Wednesday, July 20, 2011

I need advice please! And quick!

What a day.

Ok, so first is CD1!!!! I was so excited. I called the RE's office to set up my appointment and they put me on the phone with the nurse who is handling my IVF cycle. She said something at the beginning of the conversation (which was sort of mumbled) about Lupron. I thought she had said "Do you have your lupron?" And I said "Heck yes, it came today!" Well I didnt say "Heck yes" but it did come today. Anyways, she continued on with scheduling my appt for friday morning. And then I stopped her and said " Im sorry what was it you said about the Lupron, I dont think I heard you correctly." Apparently, I was supposed to be on a long lupron cycle before I start taking my meds. She insists she explained this to me over the phone a few weeks ago...BUT SHE DID NOT. Because if she did I wouldnt be so in the dark and shocked and saddened at the thought that this process is actually two months long!!! So I got really upset, I was shaking my voice was cracking, I said " You know this whole process is hard enough as it is, to hear that I have to wait a whole extra month to actually start the meds is devastating." So she said she was going to talk to the doctor and put me on hold. She came back and said the doctor said that could jump right into the meds and not do the long lupron, but that it puts me at risk for OHSS. My question to you girls is....

WHAT SHOULD I DO??? Have any of you started an IVF cycle without the long lupron thing?? My gut tells me to go ahead with everything, but theres a little piece of me saying I should follow what the doctor usually plans for. I mean, the risk of OHSS is always there. With injectibles, with clomid, with it all! So I guess I dont really understand. I need to figure out what Im doing by Friday so any advice would be very much appreciated!!! If I did the long lupron cycle, that means I would even be starting the stims until late august possibly even september. Which means this whole process wont be over till almost october! :(

I just think there is an OHSS risk with anything we swallow or inject into ourselves. I feel like I should go ahead with it, but I guess I'd like to hear some other stories of starting IVF without the long lupron!

***Stay tuned for tomorrow's post where I blog about my BEAR encounter this morning!! So friggin crazy. And we don't even live in "bear country"!!***


Anonymous said...

Oh gosh....I completely understand your frustration!!
I have been on one of each; long lupron and not. I had a mild form with the past cycle and it SUCKED so anything I could do to avoid again I would. I could barely walk without groaning.
I would talk to the MD and see why he thinks you are at risk: high, med, low. Do you respond really well to stimulation or have PCOS? If yes, I'd take the lupron. What's another month in the grand scheme of things? Truth is, if you have OHSS you may have to then wait to transfer and do a frozen cycle.
Again though, had I not had a bit of it last cycle I'd probably say take the chance! (not much help huh?)

sunnyside up said...

Mine finished today and yours started!
I knew my wishing and hoping for you would work!!!

I wish I could help you with OHSS and IVF questions, but I'm a rookie and have neither of those experiences. And from the sounds of the comment above, I don't think I want too.
I hope you get some good answers to all of your questions!! I can't wait to see which avenue you per sue.


Emily said...

Oh how freakin' frustrating!

With this last cycle I was on birth control for almost six weeks, then lupron for 10 days before I started stims. And I just came down with a mild case of OHSS two days ago. It isn't fun, but it is bearable. Luckily, it isn't severe enough to delay transfer, but that is totally a possibility if you get a more intense case.

Sadly, I'm not going to be much help. If you are at a higher risk of developing it, I would take your doctor's advice. But if it is just a standard precaution of his.... well, I don't know. I completely understand the want, no, the NEED to get things moving!

Moe said...

Here's my non educated 2 cents. (Also keep in mind I just googled what OHSS meant...cuz I didn't know).

My question is - does skipping the long lupron cycle have a negative effect on your changes of a successful IVF? If "yes" do you have the "money back guarantee program" for IVF? If "yes" to that too...I say go for it.

If "no" to the 1st question....I say go for it. But if it can lower your chances and you aren't doing the "insured" program I'd say wait it much as that really really sucks.


Marissa said...

Well, I'm not entirely sure this comment is on point.

BUT if she's offering you the option of switching to the Antagonist Protocol (instead of long lupron), I would go for it.

Now, I may be biased because lupron stims me, and so I hate it and had 2 cancelled cycles on it.

HOWEVER, the antagonist cycle is increasingly becoming the go-to cycle. Long lupron is often the first thing they throw at women under 35, and lots of women do have success with it. The antagonist cycle requires you to buy 3-4 shots of the antagonist (Ganirelix or Centro-somthing?), and they're about $120 each. So it's more expensive.

BUT, if you're at risk for OHSS before retrieval, you have the option of TRIGGERING WITH LUPRON instead of hCG. This is awesome because hCG makes hyperstim way worse (hence why it often worsens after a positive HPT).

Also, your doctor can put you on Dostinex (no matter what type of protocol you're on), and the dietry restrictions totally help.

I love the antagonist--I got 12 eggs the first time around, and 18 the second. Zillions of women on FertilityFriend love it too, and my sister, when she did her RE/I rotation, learned about it and was taught it had 'equal success' with the LLP.

The main concern with antagonist over LLP is that you might not get as even of a cohort...but I don't know that there's any research to back that up. Everyone I "know" who has tried both got as good, if not better, cohort growth with the antagonist.

Hope that helps!!!

Baby Hopes said...

I personally think that this is a decision you need to make for yourself, but I will share my thoughts.

Personally, I would go with the long lupron if that's what your RE feels is best. I did the antagonist protocol where you come straight off of BCPs and jump into meds. I didn't get OHSS that I'm aware of, but there was a lot of pain and bloating to the point where my mom (an RN) was concerned.

I'm less concerned for you about the potential pain and bloating - I know you can handle it and that all of us are willing to take on a lot of pain and discomfort for the hope of our children. What I am more concerned with is your response to the meds.

Starting out on an antagonist cycle for my first IVF, my egg quality was horrible. We had a low fertilization rate, slow division, and a lot of fragmentation. Once we complete our adoption, I'll be going back in for a second round of IVF - this time on an estrace prime protocol, which extends things a bit.

At any rate, I would ask your doctor what he thinks is best. I wouldn't let the fact that it will take another month be a deciding factor. Believe me - I know how incredibly horrible waiting feels when you've already waited so long and through such horrible circumstances. But it's a worse feeling to have an unsuccessful cycle and feel like the protocol wasn't the right one. I would personally go with what your doctor feels is the best. An unsuccessful IVF is devastating, and whatever you can do to position yourself for success, even if it means waiting another month, I would go for.

Wishing you the very best of luck!!!

cgd said...

Talk to you RE pronto, ask him/her the pros and cons for you for both. Ask what they will do if you do have OHSS (will they freeze the embryos or transfer).
Personally I would want to do the original plan, while this is a delay- you will probably get to start lupron in about 3 weeks (one week after you ovulate).
I have done both kinds of cycles, I get better results with lupron, even though I am not really one to for hyperstimulation, but some how I get better embryo quality- varies for each person.
so sorry about the mix up, that sucks!!!!!!!!!!!!!!

Liz said...

I definitely can't tell you what to do, but I can tell you about my experience.

I also have PCOS and did the long lupron protocol. I started the Lupron on day 21 of my cycle and continued until I got my AF (2 weeks later.) At that time I started stims. The entire process covered 2 cycles but I never went on BCP's. Once you start the Lupron time really starts to fly.

I think my cycle went well and I had a lot of eggs around the same maturity. Suppressing me first seems to give me a got batch of eggs all around the same size and maturity.

The first cycle I was going to do IVF I remember calling on CD1 and being SO disappointed I couldn't start Lupron until day 21.

I would play it safe, especially since you have PCOS and are more likely to hyperstim. I had some free fluid in my abdominal area, but wasn't considered to have OHSS. It wasn't comfortable or pleasant, so I can't imagine how much getting hyperstimulated sucks.

It is disappointing to wait, but it is also disappointing to pay all that money and not be successful. You definitely don't want to look back and regret decisions made or feel like you didn't do everything in your power for success.

You don't have to tell me how much waiting sucks right now.

A simple being said...

i did two ivfs and one was with lupron prior and one with out we actually got eggs to store with the without one...maybe you are following the plan not the drs plan amazing where and how we end up right where we are to best ivfs were the one that were insanely crazy weather illness appts dates insane

Babydreams2011 said...

Well I am on the other end of the spectrum.. I have done long lupron before with my very first IVF and had OHSS! E2 got over 5300.. It wasn't super horrible, but it did suck.. So I am against long lupron. Antagonist IS the new go to cycle (It didn't seem like they offered you that only shorter lupron phase) I agree with the PP who said ask your RE why he feels you would be more at risk for OHSS or is he simply saying this to cover his butt. If it's simply CYA statement I would move forward now.. If he has a legitimate concern, I too would just go with long lupron.. I don't know why you would really need long lupron and quality is more important than quantity (but of course you don't want to end up with 1 follicle, but you get what I'm saying) Good luck with whatever you decide!

Good Timing said...

It is so hard to decide what to do isn't it? That was how I felt with deciding to do injectables or not. Even if you just do injectables there is still a risk of OHSS, there always is. Did you have a chance to talk to your RE about what to do? Good luck with your decision. :)

Jenny said...

I didn't take anything before my IVF cycle. AF came and I just started stimming. Nobody ever advised me to take anything either so I really don't understand the purpose...but I'm not a doctor and don't know your personal situation...but keep in mind I have stage 4 endometriosis and they never put me on lupron so I don't think it's a necessity...I had no OHSS and obviously my cycle was successful as my baby girl is right here! Good luck

manymanymoons said...

I have no advice on this, but just wanted you to know I'm thinking of you. There is nothing worse than somone else's falling down on the job costs you time and heartache!

Shannon said...

I completely understand. I thought we were going to be doing IVF this upcoming cycle (in 2 weeks), but my doctor wants me on bcp to supress ovulation and the formation of cysts. Because I have a history of cysts and had surgery to have some removed, we decided to go along with this. We were so bummed this delayed everything a month, but we are so excited to start IVF this month!!!!