GHOST---should I bother or am I crazy??

[miyaya]

Dear Ghost~ Its been a while since I have been on the boards. I had been an active poster and was so thankful for your advice/feedback....I am wondering if I should even consider IVF again. In a nutshell, here is my hx:

34 yo. PCOS
TTC#1 2.5 years. Conceived my ds with 100mg clomid, monitoring and hcg trigger.
TTC#2 for 3 years. I started with clomid again, moved on to 6 FSH cycles. All producing large follies bt resulting in BFN.
IVF#1: 9/18/2009 started first IVF cycle using 225iu gonal f, lupron:
9/22/2009: e2 343
9/25/2009: e2 1100
9/26/2009: trigger
9/28/2009: egg retrieval 2 eggs. 1 mature. Transferred day two 4cf. (thoughts were ovidrel was not strong enough and therefore not all eggs releases/mature)

1/18/2010 started IVF #2. 225 iu gonal f, added 75 units repronex, lupron
1/22/2010: e2 207
1/25/2010: e2 1280, LH 1.2, progesterone .69
1/27/2010: e2 2509
1/28/2010: e2 2530 trigger
1/30/2010: egg retrieval: 21 eggs. 9 fert. 2 made it to day 3 transfer: 4Bf, 2Bf. Ended in chemical (thoughts from RE is that while 9 fert, more were mature but did not charge egg. Possible protein issue. Will add ICSI next time)

7/20/2010 started IVF #3 225 iu gonal, 75 units menopur, lupron
7/20/2010: e2 495, LH .5
7/22/2010: e2 1203
7/23/2010: e2 1893 trigger
7/25/2010: egg retrieval 12 eggs added ICSI….7 mature, 6 fert, 2 survived. Transferred 1 on day 2 6cf (thoughts from RE is that possible maturity/egg quality issue).

I have had fragile x, vit d, thyroid and chromosome testing as had dh. My three IVF cycles were with Reproductive Science Center in Lexington.

I then consulted with Boston IVF and they felt they triggered me too early given my PCOS status. They recommended ovarian drilling to to possibly try a femera cycle before doing IVF again due to costs.

October 2010 I had drilling done. Since have done 3 clomid cycles, 1 I added FSH. All cycles produced 2-3 mature follicles. BFN. Recently my dh had another
Density: 97 million (>20mil)
Motility: 60% (50%)
Forward Progression: 3+ (3+ or better)
Morphology: 14% (12%)
Fertile score 1.7 (1 being most fertile, 15.8 being sterile)
slight sperm antibody detected

and I had some labs done through I was on day 43 of cycle. they were as follows:
86.1. slightly high
FSH: 6.6
LH: 15.2

So here I am....desperate to have another baby and give my son a sibling. We looked into adoption but with no financing available and the tune of 35K...we cannot afford it. We are considering IVF again. But I am so scared. I know its my decision and there are no guarantees......but is there a chance in heck? Would you recommend anything different?

I am also trying to decide what clinic to use....RSC in Lexington or Boston IVF???? Please help....anyone....am I nuts to consider this?

[NancyB]

I have no input for you. You've certainly been through a lot. I just wanted to let you know that I recently read that Ghost is on summer vacation (I'm not sure for how long etc...) but I read it just the other day.

[Wishingandhoping]

I can't answer any specific questions, but I can say that there are always ways that they can change a protocol that may work better for you. Don't give up hope. There are plenty of women on here that went through several cycles to get a BFP. Good luck!

[dys24]

have you been on metformin at all for any of your cycles? my 1st cycle (BFN) i never took it and for my cycle2&3 both BFP i took metformin 3 months before the begning of ivf cycle. Just a thought, my RE says it greatly improves egg quality in PCOS women.

[MamaBoo]

I had one thought that is akin to adoption, but cheaper...donor embryos. I hope you get that sibling for your DS.

[miyaya]

thanks ladies for your responses and for letting me know GHOST is away.

dys~ I have been on metformin for 5 years at 2000mg per day. My second IVF cycle they added repronex to help with maturity.....I went from 2 eggs to 21 so that was helpful however they were still immature and dh sample was not so great at that time. His most recent sample was stellar however it showes a slight antibody....I know very little about this....

thanks mamaboo~we have thought about donor embryos however its not so much an option where I live. Plus, I think if we go IVF again dh would like a bio connection.

[riogirl71]

I did DHEA and femara for my last cycle and got double the amount of eggs as in my cycle 3 years ago, I also did Coq10 and had DH take Coq10 and men's vitamins and his counts improved a lot. My cycle was an antagonist cycle.
Good luck!

[miyaya]

rio~ did you do DHEA and femera as part of a IVf cycle or just a medicated cycle with timed intercourse or IUI?

[riogirl71]

As part of an IVF cycle, my DH's counts were too low to even do IVF without ICSI.

[miyaya]

thanks rio. I never heard of doing femera as part of an ivf cycle. My DH counts are fine but he has a slight antibody. I have no idea what this means in regards to its negative impacts for IVF. DH and I are currently looking into financing options through ARC to see if we can finance some cost. We have spent soooooo much on fertility that the only way we could consider it is through financing.

[miyaya]

rio, interesting timing. After I learned about your cycle, my RE indicated we might want to try a mini ivf.....which uses femera etc.....found it interesting. How many eggs were you able to produce? With clomid I only get 1-2...max three. I have never done femera as most docs here will not use it.

[riogirl71]

miyaya - my first cycle at 36 I got 10 follies and 7 eggs, 2nd cycle at 39 6 follies and 6 eggs, with femara and antagonist cycle - I switched to a new RE, at 39 I got 14 follies and 14 eggs! I also took DHEA and coq10 and did not do BCP. I am with you on the cost we had to pay all out of pocket since insurance did not cover anything, financing is the way to go, good luck!

[Maximus]

The issue here is almost certainly an egg quality issue. While it's not unreasonable to try again, the best chance of success at this point would probably be egg donation, but that also has a high price tag.

[miyaya]

Maximus~ I am curious to why you assume egg quality issues. While I am aware that could be of concern, it appears when my eggs were harvested they were less than mature for some. It was not until recently (within the month) that they tested DH for sperm antibody. It was detected 10-40%. So, is it fair to assume that it could likly be also do do poor SA sample and antibody?

[Maximus]

Part of the issue with PCOS is inherit egg quality issues, in this case I believe there was never a transfer on day 5, one on day 2 and the embryos have not been of th best quality. It would be rare given his semen parameters that it was the cause of the grade of the embryos