# FET protocol - Agate please help



## Svetlanab1 (Mar 2, 2013)

Good morning Agate, ladies, 

I am 45, cycling in  Czech republic, using DE and just about to have my last FET in the middle of May. I will have full immunes, ivig, clexane, thyroxine simple all I need. 
I am however not happy with my FET protocol as ET should happen very late.. which is about 1 month after my period. Am I dreaming or is is the truth that I read somewhere that if you lining is Old, in meaning too many days from you last periods , then lining becomes less receptive ? 
This is my last so I am really worried and want to have best possible chance. Could you please let me know what you thing of my FET protocol 

1. get gonapeptyl 3.75, decapeptyl, diphereline 3.75 intramuscular shot on CD21 . Wait for you period, AF. 
2. 14 days after you period starts, go for a scan. If you lining is up to 4 mm and if you follicle size is 9 mm then start with oestrogen tablets 2 mg  3 times a day.  ( This is classed as first day of you cycle now )
3. 12 days after starting using oestrogen tables ( e.g. 26 days from your period )  go for a scan. If you lining is at least 7 - 8 mm start with progesterone . ET will then will be  in about 5 days. 

With my fresh ET I have been sniffing Synarel, from day 1 or 2, ( not too sure ) altogether with starting oestrogen tablets and then it just goes typical way if lining is good on day 11, soon progesterone follows.  I liked this protocol more. 

Could you please let me know if there better chance with this very long protocol  ? For some reason I am not happy with it but not sure why. 
I am having immunnes with Dr G and clinic is in Prague so they also do not know about all the stuff I will take. 
Also pituitary gland will be completely shut by Decapeptyl so it might affect my Thyroid as well , not sure if that is good at al. 

Please help, please shed a light  if you can.  Very much appreciated. Thank you. 
Svet


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## mierran (Apr 24, 2009)

Hi,
I'm sure agate will be along soon but meanwhile I will do what I can to help.

I think they must mean that at the scan 2 weeks after gonapeptyl shot they want your lining under 4mm and your follicles less than 7 mm. They want to check you are fully down regulated before they start the oestrogen ie they are doing it like a long oe protocol rather than a short protocol. This won't affect your thyroid. The problem with it is that, with such a long time between af and starting oestrogen there can be a problem with your lining thickening.

with regards to the old lining it is how long you have been on oestrogen. So if you are on oestrogen for more than 4 weeks before starting progesterone success rates are lower. Because you are not starting oestrogen till later you should be ok. 

I haven't heard any stats suggesting this protocol is more successful in fets. If you are not comfortable with it speak to your clinic. Ask why they want you to do this protocol. You need to feel happy with what you are doing.

good luck.

x x


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## Svetlanab1 (Mar 2, 2013)

Thank you Mierran, 
its means a lot that you replied. 
Have a nice day. 
Svetlana


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## Svetlanab1 (Mar 2, 2013)

Hi Agate,

Hope that as I will start oestrogen 2 weeks after my AF and actually 2 weeks or so before ET my lining will behave and will not hopefull be OLD LINING. 
What do you think?

I have spoken to my doctor advised of my concerns and she still recommends above protocol so will have to go with it. 
Thank you to Mierran again for her advise re estrogen.


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## agate (Nov 14, 2008)

1. get gonapeptyl 3.75, decapeptyl, diphereline 3.75 intramuscular shot on CD21 . Wait for you period, AF.

This 3.75mg depot shot shuts your cycles off. So you shed your lining, but your next cycle doesn't start.

2. 14 days after you period starts, go for a scan. If you lining is up to 4 mm and if you follicle size is 9 mm then start with oestrogen tablets 2 mg 3 times a day. ( This is classed as first day of you cycle now ) -

This bit sounds like they want you to wait 14 days (a little longer than normal maybe, but not a problem) and then use a scan to make sure your lining is thinner than 4mm and you have no large follicles - they want to be sure you are down regulated and your own cycles are switched off. The only notable bit of that to me is that they are starting you off on 2mg x 3 per day and not taking it up in steps, but lots of clinics do use that protocol.

3. 12 days after starting using oestrogen tables ( e.g. 26 days from your period ) go for a scan. If you lining is at least 7 - 8 mm start with progesterone . ET will then will be in about 5 days.

Its normal to wait until you've done 10-14 days of estrogen before checking lining is ok, then starting progesterone. Then you wait 5 days if you are going to transfer blastocysts.

There is nothing wrong with that protocol as long as your lining does normally thicken ok when you take estrogen pills. Sometimes a down reg like this helps a little if you have estrogen mediated problems like polyps, fibroids or endometriosis.

Your lining won't be old when you do ET because you don't start to grow any lining when you are down regged until you start your estrogen pills.

When you down reg, your estrogen levels will fall, which might push your FT4 up a bit and your TSH down a bit, but it wouldn't usually be a problem - you might get headaches and hot flushes from about 1 week after the depot shot until you start the estrogen though - so for that reason, some clinics wouldn't use it just for FET because of the extra side effects - but it doesn't mean that it isn't an effective protocol

Please help, please shed a light if you can. Very much appreciated. Thank you. 
Svet

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## Svetlanab1 (Mar 2, 2013)

Thank you Agate. You are invaluable to us on this forum.


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