Viable pregnancy after GnRH trigger?

[PrincessKate]

Hi Ladies,

It's my first post here and I'm hoping someone may be able to advise me as I'm going slowly out of my tiny mind!

Brief history is that I had ICSI last month. Due to my having PCOS and in turn over 20 follicles and the associated risk of developing OHSS I was advised to trigger with GnRH rather than hCG. I was informed that the downside of this would be a luteal phase defect. Upon doing some research and discussing it with my doctor I requested that I receive a 1500 shot of hCG immediately after EC. We were lucky enough to transfer 2 blasts and I received an additional 5000 hCG on day of transfer too.

I was thrilled and delighted to get my (first ever in my 38 years) BFP last week. I'm still quite anxious about being able to maintain pregnancy as I'm still not sure if the post collection hCG shots were sufficient.

My betas on 10dp5dt was 170 and on 13dpo5dt was 620. I suppose I'm just looking for some sort of reassurance that these numbers look ok and maybe someone who had a similar protocol could tell me everything was ok!

Thanks so much for taking the time to read the ramblings of a panic stricken newbie.

[Ghost]

Hi Ladies,

It's my first post here and I'm hoping someone may be able to advise me as I'm going slowly out of my tiny mind!

Brief history is that I had ICSI last month. Due to my having PCOS and in turn over 20 follicles and the associated risk of developing OHSS I was advised to trigger with GnRH rather than hCG. I was informed that the downside of this would be a luteal phase defect. Upon doing some research and discussing it with my doctor I requested that I receive a 1500 shot of hCG immediately after EC. We were lucky enough to transfer 2 blasts and I received an additional 5000 hCG on day of transfer too.

I was thrilled and delighted to get my (first ever in my 38 years) BFP last week. I'm still quite anxious about being able to maintain pregnancy as I'm still not sure if the post collection hCG shots were sufficient.

My betas on 10dp5dt was 170 and on 13dpo5dt was 620. I suppose I'm just looking for some sort of reassurance that these numbers look ok and maybe someone who had a similar protocol could tell me everything was ok!

Thanks so much for taking the time to read the ramblings of a panic stricken newbie.

No worries. hCG like you received will end any luteal phase issues after a GnRH agonist trigger. It will, however, incur the OHSS risk associated with exposing a high responder to hCG.

Congratulations on your pregnancy. Looking good.

[PrincessKate]

Ghost, thank you so much for your (obviously educated!) opinion and your congratulations.

I think what you said there really hit the nail on the head behind some of my anxiety. I would have expected to develop full blown OHSS after taking the hCG boosters, but I've only had what I assume to be a mild case. No hospital visits or draining necessary, only some abdominal bloating and discomfort. This now seems to be subsiding. Which is great on one hand, but worried me on the other. I presumed that with an increase in hCG through pregnancy would come an increase in OHSS symptoms. This is evidently not the case. It begs the question as to why anyone has to develop OHSS if this protocol can avoid it, doesn't it?!

I guess my other worry was my betas. Dr Google (I know, I know ) is showing ladies with huge beta numbers at the same times as me. This made me think there may be a problem with the embryo. Do you really think those numbers look ok? I know I'm fitting right in with the median numbers on Betabase, but I'm also assuming that some of the numbers reported there did not result in a live birth. Questions and worries, questions and worries! Oh lord, I really need to take a chill pill, don't I?!

Thanks again so much for helping to ease my mind. You have no idea how much it means.

[Ghost]

It begs the question as to why anyone has to develop OHSS if this protocol can avoid it, doesn't it?!

That protocol with hCG for luteal support does not avoid it. You were lucky to be one of those that did not get severe OHSS despite being a high responder exposed to hCG. Actually, most high responders do not get severe OHSS even after hCG trigger. The risk is much less than 50%. But if you do get it, you're miserable for weeks.

Do you really think those numbers look ok?

The "good" range is very wide. Your first number was reasonably high for the measurement point (the 5,000 IU hCG you received on the day of transfer should have almost completely cleared by then) and your second number reflected at least the expected rate of growth.

My wild guess is that you have a healthy singleton in there, but no way to be sure.

I know I'm fitting right in with the median numbers on Betabase, but I'm also assuming that some of the numbers reported there did not result in a live birth. Questions and worries, questions and worries! Oh lord, I really need to take a chill pill, don't I?!

Thanks again so much for helping to ease my mind. You have no idea how much it means.

You are welcome.