the closest place. Also what should be the defrost rate on blast Embies? I lost 2 of my 4. Is it possible the lining can get to thick? Thank you again our friendly Ghost.

[Ghost]

Thanks Ghost.
Can you tell me what Medrol is and why it is attempted to be used in ivf? Also what would they use hcg for? Sometimes I wish I were a DR. or a Scientist. My OBGYN also is likes RMA Morristown NJ. I should had listened and not of went to the closest place. Also what should be the defrost rate on blast Embies? I lost 2 of my 4. Is it possible the lining can get to thick? Thank you again our friendly Ghost.

Medrol is supposed to make the uterus more receptive. There's no proof of this, and some studies claimed to see an effect and others could not. If it has any benefit, it can't be big. We thought it reduced our pregnancy rates, so we gave it up.

The hCG was to induce ovulation. They were using the resulting progesterone from your corpus luteum, which starts production right after ovulation. Not sure why they would need it along with Crinone and PIO.

Some think hCG helps to prime the endometrium, but the best studies of this show it's a slightly different hCG molecule that does that. The ordinary hCG does not.

Survival rates of thawed blastocysts are 90% and up.

I doubt your lining was too thick. In a fresh cycle, a thicker lining is better. Nobody knows in the FET, but the linings tend to be much thinner because of the lower hormone levels in FET.

[colesmom]

Thanks again. I have a appointment with RMA with DR. Jamie L. Morris. I hope to get that + . It`s harder knowing it`s possible to get pregnant and then IVF not work.We do have a 5 yr old son. I am thankful everyday for him.

[Ghost]

Thanks again. I have a appointment with RMA with DR. Jamie L. Morris. I hope to get that + . It`s harder knowing it`s possible to get pregnant and then IVF not work.We do have a 5 yr old son. I am thankful everyday for him.

If you can manage the longer commute, U of Connecticut is also a great choice, especially for young high-responding patients like yourself.