Letter to my RE:
I haven’t had my beta yet but at 17dpo my tests are negative. So I figured I’d send my questions early to get a jump on the next cycle. I’d like to take a cycle off and cycle again starting mid/late May with that period.
1. We have 6 embryos left. Would you recommend transferring two again? What were the grades of the two I transferred and what are the grades of the remaining embryos?
She will get back to me.
2. Should I do a mock cycle and check endometrial receptivity?
No. No really reliable test.
3. Should we repeat any tests (ex. HSG, hysteroscopy)? I had a blocked tube in 2011 and it appeared unblocked in 2014. Should we check for hydrosalpinxes just in case?
Yes. Repeat hysteroscopy next cycle.
4. I added estrace pills vaginally (I was prescribed them with my semi-successful FET 5/2014), can we add these into my protocol for my next FET? I just want it documented as I don’t want to “self prescribe” anything next cycle. I did 1 AM and 1 PM pill vaginally starting on cycle day 6. My 11mm lining seemed good on CD 12.
We will repeat this.
5. Is there any way we can get the person who did our successful transfer in 2012 to do the next one? Or a doctor who has the highest success rate per transfer?
Thursdays are Dr. Austin, Friday's are Dr. Flyckt and Lisbona. I can decide which day and person I'd like.
6. Should we do an endometrial scratch the cycle prior? http://www.medicalnewstoday.com/articles/267215.php?hc_location=ufi
Yes. She will get back to me about cycle timing (I pushed for luteal phase, she wanted to do in follicular phase with hysteroscopy, I'm not comfortable NOT doing it in the luteal phase).
Immunotherapy Questions:
7. There is a link between Hashimotos and insulin resistance? Put on Metformin as a precaution? http://www.hormones.gr/556/article/low-dose-metformin-improves-pregnancy-rate-in%E2%80%A6.html
Testing for insulin resistance on 5/7. She will put me on metformin if I need it.
UPDATE: Insulin was 15.1. RE and PCP still didn't want to put me on metformin. Endocrinologist agreed to 500 daily metformin. Started on 5/15.
8. Should we add more prednisone sooner and longer? “Achievement of optimal success with corticosteroid therapy requires that the treatment be initiated well before ovulation takes place (about 7-14 days prior to anticipated implantation).”
No.
9. Should we look into IVIG? http://www.ncbi.nlm.nih.gov/pubmed/11723539
No.
10. Can we add lovenox next time? We added this with my only pregnancy post having baby #1 (FET 5/2014). It failed, but it was the furthest we got in our efforts to have baby #2.
No.
11. Should we add neupogen? http://www.sims.ie/news-views/neupogen-and-implantation.1682.html
I haven’t had my beta yet but at 17dpo my tests are negative. So I figured I’d send my questions early to get a jump on the next cycle. I’d like to take a cycle off and cycle again starting mid/late May with that period.
1. We have 6 embryos left. Would you recommend transferring two again? What were the grades of the two I transferred and what are the grades of the remaining embryos?
She will get back to me.
2. Should I do a mock cycle and check endometrial receptivity?
No. No really reliable test.
3. Should we repeat any tests (ex. HSG, hysteroscopy)? I had a blocked tube in 2011 and it appeared unblocked in 2014. Should we check for hydrosalpinxes just in case?
Yes. Repeat hysteroscopy next cycle.
4. I added estrace pills vaginally (I was prescribed them with my semi-successful FET 5/2014), can we add these into my protocol for my next FET? I just want it documented as I don’t want to “self prescribe” anything next cycle. I did 1 AM and 1 PM pill vaginally starting on cycle day 6. My 11mm lining seemed good on CD 12.
We will repeat this.
5. Is there any way we can get the person who did our successful transfer in 2012 to do the next one? Or a doctor who has the highest success rate per transfer?
Thursdays are Dr. Austin, Friday's are Dr. Flyckt and Lisbona. I can decide which day and person I'd like.
6. Should we do an endometrial scratch the cycle prior? http://www.medicalnewstoday.com/articles/267215.php?hc_location=ufi
Yes. She will get back to me about cycle timing (I pushed for luteal phase, she wanted to do in follicular phase with hysteroscopy, I'm not comfortable NOT doing it in the luteal phase).
Immunotherapy Questions:
7. There is a link between Hashimotos and insulin resistance? Put on Metformin as a precaution? http://www.hormones.gr/556/article/low-dose-metformin-improves-pregnancy-rate-in%E2%80%A6.html
Testing for insulin resistance on 5/7. She will put me on metformin if I need it.
UPDATE: Insulin was 15.1. RE and PCP still didn't want to put me on metformin. Endocrinologist agreed to 500 daily metformin. Started on 5/15.
8. Should we add more prednisone sooner and longer? “Achievement of optimal success with corticosteroid therapy requires that the treatment be initiated well before ovulation takes place (about 7-14 days prior to anticipated implantation).”
No.
9. Should we look into IVIG? http://www.ncbi.nlm.nih.gov/pubmed/11723539
No.
10. Can we add lovenox next time? We added this with my only pregnancy post having baby #1 (FET 5/2014). It failed, but it was the furthest we got in our efforts to have baby #2.
No.
11. Should we add neupogen? http://www.sims.ie/news-views/neupogen-and-implantation.1682.html
No.
Hi Lauree. Have you been tested for Mthfr? You mentioned that you had a bfp on your cycle with lovenox. If you are homozygous mthfr, you would need to be taking methylfolate instead of folic acid. I was prescribed Metanx and I am just heterozgous mthfr.
ReplyDeleteHey Chantal! I am heterozygous for the MTHFR genetic mutation. My prenatal powder is from Seeking Health and has methylated folate in it. I also take a methylfolate supplement as well. Thanks for thinking of that! Definitely have it covered!
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