Ghost Question-Update

[garfieldtracy]

Ghost - I have mroe questions for you.

My past cycles my RE had me take ganirelix around day 6/7 of stims and then trigger 2-4 days later (my LH runs high - that is why I was told he gave me ganirelix). This time I did not go on ganirelix and I triggered about 2 days earlier. The concern I have is that my lead follic is only 17 (the other times my lead follic were either 18, 19, or 20). The problem I have with triggering earlier is that when I triggered the follics I had were 17, 15, 15, 14, 13 and smaller ones. I thought that if I stimmed for 1 more day the 13 could make to maturity, but now I have my doubts. He said he triggered early because my E2 "plateauing" - the E2 level results are as follows:
Day 4 stims: 182
Day 5 stims: 343
Day 6 stims: 559
Day 7 stims: 1129
Day 8 stims: 1120

I have all my numbers if you need something else.

My questions are:
1.) Do you think I could have stimmed for 1 more day without ruining the cycle?
2.) Do you think that the 13 and 14 follics can be mature by time of ER?
3.) Why would the RE not use ganirelix this time - what could be the reason?

Thanks,
Tracy

[Ghost]

My questions are:
1.) Do you think I could have stimmed for 1 more day without ruining the cycle?

Hard to say what would have happened, but a drop on E2 in the last days of stim is associated with reduced success rates.

2.) Do you think that the 13 and 14 follics can be mature by time of ER?

Possible. Sometimes good oocytes come from smaller follicles, but it's more likely when they're over 15mm.

3.) Why would the RE not use ganirelix this time - what could be the reason?

Just a guess, but he may have been saving you some $$$. Ganirelix is fairly expensive and if you are not showing signs of impending ovulation, then it may make sense to skip it. I can't say for sure, since my clinic always starts the ganirelix around day 6 of stim. We don't like to take chances with premature LH surges.

There is an interesting study by some of the best IVF researchers in the business on when to trigger. They randomized patients into two groups. One group got triggered when the lead follicle reached 17mm. The other group was triggered 2 days later. The latter group had more eggs and embryos, but the former group had the greater pregnancy rates. The conclusion was that longer stimulation results in reduced endometrial receptivity. It's not only about the eggs and embryos. In other words, your RE may have made the best choice.

[garfieldtracy]

Thanks Ghost,
It is nice to hear you thoughts. I am glad to hear that triggering at a 17 is good. As for the E2 dropping - I can just hope that a drop of only 9 is not that bad. As for the ganirelix it can't be because of cost because I have 6 shots (got them before our insurance ran out). My LH is always high and we have done this a few times so I just thought he no longer gets nervous - like he would with other people.
Again, thanks for calming my nerves for ER!!
Tracy

[garfieldtracy]

sorry double post

[garfieldtracy]

Ghost - just an update.
Of the 5 eggs - 4 were mature (the 13 didn't make it like I thought) - and 3 fertilized (guess the 14 was there either).
We will be transfering the 3 on Friday. Hope it being Good Friday helps us (the baby we lost at 36 weeks came from 3 eggs being transfered 2 years ago on Easter Sunday). Hopefully, this time of the year will be lucky again for us!!
Tracy

[angelaezra]

Ghost - just an update.
Of the 5 eggs - 4 were mature (the 13 didn't make it like I thought) - and 3 fertilized (guess the 14 was there either).
We will be transfering the 3 on Friday. Hope it being Good Friday helps us (the baby we lost at 36 weeks came from 3 eggs being transfered 2 years ago on Easter Sunday). Hopefully, this time of the year will be lucky again for us!!
Tracy

I am wishing you good luck!

Angela

[Ghost]

Ghost - just an update.
Of the 5 eggs - 4 were mature (the 13 didn't make it like I thought) - and 3 fertilized (guess the 14 was there either).
We will be transfering the 3 on Friday. Hope it being Good Friday helps us (the baby we lost at 36 weeks came from 3 eggs being transfered 2 years ago on Easter Sunday). Hopefully, this time of the year will be lucky again for us!!
Tracy

Thanks for the update. Best of luck to you.

[Kimmiles]

Good luck!!! Maybe the easter bunny will bring you something......

[jenice]

Good luck to ya !!!!!! Hoping Easter Bunny gives you a surprise I also had a problem with my E2 level except mine was high @ transfer was 6000. I had a BFN with 2 blasts Then I had an FET with a 2-cell and a 4-cell and did get BFP, go figure, right ???? I think my endometrium in the first cycle wasn't receptive, so little embies never stood a chance. My new RE said he would have froze everything and not even transferred So now I have to do another fresh cycle, I ran out of embies after my FET which turned to be a chemical pregnancy. I think your RE was right in not waiting, cause I think there is a small window of time to transfer,just my opinion of course. Good luck to you, I saw your history and you soooo deserve this. Sending you TONS OF BABYDUST your way