Sunday, February 27, 2011

IVF Questions- Part 1

I have two days left to take progesterone.  I am on day 5 of Lupron shots.  I am supposed to call Nurse LLD when AF shows up after the last progesterone pill.  Disclaimer- I know that every cycle is different, every person is different and to 'expect the unexpected' over the next few weeks.  Nevertheless, I always have questions floating around in my head (hence the Part 1) and say "thank you" in advance to anyone who would like to share your thoughts about any of the topics below. 

1.  How closely does the antral follicle count predict number of eggs at retrieval?
2.  When I get to the stims, are their any foods/diet tips associated with reducing the risks of OHSS? 
3.  Did anyone else not take BCPs prior to an IVF cycle? 

Lastly, should I put this back under the counter or not?!?
 
It's had a home under the counter for a long time but my RE clinic is also connected to a university and my "delicate and sensitive areas" as described on the box will soon be on display for research purposes as well as IVF.  Prerequisite for IVF- keep your sense of humor about some things!  :]  

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Baby Hopes said...

I love that you're asking questions and keeping a sense of humor about it as well!!! I'll be following along as I have several questions about IVF and anticipate that we may be there soon. I'm excited for you!!! Best of luck!!!

Anonymous said...

I totally recommend a continued sense of humor for SURE! LOL. And, yes to the bikini wax (although "microwave forumala" scares me....haha).

I didn't take BCPs prior to both of my IVFs, just Lupron. I had OHSS on the first cycle and was fine on the 2nd. I'm absolutely unsure about diet tips to prevent OHSS, because it was totally unexpected for me....hmmm, now you've got me curious, and I want to do some research on that subject.

Antral follicle count: Yup, everyone is different. For me, the eggs retrieved were roughly 2/3 of the antral follicle count. Then you have to think about egg maturity and the number of eggs that fertilize...oh so much to think and obsess about. Good times.

Perhaps a Brazilian Wax will help reduce the obsessions. ;-)

~ebc~ said...

ok, i'll take a stab (ahaha) at answering--
1) antral count--you can't (well, rarely if some are hiding i guess) get more eggs than you have antrals, but you can get way less eggs than you have antrals. for example, my first ivf 9 antrals turned into 5 mature eggs; for my fifth (gasp) ivf 7 antrals turned into 1 mature egg. of course, i have dor, so i'm probably a piss poor example, but all that to say--it totally depends on the person, their reaction to the meds and the cycle. stupid unpredictable ivf.

2) while i would almost be grateful for enough eggs/antrals to induce OHSS, i only know what i've read--if i remember correctly, there is something about protein--i think maybe increased protein lowers the risk, but too much is a bad thing too?? not sure--go ahead an google that I suppose if you start over responding. there's also something about gatorade, but i seem to remember a split opinion on that as well. yeah, that wasn't really helpful, but maybe gave you a few keywords to start with.

3) i only did bcp prior to one of my ivf cycles. it's only a part of one of the two main protocols out there i believe (heck, I've been through this enough i should know more but the knowledge is only temporary i've learned--at the end of the cycle i seem to literally flush all the depth i once knew). anyways, the other times i did lu.pron or gani.relix .

4) kuddos if you can do a home kit like that. i can do shots like a champ now...but not a home wax! i will admit, i do trim my up before fun appts, but never been brave enough to wax.

hope you found a least a word of two of this helpful. good questions to be asking though--gotta know enough to advocate for yourself but not so much you drive yourself crazy!

Kristen said...

Best of luck with your upcoming cycle!
In answers to questions 3 and 4:
I didn't have BCPs as part of my protocol...it's seems a little unusual and I never asked why, but just wanted you to know you're not the only one.
Also, I waxed before IVF...it's something I normally do and I tried to keep things as normal as possible...there are enough things a girl has to change when going through this. :)
Wishing the best for you...

Kerrik said...

Here is the info my doc has on his site:

1. When there are an average (or high) number of antral follicles, we tend to get a "good" response with many mature follicles. We tend to get a good number of eggs at retrieval in these cases. Pregnancy rates are higher than average.

2. When there are few antral follicles, we tend to get a poor response with few mature follicles. Cancellation of the IVF cycle is much more common when there is a low antral count. Pregnancy rates are lower overall in this group. The reduction in success rates is more pronounced in women over 35 years old.

3. When the number of antral follicles is intermediate, the response is not as predictable. In most cases the response is intermediate. However, we could also have either a low or a good response when the antral counts are intermediate. Pregnancy rates are pretty good overall in this group.

I had 46 antrals (PCO) at last count, so I'm hoping for a good response but I've never been stimulated before so I'm kinda nervous. I know they are going to be suppressing me with Lupron for almost the whole cycle, which is also kind of scary but I guess they know what they are doing.

Anyway, hope that helps a bit.

Anonymous said...

Like you said, everyone is different and every MD had different protocols....but since you asked
I took BCP for 14 days then did 1 shot of lupron. Because I am 'high risk' for OHSS Duke does one lupron in the beginning and one as the trigger.
I had 10 follicles >20 and had 8 eggs retrieved, 5 were 'ICSI quality' and all 5 fertilized (which was amazing bc it's normally 80%-its the only thing that worked 'perfectly' for us). I have seen some people get all the eggs from follicles seen and some only get a few. It also depends on the size of the follicle- I was told only expect a 'good' egg from those >20
PROTEIN!!! Protein is the best thing for you to eat if you are at risk for OHSS. Gatorade is also good bc of the electrolytes.
Otherwise, everyone is different, don't compare yourself, your protocol or results to anyone else. No 2 people will have the same of anything and that is okay...just trust what is happening to you and for you is correct and laugh, enjoy and relax. (I know WAY easier said than done- this is coming from a stress ball persona :))

Brice Barnes said...

My stats were, 18 astral follicle count, 12 retrieved, 9 mature and ICSI-Ed, 2 transfer, one frozen.

Good luck, I never had ohss, but I have red to eat a high protein diet.

Will be thinking of you in the next few weeks, good luck!

Krista said...

The number of antral follicles at baseline is a pretty good indicator of many eggs will be retrieved. I had 60+ antral follicles at baseline, and they retrieved 50 eggs. So, it's definitely not an exact...sometimes more follicles will show up later on after the baseline, sometimes there aren't eggs in every follicle, sometimes some of the follicles will get "starved off" (as what happened to me.) Antral follicles at baseline give you a good idea of many eggs may be retrieved...but not exact!

They didn't give me any diet tips to keep OHSS away. But if they think you are at risk, they will give you a med called cabergoline to take for 7 days starting at trigger. If you get OHSS, it is best to eat protein and drink gatorade...that's how I kicked mine!

I did NOT take BCP before my IVF cycle. I just did Lupron injections. I still had an awesome response to the meds, so I don't think BCP are necessary.

Keep in mind that your next cycle may be a bit different then what you are used to...it is called a "lupron period" because it tends to come late and it is usually a lot lighter than normal.

Let me know if you ever want to talk...I just went through all this last month! :-)

China Doll said...

I haven't started IVF yet so can't really help with those questions.. but definitely go for the wax would be my advice :) But you're brave if you can do it at home.. I always get mine done at a salon and that's bad enough! (Not that bad really!)

Miss Mac said...

Thanks everyone for taking the time to respond on these topics. This is a such a solid support system... I can't imagine going through the next few weeks without the connections through this blog! Thanks again!!!

Christina said...

I'll take a stab at your questions...

1. I wish I knew this one...
2. My RE says it's best to stay hydrated, only he says to drink Cytomax instead of Gatorade. I guess it's higher quality and much less sugar. The other thing is to eat a lot of protein, especially eggs. Apparently they give you albumin (it's in eggs) at the hospital if you have OHSS.
3. I do know that I will be taking BCP's.

And, lastly, I know nothing about waxing - I usually just keep it trimmed, but then again I don't have much for stragglers outside the bikini area - lucky me :)