The Official TTC for 6 Months or More Thread

[split_shank]

Delurking to say that although I'm only TTC for 5 months, I was hoping for some insight on progesterone supplements. My CD21 progesterone level came back at 5.1 As much as I am disappointed, I feel a little relieved to maybe have an answer and confirm my theory all along. My OBGyn gave me the choice of Clomid (I don't think I'm having trouble ovulating to be honest, I have surges every month that I've tracked with symptoms to go along with it), or progesterone supplements, either Prometrium pill or Crinone gel. I'm leaning towards Crinone but just wondering if you ladies could offer some opinions. TIA!

 

[monkeyprincess]

SS, were you 7DPO on CD21? Just curious because if CD21 was not 7DPO for you, then your progesterone reading would not necessarily be accurate. A lot of things I've read suggest that if you have low progesterone, it may be caused by inadequate follicular development, which results in a weak ovulation and low progesterone. That's probably why your doctor offered clomid, because theoretically, you may have a stronger ovulation and higher progesterone with clomid. Have you tracked your cycles to determine you have a short luteal phase or do you have spotting before AF? There is a lot of dispute as to whether progesterone supplements really do anything, but as far as I know, taking progesterone wouldn't hurt anything as long as you make sure you track ovulation and don't start it until a few days after ovulation. You also have to stop it after you confirm you are not pregnant, or it will delay AF. You could also try clomid and monitor with ultrasounds to see how you react. Clomid has helped a lot of people around here get pregnant. Hope that helps.

 

[split_shank]

I was 7-8 DPO. Thanks for the info re: Clomid. I didn't know that would have a significant progesterone effect. I didn't research that as much as I "assumed" I was ovulating. Now I'm starting to question if it was weak. I always wondered about PCOS as well. On CBE advanced monitor, I get a high reading for several days but never a "peak" reading. Could this mean I'm not actually ovulating? I am pretty clockwork otherwise, getting the surges around day 14, and AF on 28 or 29. I have had spotting about 4 days before AF the last few months leading me to believe it was indeed progesterone/LF defect. So confused.

 

[BrightSpot]

SS, welcome! And ditto to everything MP said. My OB said a progesterone level above 5 at 7dpo indicates ovulation but they really look for a level of 10 in a non-medicated cycle, 15 in a medicated cycle. I wonder if you might not be ovulating.
It's relatively rare, but it's possible to surge but not ovulate (look up LUFTS). Or you might have a "weaker" ovulation. Either way, clomid could help & is very easy to take.
I haven't used prometrium, but I have used crinone 8 suppositories for several cycles. It's easy to use & isn't messy.

Whatever you decide, good luck & we're here for you!

 

[split_shank]

Thank you for the replies! FWIW, my CD3 LH and FSH were 5.19 and 4.73, respectively. Not sure if that helps decipher anything.

 

[tammy77]

SS, I wanted to ditto MP and Bright. I ovulated every month and had well timed BD for 14 months (temped and opk'd). I finally got pregnant using Femara and an IUI (first try, we were VERY lucky). Once I did get pregnant, they continued to monitor my progesterone levels and I had to be on supplements for the first 10 weeks. Even with the medicated cycle, mine was still low. I'm not sure what your FSH/LH levels mean, I ended up getting my AMH and antral follicle count instead of using the FSH/LH blood tests. If you haven't yet, I'd encourage you to ask for those too. It gives you a much clearer snapshot of your remaining years of fertility. Mine was very low, so we didn't waste anymore time getting to an RE after getting my AMH results back.

Good luck ladies! I'm cheering you all on from the sidelines. Bright, I can't wait for your update in a few days! Will they give you updates on how well they're growing between now and then?

 

[tbaus]

Hi everyone! Long time lurker, jumping in!

First of all, I just wanted to say I'm sorry any of us have to go through this. But it is awesome to have access to such a supportive group of people. I hope everyone's wishes come true sooner rather than later.

Some background info on me (I"ll try and keep it short). DH an I have been together for 11 years, and this past Monday was our 3 year wedding anniversary. Just before we got married I was having some doubts about my fertility so I wanted to start trying straight away after the wedding. We were only 25 when we got married so my DH wasn't too keen, so we took the not trying, not preventing approach. Fast forward a couple of months and I got my PCOS diagnosis. My main issues were piling on the weight and the fact that I have anovulatory cycles. Later came the hair loss. And then we found out I was insulin resistant too. I was put on metformin and after a rough year we decided to stop trying for a year and go travelling for 8 months. The Dr actually suggested it might be a good idea to wait a while before TTC, so my body would have time to adjust to all the changes. I'm not going to lie, we kind of still hoped we'd have an accident along the way. No such luck.

We arrived back home in February, and it has been non stop testing from then on. The clinic I go to is specifically for PCOS patients, and I guess they just move you up the scale depending on the severity. Originally I was seeing a PCOS "specialist" (a glorified GP essentially), and after seeing that a year later my hormone levels haven't really changed she decided it would be best to move me on and see an Endocrinologist. So I am now seeing the new doctor who I am not totally happy with to be quite honest, but that is a whole other post in itself. Another round of tests later (I have had so many blood tests in the last 5 months my husband now calls me the human pincushion) and I finally had some baseline tests done yesterday. The Dr called to give me the results and all she told me was my estrogen levels were 243 and she wanted me to start clomid straight away. So for now I am on 50mg once a day for 5 days. I took my first pill last night, and no side effects so far. I go for another blood test next Tuesday.

It has been a long road, and it has taken it us 3 years to get here, but I feel like we are officially TTC now. I hope you guys don't mind if I join you. We are trying to be positive and hope this is all it takes, but we are realistic too given the severity of my PCOS.

As for a cycle day, I don't know? The first day of my last period was 2nd March. I just checked Fertility Friend and it says: "Cycle Day- N/A" That helps!

Nice to "meet" you all!

 

[split_shank]

tbaus welcome! I hope your journey is short lived and successful, as well as the rest of the helpful ladies here. Its so nice to have a sounding board as well as some helpful advice. I apologize for not being able to respond to everyone with information or suggestions, as I am as green (and most likely uneducated on the topic) as they come around here. I just hope everyone gets to the place we are all aiming for in the end.

Re: Clomid, I am fearful to be honest. I truly feel I am estrogen dominant/progeterone deficient, as my symptoms go beyond infertility. The past endometriosis, hair where it shouldn't be, general waist weight gain (7 lbs in the last 4 months, in spite working my a$$ off and keeping a fairly good diet), spotting before periods, mood/anxiety issues, the list goes on. If I read the info right, doesn't clomid increase estrogen even more? Or at least spike production of more? I don't think I can handle any more! I feel like I need to get my progesterone levels figured out to get my body regulated, even if it means the pregnancy doesn't happen right away.

Someone please correct me if I am way off base on this info. I am reading so much and getting different info on clomid and progesterone. You ladies are a great help and I don't mean to dismiss any of your great advice.

 

[monkeyprincess]

SS, I really don't know much about estrogen dominance unfortunately. Are you seeing an RE? If not, I think that would probably be your best bet to figure out if your hormone levels are appropriate. The fact that your progesterone was so low on 7DPO leads me to believe you are having ovulation problems, and it might not hurt to do a monitored cycle of clomid to see what happens. I also think it depends on what your goal is. If you are not in a rush to get pregnant, then it might be smart for you to really focus on getting an accurate picture of your hormone levels throughout your cycle and figuring out ways of regulating them and monitoring your follicles and uterine lining, etc.

tbaus, welcome. That's interesting they are having you start clomid in the middle of a long cycle. Normally, you have to wait until CD3 or CD5 to start it. I hope you have good luck with the clomid and do not have to TTC too much longer!

Bright, still thinking of you and your little embryos! Hope you are hanging in there and managing the shots okay!

 

[JGator]

SS, I ended up doing 3 cycles of Clomid (100MG) with a trigger shot (Ovidrel) and timed intercourse, and we were lucky on the 3rd cycle. All of my test results came back normal and so did my husband's. I had no symptoms with the Clomid, and I think it really helps improve your odds by helping you ovulate the best egg(s). We tried for a year, and had one miscarriage about 8 months into trying. Then, we started to see an RE and used Clomid/Ovidrel. With my first pregnancy, I needed to take Crinione because I had low Progesterone in the pregnancy, in my 2nd pregnancy, my Progesterone levels were normal and I did not need to take the Crinone. I also had no issues with Crinone. I think you should definitely try the Clomid as it really has helped a lot of people with unexplained infertility.

Welcome tbaus! Good luck with the Clomid. I hope you have the same results that I did with a BFP.

Bright, thinking of you and your embryos!

 

[split_shank]

Thanks ladies. I think I'm going to try the Crinone for a month or 2 (I realize it may take a few months for levels to rise) and then if things aren't improving, I will ask about Clomid. I would probably still do the Crinone. I suppose if I end up pregnant, I don't have much to say or do with my raging hormones until after pregnancy. We'll cross that road when we get there. The goal is pregnancy right now, not the 7 lbs. I haven't read back very far, but have many experienced multiples with Clomid?

Also, do you have to do a trigger shot with Clomid?

 

[monkeyprincess]

Thanks ladies. I think I'm going to try the Crinone for a month or 2 (I realize it may take a few months for levels to rise) and then if things aren't improving, I will ask about Clomid. I would probably still do the Crinone. I suppose if I end up pregnant, I don't have much to say or do with my raging hormones until after pregnancy. We'll cross that road when we get there. The goal is pregnancy right now, not the 7 lbs. I haven't read back very far, but have many experienced multiples with Clomid?

Also, do you have to do a trigger shot with Clomid?

SS, the thing with progesterone is that by taking supplements, you won't actually be building up your levels of progesterone over time. You probably know all of this, but I'll say it just in case. In a nutshell, each month you ovulate after one follicle becomes dominant and releases an egg. The ruptured follicle/corpus luteum then produces progesterone to prepare your uterus for pregnancy. If there is no pregnancy, your progesterone peaks at about 7DPO and then falls abruptly at the end of your luteal phase, and you get AF. If an egg is fertilized and implants, signals are sent to your body to keep producing progesterone until the placenta takes over. So if you take a progesterone supplement, you take the progesterone after you ovulate until about 14DPO. If you aren't pregnant, you stop, and AF comes. So, I think the only way a progesterone supplement is going to help you is if you are in fact ovulating and the egg is fertilizing, but you don't have enough progesterone to allow the embryo to implant properly. Doesn't hurt to try it and see what happens, and then try clomid later on if you want.

As far as clomid, I used it one month of 25 mg days 3-7, and I only had one dominant follicle. No trigger, no progesterone, BFN. The next month I took 50 mg days 4-8, 3-4 follicles, no trigger, no progesterone, BFN. The third month, I again took 50 mg days 4-8 (I think), 3-4 follices, trigger, IUI and prometrium (progesterone), and I finally got my BFP, and it was just one baby. I really didn't notice any side effects from the clomid or the progesterone. I'm sure your doctor would be monitoring you to see your response if you are concerned about multiples. Hope tht helps a bit. I know it is all daunting!

 

[Laila619]

Bright, 5 of 6 eggs fertilizing is awesome news!! Did you do ICSI? I'm so rooting for you! Grow embies, grow!

 

[split_shank]

Thanks MP for the info. I am definitely an amateur at this and clearly need to do some more reading! I didn't think it would come to this so it is all coming at me very fast. I really appreciate this!

 

[BrightSpot]

SS, you've gotten a lot of great advice from the lovely ladies here. I think the incidence of multiples on a low dose of clomid is very low & a trigger shot is not always necessary. I've taken clomid twice without many side effects. I would also recommend seeing a reproductive endocrinologist (RE) to figure out what's going on. Usually the first round of fertility tests involves day 3 & day 7 (progesterone) bloodwork followed by a semen analysis for your DH & a hysterosalpingogram (HSG) for you to check that your tubes aren't blocked.
With the weight gain, irregular cycles & hair where you wouldn't expect it, it's worth checking if you have PCOS as well.

Tbaus, welcome! I'm so sorry you're going through everything you are but glad you've come to join us. DH & I have been ttc for close to 3 years as well & since we started I've been diagnosed with pcos & have been cursed with weight gain, irregular cycles, fertility troubles (getting & staying pregnant) & hair loss. It's a pretty heartbreaking process but you're not alone. As awful as having pcos is, that's great that you have the diagnosis and are seeing a specialist. For many women with pcos, clomid is all they need to get pregnant. And time is definitely on your side. Best of luck to you in your journey!

I don't know if you've found any of these resources online or not, but I've found the websites soul cysters & pcos diva to be very helpful.

MP & Jgator, thanks! I hope my embies are doing great & growing away. It's a little weird & surreal to just sit & wait, not knowing what's happening. DH has taken to calling them "the quints." It's pretty cute.

Tammy, thanks! I don't think I'll have another update until tomorrow, so I'm just waiting now.
As for freezing, if we have any extra good quality embryos, I would love to freeze them. It would be a relief to have a backup if this cycle doesn't work out to use or for a future pregnancy.

Laila, thanks, lady! Yep, my RE's office always does ICSI with IVF. We didn't start out with a huge number of eggs, so I'm glad so many fertilized.

Afm, I'm still sore but feeling better every day. I hope all is going well with the embryos. It's odd not to know what's happening, but I guess I'll have to be patient.
The embryos are set to be biopsied tomorrow (prayers that it goes well!) so I think that'll be our next update.

We start my lovenox (blood thinner) injections tonight. I'm a little nervous about those side effect wise. I guess I'm skipping ahead a lot here, but it seems, of people who are put on these injections, they are usually on them until 6 weeks post partum & often can't have an epidural.
But....one thing at a time.

 

[Bella_mezzo]

Bright! 5 embryos is great and I hope that they are strong and healthy!!! Please let us know how the testing comes out and how the transfer goes!!! "the quints" is adorable!

SS- FWIW I seem to be strongly estrogen dominant as well and took clomid for 2 cycles. I only took 50mg (though my Dr prescribed 100mg) b/c I was concerned about how my body would react. 50 worked great the first month to stop the constant uterine bleeding I had been having. And the second month, I got PG (I am now 9 weeks). I had some side effects (weird eye strain, very moody, some cramping/bloating/constipation) but it wasn't awful.

 

[LtlFirecracker]

I am iPhone posting as my Internet is down, so forgive me for being brief

Split shank. A day 3 FSH is a marker of a ovarian reserve. That number looks great!

Bright. I am so excited that 5 fertilized! Day 5 embryos have a better implantation rate. Wishing you luck!

 

[split_shank]

I talked to my OBGYN's office today after calling for a different reason and they said whenever I am ready to call on a CD1 and they will call in a Clomid script. Sounds like she would do 50mg for 5 days, days 3-7. I'm going to give my left ovary one more chance next month (she's the good one with no old endo ), then likely try a few rounds of Clomid with Crinone. Thanks again!

 

[tammy77]

Popping back in because I forgot to mention my experience with clomid. I took two rounds, the first was 50mg and that produced one dominant follicle. The second cycle was 100mg and again, only one dominant. My Femara cycle I can't remember the dose but it also only produced one. So my experience with the meds is similar to the other ladies that have already posted. The great thing about going to an RE (though a good OB could do so as well...) is that you'll be monitored to make sure that your body doesn't produce too many follicles for your comfort level. It really is a good idea to make sure that you get in for a scan around CD 10-12 when you take it, at least the first time.

Bright, I'll be stalking this thread for your update tomorrow my friend and I'm continuing to send up those thoughts and prayers!

 

[BrightSpot]

Day 3 update is not good news. Of the 5 embryos that fertilized, only 2 are candidates for biopsy & pgd. We just spoke with the doc, who said even these 2 don't look very good & barely meet the criteria for biopsy.

We're going to wait 2 more days until day 5 to see how they develop. At that point we could either biopsy, then freeze the embryos for a possible FET later (if the biopsy results come back normal) or do a transfer & cross our fingers hoping that it either works & we have a healthy pregnancy or we get a BFN (rather than a BFP followed by another blighted ovum & miscarriage).

I'm so heartsick. (And here I was worrying about my epidural yesterday. You'd think I'd be smarter than that by now.)

 

[monkeyprincess]

Bright, I'm so sorry to hear that you didn't get better news today. I don't even know what to say, but just know you have a lot of people who are thinking about you. I'll be sending lots of thoughts and prayers your way that things are looking better with the embryos by Saturday. Hugs.

 

[NewEnglandLady]

Bright, I'm so sorry that the news isn't favorable. I realize that the embies are being biopsied, but there is no option for an earlier implantation, is there? My friend had planned to do a transfer at day 5, but 2 of her embies were barely growing (1 4 cell and 1 6 cell with fragmentation) and they decided to implant her at day 3 based on research that weak embryos tend to do better inside the body (day 5 transfers have higher success rates for stronger embryos). I'm probably not being helpful at all...and this was 4 years ago, which seems like light years in the medical world. Thinking of you and really hoping that the embies pull through.

 

[JGator]

Bright, I'm sorry to hear you are down today. I am still holding out hope for the 2 embies. Can they do any genetic testing on the embies to figure out why they are not looking good? Hugs to you my dear.

 

[lliang_chi]

Bright, my dear, I'm sending lots of dust your way that the em's will show great signs of development in the next few days. I really hope this will it for you.

 

[BrightSpot]

MP, NEL, JGator & LC, thank you so much for your sweet posts. Your words brightened what has been a pretty dark day.

So I think we've decided not to do the genetic testing. I think it would only tell us if the embryos are normal or not (and maybe not why they are abnormal/if there's anything that could be done differently to get a better result.) Since we're down to only 2 potentially viable embryos, there really isn't any weeding out that the PGD could help us with. (Not to mention that it's almost $5k out of pocket on top of the IVF cycle charge.)

So I guess we're just waiting until Saturday to determine if we transfer the remaining embryo(s) or not. If they look ok, then we'll transfer. If they don't look good I don't know if we're better off discarding them (sob) or transferring them anyway hoping for a miracle.

NEL, interesting about your friend's cycle. Was it successful? I'll run that question by my doc.

 

[NewEnglandLady]

Bright, I think that given the circumstances (2 possibly viable embryos), skipping the genetic testing is a good call. Will your doc not give you any updates until Sat.?

My friend did have success. They implanted both and ended up losing the 6 cell, but the 4 cell went on to thrive. At least the doc thinks it was the 6 cell that they lost...I'm not quite sure how they knew. Anyway, that 4 cell embryo is now an absolutely adorable 3 year old boy.

I'm keeping absolutely everything crossed for you and am sending all the dust I have to those growing embies!

ETA: Not sure if it helps at all, but my friend did her IVF through MGH. Not sure how research works in the medical world (maybe the studies this doc was using were proprietary?), but just thought I'd throw that out there. I've had other friends go through IVF at other hospitals, but the MGH doc was the only one who recommended an earlier transfer for weaker embryos.

 

[Loves Vintage]

Bright, Sorry to hear about your news from this morning, but glad to hear that you have a plan in place. I am hoping for the best outcome for your embryos! I wondered whether you could transfer even without the testing. Can I ask another question? If the other 3 are not viable for testing, is it possible to transfer those as well? I am not sure how many total you had planned to transfer, but just curious whether they are still possible candidates for transfer.

Wishing you all the best!!

 

[BrightSpot]

NEL, thanks for the update. How interesting that the smaller embryo was the one that wound up flourishing & becoming your friend's adorable son. I wonder how they knew that.

I haven't done a tremendous amount of IVF research but I kind of feel like I've heard something similar before too though about day 3 vs day 5.

LV, thanks for your post. I guess the determination on which embryos were doing best/were candidates for biopsy was the level of cellular development. I'm not sure if the other ones that were behind could catch up in the next couple of days or if they will stagnate & not be viable. I assumed that the other 3 embryos were not candidates for transfer but I didn't confirm that. And we could definitely transfer without the genetic testing.

This is from my doc:

"It won't give them a better shot, because if they're normal now they'll be normal then and vice versa, but if you want we can transfer them tomorrow.
The reason to go to day 5 is to avoid transferring anything that is abnormal, becuase if they look very deficient on day 5 then we know they are abnormal."

He left the decision up to me & I'm a bit uncertain but am leaning toward the day 5 transfer because he seems to think this is what's best. He also offered the possibility of a day 6 transfer on Sunday but DH is going out of town on business on Saturday evening & we would both rather get whatever news is coming on Saturday when we'll be together than Sunday when I'll be alone.

Ugh.

 

[monkeyprincess]

Bright, you must just be reeling right now.

I'm a geeky science nerd and was doing a little reading up on IVF recently I think when Firecracker was going through it, and I distinctly remember reading something along the lines of what NEL said. It was saying something like only certain embryos can get to day 5 or 6 outside the body, but others do better if you put them in sooner. However, I agree that you should go with what your doctor thinks is best in your particular case. I also think I would opt not to do the genetic testing, because I think I read something that it can sometimes damage the embryo's remaining cells, and then there is no guarantee they would freeze and thaw properly anyway. But obviously this is only my layperson rambling.

Sendings hugs your way. I wish this didn't have to be so hard.

 

[Loves Vintage]

That's great that you can email your RE!!! Fingers crossed over here!!!