Help Me Out Here…

Alright, I just had a chat with my friend who is currently trying to do IVF.  She got all ready in December and medicated herself.  She started meds on a Sunday and didn’t have an appointment until Friday to check follicles.  Turns out she had three sized 14-15 on one side, and three sized 5-6 on the other.  The doctor decided that the others would never catch up in time, so he cancelled the cycle.

— Okay, so let’s analyse all of this for a second.  First, should she have had an appointment earlier than five days after starting meds for the first time?  This was her first time on injectables and there was no telling how her body was going to react.  Second, that’s all I had for this section.

So, she’s super bummed and goes in for another consultation to discussed what they are going to do differently this time around.  The doctor tells her that they are going to keep her off of birth control the month before IVF, because sometimes this can prevent IVF from working well because it hinders egg growth.  Then he tells her that once her period starts, he will bring her in on day three and she’ll have an ultrasound to check and see how many potential eggs she has in her ovaries.  Then, if she has enough potential eggs, they are going to start her meds at a higher dosage.  If she doesn’t have enough eggs, they will wait to start until next month (if the scan goes well that month).

— Okay, so… I didn’t know that birth control before IVF could decrease your potential eggs for the cycle.  Every single person I’ve talked to, and every blog I’ve read, have seemed to have the same theme of “birth control for a month, then we’ll begin!”  Have any of you heard of not taking birth control before starting IVF treatment to increase the potential for a higher follicle count??  Also, has anyone ever heard of the doctor being able to look at your ovaries and tell how many eggs have the potential to mature that cycle?  I have never, in my three years of reading and talking to doctors about infertility, heard anything like that.  I know when I was diagnosed with DOR, due to my low AMH number, they brought me in for an ultrasound to confirm that my ovaries were pretty empty.  I assumed they were looking at how full they were in general, not how many eggs were available at that moment.  I mean, I was still on birth control during that scan, so had I assumed right since birth control prevents you from ovulating, how would eggs show up on a scan as “ready to go”?

I’m confused by the things she’s telling me because everyone else I’ve ever talked to about this stuff has been consistent with their information and she’s throwing out things I’ve never heard of.  I just hope that her doctor is taking care of her, and is following correct protocol to get my friend pregnant so that she can enjoy pregnancy like I am.  I want the best for her.  I told her that if her doctor can’t get her dosage right this time, that she’s spending the summer with me and she’s going to my doctor.  She has unexplained infertility at the moment, although she said the doctor told her that her AMH is a little lower than average for a girl her age.  I think my doctor could get her knocked up.. if anyone could.. it would be him.  Does that sound weird?  😉

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8 thoughts on “Help Me Out Here…

  1. Hmmmm…well, my third IVF cycle we did a “natural start” cycle, where I didn’t take birth control at all and went in on day 3 of my cycle so they could look at my resting follicles (we started stimming either that day or the day after). The doctor said she was concerned that the birth control was over-suppressing me. So, I wonder if that’s what she means – a natural day 3 start and then they check her resting follicle count?

    • That sounds right. I’m glad someones heard of it! I just thought her doctor was crazy. 🙂 Thanks for helping me out with that. It will help me when I’m talking to her about this, since her protocol is so different from mine.

  2. I have large endometrioma cysts in both of my ovaries, so my RE had me do 2 months of birth control instead of one, along with Lupron. That regimen completely oversuppressed me, only had 4 follicles at my suppression check. So, since then I haven’t taken any birth control for IVF #1, #2 or FET. I don’t think it’s unheard of.

  3. I didn’t take bc for my second cycle. I’m DOR and my RE didn’t want it over suppressing my ovaries. Also, they can look and see how many antral follicles she has on day 3-but it doesn’t necessarily correlate to eggs retrieved. On our second cycle I had 10 antral follicles, but still only got 5 mature eggs. On my first I only had 3 antral follicles and got 6 mature.
    Also, with both cycles, I didnt come in for my first monitoring appt until day 5. I think it was fast to cancel her though-maybe they should have adjusted the dosage and given it a couple days to see what happened.

    • Ah, okay. That makes a lot of sense. I didn’t think it could correspond to eggs though. She said they always saw 12-14 “potential eggs” each time she went in for IUI’s, but she’d usually only have 2-3 follicles. Not sure why they are letting the antral follicles be the deciding factor in her cycle though. Hopefully they see enough to let them go ahead with the cycle. 🙂 thanks for the information! I like to try to be informed so I can talk to her and ease her mind when I can. Her protocol is so different from mine though!

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