# Day 9 scan done and no instructions/feedback from Stepan



## greatgazza (May 27, 2010)

I had my US scan done yesterday and immediately emailed the results to Stepan at reprofit so I could find out what to do next (my first ever tx for DIUI) and he hasn't replied yet!! I leave tomorrow morning and I don't have a laptop.  Just wondered if any of you could tell me what my results look like i.e. is treatment likely to be able to go ahead?  Any ideas when I might be told to take my Pregnyl shot and when might treatment be likely?  If you can't answer no worries but any info you have about lining thickness etc would be great.

Anteverted uterus with a triple echo sign.  Endometrial thickness of 7mm
The RT ovary appears small 25x14x14 mm with tiny follicles the largest measureing 5mm with no significant dominant follicle.
The LT ovary is larger and contains four significantly large follicles measuring 5mm and 13 mm and 10mm and the largest leading follicle 14mm.
No free fluid noted.


Getting in a bit of a panic now!!  

GG xx

Have posted on the IUI thread too as just hoping for some info as soon as poss


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## suitcase of dreams (Oct 7, 2007)

Lining thickness is fine - they like it to be 7-10mm

Can' help with follicles I'm afraid as it's been too long since I did IUI to be sure what size they like the lead follicle to be before trigger
Suggest you text or call Stepan if you are worried about waiting for a response to your email - will PM you his mobile phone number

best of luck
Suitcase
x


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## caramac (Mar 21, 2010)

Last time I was out there I was told that the lead follicle needs to be 18mm but I can't remember if that was to trigger or for actual IUI. By the sounds of your results that's pretty good for day 9, I would still head out there and try and go for a scan at the clinic as soon as you can to get an update on the situation. Which will probably be Monday morning. Most likely they will tell you to do the trigger Monday am, then IUI Tuesday am.

If you're staying at the Grand they have a computer in the lobby where you can check your emails. Take your pregnyl shot & needles with you just in case you need to trigger on Sunday though.


Oh, and edited to add that Stepan usually responds in the evenings so it's likely you'll hear back from him later tonight.


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## caramac (Mar 21, 2010)

Just saw that you actually emailed him yesterday...I would email him again right now and ask specific question: when should you trigger?


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## greatgazza (May 27, 2010)

I know that's why i was panicking as he didn't answer last night as i expected.  I have since texted him and he has emailed a reply.  Im having my shot Sunday morning and tx monday at 11.  Although he didnt' give me a specific time to take my shot so I have emailed him again to ask if there is a particular time.  It would be so much simpler if he just answered all the questions first time!! but as i have been told on here there's a knack of how to ask him stuff which i haven't quite got the hang of yet..hey ho.

xx


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## caramac (Mar 21, 2010)

I always have had my trigger about 24/25 hours before tx. So I would probably do it at 10 on Sunday morning if I were you. Hope that helps!


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## greatgazza (May 27, 2010)

hi there

stepan has told me to do it at 10 tomo....however, i have no idea how!!! i'm currently sitting at the grand hotel with  3 vials of powder, 3 vials of liquid and don't know how much to take. i tried calling stepan on him mobile and the clinic, no luck. called an emergency number on the reprofit prescription and if they have understood me right and vice versa i only use 1 vial mixed with 1 liquid, they just happen to come in a box of 3.  would really like some reassurance on this as feeling a bit concerned. don't have a laptop so will check in as soon as i can.

thanks

gg x


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## upsydaisy (May 9, 2009)

Oh poor you    !!  I'm wracking my memory banks (we're talking 3 years ago!) and I really hope someone with more recent knowledge comes to your rescue.  I was only given one vial of powder and 2 of liquid (good job too because I wrecked the first one   ).  I presume you have the other instructions about drawing up the liquid into the syringe (watch yourself if it's in one of those tiny glass thingies, I had mine the wrong way up when I snapped the top of and the liquid went everywhere  ). Then mixing it with the powder and drawing it up again and changing the needle head.  I'm afraid that's all I can remember, it was like a blinking home chemistry kit!  I had to phone the out of hours nurse and I wasn't abroad!.  Hope you get some advice soon just wanted to send you some mega      Hopefully this will become a tale to tell your LO

      Upsy
xxx


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## some1 (May 13, 2006)

Greatgazza - how stressful for you trying to figure all this out at the last minute  .  I must admit it worries me a bit that Reprofit operate in this way without giving patients the information that they need.

I will give you a run down of what I had to do with my Pregnyl shot ...

You have got it right, you need to use one vial of powder and one of liquid.

Put pink drawing up needle onto syringe
Break vial of liquid
Draw up liquid into syringe
Break vial of powder
Gently squirt liquid into the powder vial, it should dissolve immediately and go clear (if not don't use)
Draw the mixture back up into the syringe and flick to get rid of any air bubbles, expel any air
Remove the pink needle and attach the smaller, yellow injection needle
Inject slowly into your tummy

Good luck, hope it all goes smoothly   

Some1

xx


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## morrigan (Dec 8, 2009)

Hi

Just extra few tips for vial- to get liquid out top part of vial before you break it slide it quickly across a flat surface whilst upright quickly or swirl it in a circle. They can be tough to snap there is a 
spot sometimes which you should have towards you as it's easyier to snap that way. A confident snapping motion works best.

The dose I used was 5000iu so if you have that written in vial that will be how much drug you get regardless of water added. 

You need to get bubbles out but don't panic if there's a tiny one it won't do you any harm. The liquid will be a bit frothy until powder dissolves.

Good luck

Good luck!


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## greatgazza (May 27, 2010)

hi thanks guys

after much effort i eventually managed to speak to someone at reprofit and went there for them to do it for me.  what a bloody kerfuffle for what turned out to be such a simple injection.  And nearly an hour after I had the shot Stepan has just text me back to tell me to take just 1.

to clarify for anyone else I used 1 x powder and 1 x liquid.  I dont know if its the same for everyone.

i know we come to cz cos its cheap but as someone else said it really is ridiculous that i have got to this stage with hardly any instructions from reprofit\stepan.  most of the information that has helped me has been from you guys.

prettz scary really.

gg x


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## caramac (Mar 21, 2010)

Glad to hear you got it sorted GG. I know what you mean about reprofit being a bit slack with the instructions/help. Just wait until you turn up there tomorrow for your IUI and they have no idea of who you are or what you're there for! That's what happened to me the first time!


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## greatgazza (May 27, 2010)

omg!! haha! briliiant can't wait.  this just gets better and better doesn't it!!  these things are sent to try us.....but why, haven't we all got enough to think about and had enough sent to try us when 16 year old chavs, crack addicts and smack heads can get knocked up no bother!! and then they probably get given a bloody house just to help them along a wee bit. sorry, bit of a rant there.

i know we come to cz cos it's cheap but we are still paying for a service and it is supposed to be an 'international clinic of reproductive medicine' they should still have some better standards.  and if stepan got his act together and realised what we need to know he'd probably get half the email questions he does.  surely he knows by now what information we're going to want. these people are still drs and not dimwits! 

ggrrrrrrrrr.. rant over

GG x


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## caramac (Mar 21, 2010)

Yeah, don't sweat it GG (as they would say over the pond!). Good luck for tomorrow!


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## sweet1 (Oct 5, 2008)

good luck for tomorrow GG xx

By the way I used Ovitrelle for my trigger shot. I don't know which is supposed to be the better one tbh but by the sounds of it Ovitrelle is a heck of a lot easier. It just comes ready in a syringe and you just inject it. Maybe you could ask for that next time (I hope there isn't a next time, of course!!! xx)


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## greatgazza (May 27, 2010)

caramac you were right!! they had no idea who i was or what i was there for! glad you'd told your experience otherwise i would have been totally freaking out.  what a farce!!  my appt was at 11 but they said something about the sperm not being ready!??! and could i come back in an hour, so i did and then waited a further half an hour.  my god i can't quite believe how they run some of the things there tbh, Stepan asked me if i was using my sperm or their sperm and how many follicles i had!! ffs does he bother looking up anything you tell him or worry about any medical history!

i happened to ask if i should take more pregnyl following the procedure as i had read it can help...he was going to say no then thankfully i mentioned i had had two miscarriages  so he advised me to take another shot in 5 days, then another 5 days after that so i will have to wait longer than two weeks to know.  however, i've had the pregnyl out of the fridge for a few hours and now have to think about transporting it home safely so don't know if it will be ok.  my god what a kerfuffule for about a six minute procedure.

i don't know why he doesn't type up a full list of instructions for certain procedures he can use as a template and modify to send out when we start asking questions....

aaaaagggggggghhhhhhhhhh.  hey ho.  haha!

GG x


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## bingbong (Dec 9, 2008)

Congrats on being PUPO GG. Every time I went there they were expecting me and the last time the receptionist clearly recognised me and they were all very friendly, I was never asked to go away. They don't defrost the sperm until you are there I believe, which makes sense as if you are delayed or don't come then it would be wasted. 

I do think that they assume that you have had previous tx and therefore some knowledge, but clearly this isn't always the case and it would be good if they gave more info. Thank goodness for FF at times like that though. 

bingbong x


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## greatgazza (May 27, 2010)

Thanks.

BTW what does PUPO mean? there's still so much i don't know.

Congrats on your news.  Just curious how many follicles and what size were yours etc it's just that stepan made a comment about twins with me and i'm not sure if it was a joke so i'd be interested if your size/number were similar to mine in case he meant it!!

Cheers 

GG xx


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## morrigan (Dec 8, 2009)

Congratulations on being pupo ( pregnant until proved otherwise! ) I hope your now more relaxed. Are you going to have a blood test on otd ( official testing day) because of extra hcg?


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## greatgazza (May 27, 2010)

cheers for the translations!! he said to take another pregnyl shot on friday 13th and then weds 18th and take a test ( he wrote down an hcg test is what a pg test is sometimes called, im presuming so?) on sat 28th.  so it's 5 days later than i would have been without the injections i think.  what do you suggest?  thought i should try and hold out as a false positve could be pretty distressing?  not trying to be negative but possibly realistic do you know how taking this injection might impact if i have to come back and have another go? just wondering how much it might mess up my cycle and how soon i could plan another trip if necessary.  maybe i shouldn't think like that for now, but if if was bfn i might want to try again as soon as physically possible.

gg x


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## morrigan (Dec 8, 2009)

Home pregnancy test does test for hcg but doesn't give much indication of how much. I presume he means beta hcg which is blood test to check actual amount if hcg. I know trigger shot can remain in system for approximate 6 days so you would be in danger of positive from injection.

I've got no experience of taking extra hcg - I know progesterone delays af- obviously you will get bfp and it won't be relevant but I presume day one is day one of next cycle.

In terms of testing I would suggest you need to either wait 7 days post last hcg injection ( yeah right I'm impressed if your that patient!) or ask gp if they will do beta hcg- you'll prob need 2 spaced a couple of days apart to show levels are increasing- some gps will do this some won't- you can get betas done privately. Maybe someone else who's taken supportive hcg will be able to advise.


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## greatgazza (May 27, 2010)

something else that has just occurred to me and made me a bit worried....as i said in my first post i had my scan on day 9 and tx on day 13...Stepan didn't do another scan or any tests here in Brno, he didn't even have the information of the size/no of my follies etc, as i mentioned.....is there a possibility my follies could have grown quickly and i ovulated before my tx....it suddenly seems a bit hit and miss now without having any more tests/scans.... is this quite normal? reprofit just take the one scan you do at home and that's enough?


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## bingbong (Dec 9, 2008)

GG they don't do another scan before the IUI, as far as I'm aware clinics here don't either. They tell you when to trigger based on your earlier scan and go from there.

IUI timing can be a bit hit and miss but try not to worry too much.

You asked about my follies and tbh I can't remember and having just moved and without internet at home I can't really post the answer to you. I think that I had three dominant follies that were over 15mm at the day 10 scan. I did post about it on the IUI thread at the time of my BFP but that would take some trawling through to find. 

I've never heard of someone having a pregnyl shot after IUI, normally people use progesterone so I have no idea about tests and timings. I think that to get the earliest result you would need to do two beta's like Morrigan suggested, 48 hours apart to find out whether the hcg level was going up or down.

bingbong x


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## kizzi79 (Jan 9, 2009)

GG - welcome to the 2ww madness    - glad you finally got your treatment all sorted - really hope it works first time   

Love Krissi  xx


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## blueytoo (Oct 5, 2003)

GG - I had two scans at Reprofit for my IUI but that was because my follies weren't ready at the first scan there. As long as your lining was at least 7mm when you had your scan here, then you wouldn't need another scan at Reprofit, so don't worry about that unless you felt that you had ovulated and then you could have asked for a scan there and would have had one done. 

Stepan definitely does less monitoring for IUI than the clinics here. I had 3 scans minimum on all 3 of my IUI's done here to ensure perfect timing, but then again Reprofit does very few IUI's every year hence the sometimes kooky timings which work for some, but not for all. 

After my very first IUI I was given extra HcG instead of progesterone as they weren't prescribing progesterone at all in those days not even for IVF at that clinic. That was 13 years ago though at the LWC who were at the time (and still are actually) the UK clinic that does the most IUI cycles each year. From memory I had one done about 3 days after IUI and another about 3-5 days after that. I was told to POAS 16-18 days after IUI. HcG does come out of your system fairly quickly as I've tested it out on several IVF cycles and it's always been gone a few days after trigger. When the same clinic did my two IUI's in 2003 I didn't get prescribed progesterone or HcG at all as neither are necessary for IUI and they had clearly caught up with the research by then that shows that.

If you do your last HcG shot at 10dpIUI it should be out of your system by 14dpIUI which would really by the absolute earliest you could test but to play it safe you are possibly better off waiting until 16dpIUI at least or using peesticks to test the HcG out of your system, but you'd have to start now and test every day for that.


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## greatgazza (May 27, 2010)

Thanks girls

Krissi, i'm just curious as to why you had 4 unmedicated IUIs before going medicated?  If i have to have more treatments i was thinking maybe one unmedicated and then go medicated so i'd be interested to know why you did several before doing a medicated one?

Blueytoo i'm curious that you say you didn't get prescribed progesterone or HcG in 2003 as "neither are necessary for IUI......" other people have told me it can help implantation so i'm a bit confused now.  Or does it only make a difference with someone that has had miscarriages and it's not necessary if you haven't got that sort of history?


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## blueytoo (Oct 5, 2003)

GG - I have a history of miscarriage & bio-chems but progesterone doesn't stop either happening neither does progesterone help implantation. In IUI or a natural cycle, a corpus luteum is made and not disturbed and so that provides all the necessary progesterone. In IVF the CL is disturbed so that is why you only need progesterone with IVF. There's an explanation here:

http://infertilityblog.blogspot.com/2007/10/why-is-progesterone-used-to-for-ivf.html

If you have a progesterone problem, such as I and a few others here do, whereby your body doesn't make enough and you need very high levels of progesterone as your body doesn't absorb it well, then you would need progesterone support for an IUI as well. You have to have tests to show this though, there is no other way of knowing. For me, even 800mg of cyclogest and a gestone injection a day does not keep my progesterone levels to a safe level so I have a big progesterone problem which is why when I had my IUI at Reprofit this year I did take progesterone, ditto with my FET in 2007 as well as with all my IVFs.

All progesterone does is support a viable pregnancy once it has already implanted so it isn't correct to say it helps implantation or stop miscarriages unless you know for a fact that your miscarriages (and they would be very early ones, literally a few days after implantation, so likely before or just after OTD) are due to low progesterone issues. Which again you wouldn't know unless you have had a beta HcG and progesterone blood test done when you get a BFP and before you miscarried and even then, most pre-16 week miscarriages are because the pregnancy isn't viable.

/links


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## greatgazza (May 27, 2010)

Wow, thanks blueytoo.  God there's so much information and it's such a minefield isn't it.  I met guccimama in Brno and she gave me so much information i had no idea about as well - actually another thing that concerned me relating to my original topic heading re: no instructions - i had no idea i shouldn't take a bath!!!  If i'd had my swimming stuff with me i may have gone for a swim in the lake near the hotel santon!! 

So are pregnyl and progesterone pretty much the same thing, or at least do the same sort of job?  what's the reasoning behind me taking two more pregnyl shots then?

GG x


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## kizzi79 (Jan 9, 2009)

Hi GG

I had 4 unmedicated iui's at my clinics suggestion. They felt in view of my age and test results i shouldn't need the help of drugs... but after 4 goes decided to see if they might improve things by increasing the number of follies.

Really hope its first time lucky and you don't have to decide what to do next   

Love Krissi  xxx


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## greatgazza (May 27, 2010)

Thanks

Morrigan

Not sure if i've asked you this already on another thread (get so confused where all the posts are) i'm curious as to why you had so many unmedicated cycles and why you chose denmark?  i was reading your diary last night....wow what a rollercoaster you've been on...and you mention that you're moving to CZ to have medicated, was this not available in denmark?

GG x


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## morrigan (Dec 8, 2009)

GG- Denmark because I met midwives from storkklinik at the fertility show in London last tear and was really impressed - that clinic is midwife led so can't do medicated . There are dr led clinic which can over there. Storkklinik very much in favour of everything natural which I do agree with - the average number of attempts for my age group is 5-6. It might be worth reading there website and downloading pre treatment document as it has loads of really useful info where ever you're been treated.

According to nice guidelines in uk you should be referred to specialist once you have been ttc for 6 months when over 35 and 1 yr when under so now I'm in that category most dr would suggest moving to ivf but I want to give a couple of medicated cycles ago first.


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## greatgazza (May 27, 2010)

Oh ok those nice guidelines are quite interesting.

I guess the difficulty with us singles is what qualifies as ttc in tx terms - if we were in a relationship and having sex all the time we would say we'd been ttc for 6 months, for example, but suppose in a six months period you have 3/4/5 iuis would that be considered an equivalent? as really that's only just a bit better than having sex 3/4/5 times isn't it?

also as i may or may not have pcos (?) my gp advised unmedicated iui in case of multiples...if unmedicated doesn't work and medicated isn't really a great option i'm trying to decide when to consider switching to ivf.  With time being such an important factor due to my age i don't really think i should hang about spending a year or even several months doing iuis medicated or otherwise.  Might post this question for advice on another thread but not quite sure where it would be best to put it. any thoughts?


Also re: being referred to a specialist, either due to being single and/or my age i'm presuming you mean a private referral?

If it's private can't you just ask for one anyway/anytime?
GG x


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## morrigan (Dec 8, 2009)

Gg - I've had a Nhs referral - I seriously doubt I'll get funded for any tx but the advice and opinion would be great. What nice  guidelines say it's down to gp to decide- can I suggest you try and get hold of zita wests book on assisted conception - it's a great resource and explains lots great ref to have in house.

Try and relax ( I'm a forward planner so I know where your coming from!) this journeys has to be taken step by step to stand any chance of staying sane- I'll be positive for you you could well be pregnant already!!! Fingers crossed you are.


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## greatgazza (May 27, 2010)

Thanks

you're obviously a bit of a night owl like myself!

GG X


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