# Natural, mini, mild (etc) IVF chat thread



## Cloudy

* I have noticed quite a few ladies recently have mentioned natural, mild, mini IVF so thought I would set up a chat thread for all the people who are thinking about, are planning on starting, or have started this type of IVF.

It's not intended to replace the Cycle Buddies, and not for pregnancy chat (as per the normal rules), but I just thought we could give it a try and see if there are any takers as I know that there isn't a specific "home" for this type of IVF.

I hope it's helpful, but if not the thread can slip into obscurity just like the amazing band that was Let Loose! 

*


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## AnnaMathilde

HI, thank you for starting the thread. Yes I would love to speak to more women considering/going through mild or natural IVF treatment. I am with IVI in spain, and started mild/modified (what is the difference??) IVF. The reason (I guess) why my DR choose this protocol, is that I only have 1 ovary and no tubes. So the idea is to do several rounds of EC & EF.

I started taking Clomid daily with Menopur 150iu every 48hrs. At the first scan I had 2 tinny follicles. At the second scan I only had 1 left, but that one is definitely growing (currently day 14 of stimms, next scan tomorrow)

I have asked for a meeting with my ER to discuss my treatment and "strategy". I am worried they want to cancel. But I don't want to cancel, because with this strategy it was never about quantity. I am worried that I am not thinking objectively/logically or being realistic because I am obviously a believer in miracles and feeling pretty hormonal. 

I want them to collect this one egg. My non-medically-educated brain tells me that this one must have more chance of being a "surviver" as it must be the natural dominant follicle which is growing. Going for quality over quantity, no? 

I don't actually want them to stuff me with more drugs, because with 1 ovary I will never get any serious quantities of follicles/eggs. I am thinking at most I could get 2 eggs (from 4 or so follicles). I don't want to stress my ovaries either and having to delay treatment. So I want to ask them if I should do a natural IVF with back to back cycles, after this current cycle. I fell pregnant naturally in August 2014, in September I had my only tube removed because the pregnancy was ectopic. Though this proofs that I can get pregnant, I know I ovulate, I know I have still (fingers crossed) a few eggs left. So would the best strategy possibly be: natural cycle, EC, ICSI and transfer, if BFN than go straight into the next cycle? Though it would have to be a cycle without Clomid, otherwise its best to do egg-freezing.  ? 

Anybody any advice, or am I just hormonally/stressed ranting 
xxx


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## CrazyHorse

Hi, Cloudy, many thanks for setting up this thread. I had a recent miscarriage and am coping by trying to figure out what I can tolerate in terms of future OE cycles; my conclusion has been that I need to find an approach that is easier on my body. There seem to be multiple clinics in Czech Republic that offer natural and mild IVF treatment, and I am going to start contacting them next week.

AnnaMathilde, in your shoes I would go to egg collection, but that's because I know at this point that my DH and I have excellent fertilisation rates -- it sounds like you and your partner don't have that info yet about what your fertilisation rates will be. I guess the question is how much will you wonder about the what-ifs if you don't go to egg collection, vs. how much benefit will you get from being able to use the balance refunded from the current cycle to fund another go on a different protocol. It's a very personal decision, but if you feel strongly that you should give this egg a chance, you should do it. I followed my doctor's advice on my first cycle and didn't, and I regret that now.

Here's my situation:

- Preexisting issues: Age, low AMH, elevated FSH (not premenopausal levels, however), intramural and subserosal fibroids, presumed endo w/ tubal involvement (no lap performed, but long history of endo symptoms and tubes not patent on HSG). TTC naturally 5 years, never a whiff of BFP.

- IVF Cycle 1: "Poor response" on short protocol with 225 iu/day Gonal-F plus Cetrotide. 13 days of stims, 1 lead follicle on each ovary (one much further ahead that became a follicular cyst). No problems with side effects on Gonal-F and Cetrotide. Cycle cancelled and converted to IUI (a decision I regret, in light of my subsequent 100% fertilisation rate). BFN.

- IVF Cycle 2: 6 follies on long protocol with Buserelin and 300 iu/day Gonal-F. 3 weeks downreg, 18 days' stims (coasting last 3 days at 150 iu/day Gonal-F). Daily migraines from the Buserelin. 3 eggs, 100% fert. 2 embies transferred on Day 3, one good quality, one with small amount of multinucleation. BFN. 3rd embie cultured to blasto, but not suitable for freezing due to multinucleation. 

- IVF Cycle 3: 3 follies on flare protocol. 3 weeks downreg on Yasmin (hormonal BCP) followed by 5 days of Synarel, 13 days' stims on 300 iu/day Gonal-F plus Synarel. Depression from the Yasmin, headaches from the Synarel (albeit less severe than from the Buserelin). 1 egg, fertilised. Good-quality embie transferred on Day 2, BFP. Miscarriage at 8w6d. 

I have regular cycles (usually about 25-26 days long, occasionally shorter, very seldom a couple of days longer, but I've never had a "missed" period) and ovulate regularly as indicated by LH test strips and EWCM 14 days before my period. Basically, it's very difficult to persuade my body to deviate from its normal routine. When downregging on long protocol, I had to do a 3rd week at a double-dose to thin my lining out; when on Cetrotide, I still developed a very strong dominant follicle, and also had to take a double dose of Cetrotide one day to stop a natural LH surge. 

I will never produce more than 2 or 3 eggs at a time on any protocol, but my egg quality is clearly good for my age or we would not have such a high fertilisation rate (also, one out of 3 embies put back so far resulted in pregnancy). I believe that my egg quality suffered from the lengthy stimulation required on the long protocol, and that's why we saw the multinucleation. At this point, I think we have to work on maximising egg quality, because higher quantity is off the table. 

What I want to do is "natural" IVF with Cetrotide to control ovulation, and adding in low-dose Gonal-F or Menopur if the follicle does not seem to be maturing fully without additional stimulation. I'm aware that there's a risk of retrieving zero eggs on this kind of cycle, but I think we'll have a much better shot with any eggs that we do retrieve. 

Currently I am working only part-time, doing consulting from home (or wherever I and my laptop are). At this point, I intend to continue this, even though I would like to have more face-to-face time with colleagues and actually grow my career -- but realistically this is my last year to conceive with OE. So I intend to keep my flexibility high to enable whatever travel I need to do to catch the egg each month. 

Has anyone here had natural IVF at a clinic abroad? If so, at what points in your cycle did you have to travel? I'm sure I'll get some answers when I start calling clinics next week, but I'm very interested in what other ladies have actually experienced.


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## AnnaMathilde

I completely agree and understand. I don't think that for some the full-on drugs is productive. I had my meeting at the clinic on Friday. The doctor was brilliant. Before I mentioned anything she already said exactly what I would have liked her to say. Wednesday they are going to collect my 1 follicle from this long-cycle (Japanese mini-IVF). She agreed that obviously the drugs don't do much to me (except for sweats and headaches, but I don't mind as its all for the cause!). So once this follicle is collected ( that its a big fat wonderful quality egg), then for the next cycle we'll do a mild IVF. If that doesn't give me more than 1 follicle, then the third cycle will be just a modified-natural cycle. She also said, that no point in taking the drugs if the results are no different from a natural cycle. I always ovulate, have regular cycles and fell pregnant naturally twice in 2 years of trying (mc + ectopic, and now no more tubes). 

I was worried that the egg freezing has worse statistics than embryo freezing. Though she said that at their clinic they actually have better stats on egg freezing than embryo freezing. Fingers crossed this is true and true for me. 

Also to ICSI at each cycle, would be way too expensive, so egg collection a better option. I am thinking of doing another 2-3 cycles for collection and then going to transfer. 

About the travel for natural IVF, i am not sure. The doctor did say that there will be less ultrasounds with mild & natural IVF cycles, and that they will only use the drugs to control ovulation. I am with IVI in Spain (Bilbao). 

Let me know how you get on. I am very interested as well in hearing stories about modified-natural IVF. Preferably success stories!


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## Briss

ladies, I hope you do not mind me joining.

*Cloudy*, thanks so much for starting this thread! I was looking for something like this but could only find very old threads mostly related to Create.

*CrazyHorse*, hi! Thanks for the link! from reading your story I have a very similar response to cetrotide i.e. I also develop a very strong dominant follicle, and my natural LH surges while I am still on cetrotide.

A little about me:

I started my "IVF career" at Create, London. we had two cycles: (i) natural/modified and (ii) mild stims. natural/modified was probably the best cycle so far as we had a chemical pregnancy - the closest we ever got to a real BFP. They were very supportive all the way. I was on 150 menopur from day 6 + cetrotide, trigger, and progesterone after ET. Our second mild stims cycle involved stimming from day 2 with Gonal F on 125 which was then upped to 250, we had 3 follicles but got only 2 eggs as the dominant ovulated early - all eggs were of poor quality and did not fertilise. Opinions divided: some said we should go back to natural, others said mild stims is silly we should do proper stims.

I have high FSH but was still eligible for the NHS funding in the UK so we decided to give full-on stims a go, spent a year waiting for our 3rd cycle but it was a complete disaster. I was on short protocol with 450 menopur from day 3 + cetrotide (which btw does not work for me and my LH goes up when my body wants to ovulate regardless), we had 4 eggs but it was the same story as mild stims - all eggs of poor quality and none fertilised. it's something to do with maturation and cetrotide not working that in the end affects egg quality because on my natural cycles when I get 1 egg - it's of good quality and it fertilises. unfortunately something also went wrong during EC and I started bleeding internally which I did not realise immediately as I was told pain is normal after EC (I had no pain with natural IVF), in the end I was hospitalised and was on morphine. I lost about a litre of blood which was trapped in my abdomen causing a lot of pain and it took 5-6 weeks to recover. Nobody tells you this can happen as IVF is considered safe. At this point we made a decision that we are going to stick to natural IVF but we need some help with sperm selection as ICSI is just not enough. Also, we started looking at clinics abroad as the cost of natural IVf in London is similar to stim IVF while in Europe you can do it so much cheaper. we are saving b/w 3-5K depending on the clinic on each cycle by going abroad.

I am preparing for my 3rd back to back natural IVF cycle. the first two we had in Brno, Czech Republic and now we are moving to a clinic in Munich. the main reason is that they offer IMSI (we have severe male factor) and Brno clinic can only offer PICSI (but DH's SA was not suitable for PICSI so we could not do it). I know my body quite well so I like clinics that are prepared to be flexible. I really liked Reprofit in Brno. I had all my scans in London and then just flew to Brno for EC/ET. The first cycle was a failure, I had 2 follicles growing (naturally with no stims!) but they are most likely ovulated just before the procedure, they did not collect any eggs. I did feel I was ovulating but the procedure was delayed and I think that's why we lost them. For our second cycle our doctor agreed to have the procedure very early on, I was in the theatre before 8am! also, even though she personally did not believe in this she agree for me to take indometacin from the trigger to EC. since I have this issue of losing eggs to early ovulation I believe indometacin really helps because on the 3 cycles I was taking it we did not lose the eggs even the second time when my dominant follicle virtually started ovulating the egg was still inside and they got it. so I am a firm believer in indometacin. Our second cycle with them was very well managed and we got that egg. unfortunately sperm let us down, the sample was not suitable for PICSI so we had to rely on ICSI, it did fertilise but it was a BFN.

I have to say that all the planning and travelling - everything has to be booked the last minute cos natural IVf is very unpredictable - all very stressful. If I could get success with stim IVf I'd rather do one stim IVF than many natural IVfs but unfortunately I cannot, stims just do not work for me. I am just happy a lot of clinics are prepared to go natural IVF route however painful it is and this is probably the only chance we got.

here is a success story from a friend on B&B, very inspiring - http://babyandbump.momtastic.com/assisted-conception/1934573-7th-natural-cycle-ivf-w-o-meds-finally-bfp.html

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## AnnaMathilde

I am sorry that you are on such a roller coaster! I have no idea what to advice you on, as I am far from an expert. However I do agree with you, that just pumping lots of drugs into the system, doesn't really work for some of us. 
I am sure that the stress and travel doesn't help either. What is you next plan? 

Egg collection (only 1 follicle) for me on Wednesday and trigger tonight. Next round will be mild-IVF, and see how we go with that one...


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## Cloudy

Just popping in to say hello!

Briss - im glad you joined up, I am a Reprofit thread stalker (its somewhere we may consider going in the future) and have been following your situation. Good luck with Munich x

AM - good luck for EC x

CH - hope you are ok honey, thinking of you  

Good luck everyone xxx


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## Briss

*Cloudy*, thanks! I have only good things to say about Reprofit but you probably know that from Reprofit thread. I just wish they offered IMSI.

*AnnaMathilde*, best of luck with your EC! I hope you will get that egg and it will be your lucky one. I strongly believe that you body knows best and it chooses carefully the right follicle to become the dominant one so you can be sure this is the best egg this cycle.

Are you going to have any sedation? In CR and I think in Germany as well you can have EC without any sedation. I had it two months ago and it was actually fine, a bit painful but very quick.

I have my scan tomorrow so we will see if we can try again this cycle. I already decided that we are going natural IVF route every month until we are lucky. I may change my mind of course and try stims again probably long protocol but at the moment I am sticking to natural IVF. It's much easier on the body.


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## Lizzie070

Hello, 

Do you mind if I join? 

A bit about me. I am on my third round of natural modified ivf at Create in London. I am having three rounds of collection, with (I hope) ET next month. 
I had one round on the nhs before age cut me off, and was on max Stims. I had three weeks down reg on burserelin, and then 23 days of 450 gonal f. It was quite hard going. I only have one ovary, have endo and a fibroid, so things are stacked against me. The nhs cycle resulted in 5 eggs, 2 were no good, but non fertilised as we weren't given the option of ICSI.
The natural modified we have opted for ICSI, and the first round gave the exact same results with only 150 menopur, but two of the three ok eggs fertilised. My second round got one of two, and my third... Well who knows, as EC is sometime this week. It is so much easier on this protocol, and for me the results have been much better so far, but as still have not had any et, we cannot tell.

Good luck to all out there what ever the protocol.


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## Briss

*Lizzie*, good luck with your EC! can I ask on what day after EC do they freeze your embryos? do they take them to blastocyst stage? how are they going to select which ones to transfer?


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## Lizzie070

Hi Briss,

They freeze day2, and as far as I know transfer day 3, but haven't got there yet. Have been saving them all and if they survive the thaw will use the four in two goes if needed. So defrost two and have them, then if that doesn't work try another fet with the remaining two.

Its amazing that1/3 of the drugs has given me the same eggs, and I have coped so much  better with this approach.

All the best


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## Briss

Just had my day 8 scan and not sure what to make of it. I do not have a dominant follicle. The largest is only 7.5 mm. Usually by day 9 I have at least 16 mm dominant follicle. Does this mean I am going to ovulate later than usual and the follicle is just taking its time to grow or something is not right about this cycle? My lining is 8.7 which is as it should be so it's basically ready for ovulation. My CBFM has been giving my HIGH readings last two days so I guess my estrogen must be high and I thought I will be ovulating soon. Now I am just puzzled. Still waiting for my blood test results of this morning and a response from the clinic.

*Lizzie*, how does this work to increase your chances compared to having ET every cycle? If you transfer fresh embryo every cycle you can obviously get BFN/Chemical if the embryo is not viable but wont you get the same result if you transfer them later but by freezing them wont you be decreasing your chances as maybe a viable embryo wont survive the freeze? I might be completely wrong here it's just how logic goes in my head, I heard of people doing 3 cycle thing with one transfer but just trying to work it out in my head. Did create explain the benefits of this approach?


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## Lizzie070

Given my poor response, I wasn't sure I would get any fertilised as nothing worked on my first cycle. Therefore I thought this approach would give me a chance of one et after the three cycles as aiming for just one quality egg each cycle would give me a chance of fertilisation. I have been lucky to get three and on ny third cycle am working on a fourth.
with freezing I figure if its strong enough to survive that, it should have a chance, and have been told figures for fresh vs frozen are pretty equal.
I am day 11 and my folicle is only 14 so I don't think your progress is too bad, but maybe your bloods will give a better clue if the other signs are contrary.
good luck


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## Briss

Had a very disappointing day today, my blood test results were even more confusing. my LH was quite high at 12 so looks like my body wants to ovulate soon but estrogen is lower than usual at below 600 (while on previous cycles when I had a dominant follicle it was 1,400-1,800 on day 9). On top of that the clinic said that they think I already ovulated because my progesterone was elevated at 1.8 ng/ml. I am now beyond confused. How is this possible it's only day 8, my temp is still low and I thought 1.8 is rather low for ovulation? There only way this could possible happen if progesterone really messed up my cycle by delaying my period so that there was a mismatch between the start of the next cycle (i.e. AF) and follicle development which started a few days earlier. This could logically explain abnormally early ovulation if follicles started growing 3-4 days before I got my AF but is this really possible?

anyway, my doc was not even in today so I am hoping he will clear things up tomorrow but I think I would still like to repeat my bloods/scan later this week even if only for my own understanding. Quite an expensive exercise but I feel I need to understand what happens if synthetic progesterone really affects my follicle development and makes me ovulate early the next cycle cos I may need this for my future natural IVF cycles


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## AnnaMathilde

Hi Lizzie, Can I ask, do they fertilize at each collection? my clinic told me that that would be way to expensive to have ICSI at each collection. So for finances its better to collect a few before going to ICSI. But I would possibly be interested in fertilizing at each cycle, so you know a little better what your chances are before transfer. I am thinking of waiting a month between last collection and transfer so that the drugs get out of the system... Though I don't know at what stage I should stop collection.... that's why fertilization at each collection would be a good option... 

Briss, I have no idea what is happening tomorrow with EC... maybe best be a little ignorant otherwise I won't sleep. I'll just let it happen, I guess. No idea if there is sedation or not... For your disappointing day, I have no idea as not an expert. However I sometimes get a little annoyed with statistics and test results.... I sometimes prefer not to look at them. Remember that the benchmarks are just averages and "ideal"-levels. I have read on this board people with abnormal levels who according to the benchmark had 0% chance of falling pregnant/having successful IVF and still they did. I don't think my estrogen has gone anywhere near your 1400, and I don't even know what it should be. So if your estrogen is "too low" according to the "theory", then firstly you can't do anything about it this instant, so maybe just go with the flow and stay healthy and focussed.... and secondly the stress of worrying that you may not get to the "right" level will only have a negative effect. Stay Zen... 

I started my first IVF for EC cycle on 5 december (long protocol), and I feel I have joined a hidden/secret/silent society of IVF-'sufferers'... I just cant believe the hard work/stress/hormonal-effects etc IVF has on you, and that there are sooooo many women going through this and you never hear a single moan in public, they do it all in secret. I told someone today that if men had to do IVF, the whole world would know about the stress of it, the agony of it, the side effects of all the drugs, the injections.... This is not a moan as I am grateful that IVF exists and is an option for us, and I am just in admiration of the female-sex for their stamina! ....Amen


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## AnnaMathilde

Just in case anybody is reading... I did my egg-collection today. I did get sedated... only a light one, but it worked a treat for me. Didn't feel a thing and was only "out" for 10minutes.

However there were no eggs. Just 1 empty follicle.... Not sure what to think of it. Obviously very disappointed. And just worried this is a very bad sign for any success in the future. Worried that I am wasting my money, being stubborn and naive. 

Not sure if I should just "accept" the worst and be grateful (   I sooooo am) for the beautiful daughter I have and give up on this immense desire to have a larger family (I come from a big family myself, and my brothers and sisters are my most precious thing in my life!!). Or should I consider donor egg? My partner will never ever accept that... so.... 

Am going straight into a next cycle with a new protocol... we'll wait and see what happens...


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## CrazyHorse

Anna, I'm sorry for your disappointing result today. The follicle may have been empty, or the doctor may simply have been unable to capture the egg. Unfortunately, there's never a guarantee that the egg will be captured during aspiration of the follicle, as it's a very inexact process. This is one of the reasons that most clinics really prefer the standard IVF methods if you can get good results with them -- no one wants to have to tell a patient that they went through the heartache of a cycle and didn't even get a single egg.

Wishing you lots of luck with your new cycle. I don't know your partner, but many, many people find their feelings on donor eggs change over time, as they experience the heartbreak of BFNs and/or miscarriages, and watching their loved one's disappointment. My husband didn't like the idea at all at first, but he's accepted that's what we'll eventually do if my own eggs just can't get the job done.


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## Lizzie070

Hi Anna, Sorry to hear your news. I wish you much luck for your next steps.

I have fertilisation after each EC and freeze at day 2. ICSI is a bit more expensive and I do have to pay for each one, so this is the third, but I got zero fertilisation with normal ivf, so this seems the best option.  I have one folicle this time, the others stopped at about 7mm, I am having a scan tomorrow where I am hoping that it will be ready to trigger (it was 14 at the last scan). 

No of folicles not so great this time, but not sure if this is because I didn't have a gap between cycles this time (getting impatient).


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## Briss

*AnnaMathilde*, I have been reading a lot on empty follicles situation and apparently in most cases it's just pure human error in retrieving the egg. do you know your oestrogen levels on the day of trigger? in any event if your levels were too low they would not have proceeded with EC as they would have suspected there is no egg or poor quality egg but if oestrogen levels were good you most likely had an egg but either it got away or they failed to get it. I happens all the time. I totally support your decision to carry on with the next cycle. on my first cycle they did not get any eggs but we did get one the very next cycle so you just never know.

*afm*, my temp was up this morning so it's possible I ovulated by day 8 of my cycle which is quite shocking. still trying to get to the bottom of what's happening but to me it's quite clear that this is to do with my ET/progesterone from previous cycle. I was hoping to do back to back natural IVF but it looks like if we get to ET and get BFN then the next cycle might need to be skipped to get my body recover from progesterone.


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## Altai

Anna- so sorry for your disappointing result. Wishing all the best for your next steps. 
Unfortunately, there is a high cancellation rate for (japanese) mini Ivfs. 
Don't know how old are you but for my age group it's more than 50%. 

Briss - sorry cant comment in ovul symptoms as don't think I ever could feel them. 
Hopefully bloods retest will give an answer. 

Lizzie - good luck with scan.

Afm- have started japanese mini ivf. The plan is to do 3 rounds of embryo banking. Was on femara this cycle, grew 3 follies but only got 2 eggs, both fertilised and were put in on D3.  I had a fresh trf this cycle due to the cost. But if this round is not successful, then straight to banking. 
Next cycle is planned as tamixofen combo. Praying I won't need it.


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## Briss

*Altai*, I am very curious about Japanese IVF - what is it? also why would you take tamixofen? My DH was taking it to improve his FSH/Testosterone levels which it did, however it did not result in sperm improvement.

afm, My today's bloods showed that progesterone levels have increased suggestive of ovulation and since my temp has been up I reconciled to the fact that it's all over this cycle. I was not even sure I was going for a scan - seemed like a waste of money. The scan actually made it all even more confusing than before. On one hand it showed that one of the follicles on the left side had irregular shape and signs of haemorrhage - suggestive of rapture/ovulation. however, at the same time my estrogen levels have also increased and follicles have actually grown since Tuesday (the largest were 12.9/10.3/9.4 compared to 7.5/6.4/5.1 on Tuesday)!! How is this even possible to have both estrogen and progesterone increasing?? progesterone is supposed to stop follicles from developing and yet they are growing. I do not even know what to think anymore

waiting for the Munich clinic to tell me if we can still do natural IVF this cycle or not. probably not cos progesterone levels are just too high but then what do I know


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## Altai

Briss- so called Japanese ivf is mini stim ivf, first pioneered by Kato clinic in Japan. There have been different modifications/developments to the protocol since then.
Initially started with clomiphene citrate/femara or combo. 
Here is one link. I also put more links in another thread with clomid.
http://www.infertilitysolutions.com/teramoto.html

I don't know why the dr suggested tamixofen instead but it is similar drug to clomid. Though I've done ok with femara getting 2 embryos. With full stimm (300u) I usually get 3 on D3, too.
So not a big difference.

Sorry, things are so confusing with you. I don't know abt progesterone and not sure why you already testing it. In all my previous clinics I tested @ trigger shot day and ET.

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## Briss

*Altai*, thank you! That's really helpful

*afm*, got my verdict today - no surprises: "progesterone indicates ovulation already happened so repeat scan/bloods on day 7 of your next cycle". the doc did not answer any of my questions as to why and what's happening with estrogen and follicle growth. I will be sending my forms and documents to Gennet next week to start the process with them as their waiting list is quite long but I am still giving Munich a chance. after all they were really spot on saying from the outset that ovulation took place. even though at the time it seemed ridiculous to me. honestly day 8 ovulation?? I am not even sure this was proper ovulation, the follicle cant just disappear, in case of ovulation it collapses but it's still there and they can usually see it changes it's colour and form. on day 8 there was no such follicle or maybe they just did not see it cos they were not looking for it. The sonographers are pretty useless I must say, they keep thinking my cyst is a dominant follicle pretty much every time

I also contacted another clinic in Munich but they have not responded yet.


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## Altai

Briss- sorry this cycle didn't work out as expected. I think the follicle can disappear. I had the same on femara and read that some women had it on clomid, too. 
Do you have your scans in fertility clinic? 
scanning skills vary, so perhaps the best option would be to have scan in fertility clinic. Especially when doing natural/mini/mild because of high cancellation rate or when closer to EC.

I found this study on chromosomal abnormality of embryos resulting from mild and conventional ivf. But their patients were <38, bmi 19-19 , good sperm = good prognosis patients. Resulting embryos were PGS-ed for 10 chromosomes. 
They concluded that proportion of chromosomally normal embryos is higher with mini ivf.

But mini ivf cancellation rate was high, too in their study, so perhaps a bit biased towards natural selection of strongest or 'bestest' embryos.

http://humrep.oxfordjournals.org/content/22/4/980.full.pdf

Still sounds very encouraging.

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## Banjo55

Hi Ladies

I have a question.  I've never had IVF before and I'm researching clinics abroad because of the cost. Who decides whether you should have full or natural ivf, would it be the clinic or do I have to state which option I want at the outset?

To be honest I'm nervous about the prospect of my cycle being messed around by loads of drugs but obviously I want the best outcome as I don't think we'll be able to afford more than 2 cycles.

Decisions, decisions.


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## Briss

Banjo, I think the important thing is to find a clinic you can trust. I'd approach several clinics and explain your history and see what they offer: stims, mild stims or natural. tbh it's unlikely anyone will offer natural because the success rates are too low so it's most likely b/w stims and low stims/mini IVF. until you try it's really hard to say which is going to work best for you. when i started IVF I knew I was going to be a poor responder because of my high FSH levels and I was convinced low stims are going to work for me. they almost did but not quite. then I thought I really need to try full on stims but it was a disaster so we are now back to natural. all clinics I approach are trying to persuade me to do at least mild stims but I have been there before and know that it's most likely not going to work so I usually tell them what i want (but that's because I have already tried many things).


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## Banjo55

Thanks Briss.  One of the clinics I contacted has come back and said it would depend on the outcome of the consultation and various tests.

There's so much to take in I've found it a bit overwhelming. My brain has been in overload.


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## KRichmond

Hi there. I have also just started low dose ivf with Icsi at create. I had two previously unsuccessful rounds with high dosage. Got to et but bfns both times. Am hoping this time they will stick. Have got two at 14 and one at 10 so really hoping they will have a growth spurt. Am doing 3 cycled of ec and then one et. Would live to know how you all get on.


----------



## K8O

Hi everyone

Hope you don't mind me posting!  I've recently been to Serum and it has been suggested that we try a mild IVF with femera because I overstimulate with the normal approach.  Just wondering if anyone else has done this in a similar situation?  I feel happier with the approach rather than menopur and then being really ill but just wondered if anyone else had followed the same path so to speak.  I was told in the UK I had PCO but Serum told me I don't I'm just very fertile!

Kxx


----------



## Briss

*K8O*. unfortunately I do not have any experience with Femara or chlomid, I only used menopur and Gonal F and neither worked for me.

Can I ask you about your DH's sperm, it says in your signature that it improved after some protocol? can you please elaborate what it was that made a difference? we have tried so many things but so far nothing made any difference to his SA. it's either bad or terribly bad 

*afm*, just waiting for AF and hoping to do a natural IVF again.


----------



## K8O

Hi

DH has been taking Vit C and Vit E (I would have to check the doses but he is away with the bottles at the moment).  He went from counts of 10 million to 22 million. I can't remember the rest of the results but can have a look,  everything had improved a lot. He has no DNA fragmentation as we had that tested.  He is now also on 40 days of anti biotics.  It is the sperm improving protocol that Serum suggested and the vitamins alone have made a massive difference.  He has also lost a bit of weight and started running.  The consultant thinks our failures are done to quality rather than other factors so wants us to see what happens in the next few months before we go for treatment but I'm impatient!

Hope af doesn't take too much longer for you.


Kxx


----------



## Briss

that's very impressive! My Dh has been taking E and C and billion of other vits for a few years but there was no noticeable improvement.  why did they suggest such a long antibiotic treatment? has he done culture test that caught something?


----------



## K8O

They want to get rid of any possible underlying infections that may exist but not present themselves if that makes sense.  His vit c is 1000mg and Vit e is 400 plus his well man conception tablet


----------



## Briss

thanks, still 40 days of antibiotics seems really long and harsh but they know better I guess.  we have similar doses of vit E and C, and higher doses at some point. he used to take wellmen, now on fertilaid + count boost + motility boost + various additions (quite a long list)


----------



## KRichmond

Hi Briss

You mentioned early ovulation and that is my main concern at the moment. Were you on centrocide? Did you only know that you had ovulated early on EC day? 

Lizzie70 - don't know if you are still checking this but I would like to know how you found the 3 cycle process and hope that it is going well. I have the first EC on Monday but am really worried that I have ovulated this afternoon....I might just be paranoid and I am trying not to get too stressed about it.


----------



## Briss

*KRichmond*, I generally know I ovulate early around day 11 so in a natural cycle it's not an issue as I have my first scan around day 9 and if follicle is ready they trigger me the same day. my last cycle I ovulated exceptionally early by day 8 but this is so out of order for me, I personally blame progesterone I was taking from EC the cycle before.

On my stimulated IVF cycles I was on cetrotide both times and LH just went up regardless of cetrotide. The were concerns that I may ovulated before EC but it's not certain until you are prepped for EC and they do the scan. The first cycle we lost my dominant follicle it was there on the day of the trigger and disappeared on EC. on my second cycle the same thing happened LH went up and they had to trigger me after only 9 days of stims but I started taking indometacin from trigger and up until morning of EC as it helps keep the follicle from rupturing and releasing the egg. On EC they saw on the scan that my dominant follicle had irregular shape which means it started ovulating. They still proceeded with EC and luckily the egg was still inside so they got it just in time.

because both stim cycle it did not go according to plan mainly due to LH rising despite cetrotide they say I should not do any more cetrotide protocols and may consider long protocol which should theoretically help with my early ovulation. I am still considering trying long protocol but I have reservations (i) I know short/cetritide protocol works better for high FSH ladies so if it did not work for me than maybe long protocol will be even worse? (ii) I am afraid of quieting my ovaries what if they won't wake up after that? I have read about ladies who were taking down reg meds after which they stopped ovulating so I am concerned.

at the moment I carry on with natural IVF because it works for early ovulation (not as early as day 8 of course). it's obviously a gamble every time with natural IVF as it's hard to time EC so from time to time I will have cycles where no eggs collected but indometacin helps a lot so I am hopeful.


----------



## KRichmond

Thanks for the response Briss. I am always early too.....and my temperature has gone up. Oh well I will just have to see what happens on Monday. I did get my blood tested today.  Good to know that they got the egg in your case. I have done 2 long protocols and I was thinking this was the better option. When is your next cycle? Just off to do my trigger now.

Thanks again for the details.


----------



## Briss

good luck with your trigger and EC!

Can I ask you about your experience with long protocol? btw, what's your FSH? is it normal?

on my very first natural/modified cycle my temp went up on the morning of EC and I was so depressed, was sure we lost that egg but actually it was still there and they got (ended in chemical pregnancy unfortunately). so temp is not always accurate. but this cycle when they told me I already ovulated by day 8 I did not believe them cos my temp was still low but sure enough it went up on day 9 and stayed up and then the blood test confirm my progesterone also went up.


----------



## KRichmond

Hi Briss

My FSH is 5.4. I was fine with the long protocol in terms of feeling OK and getting some eggs the first time but the second was a bit of a disaster but I was so geared up for it in terms of time off work, finances etc that I went through with it even though I wasn't really responding well - 13 days of stimming on Gonal F 300 after 35 days of down-regging.

I will let you know how I get on tomorrow. Am a bit concerned as I did an OV test this morning and it was positive. The doctor yesterday said it was rare to ovulate ahead of EC so we will see. My LH yesterday was normal at lunch time but I know my body and I am sure it was yesterday evening....sorry going on about it as my DH is not at all interested in these details!!!!

And given that  I am doing the 3 cycle I can only learn from this experience. Given my DH's sperm results ICSI and IVF is the only hope but it is quite a gruelling process isn't it?

Are you doing no drug other than centrocide and the 'i' one?


----------



## Briss

KRichmond, wow 35 days of down-regging!! poor you that's just awful. how many eggs did you get on that cycle? your FSH is very good so you should respond properly to stims. I understand your concerns about O, I have that fear every cycle. have you not had to do the trigger shot? if you did that should give you positive OPK the next day but maybe it's different for long protocol? 

I am not on cetrotide anymore as it does not work for me, at the moment it's just natural (no stims) + trigger shot + progesterone when we have an embryo


----------



## KRichmond

Hi Briss

You are absolutely right about the trigger shot causing this! I have just been for EC and they got 3 which is great. I just need to keep fingers crossed for fertilisation. I think now I have been through this once I will feel more relaxed about the next two goes.

I got 4 eggs from the long cycle with only 2 fertilising. So anything more than that is progress.


----------



## Briss

KRichmond, 3 eggs is wonderful news! keeping everything crossed for fertilisation


----------



## LuckyE

well done Krichmond.


----------



## KRichmond

Got the phone call at 9.30 that none had fertilised properly so I haven't got anything. I think the eggs were of poor quality. Oh well I am going to give it two more goes and then see. Not sure there is anything too much that I can do to improve this, have been taking my vitamins, accupuncture etc.

Thanks for the encouragement anyway Briss and LuckyE. My DH is being surprisingly positive as I was all set to abandon all hope.


----------



## Briss

KRichmond, I am so sorry to hear your news. it's devastating. you might be right about egg quality being compromised during IVF. what protocol did you do this time? was it the one where you had 13 days of stimming on Gonal F 300 after 35 days of down-regging? sorry if you already mentioned this before but have you tried mini IVF or natural? it may make a difference to your fertilisation rates and egg quality. I personally do not think acupuncture or vitamins can improve your egg quality if they are up against very powerful stim meds. take a month or two to recover before trying again. also, please ask your embryologist to explain how eggs looked on collection, they usually tell you if they see something is not right: colour or shape or granulation. This can help you decide whether this was due to eggs. 

also was it ICSI or IVF? if it was IVF definitely do IVCSi next time even if the sperm is good, it may not be able to penetrate the egg or on the contrary more than one sperm goes it. what did they mean when they said the eggs did not fertilise properly? were there any eggs that had 3 Pronuclei?


----------



## LuckyE

Krichmond - I am so sorry.   I hope you are being kind to yourself. You got eggs last time which fertilized, so it's strange how these didn't. Was it a natural modified cycle they did? What were the drugs? I agree with Briss, you need to speak to the embryologists they give you more information than the consultants I find. Deep down in my gut I feel it's the clinic the did something wrong. It happened to me with my first cycle. They said it was my eggs that were bad - all 7 of them. They said it was my age. But other consultants said they stimmed me for too long and used a drug that didn't suit me - Gonal F.  And since changing my protocol I have ALWAYS had blastos and no one has ever said my eggs are bad. The thing is, clinics can't take the blame or they have to offer a refund. 

Diet - I guess it's true. A consultant told me that people starving in the 3rd world get pregnant. That put it in perspective for me. So definitely do what you feel.


----------



## KRichmond

Thanks for the notes. I actually had low drugs and icsi. The two other times when I did get eggs was high stimms and icsi. So who knows what is right for me. I will try to find out a bit more but am trying to catch up with work at the moment. How are you both doing? 
If the next go is the same result I may have to wait a while.


----------



## Cloudy

Bump


----------



## gpk

Hello,

may I join this thread ? 
I am currently in the natural IVF path, after failed stim cycles.

I had afc of 3 on my initial consultation at Create in Jan 2015. AMH was 7.9 tested during my last cycle at ARGC in Sept 2014.

xx 
gpk


----------



## Briss

Just a quick update from me, i've been very ill so was not sure if we could go ahead with natural iVF this month. but we went to Munich anyway, I was reading about ladies who got sick but the clinics were still willing to do EC so I fought I leave it up to them. Luckily my temperature was down on the morning of EC and they went ahead. We got one egg. Very unexpectedly i had two follicles on the scan before the procedure, no idea where the second one appeared from but they were both same size. that second follicle on the right had an egg but the main one did not. very strange. Maybe my body switched follicles in the last minute because of my illness? the procedure was very brutal, no sedation and it took 5-6 tries before they got to my left follicle, i was close to passing out from pain. I am not sure I can find it in me to do that again. I will ask for sedation. I also started bleeding after the procedure. and all that on top of my general chest infection. basically in the end the egg fertilised. It's really strange how I never get any fertilisation on stim cycles but my eggs tend to fertilise when it's a natural cycle. We went for IMSI this time as the sperm sample was not great. I had the transfer on day 2. I was still bleeding but they said it's vaginal from EC wound so not an issue. I saw my beautiful embryo on the screen before the transfer  I am PUPO!!! but so unwell i am still coughing and my chest hurts a lot but I am so pleased!

The next step is to test on 11 DPO. seems early but that's how they do it in Munich. I was told not to pee on anything but do a blood test. if it's above 5 than I am to repeat the blood test but if it's below I should stop progesterone. no "late implanter" hoping there


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## janieliz

Hi,

I can join this thread as well please?

Congratulations on being PUPO Briss, sorry to hear that you haven't been well, fingers crossed this embryo is snuggling in.

GPK, you have an AFC similar to mine! When are you thinking about having a cycle? i had one in January at Serum and managed to get 2 eggs and they both fertilised and were put back in on day 5. Unfortunately I have had a chemical pregnancy. I am going to try again in April. How did you respond to stim cycles? I was a truly terrible responder, and was over the moon when I got two eggs on the natural cycle!!

x


----------



## Briss

janieliz, welcome!

ladies, can I ask how do you decide on what day to transfer? With natural IVF most clinics do the transfer on day 2 because there is usually just one embryo so no scope for choice but the Munich clinic said it makes no difference on what day to transfer. There is a theory that the embryo feels better in the uterus than the lab so the sooner you get it in the better but others disagree and say that the embryo is travelling down the tube for about 5-7 days and the environment in the tube is very different to uterus so there is no advantage in early transfer. later transfer day 3 or 5 let you get more information on embryo quality. there is a risk that embryo will arrest before the transfer but it would stop developing in the uterus anyway so it makes no difference. I always had day 2 transfers cos I wanted to be reunited with my embryo asap but now I am thinking if we should transfer later so we have a bit more information on the embryo quality?


----------



## janieliz

Hi Briss,

It really is a difficult one with regards to transfer day. I decided prior to my cycle that I would go for day 5. I don't think Serum do day 2 transfers but I could have had a day 3. On day 3 the embryologist said that they were happy to try for day 5 and I was feeling brave with two! I think you do have more information about the embryo if you wait till day 5. If I was to do it again, I would aim for day 5 again, if its going to make it in the lab hopefully it will make in the uterus. I think that with natural IVF we know we may have to have a few goes so if you haven't tried a day 5 transfer before, I would go for it especially if your clinic are supportive of this- hopefully though you won't need it and this cycle will be your BFP.

x


----------



## Briss

janieliz, thanks! that makes sense. I guess there is also a logistical issue since I go abroad for my EC/ET. theoretically I could return to London on the evening of EC and come back for 5 day transfer, additional flights will probably cost the same as staying a few extra days at a hotel but I would not need to take as many days off work  (which is always a huge issue particularly when I need it every month). tricky


----------



## Altai

hi ladies,

Briss - hope you'd make the most convenient decision for you as to the ET day. 
I've just had my Japanese mini ivf cycle, got 5 eggs, all mature. I was over the moon - I get around 4-5 mature eggs with 450u stimms. But then 1 fertilised abnormally, so got 4 embryos, 3 remained on D3.
I was planning to do embryo banking. Unfortunately doesn't look like EB is going to start this cycle.  
Had 1 transferred on D3, the remaining 2 have slowed after D3. I still don't know their progress but tbh not hopeful as D5 quality wasn't good for freezing or  transfer. 

You may end up with nothing to transfer but at the same time as embryos didn't make to D5, then perhaps wouldn't have made it in the uterus but there is no way knowing.

I think I will do the same for the next cycle- return to London evening day of EC and if (once again) quality not suitable for freezing, then return D5 for ET.

Janieliz - well done on 2 eggs on natural. 

good luck to all for the next goes.

KR

A.


----------



## Briss

Altai, 5 eggs sounds great! I know you are disappointed you could not do EB this time but at last you had one transferred so who knows maybe you won't need EB after this cycle. I hope you will get your bfp and hopefully those two embies will still be good enough for freezing for next time.
I agree with you that if you wait for day 5 transfer you may end up with nothing to transfer but the embryos that didn't make it to D5, probably wouldn't have made it in the uterus anyway even if you transfer them earlier. It's a bit of a gamble. 

have you had assisted hatching? My German doctor said it's just a money making technique, there are very rare cases where the outer layer it too thick that require AH and most other situation it's just not called for. My Czech doctor was of the same opinion but I know some clinics routinely do AH on most embryos.


----------



## Altai

Briss- no I won't be doing assisted hatching. My plan is (or was) to do EB and then PGS all embryos I could get.  I've been  kicking myself for not doing that earlier and keeping transferring all embryos. But the reality is - I may not even get  anything to freeze and hence to test.....
I 'll give it another go with the same protocol and hopefully will get better results. 

I think it's disappointing to have nothing to transfer as if cycle completely wasted. 
Plus even if embryo/s would survive till D5, would you still transfer if quality is not good? 

In my case - the clinic didn't suggest to come back  for D5 transfer and to be honest I don't think I'd as embryos are/ were low quality even though they survived till D5. 

Have y decided on your ET?

Good luck hope all goes to plan


----------



## LuckyE

congratulations Briss and Altai on being Pupo xx 

But I'm sorry your description of EC sounded just gruesome. I have heard of some ladies doing EC without sedation and their stories have never been that bad. But I am    that this egg is the one. I think with natural it's just a numbers game. I wish I could go somewhere cheap! 

Briss, I have heard of some clinics who just do day 2 transfers. I think there are some in the states. They must have their scientific evidence. But I've also heard that clinics do day 2 cos they fear that they'll have nothing to transfer so they can blame the woman as to why there was no BFP (very cynical I know but that's what I've read).


----------



## Briss

Altai, I am not sure how important embryo grading is actually. it's just morphology, isn't it? even if an embryo is not looking that great morphologically, it can still be chromosomal sound and make a perfect baby, is it not?

Lucky, re EC, it was really strange cos I had EC without sedation before and even though it was painful it was nothing like this time. she tried twice: once for each follicle and that was it but this time they were trying again and again to reach that left follicle and she even asked for a different doctor who finally managed after two more tries but that was just out of this world pain wise. she had to hold me cos I started to shake. anyway, I clearly see benefits of sedation now. My ovaries are probably just too sensitive, I usually feel ovulation and follicles growing. 

Our czech clinic does day 2 or day 3 transfer but I could not understand how they decide which is it. maybe just convenience. It was actually the first time that I was offered to consider which day I want the transfer and I was not prepared cos I am so used to day 2 transfer. all opinions and info is welcome.


----------



## gpk

Congratulations to Briss and Altai on PUPO.

@ janieliz : Sorry, for the delay in responding. I had EC on Sunday.
It was bit disastraous. I had been sedated, but they said, I started coughing during EC. They could only get 1 egg out of 3. 
Then they said, I will be given mild sedation and they try removing other 2 !. I cannot imagine this !.
Finally they collected 3. Got a call yesterday, 2 fertlilised, but one of them was abnormal. So I wait for today, reg one left.

I am thinking, if there was damage while removal, that has caused this


----------



## Briss

*gpk*, I am sorry to hear EC was so difficult. I was actually coughing myself and I think that was the reason they did not do sedation, I could control my coughing. but with 3 follicles they had no choice it had to be sedation. It's really hard to say what was the reason for one of your eggs not fertilising and the second one fertilising abnormally, best to talk to embryologist and ask about the quality of the eggs. They can usually say by looking at the egg and judging by its colour, shape etc whether it's going to fertilise. Two times when my eggs did not fertilise I was told that it was either darker or granular so both times there was an indication of poor egg quality (most likely to do with stimulation rather than collection process). however, during my review the doc said it's not necessarily the egg, it could have easily been due to poor sperm quality, basically impossible to say but I tend to trust the embryologist.

also, was it ICSI? I know that ICSI can go wrong and affect fertilisation it all depends on the person doing it. Did you ask about abnormal fertilisation? was it 3 pronuclear or something else?

Fingers crossed the one that fertilised is your lucky embryo and is all you need to get pregnant.


----------



## gpk

Briss, it was ICSI. And the abnormal one had 3 pronuclei ! It is hard, cant guess what might have gone wrong


----------



## LuckyE

GPK -   that your embie is the golden one.


----------



## gpk

Thanks a lot for the wishes Lucky..


----------



## gabiladybird

Hello ladies, I'm so glad i've come across this thread, we all seem to be in the same boat, it's good to hear from others with similar background. I've had two ICSI short-protocols, fully blasted with drugs and not producing much. Last cycle with ARGC, managed 5 eggs, 3 mature, all 3 fertilised. Follow-up consultation revealed embies were all multinuclei, possible cause for non-implantation. Next step is to try mild cycle to preserve egg quality so we're going for quality as opposed to quantity. I'll still be taking Cetrotide so shouldn't miss ovulation. 
Every since my first failed cycle a year ago, I've had the feeling that my body is not going to co-operate with all these drugs and will just do its own thing. Bit stubborn, just like me.
Congratulations to all PUPOs and good luck with all upcoming ETs. 
GPK - i'm sure i remember you from an argc thread...  I've been lurking around for some time...


----------



## gpk

welcome gabiladybird  Yes I was in ARGC two cycles last year ! Wish you goodluck in the mild path.

Just got a call from embryologist. The one fertilised has turned 4 cells and they have frozen it.


----------



## janieliz

Congrats gpk, that means its a good one if they can freeze it! Are you going down the embryo banking path?


----------



## gpk

Thanks janieliz. Yes, i am thinking of embryo banking, also i have chosen the 3 cycle package from Create. But Not sure yet whether I go ahead with the ET, after these 3 cycles yet !

Btw, I was asking embryologist about the quality of eggs before the fertilisation, she said, they were not good quality. She was not able to speak very fluent english, so i didnot dig too much. But what i understood, she was talking about cytoplasm and shell quality. But she said, the one fertlilised looks good quality after fertilisation with 4 cells and grade 1. Not sure whether the quality before fertlisation will affect the implantation.


----------



## janieliz

GPK, I looked at the 3 cycle Create package, it looks good. Are you cycling back to back for the next 3 months then?

I don't know much about the egg quality prior to fertilisation, I am guessing though as it fertilised and looked good quality it should be fine. I think they say implantation rates are better on a FET due to less interference from drugs etc so hopefully it should balance it out.


----------



## Altai

Briss, gpk - sorry you had troubles with EC. Hopefully it's all behind now. 
I had a cough during EC in Lister and they did accupuncture while I was under sedation to suppress cough. Apparently it worked. 

Gpk - I also had 1 embryo abnormally fertilised with icsi this cycle. 

Afm - my 2 remaining embryos slowed down after d3, so nothing to freeze this cycle. I do believe it might be because of icsi, also new sperm perhaps not good match. 
Unfortunately, the clinic does either 100 icsi or 50/50, no traditional ivf and freeze only good quality blasts. 
So, changing a clinic  for the next cycle. 

Hi to ladybird, lucky, janiliez and to all who's reading.


----------



## janieliz

Hi everyone,

Altai, where are you cycling at the moment then? If you are using donor sperm, shouldn't it be IVF that they are using or does it depend on what the eggs look like? You seem to be getting really good numbers on this lower dose of stims. I think my FSH is too high now and my follicle count to low.... I need to speak to Penny about whether there is anything I can do to lower it etc.


----------



## gabiladybird

Hello all,
Does anyone know whether ICSI would damage the egg? I think there is a higher chance of it happening but the embryologist would always offer ICSI if there are a low number of eggs to work with. So far, we haven't had problems with fertilisation but the quality hasn't been the best. I was just wondering if IVF would give us a better chance though we might end up with no fertilisation at all. Difficult decision....
I'm so desperate to get away for a weekend but can't book anything while all this is going on. Life is on hold...


----------



## Altai

Janiliez- am did this cycle with Altra Vita, Moscow. I was surprised myself with 5 eggs. 
Peny had me on 450u plus 2 femaras- I got 7 eggs but only 5 mature. Got the same numbers on mini protocol. 

Altra has tailored protocol to me so well. Pity that they didn't deliver on embryology side. Unfortunately, it's almost always  icsi as method  of fertilisation with them. Doesn't matter DS or  de. If oe at my age and my n,  then definitely icsi. Even though initially I agreed with dr 50/50 split. 

My first ivf was with Create - they, too, did icsi and quality of resulting embryos was very poor.


----------



## LuckyE

HI All... 

It's so funny. Some clinics say ICSI is a sperm problem not an egg problem. So at Guys they did IVF cos there were so many sperm. Although when I spoke to the embryologist there was something about poor egg shell or something. I questioned it but she didn't really explain. She said the egg fertilized. I am not sure what Serum do. I am assuming IVF but I don't know. 

Altai, GPK, Briss - hope you are bearing up well. Am saying a little prayer for you all tonight. xx


----------



## lollipopwanted

hi ladies,

may i join you all?

Im heading to reprofit in APril and havinng mild ivf with clomid 150mg daily and 75iu menapur. we are starting out with mild ivf as i have PCOS so the lower the stims the better for me and my cysts lol if it doesnt work we will switch to full ivf but depends on how i respond etc etc. Also paying for icsi on one egg and think if we get anymore i will just let them do it the normal ivf way although not 100% on this as of yet i have factured 2 icsi into the fund just incase lol

Rach x


----------



## Altai

Welcome lolly. Hopefully it'l be a winning  combination for y & u get more than 1 egg. 
I've looking at Eastern  European clinics (incl Russia)  and was surprised that mini ivf is quite often used there. I think much more that in the UK. 

Lucky - I think Serum does traditional ivf if there is no sperm issues. Mine were all ivf and it worked well. 

Afm - once again negative. Though official otd is next Wed. So,  still taking drugs just on case (of what?) but already started planning next cycle. 
Trying to decide on the next combination of drugs - not that I have the whole pharmacy store with me but there is a little bit of room for manoeuvre with drugs. 

Hi to all and a good rest of the Sunday


----------



## janieliz

Hi everyone,

Altai - sorry to hear that, is it not a little early to test though? Planning next steps...will you cycle again next month?

x


----------



## LuckyE

Altai, how are you doing? I am hoping things are looking up. 

guys, I need ur advice. 

I am about to do natural IVF but I need to know how intense is the monitoring as I will not be able to get a scan for 2 days... Is is every day or every other day?

Also, I might have to trigger at home in UK instead of abroad where my clinic is. Did anyone who did natural use ovulation predictor kits? If so do you still need to trigger if it says you're ovulating? I didn't think you would need to as isn't that the point of the trigger? Or is the point of using the trigger to trigger BEFORE you ovulate?

I dont' want to bother my clinic with all this. So any advice would be greatly appreciated.


----------



## Briss

Lucky, just quickly to respond. I find natural cycles required less monitoring, once they established your dominant follicle they can usually predict ec day by follicle growth which is about 2 mm per day.  I usually have only 1-2 scans/bloods per natural cycle. They start usually later around day 8-9 and I ovulate early sometimes I just do a scan on day 9 and my follicle is already over 18 mm so they trigger me the same day. You need trigger in natural ivf so they could time ec. I always do the trigger in London and fly the next evening. Ec is usually 35-37 hours after the trigger. They should tell you the exact time for trigger and ec. Good luck!


----------



## LuckyE

Thanks Briss. It's all a lot clearer. 

Ps I've been keeing tabs on you since your terrible egg collection at CRGH. And I'm really pleased for you.   for a happy 9 months.


----------



## Briss

Lucky, thank you! I will be updating you all properly once I get my scan next week and feel I little more confident. Its just so scary,  after TTC for almost 5 years I just do not dare to believe it. But I am a firm believer in natural IVF (with IMSI if sperm is not great) in certain situations. For me personally completely natural cycle with only a trigger and progesteron after ec works best. But everyone is different.


----------



## gabiladybird

Had my D3 scan today and I seem to have 2 follies in each ovaries, which is pretty good for me. Doctor said they'd review my file and may put me on the short-protocol again. I'm concerned that will damage the egg quality, i was actually looking forward to doing mild stims and giving my body a better, more natural chance. We'll see, they should call me later on, I have tons of drugs in my car, just in case I'm back on the high doses.  
How's everyone doing? Hope you're all well. x


----------



## janieliz

Briss.....fingers and toes crossed here for you...xxx

Gabiladybird - 4 follies, thats brilliant! Let us know what they decide. x


----------



## LuckyE

gabiladybird - 4 follies is Fab. Are you definintely doing short? What will be the amount of drugs they'll give you on the short? 

Briss - I'm so glad you stuck to your guns. I think natural is best in some situations, definitely. Good luck for the scans.


----------



## gabiladybird

So, I'm going all natural!  (I already have if we count not shaving my legs, such a chore ) 
No drugs yet, probably starting tomorrow, they've said it's normally d5. Back for bloods and scan tmrw morning and then we'll see how it goes. Consultant seemed to try to talk me out of natural cycle, I said I would do whatever they advise but I want the healthiest egg/eggs possible. Not holding my hopes up, I did that last time and the disappointment was very bitter. How can you stay positive and prepare for bad news at the same time? Ahhh... 
Good luck with your scan Briss!


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## Briss

gabiladybird, every clinic tried to persuade us to do stims. But I just know after several failed cycles its a waste if eggs for us so we were firm. I only had embryos and transfers on natural cycles, never on stims so it seemed pretty clear to us


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## CrazyHorse

I have started stims this morning for my cycle of mild IVF with Reprofit -- letrozole 2.5 mg twice per day, 75 iu Menopur once per day. I'm also on 5 mg per day of prednisone on an empirical basis, due to my long history of immune-related issues. 

Since I'm an early ovulator, and am doing work where I can telecommute, I've arranged to be in Brno from cycle day 10 onwards, with a scan in the UK on cycle day 8. Because it's an enormous pain in the backside to travel from my home in Edinburgh to Brno, I'm just going to stay in Brno straight through ET, assuming we have something to put back. I'll have intralipids administered there on CD10, and they'll also do the blood tests for clotting disorders and elevated NK cells (MUCH cheaper there than in UK).

Fingers crossed!


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## janieliz

gabiladybird - are they going to add any stims in at all or is going to be completely au natural?! 

Crazyhorse - Good luck with your cycle, it all sounds very organised, how are you feeling about going to Brno, I think this is your first IVF abroad? Is the first time you have had steroids and intrallipids? You will definitely have something to put back, everyone feels like that on a natural cycle.


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## gabiladybird

Briss - thank you for the reassurance. I totally agree, I want to do what feels right to my body and I know how awkward it can be, sticking two fingers up to stim drugs and producing only 1 egg, so what is there to lose? 
Crazyhorse - I love Brno. It's a lovely place and the people are very friendly. I know you're not going there to have a good time, far from it! I must look into prices for IVF abroad, sounds like a less expensive option. Good luck with the treatment!
Janieliz - I will be taking stim drugs but low amounts, such as 75 merional I think and will also be taking Cetrotide, probably from quite early on as I tend to ovulate early, so we'll need to keep those eggs in till they mature. If everything goes to plan, I could have EC next weekend. Scary!


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## janieliz

gabiladybird - that all sounds really positive, I had low stims and I managed to produce 2 eggs from 3 follies so you will deffo do eel with 4 folliesl. I bet your egg quality will be really good too with this approach. Very exciting!!


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## gabiladybird

I'm hoping it will be good enough to produce that golden egg Janieliz!


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## Briss

Brno and reprofit are fantastic. I really liked the clinic, it also helps that they do not charge you if you have no eggs at ec.


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## CrazyHorse

Thanks, ladies. I really like the people I have interacted with at Reprofit so far. I'm pretty calm about going abroad for this -- many of the people at the clinic speak good English, and based on my experiences traveling elsewhere I'm sure all of them will speak at least a few words of English or German. With the Internet, English really is the language everyone defaults to these days when your native languages aren't the same. DH is concerned about the language issue due to the fact that it will already be a high-stress situation and he doesn't want to deal with silly misunderstandings in restaurants and so on, but I'm sure it will be fine. I'm looking forward to walking all over Brno while I'm there.  

Wishing lots of luck for everyone else currently cycling....


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## LuckyE

Crazy horse - so exciting! Good luck.

Good luck Gabiladybird. 

Please keep us posted


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## gabiladybird

So those 4 follicles are now down to potentially 2, one at 10mm and one at 13mm. If little one doesn't catch up then we only have the golden egg to hope for! That's pretty much all I had with the highest dose of drugs in my first cycle, so am I worried? Nope, I'm actually quite relieved and liberated that I didn't have to take any drugs so far and I've still managed 2 potential candidates. I'm waiting to hear back with my blood results this morning, I have a feeling they're starting me on cetrotide very soon if not today. 
On a positive note, I was chatting to a lady in the waiting room and she was having pregnancy monitoring. She's said she suffered with IBS all her life, had 1 failed cycle before ended up at this clinic. She then thought to give up gluten to get healthy for the new cycle and hey presto, she got pregnant and her IBS disappeared. (she wasn't pretentious about it at all, just wanted to be helpful) 
We all know gluten is not good for us but it's hard to go without it and when people keep telling you that they just ate everything and carried on with their lives, you do wonder if this is just a myth or does your immune system is really holding you back from having a baby? Because you're one of the unlucky ones who do have to watch what we eat to control those inflammations. 
Briss and Crazyhorse - Reprofit sounds great, I'll keep it in mind as a very, very last try, if I manage to save up some money.

Hello LuckyE, Janieliz and everyone else.


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## LuckyE

so pleased for you gabiladybird! So good that your eggs are roughly the same size. 

Did the lady say how long she did gluten free? I have gluten intolerance and dairy - but it's so hard to stick to. I think if you don't have ibs you don't need to give up gluten. I could be wrong. But a lot of consultants believe in immunes. MY NHS ones weren't into it but I think that's because they can't cos it's the NHS and there needs to be proper trials and all that.  I remember reading on here that one lady saw her NHS IVF consultant in the private fertility clinic she was attending! Think that' says it all. 

Glad you're getting along well, Crazyhorse. reprofit does sound ace. 

Amazing that they don't charge if you dont' get eggs! It's must be a nice comfort blanket.


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## gpk

sorry for not being  here for sometime . Was bit hectic at work. 
Briss :   on BFP .   everything will be ok and hope your long wait is over soon..

Hi Lucky, gabiladybird, janieliz and crazyhorse and everyone, how are you ?

Update my side, I had planned my 2nd cycle (out of 3 cycle from create ) back to back. But now i am thinking, whether i wait another month, (just give some time)..not sure..But my AF is already here . Still thnking abt whether i go ahead this month or not..I need to decide by tomorrow.


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## Briss

*gabiladybird*, just to come back to your discussion on ICSI, statistically ICSI has higher fertilisation rates than IVF but ICSI is no guarantee for fertilisation. egg/sperm can be of poor quality and not fertilise but also there is always a risk that ICSI is not done properly, a lot depends on the person doing the procedure. the clinics will never tell you if they screwed your eggs they will just say no fertilisation. However, it depends on the sperm a lot, if sperm is not great then again statistically ICSI is a better bet. in our case ICSI was not even enough, we had to rely on IMSI. I personally think when choosing a clinic their embryology lab is so important, protocols/stims is all very well but half of the important stuff happens in the lab. I know clinics often offer split IVF/ICSI 50/50 if you have decent number of eggs and actually they prefer to transfer IVF embryos rather than ICSI embryos. if both groups ferilise they check IVF group first and only if this group is not great than go to see of ICSI group has any good embryos.

Your two follicles look good, good sizes so there is every hope for at least 2 eggs.

re gluten, gluten is actually fine. I think it's a marketing thing to make gluten look evil so they could sell their non-gluten stuff. There is a small percentage of people who have related illnesses and various intolerances to gluten so for these people it makes a lot of difference when they go gluten free. From what I have seen it's like a life changing thing. but for the vast majority of people it makes no difference. if you are not sure whether you have gluten intolerances it may make sense to go gluten free for a few months and see if you feel any different. You can always test for various gluten related illnesses as well. but when you go gluten free, make sure you read your labels because most gluten free foods are super bad for you while TTC because they are packed with nasty things to compensate for luck of gluten.

*Altai*, how did you chose this clinic in Moscow? Has somebody recommended them? they usually decide IVF/ICSI depending on the sperm but I am surprised they couldn't be more flexible and do 50/50 split. could you generally recommend this clinic? I personally do not know anyone who had IVF in Russia, can I ask (feel free to ignore me) why did you chose Russia? is it the price or a particular doctor? I go to Russia at least couple of times a year for business but I just never thought of it as IVf destination. Generally if you liked their protocol you could probably repeat it with a different clinic where they would do the IVF/ICSO split. but you are right they are not keen on mini IVF in London, CRGH for example will only do proper stims or completely natural cycle, I think it's mainly Create and Lister that offer mini IVFs. Have you decided where you are going for your next cycle?

*Lucky*, I also heard that ICSI is usually a sperm issue but sometimes it can be an egg problem e.g. when they had previous IVF fertilisations that failed because the egg shell was too hard (age thing) and no sperm could penetrate it or if it did not close and let more than one sperm in. in situations like this clinics would not risk it and do ICSI next time. we were su surprised when we went to Reprofit for EC, I had 2 follicles naturally with no stims but they couldn't get any eggs so they told us they will only charge 50 euro for the needle! I could not believe it. Obviously we still paid for bloods/scans in london + travel so it's not a completely free cycle but it's just so nice of Reprofit to do that. I do not any other clinic that does this.

*lollypopwanted*, good luck with your cycle at Reprofit. your protocol sounds good. You will like the clinic, they are all lovely, speak good English and very flexible so you can discuss what you want to do. Definitely go to staroburno brewery, they have lovely Czech food.

*CrazyHorse*, best of luck with your cycle. It looks like you have arranged everything perfectly. I also heard that blood tests for clotting disorders and elevated NK cells are much cheaper in CR, it would be good to get those done so you know what you are dealing with. if you have time take a train to Prague for a day, it's really nice. trains are super cheap and it's 3 hour journey. In Brno definitely go up the Cathedral, the view is beautiful!

* gpk*, it's so hard to advise cos it's a very personally decision but I'd totally go for it this cycle. My mind set was to give every egg a chance but I was doing natural so it was easier. if you have stims it might be better to skip one month but again depends on how you are feeling generally, how easy your previous EC was etc.


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## gpk

thanks Briss.

I know it is personal..Sorry, i was bit down and just was thinking aloud about my next cycle.

Sorry for that, it has been very hectic at work in my startup company..


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## Briss

gpk, that's absolutely fine, I was just trying to tell you that this is my view and you may feel differently. whatever you decide I will be rooting for you and hoping for your bfp.


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## gpk

Thanks a lot for the wishes Briss


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## LuckyE

Hey GPK - why do you have to decide tomorrow? Can't you have a scan on day 1 of AF see if your ovaries ae depleted and then decide if your body needs a rest? That's what I was did with Create. If I started my cycle with them my first scan would be on day 5. I know their scans are expensive so I did the day 1 scan somewhere else. One of the nurses reccomended it. 

Hope everyone else is well. AFM AF due any day now.... I'm hoping later so I can be in Athens before I ovulate xx


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## CrazyHorse

Had my CD8 scan today and have 6 follicles, of which I think 3 will probably be a reasonable size for collection (currently 17, 16, and 13 mm, plus the 3 smaller ones). This is a good a result as I've ever had on the conventional protocols, so I am very pleased. Am waiting to hear back from the clinic if they want me to use Cetrotide today and tomorrow, and when they want me to administer the trigger shot (I'm guessing tomorrow or Thursday). Flying to Brno tomorrow evening!


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## gabiladybird

That's great result Crazyhorse, to have 6 follies and potentially 3 eggs on a mild cycle. And you are so close! Almost ready to trigger, exciting! All the best, have a safe journey and enjoy Brno. Hope EC goes well. 
I'm a bit behind you, on D9. I also have potentially 3 follicles that are growing at around the same rate. They're only 14-15 mm today, so trigger might be another 3-4 days. So far I had 3x 75 doses of Fostimon and I'm already on Cetrotide, Clexane, aspirin and will be starting dexamethasone tomorrow. That's good result for me, first cycle I had was on full stims with only 1 egg that barely made it to collection. We need to believe in our bodies, we can do this!!


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## CrazyHorse

Thanks, gabi -- given the small amounts of meds this cycle, I'm thrilled (albeit still very stressed). I'm certainly glad I insisted that my first u/s scan needed to be CD8; Reprofit normally recommend first scan on CD10 for mild cycles, and that would have probably been too late to get me to egg retrieval before ovulation. For mild or natural cycles, it certainly pays to know if you normally ovulate early! 

Today is only Day 6 of stims for me, which means I will do 7 days of stims in total this time (letrozole 2x per day, plus 75 iu Menopur 1x per day). I have to think that's better for egg quality than the 13 days of stims -- or 18 days, after downregging on Buserelin!-- on my previous cycles. It just seems like a much healthier approach, and it's certainly more tolerable for me as the patient.

I'm taking Cetrotide today and tomorrow to make sure the eggs stay put, and taking the trigger shot tomorrow night for EC on Friday morning. Good thing I'm already scheduled to fly tomorrow!

Hi to all the other ladies...


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## CrazyHorse

A wee update from me: I had EC this morning, and got 4 eggs!!!! That's as many as from my two completed IVF cycles on conventional stims combined. So I'm over the moon about that.

We've opted for conventional IVF instead of the clinic's standard ICSI, because we've had 100% fertilisation with conventional IVF in the past, and I suspect there's at least one immature egg in this bunch that might fertilise naturally but wouldn't survive ICSI. Fingers crossed....


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## janieliz

Congratulations Crazyhorse, 4 eggs is brilliant! Good luck for fertilisation. x


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## Briss

Crazyhorse, excellent news! fingers crossed for fertilisation!


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## gabiladybird

Crazyhorse, I'm thrilled for you, that's brilliant results!! Good luck with the fertilisation, hope the swimmers will do their best. I'm heading for EC as we speak, quite nervous as I'm worries I may ovulated despite the cetrotide, it can never be guaranteed. OH wants to do icsi as we'll only have 1 or 2 eggs and he wants the best chance even though his swimmers are in good shape. We'll see, let's get some eggs first!


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## janieliz

Good luck gabiladybird, let us know how you get on. I'm sure you won't have ovulated.
X


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## CrazyHorse

Good luck, gabi!! Sending good thoughts your way.  

AFM, we now have 2 embryos and are scheduled for Day 3 transfer on Monday morning. This isn't as good a fertilisation rate as previously, but I suspect two of my eggs may have been immature, based on follicle sizes. Overall, I'm very pleased. Obviously, 4 embryos would have been ideal, but this means that we don't have the agonizing wait to see if embryos arrest between Day 3 and Day 5, or possible future decisions about what to do with an unused frostie. I can live with that.


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## janieliz

Thats great news Crazyhorse, two embryos is fantastic. Good luck for tomorrow.


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## HanaFubuki

Hi everyone

I am on my third round of IVF at Reprofit in Brno. Currently 8dp5dt.

The last two cycles were mild IVF.  

Did anyone else start out being prescribed very high doses of Menopur using standard IVF protocol and then move, after it was unsuccessful, move to mild IVF?

Thanks and good luck to everyone else in the midst of this crazy journey!

Hana


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## gabiladybird

Crazyhorse, two embies are great, I hope they're sticky ones.  

We had our EC on Saturday and heard back from the embryologist on Sunday morning, both eggs have fertilised and looking good, yipee! Different story this morning at ET, when we were told one of the embies didn't make it but the other one is doing very well, if anything, a bit too fast at dividing. In a rush, just like me! It's not multinuclei either, so i'm hoping for the best but staying firmly grounded and won't be too surprised if it didn't work. Heartbroken but no surprised.


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## CrazyHorse

Hi, gabi, very pleased you had something to put back! Fingers crossed for you.  

AFM, I had my two embryos put back this morning. At the check this morning before transfer they were 8 cells and 4 cells, but on the screen before transfer (Reprofit have a nice set up where they show you onscreen the images of the embryos under the microscope) the second embryo had clearly divided into at least 7 cells. Both were top grade in terms being low fragmentation, which is better quality then we've had previously. My embies on previous go-rounds weren't bad in terms of fragmentation, but these really did look text-book perfect. Here's hoping those nice looking cells have normal chromosomes in them and decide to settle in!

Am having some back and forth with the coordinator about getting the intralipids prescribed for administration in Edinburgh later this week. She is claiming they can't send Fertility2u a prescription for them, as the intralipids have to be administered by medical personnel. But I talked with the doctor this morning at embryo transfer and he said it would be fine! And I know Fertility2u will ship intralipids to the patient to be administered by whatever private nurse you're using. So here's hoping there's a sensible outcome. I don't know what she thinks I'm going to do, set up an intravenous drip at home with no training or equipment?!


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## Guest

Just popping on to wish you lots of luck Crazy! 🍀   Good luck everyone else here too! xx


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## shivey

Hi Ladies. I am new to posting on FF although became a member 3 years ago when going through IVF (stimms). I think you might be able to help me so I hope you don't mind me jumping on the band wagon! I really think you could help me re a natual ivf cycle, currently unsure about proceeding with treatment at SERUM, Athens or investigating Create. I have read all of your posts and I wish you luck with your journeys xxx. Anyway my story, I had my baby boy Sam 2 years ago via IVF, and I know how lucky and blessed I am particularly as having been referred to IVF re husbands sperm it transpired that my AMH was shot to pieces (1.75 the age 36, AFC 10). I was on the NHS at UCH (RMU) in conjunction with CRGH and they decided just to give it a go. I was slow to respond to the stimms but we got 12 eggs, 3 to blast. Two were transferred ad I had my baby Sam. I would love to have a sibling for Sam but try not to lose sight of what I already have. Anyway, I went back to CRGH this time as a private patient. I transferred our one and only frostie last summer but sadly miscarried at 9 weeks. I felt able to pick myself up and try again a few months ago. Back to CRGH for the dreaded Ovarian Reserve test, now .85 and seem to have lost 5 follicles too. They said it is natural ivf or nothing and I very much felt like I was on the AMH scrapheap for CRGH. The costs of natural ivf there are huge nor do I think they are the right place for it. Having spoken to friends who have been to Serum in Athens, and the lovely warm Penny herself I think this is the place for me. Penny thought it likely on those results a tailored natural ivf perhaps with clomid or another drug would be the way forward but she is going to reserve judgment until my infection test results (a test they offer at Serum) and when we meet her next month. Suddenly feeling very overwhelmed by the thought of several natural cycles in Athens and what it means practically. I am guessing with natural you need to be prepared to do a few cycles (I am guessing), would you be expected to be there from day 10 and until when? Those blasted ovulation kits have always shown smileys quite late in my 28 day cycle (1 but maybe if I was on Clomid or the like that would bring ovulation more in line? I am probably overthinking it all but just thinking ahead, booking time off work etc etc ( you can hear my mind exploding). Which then made me think maybe explore somewhere like Create who are known for natural/mild ivf but having called them 4 days ago they have still not got back to me so not sure that is a good sign.

What a long story, so SORRY, any tips much appreciated. xxxx


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## LuckyE

Good luck Crazy horse. Things sound very promising   

Shivey - I'm at Serum now doing natural. I don't konw what to expect but perhaps if you want more control over your cycles you could do clomid. If you scan at home you can be out there for 2-3 days tops but obviously you can't transfer the same month and freezing makes it more expensive.  I don't think you can plan natural cos every cycle is different. 

Gabi -    for good news.

GPK - how are you? Have you decided what you are going to do for your next cycle?

Hi Hanafubuki, Janieliz, Briss and anyone else I've missed.


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## lollipopwanted

hi all, sorry for the non posting i thought i had bookmarked the page and then lost it! doh  

briss - thanks hun just hoping i can get at least 1 good fertilised egg then ill be happy  

good luck everyone xx


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## CrazyHorse

Just wanted to let people know I got my BFP today on this mild IVF cycle. Trigger shot should have been gone yesterday, but I still had a shadow of a second line this morning, following the vaguest possible hint of a shadow of a line yesterday. Tested again this afternoon, and the line is definitely darker -- you have to look carefully, but you don't need a bright light source to see it. Will keep testing over the next several days to ensure it gets darker. Clinic's ODT for using the HPT they gave me isn't until the 23rd, which seems crazy! I will probably have beta hCG bloods done on the 20th, which is 14dpo, and when I had the beta last time.

This is a BFP a day sooner than on my previous cycle, so I'm hoping the higher hCG level indicates a healthier embryo this time.  

Sending good wishes to all who are embarking on this protocol. I can hardly believe how easy this cycle was compared to previous ones, in terms of no side effects!


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## LuckyE

congratulations crazyhorse!


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## CrazyHorse

Thank you, LuckyE! I just wanted to update everyone because I know lots of people kind of doubt that mild IVF can really work, but it gave me the best quality embryos I've had so far.


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## Briss

*CrazyHorse*, congratulations!! so happy for you. praying this is it.

*afm*, not so good news. I had a natural (no meds) IMSI cycle in Germany in Feb, got my BFP on 11 DPO and my HcG levels were very good and doubled at they should. my the first scan was very promising but a 6W5D scan showed no HB and my HcG did not increase as they should in the last two weeks. This looks like a missed mc. I never had a mc before and am very scared (as well as completely destroyed emotionally - it took almost 5 years and 6 IVFs to get this BFP). At the moment my body is still holding on to the pregnancy, I have no spotting. I was so hoping IMSI will help us with poor sperm quality and it did in a way but IMSi still cannot guarantee the sperm has sound chromosomes. I do not even know where we go from here.


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## CrazyHorse

I am so very sorry, Briss.     I know how terrible it is to have such a desperately wanted pregnancy, so long in the making, end in this way.

Let yourself grieve and try not to think too far ahead yet -- managing the day-to-day challenges is the key thing right now. I'll be thinking about you and sending good wishes your way.


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## gabiladybird

I'm so sorry Briss. Is that for definite? Is your Hcg still increasing? Sometimes heartbeat is hard to find so early on, i've heard of cases when the lady had to have 2nd and 3rd opinion to find the baby but it was there. Have you stopped all your meds yet? Maybe try to carry on with progesterone supplements until it's totally confirmed that your hcg is dropping and it was a mc. It is heartbreaking, i know, been there. Stay strong!


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## Briss

thank you, ladies. I still find it hard to believe. the scan did not show HB and the size was 1-2 weeks behind but I was not happy with the lady who did the scan so I had some hope that she just missed it or something but then I got my Hcg results they only increased from 3,200 to 10,500 in 2 weeks! they are supposed to be close to 50,000 by now as they need to double every 2-3 days. My clinic said it looks like a missed mc but I need another scan next week to confirm before I stop progesterone. I will also do a few bloods just to be sure of my HcG levels. I know mc is very common in the first trimester and after IVF but I was still hoping with IMSi we will get a good embryo. and it started off really well. something happened last week, I noticed that my breasts are not as sore and stopped growing, I did not need to pee as often and I got acne which I usually get around O/AF when hormones change but I had no spotting so I was still hopeful until the scan and blood tests came through. next few weeks are going to be very hard&#8230;

*gabiladybird*, how are you? have you had your ET yet?


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## Altai

Briss - I am so sorry, so heartbreaking to lose a long awaited pregnancy. 
Have you asked your clinic maybe HSG shots  might help? 
Look after yourself sending you best wishes.

Crazy - congratulations, fx for the successful outcome. 

Afm -  had EC last Friday,  got 7 eggs, 6 fertilised by icsi, Russian clinics seem to be obsessed by icsi, didn't agree  to 50/50 split due to the low number of eggs retrieved and my age. Had 1 embryo transferred @ D3 and the remaining 4 will find out tomorrow if I had anything to freeze. Same story as in previous cycles. Am praying I will have some to freeze.
It's my 3rd embryo banking cycle and not a single embryo has been frozen so far. I am doing embryo banking so I can have a combo oe/de cycle in the future. It's easier to accept de this way for me. 
Briss -  once I go to de, I will do it in russia, that's the reason am doing embryo banking in Moscow. 
Hi to all and best of luck in the next steps , take care

Hugs 

A.


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## N_N

Hi All
First of all, I'm so glad I found this thread!! 

DH and I are considering mini-ivf for our next round. And while I'm halfway through reading this thread, I was wondering about everyone's reasons for doing mini-ivf in the first place? 

Thanks for your time and wish all of you well


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## CrazyHorse

I had such poor response to high-dose stims (using a variety of drug protocols) that I figured I'd get just as many eggs through mild IVF. As it turned out, I got *more* eggs through mild IVF; while it seems like 50% were immature, my embryo quality from the two that did fertilise was much better. So, for me, it turned out to be the dream protocol.


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## RiftRaff

Seems as if this thread has gone quiet so thought I would join and see who is out there!
Im on my second natural cycle of IVF. I did the first one in January it was cancelled due to poor follicle growth. Only got to 13mm. I was advised by one doctor to try a stimulated cycle so got all the drugs for that but then went back overseas to where I currently live. I came back to the UK in May and was going to start another cycle. The same clinic then recommended that due to my age and reserves that a natural cycle would be best for me. Thankfully they took the drugs back due to their confusing messages. 
Im now day 14 of my cycle and the follicle is only at 13mm. Just got a call now to say that my LH levels are high 24.8 so it looks like Im ready to ovulate but the follicle is not developed enough. They want to cancel this cycle.   
 I feel really confused. Should I have done a stimulated cycle? Was there anything they could have done on a natural cycle to help the growth? What do I do next?


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## CrazyHorse

A mild/mini IVF cycle might help you with the follicle maturation. I was on 2.5 mg letrozole twice / day and 75 iu Menopur once / day for my mild cycle, with no GnRH agonist (e.g., buserelin) or GnRH antagonist (e.g., Cetrotide) except for a small amount of Cetrotide at the end to keep me from ovulating early. This gave me good-sized follicles with very minimal side effects. Some clinics also do Clomid or Letrozole on its own with no injectables. 

Given your FSH, I'm guessing you still have some decent quality eggs left. Low-dose stims might get you over the hump of not growing mature follicles, without damaging your egg quality. I see that you had a 0% fertilisation cycle years ago, but that could have been down to sperm issues or a problem with the lab -- I wouldn't necessarily assume poor egg quality by default. Do you mind if I ask which clinic you're with now?


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## Briss

RiftRaff, could this just be a one off anovulatory cycle? 13 mm is a bit small. do you know what's your estrogen levels? if they are high you may still have an egg there. i'd see if this follicle ovulate and if you have progesterone levels ager O and if so I'd try again next cycle. 

I am doing completely natural IVF + IMSI. my last cycle was super natural we even did not use trigger shot so it's just progesterone after EC. I had a few cycles where we had to abandon it cos of early ovulation or missed ovulation/LH surge or missed egg at EC, this happens all the time with natural IVF. you have to know your body quite well and help the clinics sometimes cos everyone is different. but the good news is once you get the egg it has a very good chances of fertilisation and implantation. I have zero fertilisation with stims (any stims) but on natural cycles my eggs usually fertilise although i never had more than one egg collected.


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## Pickle123

Hey team mini/mild/au naturel, and hello to all the lovelies I know from other threads!

I'm doing a natural modified cycle package with Create. I'm on cycle 1 and had my first scan today (day 4). What size follicles would you expect to see this early on without any stims? Also, what about lining thickness?

Thanks!
Pickle


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## Briss

*Pickle*, day 4 is very early for natural. I do not usually start scans before day 8-9. Although at Create when I had my modified natural IVF I had my scan on day 6 and had 6 follicles: 1 right/ 5 left; 11 mm; 10 mm; 7 mm; rest below 6 mm, my lining was 5.78 mm, estrogen 295, LH 5.6. I was on 150 menopur from day 6 so this result was before I started injections. I ended up with one dominant follicle and one smaller runner up which was not collected due to cyst nearby. One egg, 2 day transfer but that cycle ended in chemical. I do not know if my numbers are any use to you though but may give you some idea. Good luck!


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## Pickle123

Hi Briss, and thanks, that's really helpful. What are you doing treatment-wise at the moment? Hope you're doing well


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## katkat2014

Hello everyone, I know that this thread has kind of died down but in the hope someone reads it and can help.. I am thinking of doing mild IVF as I seem to have an egg quality issue. What drugs and protocol do you think would work for me? So far a clinic suggested a chlomid cycle. Another suggested Menopur. What is the difference between the one or the other in terms of results? My AFC is 10 (but 20 were counted a few months ago), FSH about 8.5, LH about 4, lowish testosterone (taking dhea now). So I have always responded fairly well to stimulation, but on the long protocol with Gonal f only I had almost no mature eggs and on the short protocol with gonal f and Menopur I had only 2 good quality embryos and 3 bad quality ones. Do you think mild or natural IVF could be an option?


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## Orchid-1

Hi Katkat - personally I would steer clear of clomid. I have been told it wrecks havoc with your ovaries. 
- mild or short protocol without down regulation [i.e cetrocide] is generally thought to be better for ladies who are older.

Natural IVF - don't know too much about that. Perhaps some of the other ladies can help.

I have been recommended menopur which I will be using for my next cycle. I don't know if it will work or not. Fx anyway. Hope it all goes well for you too. x


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## CrazyHorse

I think the bigger issue with Clomid is that it tends to cause the uterine lining (endometrium) to be thinner than normal. If you normally have a thick endometrium midcycle (e.g., 12 mm), that's not a big deal, but if your midcycle lining is on the thinner side (e.g., 9 mm), having it thinned out further by Clomid can be problematic. Letrozole (aka Femara) is a good substitute for Clomid for women who have problems with thin uterine lining and/or migraines.

The consultant who treated me at Reprofit was very big on using either Clomid or letrozole in combination with a low dose of Menopur, and said he believed they got much better results using the drugs in combination than either alone (you can see in my post upthread what doses I was on), and his opinion was that Menopur was superior to Gonal-F for this particular protocol. They did their mild protocol with no GnRH antagonist (i.e., Cetrotide) except at the very end as needed to avoid possibly ovulating before egg collection. Variations of this protocol are often also called Japanese mini-IVF because, like vitrification, it was originally pioneered a decade or so ago by Japanese clinics.


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## katkat2014

Hello orchid and crazy horse,  that's really interesting, thanks! Currently unsure if I should stick with my clinic or change, but the other clinic I was looking at (Serum) suggested chlomid but with embryo freezing and banking. My lining is on the thin side, around 8.3 or 8.7 the day before trigger. Apparently that is fine for implantation ...  not sure if that's correct... now am starting to wonder if perhaps my lining is too thin for implantation..

The Menopur/femara combo - when did you start taking cetrotide (what size follies)? On both my long and short protocol they gave it to me from around day 6 of stimulation even though my eggs were just smallish (2 days later on day 8 the largest was 15.7mm).  Just wondering if taking cetrotide too early could be bad.

With mild or natural IVF you obviously get less eggs. I keep on reading of women having blastocysts transferred on this protocol. Did your clinics recommend to transfer day 2 or 3 or did you have a choice to wait till day 5?


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## ScaryButExciting

Katkat -

Recent research shows that anything above 6mm! is good enough for implantation, that thickness is not as important as they thought in the past... 

Cetrotide prevents ovulation and as far as I understand does not impact maturing of eggs if on a short protocol... They start administrating based on LH spike, with me already on D4 of stimming both times, but had plenty of mature eggs...

Lastly, I believe clinics offer you blasts based on number of embryos on day 3... Getting embies to blast is done to aid selecting of the strongest looking... If you have a limited amount of embies and/or it is clear which ones look the best clinics will normally transfer on day 2 or 3... If you have lots of embies and they all look the same letting them mature to blast helps the selection... But as you always lose about 50% in the process it is only helpful to select...

I am considering mild for my next cycle... Have been to open day at Creatr and have follow up in start of September...


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## janieliz

Hi Kat Kat,
I had my treatment at Serum. I did natural IVF with low stims. First round, had a scan on day 6, I had 3 follies, started 150 of merional, then I had scans every other day, cetrozide for 1 day and then triggered the next day. I got two eggs and I wanted to go to blast and Penny said that was fine. Had 2 blasts transferred but had a chemical. Next round I started stims on day 3, had 5 follies, got 5 eggs, 4 fertilised and I had 3 going strong on day 3. For some reason my gut was telling me to put them back on day 3, I think because I couldn't believe I had 3 embryos! Currently pregnant with a singleton. I found cycling at Serum a very collaborative process and I listened to Penny but she also listened to me. The girls doing the clomid were all banking as like crazyhorse pointed out, it can thin your lining. However, I had also asked about using letrozole and stims and penny said that was ok too. I think reprofit and other clinics use that protocol more though so may be more experienced in it. My embryos were always decent quality on the low stims and I would highly recommend Serum but I am a bit biased!!

X


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## CrazyHorse

A lining of 8.5 mm isn't too bad, my concern if it were me would just be that Clomid would make it even thinner. Because Femara wasn't originally developed for inducing superovulation, it seems like not as many clinics use it as Clomid, but it does work well for that purpose. 

On the mild protocol, I had Cetrotide on Cycle Day 8, when the two lead follicles were 16 and 17 mm, and then a second dose of Cetrotide the following day, with EC on CD 11. I had another 4 smaller follicles at the time of the CD 8 scan, of which the largest was 13 mm. At EC I got 4 eggs, but only 2 fertilised, I believe because only the two from the lead follicles were fully mature (which was in line with my expectations for this protocol). Taking Cetrotide earlier isn't "bad", per se, it's just more in line with traditional short protocol where you take Cetrotide alongside the stims to encourage more even follicle growth. Unfortunately, the Cetrotide also slows follicle growth, and traditional short protocol didn't work well for me on a previous cycle. My AMH and AFC are pitifully low, though.

I had a Day 3 transfer, although we could have done a Day 2 transfer on the Sunday if they'd suggested it. Because of my age (turned 41 shortly after EC) there was never any question that we'd put both back if there were 2 embryos, so there would have been no point taking them to Day 5 in vitro. We weren't doing PGD or an embryo banking cycle either. Some women do embryo banking with mild protocol cycles, and I think for that clinics do often culture embryos to blastocyst before freezing.


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## katkat2014

Thank you SO much! This forum is amazing and I really appreciate your help! Seeing some of you at a similar age to me with bfp's on a mild cycle is extremely reassuring  (this said we have an added issue of MFI too)! 

The only time when I felt any of my cycles going somewhere was my first time when a blast was transferred, the NHS never did a blood test but  considering the clotty heavy weird period I had it must have been a very early miscarriage or something similar (I was too naive a year ago to check it out). So what worries me about the mild or natural IVF is the early transfer as somehow I have it in my head that for me this doesn't work (which is silly I know). Janieliz, must have been a  tough choice if you get to this point, as it is equally scary to wait and then maybe have nothing to transfer.

Considering I have had 4 failed cycles I may need to bank and do CGH per PGS or whatever, don't have much knowledge about it yet (and again, quite frightening if you find out none are genetically normal)...

Scary but exciting, good luck with the follow up with Create - will be interesting to hear what they suggest


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## ScaryButExciting

Thanks KatKat and indeed also others - am getting to grip with understanding more of the mild protocol and it is so helpful!!! X


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## katkat2014

I have just had a consultation today with a new clinic and they advises me that as I respond well to stims and have normal FSH (about 8.3) and AFC (about 10-20) they do not suggest for me to do mild IVF. Is there anyone here who had similarly normal numbers than me but went ahead with mild IVF anyway? My issue is egg quality.


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## ScaryButExciting

Hiya - Well I am still considering it with a FSH of 8-11, AMH 16, AFC 11... For me it is about less meds, more natural and hopefully better quality eggs...


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## CrazyHorse

The less-meds aspect is worth considering, as lower stims translates to lower risk of OHSS for you ladies who are lucky enough to have good AMH/AFC. However, I think you're going to have a difficulty finding a UK clinic to do a truly mild cycle (and I don't mean a short protocol cycle with 225 or 300 iu / day stims, which I have seen some clients of Create report being described to them as "mild"!) if you have normal egg reserve, as the general thinking is very much that it's best to get as many eggs out as possible up to a maximum of 12 or so, and to assume that numbers will overcome any possible quality issues. And, given the exorbitant prices of UK IVF cycles, I can see why consultants feel this gives their clients with a decent egg reserve the best shot at pregnancy for their money. If you're keen on looking at protocols that use genuinely minimal amounts of stims, I would suggest having Skype consults with clinics abroad that specifically advertise mild and/or natural IVF as one of their treatment options (e.g., Serum, Reprofit). The thing about mild protocols is that, if you are not a poor responder, you will almost certainly get significantly fewer eggs per cycle, and even taking possible improved egg quality into account there is correspondingly a reduced chance per cycle of getting your BFP as a result. However, it *is* a lot easier on your body, and it makes it much easier to consider future cycles if one doesn't work.


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## Tigger99

This is a very interesting discussion! I have an AFC of about 6-10 and an AMH of about 5.4 to 7.4 (it's gone up  ). Last time I did IVF it was short protocol 300ius of menapur per day and I got 6 eggs. Outcome was a disaster as although I got pregnant it was a pregnancy of unknown location and took a long time to resolve. So would mild IVF be better for me do you think? I'm setting up calls with reprofit and serum. Where else would people recommend?

Tigger xx


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## CrazyHorse

I wouldn't think egg quality would most likely be a cause of your PUL. Did you have any bad side effects (e.g., OHSS, major bloating, mood swings, etc.) from your previous protocol, or a low fertilisation rate and/or poor embryo quality? 6 eggs is a pretty good result! If I'd ever gotten that many and had 50% produce good-quality embryos from them, I'd probably have stuck with whichever protocol did that. Unfortunately, it's just almost impossible to predict in advance what kind of improvement you may or may not see when you switch protocol.


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## Tigger99

Crazyhorse thanks for the reply. I got 6 eggs and 5 fertilised. 4 were still going on day 3 ( for a day 3 transfer). It was about 18 months ago at serum.  I had major bloating and felt very uncomfortable. I had 10 follicles but after egg collection they told me that4 of them were cysts. 

I've had 3 failed natural pregnancies and a lot of immune testing since!! Can't seem to get pregnant naturally now so thinking of IVF again.


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## katkat2014

Scary but exciting,  thanks. Will attend an open day this weekend at Create although am still totally unsure if mild IVF is right plus costs are high here.

Tigger - if it is just the OHSS holding you back on a normal protocol, the last time I had 11 follicles and 9 eggs and it was the first time I was zero bloated and the first time I also did as my nutritionist advised: 2-3 L water a day PLUS 20mg organic whey protein powder in a pint of milk per day.

Crazy horse,  that's the thing I just don't know if it is right then that we are advised if lower stims mean better quality eggs. The way the Dr explained it is that at our age we have a pool of aneuploid eggs with a few euploid ones and with higher stims the chances are higher to get that one good egg as part of the bunch of eggs you retrieve on that normal cycle. So how can a mild cycle create better quality eggs. Do the higher drugs have a negative impact on the eggs maybe?

I have a call lined up with Serum but by email they already suggested chlomid embryo banking cycles. So I would assume the only reason for this is the genetic analysis one can do after banking. However this option should also exist with a normal protocol. I am really confused by the science behind it.


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## CrazyHorse

katkat2014 said:


> Crazy horse, that's the thing I just don't know if it is right then that we are advised if lower stims mean better quality eggs. The way the Dr explained it is that at our age we have a pool of aneuploid eggs with a few euploid ones and with higher stims the chances are higher to get that one good egg as part of the bunch of eggs you retrieve on that normal cycle. So how can a mild cycle create better quality eggs. Do the higher drugs have a negative impact on the eggs maybe?


This is the traditional model used to understand egg production in IVF -- as you age, a progressively smaller percentage of euploid eggs remain, there's nothing you can do to improve the percentage of euploid eggs remaining or to change which follicles are randomly selected for recruitment on each cycle, therefore the most important thing is to maximise egg yields per cycle in order to maximise the odds of finding a euploid egg among those collected. Hence the focus on collecting as many eggs as possible with relatively large doses of stims. However, there are significant numbers of women, including myself, who see embryo quality and pregnancy rates per embryo transferred improve with eggs collected from cycles using lower amounts of stims. Clearly there are factors at work affecting egg quality, at least in some patients, that the traditional model does not account for. Because there's not yet a good explanation and because the data collected on it is not yet of good quality, many clinicians choose to deny that this phenomenon exists, but I've read too many individual histories of women whose embryo quality and pregnancy rates per embryo have improved with lower doses of stims to believe it's not a real thing. Even my very conservative, evidence-based doctor at IVF Scotland wouldn't give stim doses higher than 300 iu / day to poor responders for the same reason -- his clinical observation was that it was bad for egg quality. If > 300 iu / day is bad for egg quality, it's not illogical to believe that significantly less than 300 iu / day might also provide a boost to egg quality for poor responders who are having issues with fertilisation, embryo fragmentation, etc., under standard protocols where they are stimming at high doses for long periods.

Also, in some older women with poor response to higher doses of stims, like myself, as many or more eggs can be collected on a cycle using lower stims -- again, due to factors that are not yet understood. However, you're very unlikely to fall into this category as your AMH and AFC are pretty good.



katkat2014 said:


> I have a call lined up with Serum but by email they already suggested chlomid embryo banking cycles. So I would assume the only reason for this is the genetic analysis one can do after banking. However this option should also exist with a normal protocol. I am really confused by the science behind it.


The other reason they really push embryo banking with Clomid mini-IVF cycles is that Clomid causes thinning of the endometrial lining, and for many women the endometrium on a Clomid cycle is not in optimal condition for embryo implantation. The lining will recover after Clomid is stopped, and then the FET can be performed when the uterine environment is more receptive.


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## Tigger99

Katkat - No I didn't get ohss but was wondering about the egg quality thing. And of course it's a lot cheaper to do mini IVF. So what do people think I my case - stick with conventional IVF??


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## katkat2014

Hi Tigger, sorry as I didn't read your post properly, realised there wasn't an issue with ohss for you.  Not sure what to suggest. As you seemed to have implantation perhaps chg testing of your embryos with IVF gives you a better picture of what's wrong with the emrbyos (if it is not the immunes)? I am really not sure, yesterday I would have said don't go for mild IVF but just coming back from the open day at Create and now am considering it for myself again.

Crazyhorse, I was now told why mild IVF could result in better eggs. The way Geeta at Create compared it to was a bunch of people in the room sharing oxygen. If there are lots then each gets less, if there are less people then each gets more and hence better quality. She also says it is natural selection (not sure about that as you take drugs on a mild protocol). She claims that a young woman with normal protocol getting say 8 eggs will have only 2 euploid ones. And on a mild protocol getting only 4 eggs she will also have 2 euploid ones. I am not entirely convinced about it also not what that means in the case when you're older, but I may give it a shot abroad. When you say Create don't do a proper mild IVF, what do you think a maximum dosage for say Menopur or gonal f would be on a mild cycle? I know everyone is different but kind of what have you heard what do other people take?


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## CrazyHorse

Hi, Katkat, I'm not saying Create don't do "proper" mild IVF at all, just that I have seen ladies on short protocol at 300 iu / day having the protocol described to them as "mild", which I would dispute as lots of clinics do short protocol at that stim dosage and just call it "short protocol"! It's very possible that Create do mild protocol with, say, 150 iu/day for women who are better responders or had bad results on higher stims, but it really stood out to me when women talked about having these higher dose protocols described as "mild", I guess due to no downreg and starting Cetrotide slightly later than many other clinics do on regular short protocol.

To my mind, the key aspects of mild protocol are: no GnRH agonist (e.g., buserelin); minimising any use of GnRH antagonist (e.g., Cetrotide) so that it's just used near the end and only if needed to prevent premature ovulation, rather than for longer periods to even out follicle growth; and injectable stims maybe half of what would normally be used for your age and AMH/AFC by most IVF clinics (e.g., 150 iu / day or less), and even lower (e.g., 75 iu/day) if they are combined with an oral superovulation drug like Clomid. Basically, nothing that artificially slows down your ovaries, except if necessary to prevent eggs escaping before EC, and drug dosages that are more in line with what you would see for stimulated IUI than for conventional IVF, with the objective being to obtain 1 to 2 mature eggs at a time. Obviously, there is no agreed definition in medical practice for what constitutes a "mild" protocol, which is a big part of the difficulty! But personally that's what I'd look for if I were wanting to do mild IVF due to poor results on more conventional protocols. However, I'm coming at this from the perspective of a very poor responder whose ovaries do much better if they're not hampered by GnRH agonists or antagonists.

There is definitely a school of thought, which it sounds like Geeta belongs to, that your body tries to select the euploid eggs first on a natural cycle, and that on a stimulated cycle it's really important to catch the eggs from the lead follicle(s), even if it means sacrificing the immature eggs from smaller follicles, as the eggs from the first follicles to start growing are the ones more likely to be euploid. I haven't really seen a lot of evidence for this theory, though, so I've kind of reserved judgement in my own mind as to whether that's one of the main drivers for the better embryo quality some people get on mild protocol.

Anyway, I don't know if that helps, but that's just my take on things.


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## Briss

I have had two cycles at Create, mild stims and modified natural and can briefly explain how this worked (or in my case did not). Natural modified is basically adding low stims around 150 menopur a bit later on in cycle from day 6 or so + cetrotide. I had 2 follicles on this protocol (I am a very poor responder). However, i have had quite a few completely natural IVfs since then and apparently my body grows 2 dominant follicles naturally without any stims on most cycles so basically adding the menopur/cetrotide was quite unnecessary. I would have got the same result without them.  

the second cycle was mild stims that started on day 2 with 125 of Gonal F which was later increased to 250. increasing the dose mid cycle added one additional follicle so I had 3 growing but despite cetrotide somehow one follicle disappeared at EC, either ovulated after trigger or something else happened. Geeta could not explain. they got 2 eggs but none fertilised. 

I since had 450 menopur short protocol which resulted in 4 eggs but zero fertilisation and several natural IVfs which resulted in up to one egg per cycle and 100% fertilisation. my conclusion is that it's actually not about the dose of stims but more about egg maturation.  neither low stims nor high stims worked for me because somehow when the clinics try to control my cycle and egg maturation process it goes wrong. it's only when my body is left alone to mature the egg it gets it right every time. for some women it seems a delicate process so when you add hormones at the wrong time or in the wrong amount the egg is compromised and won't fertilise.  Geeta as some other clinics tend to blame it on egg quality but my experience shows that it's the fault in maturation process that's critical in resulting egg quality.  

one of the docs at CRGh explained it to me that basically stims and protocols is very much guess work trying to provide sufficient level of hormones for egg maturation but they do not always get it right cos everyone is different. Most women however do fine on any stims but high FSH/low AMH women are the ones where protocols need to be taylor made in each particular case. unfortunately it seems like it's up to us to work out what protocol works and then insist on it. I have these conversations almost every cycle when they see I have a few follicles they always want to stim me and it takes a lot of energy to persuade clinics to just let me get on with natural IVF because I just know even though natural IVF has low success rates stims are not going to make it better. 

One thing I have not tried though is long protocol but since natural IVF worked much better for me than anything else I am sticking with it for the time being. also because it's really easy on your body and you can do it every month back to back. logistic of doing it abroad is a nightmare though.


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## katkat2014

Everyone is just so different! Briss, it is really great you managed to work out the best for you and should stick with it. I know we talked before about you clinic abroad. You mention you haven't tried the long protocol...maybe better don't. I did once and I had the most eggs ever (13) but 11 were immature! To be shocked is an understatement. I was told I have an egg maturation problem and basically give up. But I researched that I would have needed some LH for maturation as only got gonal f, plus that maybe I needed a double trigger. So this may have worked on the long protocol, but am so scared of this protocol now, almost traumatised so didn't want to try it again.

So the above is what I got instead on my next short protocol, here more eggs were mature and 4 out of 5 fertilised. But then my embryo quality was poor (3 out of 4 arrested, the good one didn't implant). But for some reason I was on crazy high dosages this time.

So if I went for mild IVF with lower dosages of say 150iu, can I still take a 10,000 pregnyl or a double ovitrelle trigger? Just don't want to end up with immature eggs again. And is there any advantage of combining gonal f or menopur with chlomid or femara? I don't have any experience of these latter drugs and am so scared of all embryos arresting again.

Sometimes I wonder if I am mad, stubborn or desperate that I keep on trying...but I think it is mainly the hope that for some strange reason I haven't found the right protocol for me yet nor the right drugs. Plus as long as there eggs there is a chance!

Sorry for these ME-POSTS,  if anyone has any questions for me at all, am really happy to help and give you my input too!

And not long to go for you now, crazyhorse!


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## Briss

katkat, I am not sure it matters whether you have 5,000 or 10,000 of pregnyl or ovitrelle but again this is just my experience. I am usually on 5,000 pregnyl or one ovitrel but couple of times I got confused and injected 10,000 of pregnyl and basically it did not make any difference. larger follicles produce mature eggs and smaller ones immature eggs so I personally prefer they do not try to go after smaller follicles as i need to have ICSI which requires mature eggs. if you can have IVF instead of ICSi than it does not matter even immature eggs can still fertilise normally. 

I wonder if there is a connection between the trigger shot and maturation. I always thought the trigger was mainly to time EC to ensure the egg is ready to come off but even if it's immature it can still be collected after the trigger. I think maturation is the entire journey from CD 1 (or maybe even before that) up until the trigger. and the trigger/LH surge is just for the egg to prepare for valuation. I might be wrong though but again as you said everyone is so different it may matters to some ladies. Last time I had EC without the trigger shot at all just based on my natural LH surge and we got the egg and it was mature and fertilised. 

ladies seem to have very different experience with long protocol. i was always afraid of it cos i have heard various unfortunate stories but in the end unless you try you won't know for sure if it's going to work for you or not. I also like to think that I may still have one more option to explore. 

re chlomid, I am also scared of this because my lining is generally good so at least i know I can rely on it and would not want to compromise it with chlomid. but every now and then I come across ladies who failed on traditional stims and yet got pregnant on mild menopur/chlomid cycles. so this is definitely something to think about. 

sorry I've just realised you also have male factor. have you considered PICSI/IMSI? we also have male factor and I changed clinics mainly so we could have natural IMSI. It did make a difference to our embryos. unfortunately I miscarried so it cannot completely protect you but I strongly believe it helps. 

I think exactly as you are as long you have your cycle and you ovulate you can get pregnant and you will. it just takes a lot of effort to find the right protocol and the right clinic.


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## katkat2014

Hey Briss, many thanks for your input! I had a follow up with my current clinic and they will give me two different protocols to choose from (but recommend one). I think one will be high chlomid of 100mg for a few days then injectables (the not recommended one).  I have never read about anyone else doing this...then 10000 pregnyl.

Yes we have MFI as well and the sperm was too bad for PICSI (you need good motility and we have just 25-30% motile, only 14 mil/ml count on the worst sample). IMSI was suggested as it is also the newer and better method but I have read somewhere that the time it takes between looking at the sperm and injecting it can damage sperm...Hmmm. ..only my clinic seems to believe in it, the 2 others I talked to didn't recommend it. May give it a try though

Good luck with your next cycle!


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## MissMayhem

Hi everyone, glad to see thaCetrotide this thread has become active again, hope it's okay for me to join in. I feel the same as you kitkat, an not sure whether it's stubbornness, not finding the right protocol or foolishness that keeps me wanting to try with my own eggs

My AMH is pitiful, 0.5 now that I've had one ovary removed. I so wish I'd insisted on stimming and freezing eggs before my op as Iit had been a quite respectable (for my age) 10.6 prior to that. I've had four failed cycles now:

#1 Long protocol 300 Menopur, 3 mature eggs. 
#2 Long protocol 375 Menopur, 1 damaged  egg (though loads of follicles so have thought since just poor trigger timing/missed ovulation)
#3 Short protocol Bravell, Menopur & Cetrotide, so called mild cycle. Cancelled due to dominant follicle so no EC converted to IUI
#4 Short protocol Merional & Cetrotide, 1 egg, told it fertilised but arrested day 3 but also told it was immature.

I respond so poorly and only ever have around four AFC. Went for high stims last time as was told that my third cycle was a complete waste as I would've responded in the same way without any medication

I'm sending off for hidden C testing and 10 in 1 with Serum as last cycle was tandem and despite excellent lining, intralipids and steroids had no implantation from Grade A donor embryos.

Don't know whether to go abroad and try mild/natural. Or try Create again where they've already told me I would have to be stimulated. I know it's so individual but anyone got any tips? Don't know whether to just give up and have donor frostie transfer first as last. Any advice welcomed. 

Good luck to you all, and hope you're doing ok crazyhorse!  xx


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## CrazyHorse

Hi, MissMayhem, you're very sweet to ask after me! I'm doing well.  

If I were in your shoes and I were set on doing OE, I'd go for mild protocol (nothing to slow down the ovaries, not even Cetrotide except to keep mature follicles from ovulating before EC). High stims haven't worked for you, so why do them again? However, if your endometrial lining is at all on the thin side, I'd avoid Clomid because a thin lining (which Clomid tends to cause) may commit you to doing an FET, and especially as an older patient you may produce embryos not suitable for freezing which could still be viable in a receptive uterine environment.

However, it really depends on finances and the emotional impact to you and your relationships. For me, it was an easy decision to go abroad for a mild cycle because DH and I both wanted to try again with OE post miscarriage and could afford to without going into debt. But everyone's situation is different and there's lots of factors that have to be weighed. But, given how frustrated you were with the clinic where you did the tandem cycle, why rush back for the frostie? You have a very limited window to try again with OE if you do want to, but your frostie will wait for you. 

Wishing you lots of luck with your decision.


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## katkat2014

Hey miss mayhem, about going abroad I think it's not a problem at all if you can get time off work at the last minute. I tend to book holidays and then just amend them when I need to at the last minute.

I have a question for those that have done mild IVF. My clinic sent me 2 different protocols now, their recommended long protocol and their not recommended mild one. The mild one includes about 5 days of taking femara starting day 1 (?) Of the cycle and 150iu gonal f daily starting on day 2.  I have not heard of this before, has anyone done this? Wouldn't I need to start gonal f much later on day 6 or so and then stop femara? What does femara do? It also shows cetrotide for 3 days a the end. Any advice would be really appreciated.


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## CrazyHorse

For mild protocol that uses both Femara (letrozole) and an injectable stim drug, you usually will take both at the same time, maybe start letrozole before the injectable. The idea is to use both in combination with your natural rise in FSH during your cycle -- I don't think there's any universal agreement as to which cycle day to start the stims on. Letrozole and Clomid both cause your body to produce additional FSH itself, albeit through different mechanisms. The injectible stims basically *are* FSH themselves and injecting them dumps FSH directly into your body, rather than causing your body to produce more of its own FSH. Using the two together can provide enough FSH to stimulate several follicles while minimising your injectible dosage.

The Cetrotide for 3 days at the end will be to keep you from ovulating before EC. Some clinics use Cetrotide routinely, others only if it looks like your follicles are growing fast enough that it looks like there's a risk of early ovulation. 2 or 3 days of Cetrotide doesn't sound out of line to me.


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## katkat2014

Hey crazyhorse, you are SOOO knowledgeable thanks   I seem to have a momentary blackout, but was that what  you did on one of your cycles, or did you say you did a clomid cycle or take just gonal f only when you did mild stims? 
My doctor really wants me to do priming for a month, then short antagonist with gonal f only. On the one hand I think I should do that and make the most out of the many eggs I have  (albeit bad quality), while on the other hand I am hoping that this femara gonal f protocol could give me better eggs. I know each Dr is different but my current one doesn't favour mild protocol for me. Am going in circles and slowly but surely insane


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## CrazyHorse

Hi, katkat, on my last (successful) cycle I had letrozole 2x per day plus 75 iu Menopur per day, as my consultant preferred Menopur to Gonal-F when combining with letrozole. I started both together on CD3.

Do you have any kind of gut feeling about which way you should go with the protocol?  When looking at clinics for my last cycle, I had a powerful gut feeling that high-dose stims were never going to work for me, and when reading about mild protocol that relies heavily on your own FSH and reduces interference with your ovaries, I just knew that was going to be my best shot. I think "intuition" is what we call it when your subconscious processes a massive amount of information better than your conscious mind does, and kind of gives you a shortcut to the best answer in a situation where there's a lot of uncertainty. But for me I was also in a situation where I was never, ever going to get a decent number of eggs, so focusing on quality to the exclusion of everything else clearly made sense. Your situation is more difficult to call. You also have male factor issues, so that could be impacting your embies as well, and I can see why that might make your clinic focus on maximising egg numbers.

I will say this, though -- YOU are the one who has to live with the outcome. If you feel like the protocols you've done before gave you poor fertilisation rates, arresting embies, etc., and you think switching up the protocol to a greater extent will help you overcome that, then you have every right to push for that. The consultant is there to offer recommendations, but at the end of the day you have to decide what will give you the least regrets if you don't get the result you're hoping for. For a lot of ladies, that means going with the consultant's recommendation -- if it doesn't work out, you took professional advice and followed it as well as you could. Then there are ladies who would be more upset if they didn't push to try new approaches even if the consultant was skeptical. It really comes down to what you and your partner can live with.


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## katkat2014

Hey crazyhorse, it's amazing how much great in info and personal thought you put in your replies, and this with being pregnant yourself..THANK YOU! 

I don't have a real gut feeling but my DP has, he really wants to try mild IVF. Only Serum had suggested it for us all the other consultations I had said to go for maximum egg numbers since I still have them and not getting any younger.  It if I all add it up in 4 cycles I only ever had a maximum of 7 mature eggs and a maximum of 4 embryos. I keep on telling myself that I didn't get the right protocol yet  but the reality is that


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## katkat2014

Sent too soon!
..the reality is that I don't seem to ever produce more than that so might as well go for mild..if the results are no embryos at all then at leat I know.

We're probably throwing IMSI into the mix as well. Then I can truly say we have tried it all


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## katkat2014

Hello to those doing mild IVF. Dr suggesed a protocol of days 2-8 at 150iu gonal f, plus days 1-7 letrozole 2.5mg and then days 9-10/11 at 225 gonal f. Isnt this quite high for a mild IVF, in particular the 225? Also to tape cetrotide for 3-4 days from day 8 when largest follicle is over 15mm. Does this sound right?


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## Goldfish45

Hello I'm also doing a mild IVF (all my other IVFs have been long protocols with high stims with variable results). On CD2 I started taking letrozole plus Menopur 150IU/day. Letrozole only for 5 days though. I'm on CD5 today. I have a feeling that 150IU is the highest I've come across for a mild protocol (some people seem to be on 75) - 225 does seem a little high? The Cetrotide once the biggest follicle is over 15mm sounds about right though.

Good luck!


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## Orchid-1

Can I just ask is letrozole different from clomid? In what way?  x


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## CrazyHorse

Letrozole is an aromatase inhibitor originally developed as a drug for treatment of hormone-receptor positive breast cancer in post-menopausal women. However, in pre-menopausal women it produces superovulation by reducing circulating estrogen levels and creating a rise in FSH (basically the same stuff you're injecting yourself with when you take injectable stims). Clomid was developed specifically for superovulation and works by depleting your estrogen receptors (rather than reducing circulating estrogen) and thus tricking your body into thinking estrogen is falling and it should secrete more FSH. Here's a good article from 2013 discussing the differences between letrozole and Clomid, and reasons supporting the use of letrozole: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3778612/. If you have problems with thin endometrial lining, letrozole is a particularly good choice.

/links


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## Annie37

Goldfish45 said:


> Hello I'm also doing a mild IVF (all my other IVFs have been long protocols with high stims with variable results). On CD2 I started taking letrozole plus Menopur 150IU/day. Letrozole only for 5 days though. I'm on CD5 today. I have a feeling that 150IU is the highest I've come across for a mild protocol (some people seem to be on 75) - 225 does seem a little high? The Cetrotide once the biggest follicle is over 15mm sounds about right though.
> 
> Good luck!


Hi thought I'd add in my experiences to date of mild so other people can also see as more and more seem to be leaning to or investigating mild. My stim were actually high for mild! My first round was 300 gonal f from day 2 then 25mg of cetrotide from day 6 and ovitrelle trigger. I managed to bank 1 good frozen on this cycle. Second cycle I had 200 gonal and 150 menopur from day 2, cetrotide day 6 and a buserelin trigger. I got THIRTEEN eggs on collection day 8 fertilised but I only managed to freeze one grade two as the rest were poor quality I was told. My third cycle I am about to do is going to go completely differently and I'm doing a more natural cycle and will only be introducing 75 of menopur on day 5. I'll firm that up when I know more in 4 weeks time!

I personally don't think my first two cycles were mild drugs and although I got great egg count for my amh snd AFC this was reflected in quality of final embryo count. However that said the process was mild and pretty chilled really considering so I think in my mind mild is not only drugs but the clinic approach. I think trying out these 3 different approaches will give me a better picture of what works best for me at the end. Fingers crossed and good luck to everyone !!


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## Orchid-1

Thank u Crazyhorse. 

Does any one know what prednizolone is for??

Clinic 1: cycle 1 used cyclacur to induce period, 75 iu merional, 5mg prednizolone, clexane, 5 mg fillicine

- got no response, few follicles w did not mature

Clinic 2: recommended utragestan to induce period, w led to follicles 10 mm , day 21 triple layer
Cycle 2: natural AF or utragestan, 225 menopur, Ovitrelle 250mg/0.5ml, organlutranOrgalutran 0.35mg

I refused clomid. But wondering about letrozole.

Worried about high Nka cells which they won' t treat empirically with intralipids etc. not sure what to do.


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## katkat2014

Hey orchid,
Prednison is used to suppress the immune system, they treated me empirically with it.  Now I know I don't have immune issues but I am given it anyway. What I wonder is if you have a normal immune system and take it, can it actually hinder implantation. .? Maybe they give it to you because of the NK cell activity?


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## katkat2014

Annie, would be great to hear how your Nov cycle goes om a more natural basis! Good luck


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## Orchid-1

Katkat - thank you. 

Probably won't harm implantation even if you don't have immune issues. x


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## Briss

when I saw dr G he recommended prednizolone on a just in case basis. although my HK cells were OK there were a few IgGs that he did not like. He said there might be an immune issue but he was not sure and doing more tests would cost around 1-2K (which is basically the price of at least one, possibly two natural IVF cycles abroad). I was concerned because this is really a hard core med, my mum has been on it due to a serious autoimmune illness but the medication has had devastating side effects (she has been taking it long term) so she was extremely worried about me taking it so lightly. when I asked dr G about side effects of prednizolone he just said that nothing is without side effects. I personally think you should only consider prednizolone if an immune issue has been identified. In the end I did not take it.


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## janieliz

I never had any immune tests, I always took 10mg per cycle and then off BFP I went up to 30mg. This was as a precaution as my mum has MS, my auntie has RA and my brother has an autoimmune lung disorder that I can't spell! I was of the opinion that 10mg would cover me if there were any issues. However in some peoples cases where there is low inflammation in the uterus it's best not to take anything prior to BFP. Sorry, not much help but I wanted to cover myself so 10 it was up to BFP.

X


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## Orchid-1

Thank you Briss and Janieliz. 

Really tempted to take it because of my high NKa cells. I will get a consult with Dr Braverman first to see if I need it. x


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## Orchid-1

CrazyHorse said:


> Letrozole is an aromatase inhibitor ......Here's a good article from 2013 discussing the differences between letrozole and Clomid, and reasons supporting the use of letrozole: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3778612/. If you have problems with thin endometrial lining, letrozole is a particularly good choice.
> 
> This post contains an unconfirmed link/information and readers are reminded that FertilityFriends.co.uk or its owners are not responsible for the content of external internet sites


Just read the paper Crazyhorse. Thank you for that. x


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## BrummyMummy

Hi all. I'll be having low dose/gentle IVF as I already have a daughter and have been advised by her paediatrician to continue breastfeeding her for as long as possible, for health reasons. We do not want to wait any longer to extend our family so our doctor has agreed to allow us to go ahead on a low-dose short protocol, so as to minimise her exposure to the drugs and oestrogen. I've just seen that the dose will be 150 units of Gonal F. Does this sound ok? It's been a while since we saw him and I really want to check that he has us down for the right thing! Thanks ladies, and lots of love and luck for your treatments xxx


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## Briss

BrummyMummy, 150 sounds like low stims to me. but you will probably be also taking cetrotide or equivalent and the trigger shot + progesterone? I am not sure how this works with BF. but i have come across threads of pregnant ladies who were BF so they could probably advise better.


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## BrummyMummy

Thanks for your reply Briss. My dr has checked all the drugs out and in fact they are all breastfeeding safe, which many doctors don't realise-mine didn't until I asked him to check!  The main risk is from a spike in oestrogen caused by the stimming, hence the gentle approach. I've actually come across so much resistance to doing IVF while continuing to breastfeed, but according to my expensive research the risks are minimal, so I'm very happy to have found a doctor who will treat us! I'm going to do a diary on here in case others want to find out more about it. X


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## CrazyHorse

Hi, BrummyMummy, I think your doctor is absolutely right about the drugs being OK for breastfeeding. The stims will cause your blood estrogen to rise, but the levels are comparable to those in pregnancy, and pregnant women breastfeed toddlers all the time. Same with hCG trigger shot and progesterone supplementation. It's really the downreg drugs that are problematic, and of course you aren't taking those.  150 iu/day is pretty mild, given you won't be on Clomid or letrozole as well (and you probably wouldn't want to take either of those when BF'ing either).


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## BrummyMummy

CrazyHorse, your reply is so reassuring, thank you xxxx


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## Rae_33

Hi I wonder if someone could advise me. Been for my scan today and told to trigger tomorrow. But Ive just realised the nurse didn't say if I should take the other injections tomorrow as well . Presumably tonight is the last dose of the other injections? 

Thanks

Rachel


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## CrazyHorse

Double-check with your clinic, but normally you do not inject any more stims (e.g., Menopur, Gonal F, etc.) or GnRH agonist (e.g., buserelin) or GnRH antagonist (e.g., Cetrotide) after the trigger shot. If you are on injections not related to follicle growth, like Clexane, you would normally continue those unless instructed otherwise. HTH!


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## Rae_33

Thanks Crazyhorse, I was worried about bothering them on a Sunday but I did call and good job I checked as it was the opposite of what I thought! Thanks for the nudge. Good luck to all. Rachel


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## Orchid-1

Anyone heard of oestrogen priming for natural mild IVF cycle??


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## MissMayhem

Hi everyone, apologies in advance as don't have time tonight to read all the previous posts. Just wondering what clinics you're all using? Am considering one last attempt at a natural (or at the very least very mild) cycle and am torn between clinics. Co considering Create in UK as it's more convenient but Serum in Athens is pulling me. I just really don't want to have the headache of travelling again though after a failed cycle in Cyprus. Anybody used either of those two and have any comments? Good or bad. Love and luck to you all.xx


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## janieliz

Hi,

I used Serum for natural cycle/mild IVF and got my BFP on my second cycle. I also know of other ladies who have been successful with natural cycle with Serum too. I really liked them and felt my cycles were tailor made for me. Let me know if you want me to answer any specific questions.

x


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## Herts85

I'm with Create and can't complain so far. Haven't started to cycle yet though and have no previous IVF clinic experience to compare it to. Nurse appt for meds went really well and once we got started communication has been really good.

Herts x


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## Briss

I had two cycles with Create, have mixed feelings about them although my natural IVF cycle was managed well and it was a positive experience overall.

I also had two cycles at Reprofit and really liked them, i had direct contact with the doctor by email and was managed by the same doctor unlike Create. They are probably the cheapest options I've tried.

Have very mixed feelings about Serum, generally Penny was very supportive and called me directly to talk through my concerns which was amazing and she replied to my rather lengthy emails with questions and responded to every single one of them. I was very impressed. but unfortunately she got my ovulation date quite wrong by 2 days and mistook a cyst for a follicle. If I followed her advice we would have travelled to Athens for nothing as they would just puncture an empty cyst and we would have missed my golden egg that cycle. 

I hear good things about Gennet Prague.


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## Orchid-1

Briss - can I ask, who did you go with for your BFP?


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## Briss

It was a clinic in Munich that was recommended to me by a fellow ttcer from b&b. They are small family practice, the website unfortunately is in German but the doctors speak English so it was nanageble. They are called BBN I think and there is no support board on here but i can send you their details if you are interested. I had two natural cycles with them and both bfps but first one I miscarried.


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## Orchid-1

Sorry Briss. I think I remember  you sent me info. Oh what am I like!  

Congratulations again


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## Viv3

Hello

I hope you don't mind if I ask a question on this very useful thread, as I'm considering mild/ natural after a cancelled IVF and a failed ICSI. Has anyone tried a mild, mini or natural cycle at ARGC? I had poor quality eggs in both my cycles with high doses of stims, the first  short flare with Buserelin and the second short with Cetrotide. The first was a disaster, they only managed to retrieve one folli out of 7 and it failed to fertilise. The second was at ARGC and I can't fault them on monitoring  but out of 6 follies retrieved only one was good enough to fertilise. I like their attention to detail but not sure how flexible they would be if I suggested certain drugs.  I was wondering if anyone has done a mild or natural cycle with them and how it went. Any thoughts would be much appreciated.


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## ScaryButExciting

Hi Viv,
I have only done 2 normal (agressive cycles) at ARGC, which both failed and Dr Raneiri and I both think it is the embryos most likely. I asked him if he believed in natural or mild cycles and he sees a place for them but just feels more eggs is more chance and therefore would always optimise egg count. I asked if he felt high doses of stimms compromise egg quality and he himself did not see evidence of that in all the women he treats. But I had 9 eggs, 3 embies and 15 eggs, 7 embies respectively so in a different position then you are... I would defo discuss with him! But if he does not agree I would cycle elsewhere personally, to me it does not make sense to pay a specialist with a strong vision and then ask him to do something else - I would go to the specialist who believes in what I want... Does that make sense?

Anyway I am doing a natural FET first at ARGC so hope not to have to make further treatment decisions xxxx


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## Viv3

Thanks Scary But Exciting for your thoughts and sharing your experience. I wish you all the best for the FET. Yes you're right there isn't much point in cycling there if they're unlikely to believe in what I want to try. I have an appointment in a few weeks so will know for sure then if they would consider a mild/natural cycle and on what meds. 

In the meantime I'm considering Reprofit, Gennet or Serum even though I hate the thought of the logistics. Penny at Serum where I had a hysteroscopy (and discovered bilateral proximal tube blockages in the process) thinks I should go straight for donor eggs but I want to give my own a couple more shots. Crazy as it seems at my age. 

I really hope this one works for you xxx


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## Orchid-1

Viv- I don't think it's crazy 'at your age' to go for OE. Go with your heart. The fertility show is in a week. A lot of the EU and UK clinics will b there, if you can make it to ask your questions. I am between clinics. As SbutE says if a clinician specialises a particular approach but you feel you want to investigate another route then worth taking that leap. 

Good luck


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## Annie37

MissMayhem said:


> Hi everyone, apologies in advance as don't have time tonight to read all the previous posts. Just wondering what clinics you're all using? Am considering one last attempt at a natural (or at the very least very mild) cycle and am torn between clinics. Co considering Create in UK as it's more convenient but Serum in Athens is pulling me. I just really don't want to have the headache of travelling again though after a failed cycle in Cyprus. Anybody used either of those two and have any comments? Good or bad. Love and luck to you all.xx


Hi there just a note to say I am using Create at St Paul's and although they are getting busier I have no complaints. I researched a bit about Prague and Athens but as my work is very demanding and also trying to keep my fertility treatment secret from my team and directors I chose to stay local to minimise the stress of juggling travelling and using much needed annual leave up. Although of course that comes with extra financial element cycling here. I'll be having my first transfer pre Xmas at the end of a 3 cycle package the third cycle which they are reverting to natural. I find out soon if they will add a little boost of stimulation to this cycle. I think they will.

Anyway so far I've found them good, the admin team do always seem to be swamped so sometimes you have to call to ensure responses to emails say on appointment times costs etc but they are nice and always a smiling face at reception which has a huge impact on your emotions to be treated kindly by the front line staff. my midwife/nurse and all the consultants I've seen have been fabulous too and my midwife usually calls (leaves a voicemail to call her back if I want if I wasn't able to answer) if she receives an email from me then follows up with an email.. She prefers to talk and I like that. The proof of course is in the pudding and whether I get the outcome I so wish to happen!! Here is hoping!! Good luck whatever you decide


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## Viv3

Orchid thanks for your encouragement   I wasn't aware of the fertility show but will definitely attend and talk to the different clinics. 

Annie best of luck with your transfer. I'm also not keen to cycle abroad if I can find a good option here. Can I ask what stims and doses you've been on at Create? Which day do they start monitoring? Did they offer single fresh transfer or are they more keen on batching and freezing for women with diminished reserve/low AMH? At ARGC  they advised me not to batch and freeze as they thought at my age eggs/embies may not do well being frozen.


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## Annie37

Hi Viv

First cycle I was on 300 gonal f which started in day 2 of my period and they scanned and blood tests with me on day 6, 8, 10. I also introduced cetrotide in I think it was day 7 and triggered with ovitrelle. 

Cycle 2 they decided to do a gonal and menopur combo and I started that on day 2 with 200 gonal and 150 menopur. They added an extra scan and blood on day 11. I used cetrotide to prevent ovulation and a burselin (spelling?!) trigger. 

Both cycle I got ALOT of eggs for my poor Amh and AFC count and a very good fertilisation rate on both cycles however none went to blastocyst and I've "only" got a couple of day 2 good quality frozen. On my last cycle out of the 13 collected and 8 fertilised they tried to take 7 to blastocyst but they all died off.. Or whatever the technical term is!! They have surmised it's likely a quality issue with my eggs that the good fertilisation rates don't achieve good enough embryos after a couple of days hence why they are trying a more natural cycle this time to try and capture that lead egg and focus on it. 

They are happy to do a fresh transfer this time as my lining has always looked reasonable (except you can't if you trigger with burselin so they will trigger with a different one this time) and have suggested they thaw one of my frosties to do a double transfer.. Or at least to see how it defrosts and if it's fine. I suppose I'll know now how mine react to bring frozen and defrosted!! If I have no success with this fresh or with my two frozen then I am probably going to do their 6 cycle natural package and if I have any extra embryos to freeze that will be a bonus. 

So in a nutshell create very much with me anyway advised on the batch and freeze in order to maximise my chances. Of course only a few rounds will really tell you what works best for you so I am sort of mentally treating my 3 cycle package as an experiment.. Albeit an expensive one!!!! If they don't work I also think I might go and have my immunes checked as I have a niggling suspicion I've got something going on .. No idea what just have!!!


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## monkey2611

Hi everyone.

Just after some advice about natural IVF for low AMH and high FSH. As you can see my AMH is very low and my FSH is very high. 
I was advised to go straight to donor eggs and have the funding for that and in currently on the waiting list.

I have recently spoken to my clinic about the possibility of natural IVF and I was told I could have a go, obviously unfunded. I was advised that this would most likely be a lower odds than the usually already low odds due to my levels, so possibly less than 5%. I have started to come to terms with donor eggs and now this has thrown a spanner in the works. I have no idea what to do! It feels an impossible decision.
I'm not sure if I can handle the stress and emotions of a natural IVF. It sounds very stressful with such a low success rate. I'm not sure if I can handle this! 
My partner says maybe try one go but from what I read it often takes more than one attempt.

Thank you in advance.


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## Briss

Monkey, I personally found stim ivf more stressful  than natural even though my natural ivfs were mostly abroad. Stims affected me quite a lot I put on weight very quickly and had to wait 2-3 months between the cycles to recover. With natural ivf I find its important to adopt the right atitude, I treat natural ivf similarly to natural TTC, its possible to get pregnant on first go but most likely it will take a few goes. It's important that the clinic believes its going to work as well. You need to know your cycle really well to help the clinic to find the right time for trigger and egg collection. I've missed a few cycles because we missed the right time for trigger. Regardless of FSH/amh if you still ovulate natural cycle ivf can work for you. My FSH was 30 when I got pregnant but I changed 5 clinics to find the one that would work for me. Also, our main issue was sperm so we also needed IMSI.


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## monkey2611

Thank you Briss. My clinic doesn't recommend anything other than natural as my FSH is so high stuns wouldn't be good.
Another problem is I may not ovulate. I have had my bloods taken every week for a month to find ovulation and it wasn't dedected. This was on two occasions. My cycles are also very unreliable as sometimes I don't have a cycle. I didn't have a cycle for about anyway then had one for a few months then didn't have one for a bout 6 months and now they algae been back for about 4 months. 

I don't think this helps my situation!


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## Briss

Clinic may suggest modified natural cycle for you with a little stims to get you ovulating. I had one of those cycles and it was good actually easier to time egg collection.


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## monkey2611

Thanks bliss. They have offered natural IVF with no stuns so far. Before we start we can even start they want us to do blood tests at cd1 and scans at cd10-15 to see what's going on. They could possibly start on the cycle after that.  I can't decide what to do. I've been told that success is very slim due to my AMH and FSH.


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## Goldfish45

*briss* firstly, huge congratulations on your pregnancy! We've bumped into each other on various forums so it's great to see a success story from a high FSHer! I've just done a mild IVF cycle where only 1 follicle grew. I had such hope for it but unfortunately at today's egg collection there were no eggs. I feel like my only hope is to try a natural cycle or donor egg (which I'm not sure I'm ready for). What did you find out when you had a natural cycle where there was a follicle but no egg? I'm terrified that all this time I thought I've been 'ovulating' that maybe I have been having empty follicles?

*monkey* I have very high FSH as well (in the past year the lowest was 18 , highest was 102). Unfortunately I don't have a success story for you....but seeing as you've not done IVF before I would say try it at least once with your own eggs, otherwise you might wonder 'what if'. I don't want to give you false hope but you just never know until you try it and then you might be able to move on. However I do appreciate what a difficult decision it is when money comes into play and you have funding for DE IVF but not for a natural IVF. All the best whatever you decide.


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## katkat2014

Hey monkey, I know it is more about the emotional strain, but if you did want to try natural and not restrict yourself to doing it just the once, then abroad is an option. I am at Gennet and their natural cycle is about gbp700, plus cheap flights in winter and low hotel costs in winter could be an option. You can stay with your current clinic as the back up DE plan. I have no idea about natural ivf myself as I haven't done it but have considered it.


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## Briss

Monkey, in our situation the fact that success rates are slim is a given unfortunately.from what I know and experienced on natural ivf it relies on you having a regular ovulation so it can be tracked and egg picked up once it's ready. In your situation you may need some stims to get it going but I agree the best thing is to do cycle monitoring with regular bloods and scans to determine what's your current ovulation situation but if they see a dominant follicle growing I would not waste it and ask them to schedule ec. I agree with ladies, natural ivf abroad is much cheaper. Reprofit in Brno for example does not charge if no eggs are collected. We only paid 50 Euros for the needle used for ec + travel which was cheap. Also scans and bloods in London which was a bit pricey. 

Goldfish, from my experience no egg at ec means the clinic did not do it right, as simple as that. It's very unlikely your body had a follicle growing with rising hormones and lining and all for nothing? Our bodies are smart. There was an egg they just could not pick it up. It happens. Happened to me as well at some clinics but others seem to manage pick it up every time. I do not think its just a coincedence. It's also possible it was a cyst rathen than a follicle. I had this on my last cycle when serum and Genet thought the cyst was my dominant follicle and wanted me to have ec which wouldn't produce an egg ( I know that looking back cis the cyst was gradually shrinking). I waited two more days instead of listening to serum and my dominant follicle was actually growing on my other ovary, everyone idnored it because they thought it was small. But it did have an egg which fertilised so my opinion is clinics get it wrong so try again or change clinics. You will get lucky, I so hope you will and soon!


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## Goldfish45

Thanks *briss*. After today's EC disaster I spoke to my usual doctor and she insisted that sometimes there is no egg in a follicle, especially in those with low egg reserve. My Dh was pretty upset as well and thought the clinic had mucked it up somehow. In my fourth cycle (18 months ago) I had 4 follicles and only 1 egg collected, coincidentally it was the same doctor who did the egg collection as today's so I think he was feeling 'jinxed'. I had my failed IVF follow up from that cycle with a different doctor, he said the same thing about follicles not necessarily containing eggs. You sound very certain though so now I'm worried about how this could've happened?? I was told today's EC did not even have cumulus cells collected, it was literally just fluid. My E2 was pretty low even though it was increasing before EC, and my lining was slow to grow too (shot up from 5.3mm on Friday to 9.5mm in just 24 hours to Saturday - which was the day they decided to trigger me after seeing the follicle grow to 17mm as well).


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## Orchid-1

Goldfish - sorry to hear about what happened at EC. 

What was your E2 at EC? Did they tell you?


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## Briss

Goldfish, I did not mean to assign blame to anyone I just wanted to assure you that your ovaries are fine and mist likely you did have an egg that cycle. It's not always possible to get it out though. Clinics are unlike to admit it because that would allow you ti claim refund or something . a doc at Brno clinic was very open with me about it but this is because they don't charge if no eggs are collected. She also mentioned that the follicular liquid was clear with no traces of blood which indicates no egg but even then she admitted the egg could have got away moments before ec. Sometimes it's no one s fault, at times this is human error or its possible you did not have an egg and they failed to recognise your body dies not mean to ovulate this cycle and still proceed to ec, its also possible to have a cyst which us often mistaken for a follicle. There numerous other reasons but the bottom line with all other clues presents its very unlikely not to have at least one egg growing . I was reading a lot when I faced no egg situation because deep down I knew there was an egg and sure enough mist studies I come across don't recognise "empty follicles" excuse, they point towards Human error during ec as most likely reason for not collecting eggs from all available follicles.

Your follicle size was good, I am currently pregnant from an egg that was taken from a 17 mm follicle but we did not know for sure if the egg would be mature. There was no doubt that that size follicle would have an egg. But again, your follicle could have been a cyst. I am shocked at how many times my cysts were mistaken for follicles during scans. You would think people who look at follicles day in and day out would know the difference but not the fact. Even specialists who are top if their profession got it wrong with my scans. 

Your low estrogen levels prior to ec might be an indication of no egg situation but to know for sure you need to know your normal estrogen levels prior to ovulation. For example my estrogen us usually quite high but if a e cyst is present they would be much higher. Even then when a doc who is top London specialist tells you its not fanctuonal cyst you doubt yourself. One such doc told me the cyst had solid component and ordered cancer marker which came positive. I was shocked and yet I still thought it was a basic fanctuonal cyst because I get them from time to time and I feel them they cause a minor type of discomfort that I came to distinguish over the years + higher estrogen levels and yet I believed the specialist. After all who am I? Not a doctor. I went to a cancer specialist feeling depressed and he ordered bunch of other cancer markers plus MRI but he warned me he did not believe I was his patient which was encouraging. And indeed all markers were negative. When I fibsly got to have my MRI there was no trace if the cyst, as any functional cysts it resolved by itself. The cancer doc who was actually a former student if the top doc who thought i had a complex cyst with solid component said "well, we get it wrong sometimes". Where did the solid component go? There was not any, it was just an organ possibly casting a shadow that was mistaken for a solid component. Complex cyst and cumpke cyst look different but even then they got confused. Not surprisingly some can't distinguish simple cyst from a follicle as they look similar. Not quite though so its really not great that they make mistakes like this.

I also have a proper complex cyst on my right ovary, how many times it was mistaken for a dominant follicle on scans just cos its the right size! It really is shocking. 

Leaving cysts aside, the other common situation is simply losing the egg to early ovulation...

Sorry am boarding a plane now will carry on in a little while


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## Goldfish45

*orchid* on Friday (day before trigger) my E2 was only 242, follicle 14mm and lining 5.3mm, but my LH was starting to rise a little and I was getting EWCM (indicative of E2 rising). On Saturday: follicle 17mm, lining 9.5mm. Nurses were supposed ring me with blood test results but I missed the call. I left 2 voicemails for them to ring me back but no one did. I forgot to ask what my numbers were on EC day. All I was told was my follicle was still there just before they did the EC. Will ask at my follow up, which I need to book.

How are you, has AF arrived yet?

*Briss* I guess I'll never really know...just have to keep hoping I have a few eggs left in me! My ex doctor said perseverance is the key and I'm not one to give up easily!!

I feel strangely calm today after crying half the day yesterday. I guess I should probably rest my body for 2/3 months and then try again - just not sure what to try or which clinic!!


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## Briss

Goldfish, I'd call the clinic to get all your blood results so you could collect all the info about your cycles and what's normal for you. However, 242 is way too low and even if the level jumped to a much higher level by egg collection it does not look good to me. The level should grow gradually together with the egg and higher levels are indicative of good quality egg. I'd ask your clinic why they proceeded to ec with such low levels? Even if they got the egg the most likely scenario is that it would not fertilise due to poor quality. The other option is that they triggered you too early, you possibly needed a few more days to grow that egg so I'd ask about the reason for timing ec as well. 

Sorry about all the spelling errors, was typing in a hurry


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## Orchid-1

Briss - sorry can I ask, approx what level should it be for estradiol at trigger and at egg collection?


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## Goldfish45

*Briss* on Friday when I heard my E2 level I did say to the nurse I was worried about it being so low (though keep in mind my lining was only 5.3mm that day). She said I only have 1 follicle so it would be lowish but as long as it was roughly doubling then it was ok - though she didn't say doubling over what time period!! I will definitely ask them at the follow up about my E2 and LH levels, as well as exactly what the follicle looked like on the morning of EC.

*orchid* I read somewhere that E2 of 500-1000 per follicle is good (UK units of measure!). This is a very wide range though, so you can imagine how inaccurate this gets the more follicles you have as someone with 10 follicles at the high end could have similar levels to someone with 20 at the low end and you wouldn't be able to tell...


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## Orchid-1

Thank you Goldfish. Hope you get your answers.


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## Briss

Orchid, I can check what my levels were tomorrow ( I don't have my notes here) but I think it's individual, my levels are generally higher than normal I think. I usually start my cycle with 200-450 on day 3 or so. Will get back to you tomorrow.

Goldfish, definitely ask for all your info. I put together a table for each cycle with all My levels for each cycle even where we did not get to ec and it really helped me with my future cycles as I could predict in advance how the cycle is going to play out based on my levels. On the cycles where I started with lower estrogen level I ovulated later and it was actually better that's why I think it's possible your body just was not ready for ec.


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## Orchid-1

That would be great Briss. Really good idea to tabulate results.

Also I noticed from a previous thread that you were tested for hidden C with Serum. So did I.
What ABs did you end up taking for your successful cycle with your German clinic? I know you said you took mild anti-biotics. My current clinic [Newlife] does not believe in hidden C, but I am worried about it. Everything else was negative for me.

Secondly were you ever tested for NKa cells and immunes? If so did you have intralipids and or neupogen before transfer and after transfer?

Sorry about all the questions. x


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## Briss

My levels: (but again my "normal" levels may not be the same as your normal levels, this is just an example but you are better off observing your cycles to determine what levels you have). I think my levels are generally higher than normal.

Also, this is just in natural cycles with no stims so only for 1-2 dominant follicles per cycle. 

1. Trigger day CD9: E2 1,809 pmol/L; LH 17.5 mIU/ml, lining 9.5 mm/ triple layer, 2 dominant follicles: 18.3 mm and 15.3 mm. no eggs were collected but I am pretty sure my egg got away just before the procedure because they delayed it by 2 hours. 
2. Trigger day CD10: E2 1,746 pmol/L; LH 49.7 mIU/ml, lining 9.5 mm/ triple layer, 1 dominant follicle: 18.7 mm, 1 egg collected, fertilised but BFN. I was taking Indomitacin from trigger to EC to ensure the follicle stays put and does not release the egg. also my LH is generally high but this cycle it was super high but evidently Indomitacin worked as they got the egg. 
3. CD 8: E2 582 pmol/L, LH 11.9 mIU/ml, no dominant follicle present, only smaller ones (L: 7.5 mm, 6.4 mm, 5.1 mm, 4.5 mm, 3.5 mm, 3.4 mm; R: 5.4 mm), lining 8.7 mm - levels are too low so I checked progesterone - 1.8 ng/ml - this is indicative of ovulation taking place so abandoned the cycle. quite shockingly i seem to have ovulated by day 8 of the cycle.  
4. CD 9, 4 days before EC: E2 1,182 pmol/L, LH 8.2 mIU/ml, lining 10 mm / triple layer, 2 dominant follicles: 12.9 mm and 9.9 mm on the day of EC (CD13) both follicles were 18mm+; only one egg collected, fertilised, BFP, MMC
5. CD 7, E2 925 pmol/L, LH 5.9 IU/L, lining 8.7 mm / triple layer, follicles: 8.7mm; 6.1mm, next scan was only done on CD12 by which time I already ovulated, E2 268 pmol/L, LH 22.9 mIU/ml, lining 12.2 mm / triple layer, progesterone 2.1 ng/ml - progesterone levels are elevated and suggestive of ovulation.
6. CD 9 (5 days before EC), E2 923 pmol/L, LH 6.3 IU/L, lining 8.9 mm / triple layer, follicles: 18 mm (irregular shape/possibly a cyst)and 13.2 mm; CD 11, LH 14.5 mIU/ml; EC (CD14) one dominant follicle 17mm (this is the one that was 13.2 mm on day 9), one egg collected fertilised, BFP

obviously when stims were involved my levels were different. 

re hidden C, I feel very upset about this test I must say and regret so much that I did it. I tested positive and got all the AB to start taking once BFN was confirmed but it was a BFP. I contacted Serum and they told me to take different AB which i refused. the main reason is that they could not articulate what exactly I tested positive for? there are so many strains of Chlomydia most of which have nothing to do with fertility and they seem to have tested for everything and could not specify which one I had. all other chlamydia tests that I have done including the second one I had with Serum (a different lab) came as negative but they were specific for chlamydia trachomatis strain. that's why I do not actually think I have it but even then a small part of me have doubts and I worry and will be testing my baby  badly done Serum!  they really should understand their tests better. 

What I was going to do is to take AB together with DH from CD 1 for 2 weeks. it's a different course, not the one Serum suggested. a much milder one but I  chlamydia trachomatis is easily removed you do not need a harder AB, plus it will deal with any other infection you do not even know you have. it's important to take it together with DH though at the same time to stop reinfecting each other. 

I did some  NKa cells and immunes and they were generally OK but some IgGs came as positive and Dr G thought i needed some meds which I did not take in the end because again i just do not believe in taking meds on a just in case basis because they all have side effects and you just cant be sure what they actually do. I believ you should take these immune meds only if there are reasons to believe your immune systems is affected, otherwise you may end up doing more harm than good. 

on my last cycle I was taking raw prenatal vitamin with higher doses of Vit D and natural forms of Folate + B12, coq10 600 (prior to EC), Fish oil, progestrone after EC - this is it. no other meds.


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## Orchid-1

Briss- wow. You are really organised. Thank you so much. Really useful guide.  

Thank you re comment about meds for immunes - my tests came back pretty high for NKa cells so been worrying about it. Current clinic does not believe in those tests. My gut tells me to take it but they are a little harsh on the system. I will go with the clinic in this instance I think. 

Thank you again. x


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## katkat2014

Hi all, now that I've tried it, I can recommend mild IVF! I didn't get a bfp but everything went so much better. Letrozole for 7 days, 150iu gonal f for 11 days, 10000 trigger and I got 2 good blastocysts from it, 1 was a hatching one on transfer day (9 follicles, 9 eggs, 4 mature, 3 fertilised). Last time I had dosages of 300 iu gonal f plus 150iu menopur later on, also got 9 eggs, 5 mature, 4 fertilised, and the quality of 3 was terrible and they arrested after day 2, and I only had a 3dt of 1 embryo. I took low dose dheas and melatonin plus the rest were the same supplements as previous time. So I have to put it down to the mild IVF. Plus DP sperm was better too, something not to be ignored. Good luck!


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## Orchid-1

Briss- which anti biotic did you make instead of Serum's suggested one? You mentioned it was milder?

Did you take it 40 days before you cycled? 

Kat- thanks for writing down your protocol. Really useful.. Makes me feel really positive.  
- which clinic r u with?

AFM-Have decided against immunes for now. X


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## katkat2014

Hey orchid, I am with Gennet Prague. Not sure if they are thr best for mild IVF but I was given the choice of two different protocols by them that last time and against their advice I went for the mild one which I had asked for as the alternative one. They are pretty flexible  (which at the same time irritated me because I wanted someone to tell me this is how you do it and get pregnant). I have done this 5 times now and nothing to show for. But out of the 5 times, the first and last cycles where I stimmed the longest on lower doses worked the best for me.


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## Briss

Orchid, I did not take any AB.  I got my positive hidden C results after we have already gone ahead with ET. I was going to take them from CD 1 but could not because I got BFP. In any event I was not going to do the 25 day AB that Serum suggested. My plan was to take different AB suggested by a Russian doctor. I was communicating with several clinics at the same time just exploring my options. The Russian doc said that they usually recommend a 2 week AB course for any couple before embarking on IVF, particularly when there is sperm issue. Apparently sperm issue can be caused by undetected infection, something that is not usually tested (cos you cant test for everything) so you just would not know you have it. It turns out that often sperm improves after AB. I was inspired cos even though I had lots of AB in the past DH and I never did it together which is apparently the key. I can tell you which AB I was going to take but it might be tricky to get them in the UK because they are used in Russia. I was able to find them in London but had to pay extra as I did not have prescription (you do not need prescription for AB in Russian so she did not give me one)


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## MissMayhem

Hi girls, thanks for your comments on Create and Serum, I'm still undecided even though I went to  the fertility show, couldn't see Create and after much excitement didn't get to see Penny either, was so disappointed that we just got to see a colleague instead.

Really interested reading this thread and one of the things that stuck out is E2 testing for ovulation during natural cycle. Is this essential? I've never had my levels tested ever during standard cycles.xx


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## Briss

MissMayhem, the standard hormones that are being tested on natural cycles are E2 (oestrogen) and LH, some clinics also like to test progesterone to make sure ovulation is not ongoing. E2 provides a lot of information about the cycle and indirectly about the quality of egg. for example at Create they decided to proceed with EC on one of my cycles even though i did not respond to stims and only had 3 follicles but the oestrogen levels were good and blood flow to follicles was also good. I was told that these levels indicated that I did have at least one egg that cycle and the quality should be satisfactory. if I had lower oestrogen levels they would not suggest to go ahead that cycle. Ovarian cysts also produce oestrogen so this is not always accurate to just rely on oestrogen but they look at other things as well to see overall picture so oestrogen levels is just part of the puzzle.


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## katkat2014

Hey briss, how did you get blood tests sorted out in the UK when cycling abroad? Do you need a referral from a GP to do them?


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## Briss

I did it at path lab in bond street no need for referal and results are emailed to you in 2 hours. Each hormone costs around 35 pounds I think


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## katkat2014

Thanks, Briss!


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## MissMayhem

Thanks Briss, that's helpful to know, thanks. Makes me wonder why they don't do it during a stimulated cycle either, had a cycle changed to IUI as I only had three follicles one of which was dominant, I often wonder whether I should have insisted on collection anyway.  I don't understand  why my clinic didn't say they could've tested my oestrogen levelling you said.xx


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## Briss

MissMayhem, actually on both stim cycles that I had they tested E2 as well as LH so you should definitely ask your clinic about it.


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## Jasminetea

Hi ladies
I'm new to this forum and wondering if anyone has done or researched natural ivf in Spain? I'm thinking of doing a natural cycle at IVI or Barcelona IVF and have an appointment with them next week. I've heard they really push egg donation. I'm concerned they won't do natural IVF and will push me down the stimulated route. I responded poorly to the stimulated cycle and only produced 2 mature eggs on the highest dose of menopur. One of my eggs got fertilised simultaneously by 2 sperm and got binned- bad luck when I only had 2. 

A few Spanish clinics have already not recommended natural IVF to me over the phone because of the low success rates but I feel it's best for me. CRGH have recommended natural IVF as my best option but I'm considering abroad cause it's cheaper and Spain cause I'll be there in December. 

Briss- I've been following you for a number of years. Thanks for all your info and congrats did you consider 
Spain for your natural cycles?


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## Briss

Offline Jasminetea, I did consider Spain and i contacted a few clinics (in Alicante i think) but unfortunately i did not get a satisfactory response, I also compared their prices to CR and Germany and they turned out to be more expensive so I proceeded with Reprofit and the Munich clinic. but i think it's just a question of finding a good clinic in any country because I contacted quite a few German clinics as well and a lot of them just did not recommend natural IVF and were giving me less than 1% success rate. I found that if you are sure natural IVF is the way forward it's a constant battle with clinics. even on the  morning of my last EC I had to have that conversation where they tried to persuade me abandon the cycle and try long protocol. I have heard good things about quality of care in Spain  so it might be just a question of going through clinic after clinic until you find the one that would work with you. unfortunately I have not found that clinic in Spain so can't recommend any. Generally I think it's best to approach clinics that do not advertise DE that much cos for a lot of clinics that's their main business directed at oversees patients so they will not be very interested in natural IVF.


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## Jasminetea

Cheers for the info Briss, you've given me strength again to keep trying natural IVF even though my only go at natural resulted in no egg collected. Every time I speak to a clinic that tells me there's little hope with natural IVF it makes me feel so down and I question my decision to not try and stimulate again.


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## Baby em

CrazyHorse said:


> A wee update from me: I had EC this morning, and got 4 eggs!!!! That's as many as from my two completed IVF cycles on conventional stims combined. So I'm over the moon about that.
> 
> We've opted for conventional IVF instead of the clinic's standard ICSI, because we've had 100% fertilisation with conventional IVF in the past, and I suspect there's at least one immature egg in this bunch that might fertilise naturally but wouldn't survive ICSI. Fingers crossed....


Wishing you lots of luck x


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## Goldfish45

*jasminetea* I spoke to a couple of Spanish clinics at the fertility show recently and they were not keen on natural cycles and were pushing me to do DE or stim cycle. If you're keen on natural cycles you could look into create's multi cycle package (still fairly expensive), or otherwise it's cheaper in Greece, Czech Republic, Getmany (and probably Cyprus). Alternatively maybe worth trying mild stims if you haven't already? Crazyhorse is a big fan as she's currently pregnant from a mild cycle!


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## Briss

Jasminetea, I agree it's very difficult and I also questioned my decision a lot  and even on my last cycle a part of me broke down and we went out and bought down reg meds  that the clinic recommended in Germany cos even though I insisted that they proceed with EC and we got the egg there was just so little hope so I was seriously considering doing long protocol next month. however after we had ET I thought about it again and again but this time without the clinic putting pressure on me and analysed all my previous cycles and decided that if this cycle fails we will do at least one more natural cycle before introducing stims again. 

I also think a lot depends on the clinic and their lab, even though I loved reprofit and the doc was fantastic my both natural cycles failed, first with no eggs collected and second BFN so after two failed cycles I decided to change clinics. I am just thinking that one failed cycle could be just an accident but if two or fail it just means something is not working between your eggs and their lab so I would start looking elsewhere. 

Also, if you are going natural IVF route the attitude should change, with stim cycles or even mild stim cycles there is always hope and pressure for this cycle to work because the success rates are generally higher and after that you have to have a break before you can try again. with natural IVF cycle it's best to change this into thinking that all you do is TTC naturally, you do not expect to get pregnant the first month you managed to put a few BD sessions in around ovulation? obviously everyone is different but I found it helped me a lot to manage my stress levels, similar to TTC naturally when you are focused on trying to time your BD on natural IVF cycles I was focused on making sure we get the timing right for EC (not always possible) and of course I hoped it would work as you do but after ET it's out of your hands so I was immediately changing my focus onto the next cycle. making sure that we try our best every single month was really helping me to stay focused and not get too depressed. and of course money becomes an issue when you have to travel every month and pay for a cycle so I needed the clinic fees to be ideally below 1K euro per natural cycle cos together with London scans/bloods and travel for two it still comes down to 1.5-2K euro but then half of the time it was just around 400-500 pounds cos we missed ovulation or something else happens and you cant proceed all the way to EC.


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## Orchid-1

Briss - just wondered - a litte off topic - but how did you stop the knucklehead stuff from bothering you. How did you stay focused and positive basically. 

Had a horrid day having bloods taken at GP's surgery. I keep waking up fizzing about it. I have my cycle coming up in a few weeks need to keep my head in the game.  x


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## Briss

Orchid, quite hard to explain cos there were ups and downs. I basically changed my focus from expecting a cycle to work to making sure I give every egg a chance. I could not do any more than this. I also kept myself very busy with reading a lot of books/articles/research studies trying to analyse my previous cycles and thinking what we could try differently next month. I took a lot of positives from the fact there is always a next cycle but of course at times it did not work cos your chances go down with every cycle as well. being busy really helped, while going through a cycle at one clinic I usually negotiated with a few other clinics at the same time hoping they can offer something I have not tried before and see something else I had not thought about yet which helps as it shows you there are other options if this fails. also I was in a position where things looked really bad, I had all sorts of thoughts going through my mind about our future, I considered a divorce and going with donor sperm even though I love my DH, there were really dark moments but then there is next cycle and before you know it you are preparing for EC again so things get a bit more positive as long as there is next ovulation there is hope.  in that sense emotionally natural IVF is closer to TTC naturally rather than going through IVF.


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## Orchid-1

Briss - thank you. 

You've been really positive and focused. Always great to read your posts.  

Going to hit a few balls in the squash court! That will sort me out 

Have a great weekend everyone. x


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## Jasminetea

Thanks Briss and goldfish for your replies. Super helpful and much appreciated.


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## katkat2014

Does anyone know what type of protocol a natural modified IVF would be? 
Mild IVF worked for me, but due to cost have to move to something cheaper, plus something I can do each month without a break of 3 months in between. Also I only had 4 mature eggs on a mild IVF and created 2 blastoysts so I hope with a natural modified to get maybe 2 eggs and also 2 blastocysts. I want to increase my chances up from natural IVF so am hoping to do some form of embryo banking on a natural modified cycle.and then PGS testing after 2-3 months.  I don't even know if this is even possible though.


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## Briss

*katkat*, I think it depends on the clinic what they call natural modified. I had one of those at Create and basically it was 150 menopor from CD 6 (a bit later in the cycle than mild stims). other than that there was no difference. for some reason they make it a big deal whether you start stims on day 2/3 or day 6. I have to say that I had 2 follicles which is what I usually have without any kind of stims so for me it did not make any difference compared to natural IVF. I guess you would need to try it once to see if you produce more follicles or better quality embryos on this protocol.


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## katkat2014

Thanks a lot, Briss. I think if you start on day 2 then you may end up with many more follicles (I had 9 eggs / 4 mature on my mild IVF with 150 gonal f). Not sure what the difference is to monitoring or why it would cost 3 times the price between natural modified and mild... ah well...


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## Annie37

Hi kit Kat my last cycle was natural modified. 150 GONAL from Day 5, a couple of scans and bloods, a lead follicle , certrotide introduced an ovitrelle trigger and an egg collection on Day 11. 

I got 3 eggs 2 fertilised and these were transferred on Day 2. I've had a BFP. My first two cycles I had mild and you'll see from my other posts the results. Yes I produced lots more eggs and follicles but didn't have a better embryo result. So for me if I have to cycle again in the future I'll be sticking to natural modified!!


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## Briss

*kit Kat*, my situation was similar to Annie's, somehow it made a difference to egg quality between starting stims on day 2 (mild IVF) and day 6 (modified natural), cant explain it. I got one egg and a bfp on natural modified but it was a chemical. with mild stims I had more eggs but it was zero fertilisation. also because I only had one egg on natural modified it did not make a difference whether to use any stims or to just go for completely natural IVf, I always get just one egg so may as well do natural. sometimes they use modified natural not to increase the number of eggs but to time EC and provide more hormonal support if your natural cycle is weak.

re cost, somehow in the UK mild IVf costs the same as full on stim IVf, I guess it's because the process is the same. Create told me that there is a huge difference between mild IVF and modified natural IVF in a sense that in mild IVf they control your cycle. In my case I did not feel like they were controlling anything but since it made a difference to egg quality they might be right. but basically that's the justification why they charge more. the process wise the monitoring was exactly the same on both cycles, I had maybe one extra scan on mild stims cos they start monitoring a little early but that's it.


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## katkat2014

Thanks Annie and Briss. So much to think about. My Dr recommended I should continue with the same mild IVF protocol but what puts me off is the cost and the wait should the next cycle fail again. Time isn't on my side. I now had a follow up and my Dr also says that with modified natural he would just aim for one or two eggs only. He wants to use chlomid and a fresh transfer and he says that if I do this up to 6 months my lining will not be compromised? But my lining is only ever 8.3mm he thinks that's totally fine. This is all so confusing!


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## katkat2014

Annie - just read through your posts. Also, CONGRATULATIONS on your bfp, how exciting!! QQ, why did you not granger ever months but froze your embryo each time, was this a lining thing?


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## Annie37

Hi kit Kat thanks early days so taking it one day at a time! So my package was a 3 cycle with embryo banking and after the 3rd either a fresh transfer ( if I yielded a suitable embryo) or a frozen transfer. It's basically a case of trying to collect as many good quality embryos as possible and having the choice at the end of the 3 cycles which to transfer. That approach really appealed to me as I didn't want to have to go through it a round at a time. I have to say other than cycle two which I felt the drugs didn't agree with me as much it was very manageable. My lining is never very thick either. Gets to a triple layer but usually around 8mm mark too!!


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## WootyWoo

Hi everyone,

I'm not sure if this thread is still active, I'm new to FF. Reading it is really helping me stay positive though!
Congrats to Crazyhorse, Briss, Annie37 and anyone else I've missed. Amazing - against all odds pregnancies that give a girl like me hope!

I'd love to try Reprofit in the Czech Republic a try Crazyhorse, partly because you had success there (you are my posterchild being the same age and with similar AMH *and *Scottish!) but also because they are so cheap for natural/ mild IVF (and no extra charge for ICSI). Unfortunately they don't do AOA which we need for my DH's sperm  Huge congrats on the birth of you wee boy 

Briss I wanted to ask about the clinic in Munich you went to. I'm hoping as they do IMSI for sperm they may also be geared up for other spem fixes - i.e AOA. What did a natural cycle cost you there?


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## Briss

WootyWoo, for our last natural cycle we paid 1,400 euro which included imsi and some tests for DH but excluded scans/bloods in London and travel expenses. I am really not sure about assisted oocyte activation (if that's what you mean by AOA?), tbh we have not looked into this procedure as I just assumed our zero fertilisation was due to stims affecting egg quality. you may have to ask the clinic directly.


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## WootyWoo

Hi Briss, thank you for the info, it's very kind of you to respond  
I've sent the clinic an email to enquire if they do the AOA, it seems that most clinics don't which is frustrating! This is much cheaper than our current clinic though so fingers crossed! Thanks again x


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## Briss

WootyWoo, Let us know what the clinic says. That's very interesting that research you did into PLCzeta necessary for 'activating the egg'. I have not heard of this before. None of the clinics ever mentioned it as a possibility in zero fertilisation scenario. as you said everyone always blames the egg...  wishing you best of luck and hope you will get your BFP and a healthy baby to follow soon.


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## WootyWoo

Thank you Briss, I will let you know when I hear back. 

I also summoned up the motivation to send the feelers out again to Reprofit and Gennet to see if they've added AOA to their list of services since the last time I asked (probably more than 6 months ago...). Gennet sent a response saying 'should be able to' but they will check with their senior embryologist on 4th January   Oh fingers crossed, I'm sure it was a straight no the last time I asked so I'm very hopeful -  financially that would enable me to at least try on a few cycles to catch a good egg...

I can't take the credit for self-diagnosing the PLCzeta issue (although I've Googled endlessly on all things infertility related and have probably irritated my doctors no end  ). The clinic I was cycling in happened to be involved in a research study through Oxford University, London. As it's only in the research phase it's not offered in clinics yet which will be why you weren't offered it. In a way we were lucky to have it diagnosed...I only wish they had offered to include us in the study after the first failed fertilisation cycle instead of assuming it was my eggs  . It would have saved us £3000 in the following failed cycle. Really frustrating. 

At least it's discovered though, that's huge. Also good to know the fix before we frittered thousands on a failed DE cycle too! (which was what was recommended).
I just wanted to share that, in their study so far, apparently 50% of those who had failed fertilisation following an ICSI cycle were found to be missing or lacking this protein PLCzeta. I don't know what the other 50% were attributed to...

You are a sweetheart to stay on these boards offering advice and experience especially considering you are about to pop   I hope it goes smoothly and wish you all the best. Let us know how that goes too   you deserve a sneeze birth   Thank you again xx

Sorry for the essay!


----------



## Briss

WootyWoo, thanks! That's amazing that 50% of failed fertilisation following an ICSI cycle were attributed to this protein PLCzeta. That should help so many couples. I just knew it that it could not be all down to egg quality.


----------



## katkat2014

Hello everyone, thought I pop in with more questions. I was given a protocol that has 6 x days of letrozole on it and then 3 x 75iu gonal f. They say this is a mild protocol?! Isn't this natural modified as you hardly take any medications?


----------



## Goldfish45

Katkat, I'd say you're on a mild protocol. I spoke to Create and their explanation was that a natural modified is more dependent on your natural cycle - so they'd monitor you at the start of your cycle and only 'modify' the cycle after day 6 or so by adding stims. I did a mild cycle in October where I started on letrozole on CD2 then added stims later.


----------



## katkat2014

Hey goldfish, thanks for clarifying. I just find it a bit strange that I first had a mild protocol of 150 gonal f daily and then now it's changed to letrozole for 6 days followed by 3 days of 75 gonal f. I thought they ha d maybe changed from mild to modified natural (and associated reduced cost with it). I just wonder if they would only expect to get 1 or 2 eggs on such low dosages....


----------



## CrazyHorse

Hi, katkat, some people get more response from letrozole. I had letrozole plus 75 iu/day Menopur and got 4 eggs, although only 2 fertilised (other 2 most likely immature), and that was with my pathetic 1.8 AMH. It's worth a shot!

Hi to everyone else! Don't post much now due to new baby. Wootywoo, are you in touch with that clinic in Ghent that does AOA? There's some big threads on AOA, though you've probably seen them:
http://www.fertilityfriends.co.uk/forum/index.php?topic=329763.990
http://www.fertilityfriends.co.uk/forum/index.php?topic=338903.0
http://www.fertilityfriends.co.uk/forum/index.php?topic=335715.0

Lots of luck to all!


----------



## Xtina

Hi everyone,

I'm completely new to FF. I was at CRGH where I had 3 failed IVF and 4 failed IUI, at 43 with AMH at 3.4 and FSH at 7.6, I'm wondering whether natural IVF might be an option. Does anyone have any advice as to which would be the best clinics in London for Natural/mild IVF? I'm looking at City Fertility (Gennet) and CREATE, they seem to do 3 cycle packages...any comments welcome....

Thank you so much and good luck to everyone.

xxx.


----------



## ladybug8410

Hello Xtina, 

I have just started in Create doing my first natural modified cycle. Have had 2 failed ICSI cycles with full dose stimms which havent worked for us. So decided to try this route. When I was doing my research, I did look at Gennet (but not solely from a natural/mild cycle point of view) which did seem quite attractive but mainly from a a cost point of view esp if you did it with their clinic in Prague, it really did save you a lot of money. Most reviews I read about the clinic were also very positive. 
We decided to stick to Create as it seems to be  natural/mild is really their mission as it is all they do. The clinic is also more local to us so will help in needing time of work etc. I've only just started so can't tell you much about success (yet, hopefully) but i'm hoping, this is what will make a difference for us.

Hope that helps.


----------



## Briss

Xtina, just to share my personal experience, I was not impressed with City Fertility (Gennet), they are great at providing scan/bloods support if you cycle abroad but they are not as good at cycle monitoring themselves. they missed my ovulation and misinterpreted my scans. I'd go directly to Gennet Prague. I had a more positive experience at Create, my natural/modified cycle with them went really well but they did not do a good job at my mild stims IVF, my cycle was managed quite poorly. Having said that your FSH/AMh is quite good so you may get a better result with mild stims.


----------



## Annie37

Hi xtina I'm pregnant after a 3 cycle package at create. I had 2 mild stimulant cycles and one natural modified. The latter cycle was the easiest by far and produced 2 good quality eggs one of which has went on to implant and I'm teaching 12 week mark. If my two frozen embryos don't implant later down the line I will do natural modified again with create.. I'll skip the mild stim! 

Being able to juggle cycling with home and work life was important to me. Yes we could have saved a lot of money going to Prague or similar but the thought of packing and flying and staying somewhere unknown after a transfer did not appeal to me at all. 

Your results for amh and fsh are good really considering you are in a higher age bracket so hopefully that will assist you! 

Good luck with your decision x


----------



## ladybug8410

Hi Annie

Congratulations! I'm hoping your Create success will rub off on me! I'm in the middle of a natural modified cycle and it feels slightly unreal as I'm not really feeling much effects from the low dose meds (Not that I am complaining but it was nice having twinges before cos I felt like my ovaries were doing something!). Can I ask what day do you normally expect to start Cetriotide? I am trying to plan work shifts around it.  I previously did Cetriotide first thing in the morning - Is that what Create suggest do? I am assuming this is dependent on follicle size. Mine seemed to be on the smaller size at my last scan according to the doc but I am hoping I am just a late starter. 

Briss, can I ask how did they decide between mild stims and natural modified for you? 

Xtina, let us know how to get on.


----------



## Annie37

Hi lady bug very exciting! Don't worry about feeling nothing, I think it's amazing. Some people vow never to do IVF again as it's such hard work and I know it's not suitable for everyone but nat modified rely is a breeze compared to some protocols. I really believe this very short timescale is also a big factor in success. I know it's not proven but I do think a state of mind does have an impact on these things. At least to some extent.

I did all my cetrotides at night around 8-9pm. On my last cycle I introduced it I think on day 6 for 3-4 days (I'll dig that out when I'm at home from my notes) just a day after starting stim.  On my first two cetrotide was also at night around same time. Can I ask why do you need to sort your work around this?


----------



## ladybug8410

Thanks Annie. I sometimes work late evenings till 9pm. Would not be impossible to do injections there but rather do it in the comfort of my own home if possible. Currently doing Gonal F around 7pm when I am home but I know with Cetriotide, the timing needs to be more precise than Gonal F.  I forgot to ask before, can you remember what day you had egg collection? My natural cycles can be as long as 33 days so thinking ovulation could be as late as day 16/17 i.e egg collection will be around there? 
(Sorry, I am bombarding you with all these questions when I should really just be asking my clinic!!)


----------



## CrazyHorse

It's the trigger shot where the timing needs to be precise -- Cetrotide needs to be administered with a similar degree of precision to the stims (i.e., a lot more wiggle room than the trigger shot). I always injected Cetrotide alongside my stims on my short protocol cycle -- my consultant didn't feel time of day was important as long as you did your jabs in roughly the same timeframe every day.


----------



## ladybug8410

Thanks crazyhorse. 
Problem averted anyway- follicles not ready for Cetriotide. I'll keep your advice in mind for later. My ovaries sure as hell are lazy to get these follicles growing!!


----------



## Briss

ladybug, we started with modified natural because my FSH/AMH were not great and this cycle produced a good quality embryo but ended in chemical pregnancy. Create thought I responded well and decided to try to introduce some mild stims but it just did not work as my egg quality went down and none of the eggs fertilised. I since had 4 completely natural IVfs (no meds) in CR and Germany, sometimes back to back cycles and they are just so much easier on your body. the main stressful moment is whether they can time EC correctly and get the egg and if it's of good enough quality to fertilise. 

re Cetrotide, I was told to inject it early in the morning around 7 am. but in my case it never worked and my body was still trying to ovulate when it felt ready.


----------



## Annie37

ladybug8410 said:


> Thanks Annie. I sometimes work late evenings till 9pm. Would not be impossible to do injections there but rather do it in the comfort of my own home if possible. Currently doing Gonal F around 7pm when I am home but I know with Cetriotide, the timing needs to be more precise than Gonal F. I forgot to ask before, can you remember what day you had egg collection? My natural cycles can be as long as 33 days so thinking ovulation could be as late as day 16/17 i.e egg collection will be around there?
> (Sorry, I am bombarding you with all these questions when I should really just be asking my clinic!!)


Not a problem! I actually managed to get my scatty cycles to almost bang on 28/29 days with fertility acupuncture.. Worth s try! 
As per what crazy horse said about the timings.

So I started injecting gonal on day 6, egg collected on day 11 transferred in day 13.

Good luck with your folly growing keep positive!!


----------



## Xtina

Ladybug, Briss & Annie, I just wanted to thank you for your feedback - I'm going to a Create (St Paul's) open day on the 20th and I've got an initial consultation booked for the 26th at City (Gennet), currently erring towards City only because of price (which judging from the comments might be a false economy!) and I can get to it from work in ~25mins (mad rush for scans during my lunch hour!), but I'll see....the problem with some of these '3 -cycle packages' is what they don't include (and that can add up...).

We shall see....here we go again on the roller coaster of hope and despair! *sigh*

ps. Annie - many congratulations!


----------



## Annie37

If it helps I budgeted and spent just (only just!!) of 12k for my 3 cycle package at Create. 2 mild cycle 1 natural modified. Probably be 13k worst case scenario if you did "maximum" mild stims each cycle. 
X


----------



## ladybug8410

Hello all

In the midst of my natural modified cycle and terrified it isn't going as it should. I'm on Day 11 now and my estradiol levels haven't even reached 1000. Apparently it should be more than 1000 by now. Have 2 follicles that are around 11mm and again, I think follicles are usually bigger by this point. Most people are even considering doing trigger in a day or two but I have only just started Cetriotide yesterday!

Anyone with any experience of slow growing follicles on a natural modified cycle? Can it still be all ok in the end?


----------



## KellyD

ladybug8410 said:


> Hello all
> 
> In the midst of my natural modified cycle and terrified it isn't going as it should. I'm on Day 11 now and my estradiol levels haven't even reached 1000. Apparently it should be more than 1000 by now. Have 2 follicles that are around 11mm and again, I think follicles are usually bigger by this point. Most people are even considering doing trigger in a day or two but I have only just started Cetriotide yesterday!
> 
> Anyone with any experience of slow growing follicles on a natural modified cycle? Can it still be all ok in the end?


God yes. I didn't trigger until day 15..and my most recent cycle I didn't ovulate until day 23. Don't worry about it. Some of us just take longe.


----------



## ladybug8410

Thanks Kelly, that's reassuring to know. You seem to have got at least 1 embryo from each cycle - which is great! Have you had your embryo transfer? 
I think I just got worried cos the doctors seemed to think the growth was rather slow which didn't give me a whole lot of confidence!!


----------



## KellyD

ladybug8410 said:


> Thanks Kelly, that's reassuring to know. You seem to have got at least 1 embryo from each cycle - which is great! Have you had your embryo transfer?
> I think I just got worried cos the doctors seemed to think the growth was rather slow which didn't give me a whole lot of confidence!!


Well mine were slow too. But they did get there. And yes I had an embryo each cycle and a bonus one on cycle 2. I'm in the 2ww wait now with those two. 
Best of luck!
KD.


----------



## apples2014

Hi everyone 

I haven't posted on your thread b4 but I wanted some advice or pearls of wisdom so I hope you don't mind me jumping in! 

I am having a natural ivf cyce at Gennet in Prague right now. I am experiencing a slow growing follicle. 

I am cycle day 13 today. I have normally had EC on my other natural cycles by now! But guess they all different. 
On Saturday the lead one was 12
On Monday was 13 and today it's at 15. This cycle is different to the other natural cycles I've had though also because usually by day 9 there is only the lead follice left but even today I've got one at 9 and some wee ones ( not that they will be doing anything only chasing the lead one but just pointing out they still in there not gone but they usually have by now) 

I am just after some advice as to how to manage this as Gennet closed on Sunday's ( grrrr) we thought we would be clear of this being an issue but it's a slower grower! 

So today follicle is 15. They told me to come back Friday and EC would be monday. Monday is day 18 that's very late for my usual cycle. I was like nooooooo! I want to come tomorrow for a scan so they agreed. My last natural ivf cycle with Gennet in November we triggered at 17 and at EC it was 19 and good quality. 
I of course can't trigger tomorrow if it is not ready it's not ready and we will just have to hang out here in Prague longer. But I feel really nervous about the prospect of waiting until Monday. What if it has a massive growth spurt and goes past it! 

I've been injecting cetrotide since Friday. But I know that its not a bullet proof drug to stop ovulation, although when I mention that to my consultant she looks at me like I am being over reacting but I know it's not 100 per cent. 

I guess if I go back tomorrow and it's grown to 17 that might be okay for EC on Saturday. But I wonder has anyone done a natural cycle with a slow growing follicle and will day 18 for EC be okay? 
My lining is triple and just over 8 so no issues there! I wonder if the wee follicles not going yet has affected the slower growth this time! 

But any thoughts or advice or tips to manage my consultant are appreciated. Was told today to please relax and of course come for scan tomorrow if I want, so they are good. But this closed Sunday is a pain. 

Am so sorry to just jump on your thread and ask for help though! Wishing you all lots of luck and positivity for your cycles too. 

Briss, am thinking of you lovely lady. So not long for you now. Hope you are keeping well just a little hello to you if you still pop on here. 

Thanks 

Apples xx


----------



## KellyD

apples2014 said:


> Hi everyone
> 
> I haven't posted on your thread b4 but I wanted some advice or pearls of wisdom so I hope you don't mind me jumping in!
> 
> I am having a natural ivf cyce at Gennet in Prague right now. I am experiencing a slow growing follicle.
> 
> I am cycle day 13 today. I have normally had EC on my other natural cycles by now! But guess they all different.
> On Saturday the lead one was 12
> On Monday was 13 and today it's at 15. This cycle is different to the other natural cycles I've had though also because usually by day 9 there is only the lead follice left but even today I've got one at 9 and some wee ones ( not that they will be doing anything only chasing the lead one but just pointing out they still in there not gone but they usually have by now)
> 
> I am just after some advice as to how to manage this as Gennet closed on Sunday's ( grrrr) we thought we would be clear of this being an issue but it's a slower grower!
> 
> So today follicle is 15. They told me to come back Friday and EC would be monday. Monday is day 18 that's very late for my usual cycle. I was like nooooooo! I want to come tomorrow for a scan so they agreed. My last natural ivf cycle with Gennet in November we triggered at 17 and at EC it was 19 and good quality.
> I of course can't trigger tomorrow if it is not ready it's not ready and we will just have to hang out here in Prague longer. But I feel really nervous about the prospect of waiting until Monday. What if it has a massive growth spurt and goes past it!
> 
> I've been injecting cetrotide since Friday. But I know that its not a bullet proof drug to stop ovulation, although when I mention that to my consultant she looks at me like I am being over reacting but I know it's not 100 per cent.
> 
> I guess if I go back tomorrow and it's grown to 17 that might be okay for EC on Saturday. But I wonder has anyone done a natural cycle with a slow growing follicle and will day 18 for EC be okay?
> My lining is triple and just over 8 so no issues there! I wonder if the wee follicles not going yet has affected the slower growth this time!
> 
> But any thoughts or advice or tips to manage my consultant are appreciated. Was told today to please relax and of course come for scan tomorrow if I want, so they are good. But this closed Sunday is a pain.
> 
> Am so sorry to just jump on your thread and ask for help though! Wishing you all lots of luck and positivity for your cycles too.
> 
> Briss, am thinking of you lovely lady. So not long for you now. Hope you are keeping well just a little hello to you if you still pop on here.
> 
> Thanks
> 
> Apples xx


Yes, my follicles were slow growing. I think you're worrying too much. Go with what they say! I personally would have waited until Friday and gone for Monday EC, you're not going to ovulate until you take your trigger. It won't go past it? It will mean it's nice and mature.


----------



## KellyD

apples2014 said:


> Hi everyone
> 
> I haven't posted on your thread b4 but I wanted some advice or pearls of wisdom so I hope you don't mind me jumping in!
> 
> I am having a natural ivf cyce at Gennet in Prague right now. I am experiencing a slow growing follicle.
> 
> I am cycle day 13 today. I have normally had EC on my other natural cycles by now! But guess they all different.
> On Saturday the lead one was 12
> On Monday was 13 and today it's at 15. This cycle is different to the other natural cycles I've had though also because usually by day 9 there is only the lead follice left but even today I've got one at 9 and some wee ones ( not that they will be doing anything only chasing the lead one but just pointing out they still in there not gone but they usually have by now)
> 
> I am just after some advice as to how to manage this as Gennet closed on Sunday's ( grrrr) we thought we would be clear of this being an issue but it's a slower grower!
> 
> So today follicle is 15. They told me to come back Friday and EC would be monday. Monday is day 18 that's very late for my usual cycle. I was like nooooooo! I want to come tomorrow for a scan so they agreed. My last natural ivf cycle with Gennet in November we triggered at 17 and at EC it was 19 and good quality.
> I of course can't trigger tomorrow if it is not ready it's not ready and we will just have to hang out here in Prague longer. But I feel really nervous about the prospect of waiting until Monday. What if it has a massive growth spurt and goes past it!
> 
> I've been injecting cetrotide since Friday. But I know that its not a bullet proof drug to stop ovulation, although when I mention that to my consultant she looks at me like I am being over reacting but I know it's not 100 per cent.
> 
> I guess if I go back tomorrow and it's grown to 17 that might be okay for EC on Saturday. But I wonder has anyone done a natural cycle with a slow growing follicle and will day 18 for EC be okay?
> My lining is triple and just over 8 so no issues there! I wonder if the wee follicles not going yet has affected the slower growth this time!
> 
> But any thoughts or advice or tips to manage my consultant are appreciated. Was told today to please relax and of course come for scan tomorrow if I want, so they are good. But this closed Sunday is a pain.
> 
> Am so sorry to just jump on your thread and ask for help though! Wishing you all lots of luck and positivity for your cycles too.
> 
> Briss, am thinking of you lovely lady. So not long for you now. Hope you are keeping well just a little hello to you if you still pop on here.
> 
> Thanks
> 
> Apples xx


Plus, don't go by what you had/did before. I don't think you got a BFP from it so you don't know it was a good quality. This slow grower might be better quality, and might be worth the wait.


----------



## apples2014

Kelly thank you thank you thank you.

This is literally what I need to read. It makes sense. 

If I am being truthful this is absolutely our last try you see. Lucky round 7. We have signed up and completed paper work for embryo adoption ( we both have issues so both serum and Gennet and our London clinic recommended this but we've kept going until we feel we ready. And we are there now but the matching process for embryo adoption takes up to 4 months so this is a natural cycle last attempt whilst we wait for our match which is expected to be around April)  but for that reason I am overly flapping I think. 

Cannot tell you how much I appreciate your reply. My head is telling me no cycle is the same, stop flapping  but I just feel really worried  and I hate being like this! 


Thank you. Sending you good luck with your frosties am grateful for the reply x


----------



## ladybug8410

Hi Apples, 
I think we have spoken on one of the other forums before, perhaps failed fertilisation?

I'm very much in a situation like yours. First time doing a natural modified cycle and I'm petrified I am going to ovulate or my dominant follicle will disappear! I am currently on Day 14 and on my scan yesterday, my lead follicle was only at 13-14mm. I was worried I would be ovulating soon as my normal cycles can be as short as 28 days. They wanted to rescan me on Friday (so 3 days after last scan) and said no need for any blood tests either. They are predicting EC will not be till Sunday/Monday which will be Day 18/19 for me. I panicked and pretty much insisted I return for a scan tomorrow and had blood tests done. Clinic was obviously on the ball as bloods were absolutely fine and agreed they will rescan me tomorrow. My point is I prob need to trust my clinic more as they definitely know what they are doing!! I was also starting to panic when everyone I read doing a natural cycle seem to be having EC by Day 12/13 but I guess some of us just need a bit longer. 

I really hope this cycle gives you the BFP you deserve! All the best!


----------



## mikki

Hi ladies,
I'm new to this forum and haven't been going through IVF yet as not very keen on the drug side of things. Also have problem my body not tolerating medical estrogen very well (cannot use the pill for instance), so am keen to explore natural/modified or mild IVF, where Create seems to have good reviews. I'm 40 years old and DH 42. 

Any experiences on Create, recommendations on doctors or any other comments would be very helpful!

Many thanks,
Mxxx


----------



## apples2014

Hi Ladybug 

A cycle buddy! It's lovely of you to reply and I do remember you from the zero fert thread. Thanks so much for sharing your thoughts too. So it appears we are a pair of slower growers this cycle. I really hope you doing okay! I feel a lot calmer than earlier. What can we do? Nothing Ah! Just have to wait and see. Glad your bloods were good that's reassuring. Gennet don't check bloods on natural but neither did my previous clinic so I am ok about that. 
I really hope you get your BFP too! Will check in and see how you going. So much luck to you! I am just wrapping up and going for a walk. Had nice but big healthy dinner so off for a gentle Prague stroll. 

Mikki I am so sorry I don't know much about Create. My acpunture lady likes them! I am sure someone else can offer some advice. Wishing you all the best! 

Love apples xx


----------



## Annie37

mikki said:


> Hi ladies,
> I'm new to this forum and haven't been going through IVF yet as not very keen on the drug side of things. Also have problem my body not tolerating medical estrogen very well (cannot use the pill for instance), so am keen to explore natural/modified or mild IVF, where Create seems to have good reviews. I'm 40 years old and DH 42.
> 
> Any experiences on Create, recommendations on doctors or any other comments would be very helpful!
> 
> Many thanks,
> Mxxx


Hi mikki I did a 3 cycle package with create after meeting a couple of clinics. Like someone else said I was recommended it by an acupuncturist. Apart from the financial side ( 1 cycle at another leading clinic was almost going to cost as much as my 3 did at create!!) I liked the less drug orientated approach. I didn't bother with an open day but I did pay for an initial consultation with them and other clinic. I felt it important to get one in one with the likely consultant leading my treatment before making a decision. In a nut shell I thought and think create are great. I enjoyed my treatment considering what I was going through! There were some moments of frustration is waiting for a couple of the appointments when things were hectic there and a recurring issue with a fire alarm in the new clinic going off mid appts! but really I'm splitting hairs here! I felt looked after. The consultant was confident, not cocky, and relaxed but not horizontal! I liked his approach. I did see various nurses and consultants throughout my 3 but I quite liked meeting the different experts and having different discussions!! Anyway in a nutshell I'm pregnant now. So that speaks for itself. I'll be going back for a FET in the future and if they don't work I'll go down the route of natural modified with them again.

Good luck deciding your gut will tell you. But worth if you can afford to book an initial consultation and come loaded with questions for the consultant which are specific to you x


----------



## ladybug8410

Hi mikki

I am with Create too and my sentiments are similar to Annie really. I have been to 2 previous clinics and in comparison, Create do seem more friendly and relaxed with things. They are fairly flexible with scans in that when they suggested I could wait a few days before my next scan, my neurotic side kicked in and I really wanted a scan sooner, they were obliging. Of course after my scan today, the consultant was right in that I could have waited till tomorrow as my follicles are growing ever so slowly! Makes me think they do know what they are doing! They also scan on Saturday and Sunday without hesitation which is a relief to me. They have been good about calling back with blood test results etc which doesn't always happen in other clinics. Most of the staff seem to know patients by first names and seem genuinely friendly rather than some places where you can see they are just making compulsory small talk! There are negatives too - appointments rarely run to time, car parking issues but all in all, I think those are small prices to pay if they get the more important stuff right! 

In regards to not tolerating medications well, I have to say I thought this cycle will seem a lot shorter/less injections compared to my previous full stimms short protocol cycle. On the practical side, I haven't really found that as you are still doing 2 injections a day and scanning every couple of days. Plus if your cycles are anything like mine, you are nowhere near ready for collection on Day 13 as they predict initially. Blood tests costs have also started adding up as I think we were only planning on needing 3-5 but have definitely crossed that point! However, you are getting a lot less in terms of dosages of medications so you do feel side effects less. 

I don't have a positive pregnancy to show for it yet as I am only in cycle 1 of my 3 cycle package but I'm hoping i will soon have positive news like Annie! Good luck with your choice!


----------



## mikki

Thank you so much Annie and Ladybug, these answers definitely make me more comfortable going on with Create. Do you have any recommendations of consultants? I've now booked initial consultation with Dr Chouliaras as he was the only one having availability next week. Would be good to know if you have any experience with him?

Also, in terms of the drug dosage, do you see much difference between Natural modified cycle (on web page it says 3-5 days stimulation) and mild IVF (web page reference 5-9 days stimulation)? I suppose the dosage really depends on your personal circumstances - my AMH is 9ish and FSH also okay, but would just like to keep the drug level as low as possible, however at the same time trying to optimize the follicle growth.

Thanks again lovely ladies!!


----------



## Annie37

Hi mikki he was my consultant so you are in good hands. But again they spread the load so you won't see him every time and they obviously report and discuss each patient with the lead. He is a nice man.. Pretty chill!!! 

It does depend on personal circumstances if you click back on some of my old posts you'll see I discussed my doses. In all honestly you won't know how you will react until you try IVF. That's the beauty of 3 cycles you can learn pretty quickly what your body responds best to. For example I can produce lots of eggs for a low Amh under a reasonably high amount of (by the way initially good quality) eggs stimulation ie 300 -350 per day of gonal f or gonal and menopur mix but having 13 eggs in one cycle resulted in one good 2 day embryo. So my last cycle was just a kick of stim from day 5. And had same result really and it worked!! 

Good luck with your appt!


----------



## Moomin16

Hi ladies

First post here so bare with me as I am not entirely sure what a lot of these acronyms mean so if anyone can point me to a link that would help that would be great! 

I also am with Create and on a second mild stimulation full cycle. My story in a nutshell is stage 4 endometriosis and not been able to conceive for almost 3 years now. I am in the middle on the dreaded wait to see  if this cycle has been successful or not and have a week to go and have been doing really well so far but today I have lost it. I feel really teary and emotional and am convinced it has not worked again. I am sure this is because I am due to start my period next week and feel terrible. I am on 800mg progesterone a day and the blood thinning injections. I am not sure if perhaps this is what is making me go mental    Has anyone else had this and had a positive result?

Create is my only experience of an IVF clinic and from reading what most of you are saying I think we chose well. They are friendly and I hear you on the car parking and appointments rarely on time but it isn't so bad that makes you want to want to leave.  

Anyway just a little hello to all


----------



## jumpa

Hi Senorita, don't normally post but jus wanted to say that you are not alone. I'm also at Create and also have endo. Had mild cycle with them a few years ago and just had a natural modified one. Out first tx didn't work (I didn't respond that well to the mild stims) but then by some miracle went on to have a natural bfp. I think they are great and really agree with their whole approach. 
2ww is reeeeally tough, but hang in there. Hugs.
J x


----------



## ladybug8410

Hi Senorita, good to know there are others on this board who cycle at Create. How did your first cycle go? Are you doing a 3 cycle package? 

Jumpa, what about yourself? You sound like you had just the one cycle. All the best with your 2ww!!

AFM, I am waiting for EC on my first cycle. It feels like it has taken forever to get here; now I am not sure how I will wait for 3 whole cycles before doing a transfer!! Does anyone know what happens if I decide to do a transfer on my 2nd cycle rather than wait for 3rd?


----------



## kipperfish

Hi All.

I'd really love to hear any advice/stories from those who have undergone MILD IVF, or natural, especially at CREATE. 

I was lucky enough to conceive a wonderful daughter naturally 3 years ago after many miscarriages and ectopics but sadly after another ectopic I have now lost both my tubes and therefore we need to go down the IVF route.  We already selected a clinic nearer home and were about to start conventional IVF next month however having been our drug prescription yesterday we are now back tracking fast (!! so many drugs!) and have booked an appointment at CREATE FERTILITY.  It just feels to us that since we know we do not have an issue conceiving we should start with a more mild approach.  I already feel better about this decision whilst being aware that it may limit our changes.

Anyway, any stories of success or failure with NATURAL, MILD or CREATE FERTILITY would be so appreciated.

Many thanks


----------



## kim2406

Hi Kipper25,

I am currently day 5 into my first cycle with Create on the mild stimulation. I have felt really supported by them and feel that the approach they have is very caring. However, I do not have anything to compare it to as this is my first time and I have not used a different clinic before. The injections were all really well explained to me by the Head of Nursing at the appointment especially to discuss these and I have been able to contact her by email since then with any queries I've had.

x


----------



## kipperfish

Thank you so much, would love to continue hearing how things go for you. Hope to stay in touch. We have a consultation with them next week and nurses appointment the same day, hoping to hit the ground running. Many thanks x


----------



## Moomin16

Hi Jumpa!

Hi Ladybug! My first cycle was as for everyone a little daunting. I did feel like I had gone back in time into a biology class haha. Well I was lucky enough to have a brief implantation but it did not stay very long. They rang me to say my hcg levels were low but high enough to say I was pregnant. I had to go back and get re tested and then it all ended. I have tried to hold onto the positive from this in that it was the first time I had ever been pregnant in my life  and now need to remain positive.

The second time round has been very different as I was put on a lot more drugs post implantation (usual progesterone pessaries, yuck and blood thinning injections and steroids) to help implantation. Let's see how that goes - only a few days more to wait. I also ended up with an infection post collection which did not help at all. My face literally blew up and I was in so much pain. I was not expecting this at all so that was a massive shock to the system but again the team were brilliant, told me to get in as soon as I could and was whisked in straight away. 

Kipper the above was all at Create. They all seem really friendly and approachable about everything. If this cycle does not work I am not sure what my next steps would be but not thinking about it yet. A break will definitely be in order as it is a lot for the body and emotions to take.


----------



## jumpa

Hi Senorita, Ladybug, Kipper and Kim, and anyone else out there!

I've no experience of other clinics because once I found Create I wasn't really interested to look anywhere else. I was already anxious about the drugs and injections and felt like my poor ovaries were on their last legs so kind of wanted to be gentle on them. We were unexplained at the time, endo diagnosis came much later. I really like them tbh. Everyone kind and friendly even when they are busy. I've always felt they've answered my (dumb and dumber) questions. They seem to care, which means a lot.

I had mild stim several years ago and just had nat modified, first of three cycle package, so no ET this time. Just as well really as was in a lot of pain a couple of days after EC. It was agony - couldn't get out of bed - and all for one egg. No idea what that was about as don't remember that from before, but might be my endo trying to tell me something. It went away same day but left me feeling tender.

So basically I def recommend Create. It's still stressful, but tx is very short, less drugs which means it's also a bit cheaper, and natural cycles can be done back to back so as soon as AF arrives I will be good to go again. A godsend at my age.

Hope you're okay Senorita. I think it's a really good sign that you got pg first time. xx


----------



## mikki

Hello ladies,
I had my initial appointment at Create today which left me very confused. I'm 40 years old, my AMH is 9ish and antral follicle count 13, so they proposed me antagonist protocol with 225 Menopur and 0.25 Cetrocide. That's what they call mild IVF, so there is no down regulation, just the stimulation, success rates being 15-20% (have fibroids and endometriosis which can decrease my personal success rate). 

What gets me confused is that I've also seen CRGH and they also suggest Cetrocide, however with down regulation and their success rates are 40-45%. So I am now thinking if the difference between mild and conventional IVF is really only this 2 week nose spray for down regulation, wouldn't it be worth the effort if it doubles my success rate?

And can this 2 week down regulation really impact the success rate that much, if that is the only difference between the mild and conventional protocol? And maybe slightly less drug dose I presume.

Also reading about Menopur it says don't use if you have cysts or fibroids? I have both, but doctor still prescribed that, so not sure what to think about that...

Sorry a bit of a ramble, but am just starting my journey on this and feel very confused...  

xxx


----------



## Moomin16

Thanks Jumpa - yes I think it is a good sign too and just holding on that really. Perhaps my endo is what caused so much pain after EC too. Never thought about that. It is a funny thing endo - I have this knack of just ignoring it and pretending it is not there making my life a misery.

Mikki it is confusing and I am not an expert by all means but you do seem to be making sense. Are you 100% about the success rates CRGH? 
I would drop the Create team an email to explain your thoughts and see what they say? They do know what they are talking about but perhaps need to explain it a bit better? Then I would weight it up and you are right - if it is a nasal spray then just do it. Wish you the best!


----------



## jumpa

Hi Mikki, can't explain CRGH's protocol, altho two weeks nasal spray does sound pretty painless so I would feel the same way. 

Re: success rates, I try to be dubious about the numbers they give us because how can they know? Esp if you haven't had tx before so they can't know how you'll respond. I guess this is why ARGC does a monitoring cycle first so they can see what the drugs do to you.

My impression is that Create's published figures are typically lowish because their patients are usually older and have had failed cycles elsewhere. But then when they speak to an individual patient surely they base it on what they saw in your scan and your history. Sorry, that prob not very helpful.

But if you've questions about the tx then it's worth getting in touch with them, esp about the cyst/fibroid thing. I'm sure people come back with Qs all the time. THere's a lot to take in.


----------



## jumpa

Hi senorita, I'm really really not an endo expert, but I think the pill is used to control endo symptoms and works by suppressing the ovaries, so I figured that stimming might not be a good thing. Think there have been ladies on other threads whose endo has gone crazy after ivf. But CD be my little brain working overtime! Still not looking forward to AF. We'll see.


----------



## elcorta

I'm very grateful for this discussion thread, has really helped me and my husband weigh-up our decision whether to go with IVF treatment. Some very interesting information and its good to here it from those that have already gone down that route.


----------



## jumpa

Welcome Ellie, totally agree FF is an absolute lifeline. Good luck with whatever you decide to do x x


----------



## Blueestone

Hi all

I'm about to start my 3rd IVF (2 at lwc and now going to create) just popping in to say hi and sending baby dust!

I think I will be starting next month but just depends on the timings as it falls over Easter ... I think the Dr suggested mild modified IVF as I have lower amh 3.4 and fsh 6.6 ( which he said was normal)

Excited to be trying somewhere new and closer to home! 
Blue


----------



## kipperfish

Hello.

Just thought I'd stop in and see how treatment is going for everyone? 

We're booked for egg collection at Create on Sunday, (we've been SO impressed with Create this far).  I take my Ovitrelle injection tonight, wish me luck pls!  I had a scan today, seem to have a good number of follicules, of which at least 5+ are large. Let's hope there is a good number of eggs also.  I'm hoping my bloods stay on normal track as we'd really like to try a fresh cycle, I've been having some light period ache today and boobs are sore so hoping the Ovitrelle doesn't make it worse. If I look to be getting hyper stim then we'll go for frozen after collection but hoping for fresh! Apparently the cramping is normal  as you near egg collection so that was reassuring. Anyway, hope everyone elses treatment going well. 

x


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## Xtina

Kipper, I really hope your egg collection went well on Sunday and I'm keeping everything crossed for you! I've decided to go with Create too - I've got an appointment with a nurse on Friday to go through my treatment protocol (natural modified) with the anticipation of starting a cycle sometime in the next couple of weeks. All the best to everyone too!


----------



## Ivfsiren16

Hi
Would like to join in... I am about to start IVF #5 which will be a mini. 
I will be doing 100mg of Fertomid from day 3-7 and 225IU Menopr Days 4, 6 and 8
I haven't responded well to full ivf (300IU Pergoveris with estrogen) max 6eggs - about 75% fertilisation usually and good quality blast but no implantation. AF always arrives about a week after transfer


----------



## katkat2014

Hi ivf siren, I also just started a mild cycle. Letrozole days 1-7, gonal f 150iu days 2-11. Yesterday had day 9 scan and 2 follicles at 17mm not playing ball as they're dominant and then about 5 follicles behind at 12mm or less. Fx this won't get cancelled and the small ones pick up...   was just tubing have you had your progesterone tested 7dp transfer? You may be low on it if you get your period that early


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## kipperfish

Hi all.
I'm going for egg transfer this morning. Eek
I had gonal-f for 8 days, 11 eggs, 8 mature, 5 fertilised, 2 top grade. 
Wishing me luck and of course wishing you heaps of luck. Stay in touch X


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## Ivfsiren16

katkat2014 said:


> Hi ivf siren, I also just started a mild cycle. Letrozole days 1-7, gonal f 150iu days 2-11. Yesterday had day 9 scan and 2 follicles at 17mm not playing ball as they're dominant and then about 5 follicles behind at 12mm or less. Fx this won't get cancelled and the small ones pick up...  was just tubing have you had your progesterone tested 7dp transfer? You may be low on it if you get your period that early
> 
> Thanks Katkat - I have asked RE is I can use PIO this time around
> FX those little ones catch up, I think you still have time.


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## Xtina

Just dropping in to say hi and I hope everyone had a great Easter, ivf-wise and otherwise! I'll be triggering tonight with egg collection at Create on Friday so I'm keeping everything crossed, this is 'strike one' of a three cycle natural modified package, so here's hoping....
Good luck to everyone too x.


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## Orchid-1

Xtina-Fingers crossed for you. Sending u positive vibes


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## SMFoxing

Xtina good luck today xx

Been stalking this chat for awhile ... Waiting for AF to start so we can begin our next cycle with Create! Fingers crossed this is our year!


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## Orchid-1

SMFoxing - waiting for my AF too Lol - all the best to you.


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## Xtina

SMFoxing & Orchid thank you for your best wishes and I'm keeping everything crossed for you both too! 

For me, this round, four eggs were collected, one fertilized and this has been frozen as a day 3, 6 cell embie. Two more cycles to go......


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## Orchid-1

Tina- Four eggs - that is great news!  Sending you positive vibes all the way.


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## Merry Mary

Hello - hope it's okay to join in here. I am starting natural modified IVF soon with Create. We are doing the 3 EC, 1 ET package. Our meeting with the nurse to discuss meds is coming up soon with AF expected next week. Though AF is showing signs of making an early appearance. Found out today that my AMH is only 1.2 (I'm 37) which was a surprise since St Barts never mentioned it was low or that I had any issues other than unexplained infertility.


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## Orchid-1

Hi all - my clinic [Greece] has let me down re natural modified IVF -suggesting I have a NMC done in the UK or consider DE with them!
- would take time to sort out another clinic at this late stage. 
- Going to look at Reprofit .....

- meanwhile my period delayed but my stomach feels like my AF is coming.
- taking chinese herbs and acupuncture which helps usually.

Hope all is well with the rest of you ladies....

O x


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## Xtina

Merry Mary, I'm at Create too, I'll hopefully be starting my 2nd cycle of a 3 cycle natural modified package when AF arrives in a couple of weeks - all the best with your cycle, let us know how you get on...

Orchid, sorry to hear about your clinic in Greece - I'm a bit puzzled why they would suggest NMC in the UK...unless the cynic in me thinks that they suggest DE with them because a BFP might be more likely and it improves their stats..... Feel free to slap my wrists on that comment - I'm feeling a bit jaded today..... Good luck with Reprofit and good luck to everyone else too!

X.


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## Orchid-1

Xtina said:


> Merry Mary, I'm at Create too, I'll hopefully be starting my 2nd cycle of a 3 cycle natural modified package when AF arrives in a couple of weeks - all the best with your cycle, let us know how you get on...
> 
> Orchid, sorry to hear about your clinic in Greece - I'm a bit puzzled why they would suggest NMC in the UK...unless the cynic in me thinks that they suggest DE with them because a BFP might be more likely and it improves their stats..... Feel free to slap my wrists on that comment - I'm feeling a bit jaded today..... Good luck with Reprofit and good luck to everyone else too!
> 
> X.


xTina - you might be right there. 
Sorry you are feeling jaded. Do something nice today...
Sending you and everyone positive vibes.  

Been looking at positive affirmations on youtube. Darlene Barton does a good one on 'Chakras' and blue meditations.

re Create - do you guys get the same gynae for continuity of care? Do they do the ET procedure?


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## Xtina

Orchid, thank you for the positive vibes - always appreciated!

Re: Create - The short answer is 'no'. From my experience you have your initial consultation with one consultant, have a meeting with a nurse to go through meds etc., when you start your treatment cycle (for NMC) you get scanned every other day - by a different consultant each time/or who happens to be doing scans that day and when it comes to EC/ET it's very much which consultant happens to be doing EC/ET that day, so it won't necessarily be the consultant you had your initial meeting with - other Create ladies out there, please correct me if I'm wrong..... The only other clinic I have been to is CRGH and I have to say, they are much the same...

Hope this helps - I've only just noticed but there is a specific Create message board on this site, so you could ask there too... http://www.fertilityfriends.co.uk/forum/index.php?board=558.0

X.


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## Merry Mary

Thanks for the welcome Xtina. AF came nearly a week early so I had my day 2 scan yesterday. Was told to start the GonalF on Sunday and come in for a scan on Monday. So it begins...

As for the rotating consultants - I've been told that when you call to make your appointment scan, you can ask who the Doctor will be. A chatty lady in the waiting room told me she likes a specific consultant and tries to make her appointments with only them. Not sure how that's entirely possible given how day to day this process is, plus trying to fit in the scans before work means you don't have much choice other than to take whoever is on duty.


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## Xtina

Merry Mary - Good luck! Keeping everything crossed for you!   

X.


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## Juju44

Hi everyone,

I'm new to this group. I'm with ARGC and due to my high FSH levels (over 10) for the last 3 months, they are recommending a Natural cycle with mild/low stims for May.  I've seen a few ARGC ladies on here post, so wondering how you got on with your cycle?

Also, if you are doing this cycle, is the downtime shorter between cycles i.e would I be able to do this again the following month if unsuccessful?

thank you
Julie


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## Juju44

Hi all, found an interesting site/article on Japanese mini IVF/mini IVF. Obviously, it is tailored to that clinic, but an insightful read as I'm embarking on this treatment and was interested in finding out what it entailed and why it was called Japanese mini IVF. One noticeable difference, my clinic have said they won't freeze, and would put back in as better success rates, in case the embryo doesn't survive the thaw, so I don't know if they would use Clomid, as it thins the lining.

http://www.infertile.com/creating-new-hope/
http://www.infertile.com/mini-ivf/ (success stories)

Mini IVF vs IVF

Mini-IVF was first developed by the Kato Ladies Clinic in Japan and then perfected and popularized by us at St. Luke's Hospital in St. Louis. It takes advantage of your own natural FSH elevation with an ingeniously simple protocol that strives for smaller numbers of better quality eggs. Instead of massive doses of expensive hormones to try to blast out a few poor quality eggs, it more naturally teases out of even older ovaries their best quality eggs with a carefully devised protocol of minimal stimulation. There are no symptoms of huge hormonal swings or hyperstimulation. It is easier on the patient and much cheaper than conventional IVF.

Our approach to minimal stimulation (Mini-IVF) allows us to retrieve just as many (or few) eggs from the woman as more expensive, conventional stimulation protocols, but better quality eggs and at a lower cost with essentially no complications. We can freeze the embryos with impunity (our freezing does no damage to the embryo whatsoever) and then transfer them back to you in a later cycle when the uterine lining is more perfectly synchronized to the stage of embryo development than during a stimulated cycle. This all adds up to better success rates in even the most challenging cases, and at far less cost and aggravation for the patient.

Success Rates

Mini-IVF is tricky to perform well and many centers are not up to it. It is easier for the patient and more difficult for the doctor. There is no margin for error. There are several reasons for the success we have with these much lower cost mini-IVF techniques.

The success of this approach depends not only on a novel endocrine stimulation protocol, but also upon a flawless method of embryo freezing such as our vitrification system, and the highest level laboratory air purification system to give the eggs especially from older women the best possible environment in which to develop.

With our mini-IVF approach of storing up vitrified embryos month by month in older women, we have remarkable pregnancy rate even in women over 42-years of age of over 50%. But it takes a great deal of patience on the part of the patient to retrieve just a few eggs at a time every month until enough embryos are banked to warrant thawing and transfer. In addition, the endocrinology of mini-IVF is very innovative and requires close attention to each individual patient to avoid premature ovulation.

Is Mini-IVF Always Used ?

No, it is most useful for older women and women with low ovarian reserve. There are still many patients who are happy with conventional stimulation. However many of these women also prefer mini-IVF because of the lower cost and the lack of any risk of hyperstimulating syndrome.

Cost

Better results are the ultimate method for cost savings but also our charges remain very low to reasonable because we don't try to empty your wallet with unnecessary testing and low yield procedures prior to your IVF.

Process

Mini-IVF is designed to recruit only a few (but high quality) eggs, thus avoiding the risks of hyperstimulation, reducing the number of injections and dramatically reducing the cost of medications. In many patients who had very poor quality embryos with conventional IVF stimulation protocols, mini-IVF dramatically improved their embryo quality and resulted in pregnancy in otherwise "hopeless cases". This approach is not just a simple-minded reduction in hormonal stimulation. It is an ingeniously conceived and completely different stimulation protocol that saves the patient much of the complexity and cost associated with more conventional IVF protocols. Here is how it works:

On day 3 of the menstrual cycle, you start on a low dose of Clomid (50mgs), but you do not stop the Clomid in five days, as is usually the custom. You keep taking the Clomid until ultrasound monitoring shows the follicles to be ready for ovulation. A very low "booster" dose of gonadotropin (just 150iu of FSH) is added on days 8, 10, and 12. Clomid not only stimulates your own pituitary to release FSH naturally (by blocking estrogen's suppressing effect), but when you continue the Clomid (a new approach), it blocks estrogen's stimulation of LH release, and also usually prevents premature ovulation. Thus, with this simple change in protocol, the old-fashioned, inexpensive Clomid is able to stimulate the development of great-quality eggs for IVF.

Another advantage of this protocol is that you do not have to go on Lupron first to suppress the pituitary. Staying on Clomid blocks estrogen from stimulating your pituitary to release LH, and this added effect of Clomid will prevent premature ovulation. This means that you can be induced to ovulate with just a simple injection or nasal sniff of Lupron. This causes a more natural LH surge and avoids the defect caused by the prolonged effect of an HCG trigger. This leads to more "natural" maturation of the eggs.

The next step is to recognize that Clomid has a temporarily negative effect on the uterus (because it blocks estrogen's support of the developing endometrial lining). That is one reason why results in the past have been so poor with the use of Clomid for ovarian stimulation. The embryos are less likely to implant in such an endometrium. But that problem is now easily solved by using the Japanese protocol for embryo freezing, "vitrification" which I discuss elsewhere. We can now freeze the embryos almost with impunity using this approach. Then these embryos are transferred a few months later in an endometrium that is more perfectly receptive.

For poor prognosis cases of older women with low remaining ovarian reserve, there is a huge advantage to mini-IVF over high-dose stimulation. Such patients normally yield very few eggs anyway, even with huge megadoses of gonadotropin. If they have any good-quality eggs remaining, mini-IVF is just as likely to yield as many eggs as giving huge megadoses of gonadotropin which in a sense would "poison" those eggs because of too high a level of FSH. Even in the worst case scenario, if there are no good eggs left at all, at least you can discover this with only $500 spent on drugs instead of $7,000 (the cost of the maximum dosage).

Clomid only prevents premature LH surges 90% of the time, so we cleverly prevent premature LH surges even in thse cases by paying close attention to each individual patient, monitoring their LH very attentively and by using both a low dose of GnRH antagonist and indocin when needed. So we never encounter the problem most physicians fear, of premature ovulation.

/links


----------



## lexyla

hi Julietriett, 

thanks for these great info on mini IVF. Does ARGC offer mini IVF? it s not the same as a natural cycle am I right?
. I have a high FSH too and was told last week by the ARGC nurse that i might have to do a natural cycle. I dont know much about this procedure. I have started looking online and what i found was not great and i scared myself.  Could you please tell me what you know aboutwhat a natural cycle is?
Do you know about their success rate?

Thank you so much!!


----------



## sunflower98

Hi ladies, I was wondering if anyone over 40 tried natural or mild IVF in the UK or abroad. Could you please tell me about your experiences? I'm considering trying this as the next step after two miscarriages (2012, 2014) no BFP since then. We had 1 IVF cycle in March in Spain where I produced eight eggs and four were mature and four fertilised. They tested two blastocysts (PGS) but neither of them passed the test to be transferred  I'd like to find a new clinic to do another attempt. 
I've done some research and natural cycle IVF or mild stimulation IVF cycles are better suited for ladies over 40 and I'm considering this as our next step. I wouldn't mind going abroad again for this. Has anyone tried this and had success? May I ask where? Do you know  good clinic abroad that does natural/mild cycles?


----------



## katkat2014

Hi lexyla, I don't know about ARGC but have been to an open day at Create and they basically say natural IVF will just focus on the one (or two) eggs that you grow naturally without medication, then trigger shot at the end and IVF. They say you have higher success rates with modified natural IVF where you get a small amount of drugs at the end before ovulation, chances are you have more eggs available, say two compared to just the one. And then there is mild IVF in different forms (I take letrozole and gonal f together from the beginning of the cycle) as described in the previous post.

Sunflower,  I am 40,  I do mild IVF but I am doing it in the Czech republic.  Haven't had success yet, but had my first implantation with early miscarriage recently (IVF no. 6; the last 2 were mild and gave me 2 good quality blasts/embryos to transfer each time; while the high dose drugs must have killed the quality of my eggs as I only ever had 1 to transfer previously).


----------



## SMFoxing

Hi lexyla and sunflower 
I'm with create - I'm doing their three cycle package of naturally modified. Basically I have a scan on day 5 and then inject with low amount of stim (150) introducing cetrotide when the follicles are s certain size. Then when my follicle is big enough they collect.  

I've done two cycles  so far and they've collected one egg from each. Both have fertilised and we have two 3 day embryos on ice!  Starting the next cycle in Juky probably.

Not sure on the details of transfer as we are taking it very much one day at a time.

We decided this was a good option for us as I've had three normal cycles and got 3 eggs 2 fertilised, 2 eggs 2 fertilised and 1 egg which fertilised and u was on the max drugs and felt awful!

I've found collection with create has been totally painless. The day after the first collection I did a 4 mile run. After my third normal collection I couldn't move for 4 days. 

Let me know if you have any questions
S


----------



## Orchid-1

Pritamin said:


> Hi girls, so I just had my baseline hormone profile results that was to decide if I can finally start treatment after 5 months of immune treatment and the answer is no. My FSH came back 14.4. It's never been this high (it was always borderline around the 10 mark) and I'm just really fed up and don't see it going below 10.2 which is ARGC's threshold to start treatment.
> 
> I guess I just need some reassurance, tips what to do to get it back down again.


Pritamin - you've probably thought of this already but it may be worth calling other clinics who do natural, mild, with no waiting list, as back up. Not sure how you feel about going abroad but Reprofit does natural, mild and some of the Greek clinics do this as well where their limits for FSH are not so rigid. They have a high rate of success and are cheaper than the UK.

Good luck.


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## Chocolatebox

Hi Ladies 

I would like to know for those ladies who have tried natural cycles, how closely they were monitored by their clinics to ensure that ovulation didn't take place too early and therefore loose any eggs. Last year I tried four natural cycles at Gennet, and twice I ovulated and lost the eggs.

I would love to cycle again but am worried that this may happen again, i feel a blood test would have been good during the monitoring phase rather than just scans. Could someone please advise if this is the protocol at other clinics as well for natural cycles? Are there any other clinics that are good for natural cycles?

Thanks xx


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## Briss

Chocolate box, I usually have scans as well as bloods i.e. LH, oestrogen and progesterone , i only fly for EC if my oestrogen is high enough, progesterone is low, and LH is acceptable (I tend to ovulate early so often have very high LH early on), and also my dominant follicle is 17mm+ and lining is good over 10mm. I would not just rely on scans. having said that I missed ovulation many times it's just one of those things, sometimes it's hard to get it right. the month I got pregnant we also almost missed my ovulation but my CBFM gave me a peak and from experience I knew the egg was still there and won't be released until the next morning so I begged my clinic to schedule emergency EC and we managed to catch the egg even though I did not have the trigger shot and did not know my levels. there is an element of luck in natural IVF. 

I also find indomethacin helps me keep the follicle intact from trigger shot until EC. on the cycles where I was not taking it I lost eggs and none were collected at EC.

I liked Reprofit in Brno but I got pregnant with a small clinic in Munich.


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## Lily0750

Hi ladies,

I see you have the wealth of experience with different types of IVFs. I will try to read the whole thread this week to understand what to expect.
My protocol will be 10 days Menogon 450iu, plus Letrozole tablets first 5 days and Orgalutan injections the final 5 days. I have regular periods 25 days so will follow the periods without using BCP.
Just curious how my protocol would be classified: natural modified, mild or full stimms?
I understand 450iu Menogon is quite high. Can this dose cause OHSS even if taken for 10 days only?


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## katkat2014

Hi lily, I don't know what menogon is but to me it looks like a full stims cycle with a dose of 450.

Briss, so when you have say a 22mm follicle and give yourself the trigger shot that day, on a natural cycle would it mean you only ovulate 36 hours later after trigger for when EC is scheduled, or could it be that you already ovulate say 12 hours later and miss the egg for ec? On a natural cycle, do you transfer day 2? And would clinics allow you to tape letrozole for a few days or would it have to be 100% no drugs? H

Chocolate box, I  am sorry but don't know the answer. I was with Gennet and changed to reprofit and I know they also do natural ivf - should my current cycle me a bust then was thinking of trying a natural one with them this coming month if I am allowed to.


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## Briss

Lily, I also don't know what menogon is but 450 must be full stims. natural IVF is no medication, no stims. mini IVf is lower doses of stims, 450 is one of the highest doses of stims you can get. you can develop OHSS but this is usually if you have good ovarian reserve.

katkat, on my cycles I had a trigger when my dominant follicle was 18mm+ on natural cycles they schedule EC around 35 hours after the trigger shot. sometimes sooner. in my experience ovulation is very unpredictable regardless of the trigger shot I can ovulate at any point before EC and often did. that's why I relied so heavily on indomethacin , it's controversial but for me it worked. as soon as I did the trigger shot I took 50, the next day after trigger 3X50 and the last 50 on the morning before EC.this is to ensure that the follicle does not rapture before EC so the egg stays in and waits to be collected. 

I had cycles where I ovulated the next day after the trigger shot or even just before EC . I personally do not believe in empty follicles so if no egg is collected at EC it's most likely that you were late and the egg got away. 

I always had 2 day transfer. in my case there is no point waiting any longer because I only have one embryo per cycle (if I am lucky!) and I believe it belongs in my uterus so the sooner it gets there the better. if I had several embryos I;d probably wait longer and transfer the best quality one to reduce the risk of miscarriage .  

I do not know what letrozole is for. I never used it. generally clinics like medication and they prefer natural modified IVF to just natural. this is so they could control when you ovulate. In my case this is precisely why my cycles did not work. somehow egg production/maturation is a very delicate process (again for me personally) and any interference disturbs the balance and it often affects egg quality. so after trying for so long I just know my best shot is to let my body grow the egg without any medical help. where we need lots of help is picking a good quality sperm and getting that sperm inside my egg


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## katkat2014

Thanks briss! This indomethacin have the Dr asked you to take it or did you resarch this yourself and just bought over the counter? Assume you only ever booked your flights once you've set the trigger, and one way only? Just trying to work out logistics. 

We have male factor too and we have sperm frozen in Brno to make it all more flexible. We wanted to do picsi again but am in 2 minds if to look into imsi for a change but don't think reprofit do that. If anyone has any input about imsi vs picsi please let me know


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## Lily0750

Many thanks, Brussels and katkat2014. Menogon is the same med as Menopur. I had to order the meds from Team Miracle Cyprus as my GP refused to rewrite and signed the prescription.
I have another 8 weeks before I start my meds.


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## Briss

Julie, just to answer your question. it is possible to have natural IVF every cycle. thats what i did. the only thing is with natural IVF it's not every cycle that you get to EC, sometimes ovulation is missed and hormones are not quite right so have to skip a cycle. also if you had ET the previous cycle and is taking progesterone this may mess up your next cycle so if you had a bfn and want to try again the very next cycle I'd recommend stopping progesterone a little earlier.

Orchid, how are you doing? did you chose a different clinic for natural IVF? I just read your diary, could have written this myself! wishing you every success and hoping to read about your bfp soon

katkat, I first heard about indemetacin from Create, they recommended it on my first natural modified cycle because my LH went up despite cetrotide so they were afraid we will lose the egg. we did not. however, when i had a mild stimm cycle with them they told me not to take it because of the stimms and sure enough we lost one egg so from then on I just took it despite what other clinics were saying about it cos I just know it works for me. there was one other cycle with Retrofit where I did not take it and we did not collect any eggs even though I had 2 follicles. I just do not want to risk it any more if my LH is high i take it without asking anyone. I used up a pack that I got from CRGH and you need prescription so not sure yet where I am going to get it now.

I only book flights once i know that EC is scheduled and was told what time to take the trigger. logistically it's a nightmare particularly cos I was working full time but basically what I do is as follows:

*trigger day:* in the morning I have my scan/bloods; get the results around noon and immediately send these by email to the clinic; they usually revert by the end of the day with instruction to take the trigger that same evening and schedule ec the day after in the am. at this point i book flights (one way for myself and return for DH) for the next day pm. book hotel for 2 nights. get annual leave for 3 days (EC day, fertilisation day, ET day)

*day after trigger*: we fly out late at night after work (so we do not need to take annual leave for this day) and check in at the hotel.

*EC day*: i have EC in the morning. DH returns to London in the evening. If no eggs are collected i book my return flight on the same or the next day. if egg is collected i stay the night waiting for fertilisation report.

*day after EC*: in the morning the clinic tells me if the egg is fertilised. if not I book the return flight the same day. if yes they schedule ET for day 2 which is the next day. I book my return flight for tomorrow evening and book one more night at the hotel or change hotels if necessary.

*ET day*: I check out of the hotel, have ET and fly home in the evening.

*day after ET*: I go to work PUPO feeling grateful we are in with a chance but nevertheless I start planning the next cycle 

re sperm, our sperm was never good enough for PISCI so this is one of the reason why we changed clinics, reprofit stopped doing IMSI they do not believe in it. i do! I strongly believe this is one of the reasons I got pregnant both times in Munich (although they do not believe in IMSi either I had to insist on it). IMSi helps when there is issue with morphology, we have zero morphology  so this extra step in choosing the best (morphologically) sperm was important. but even then I had a miscarriage so it's no guarantee.

frozen sperm does allow flexibility but in our case the count is rather low so I was worried how much would survive the freezing. we are lucky both DH and I were able to book annual leave at short notice although last time I had to make up medical emergency at work...


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## Chocolatebox

Thanks for your replies ladies

Briss many congrats on your little one , I have just read your last post which is so informative.

I also had a feeling that Gennet/ city fertility should have taken bloods as well as scans to track my natural cycle .. I was swayed by their good price and the convenience of getting to city fertility. Thanks for suggesting reprofit I may try with them instead and also try modified natural rather than just natural cycles. I will be having my immunes monitored by dr Gorgy so really trying to find the most cost effective clinic.

Xx


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## Briss

Chocolate box, this is just my opinion but I did not like Gennet/ city fertility combo. I think it's better to deal with Gennet Prague directly. city fertility is very convenient for scans and bloods but i would not trust them to lead my cycle cos they get some stuff wrong. I understand you re immunes are quite costly. i went to Dr G for a consultation but luckily immunes was not my issue, i was shocked by the prices.


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## katkat2014

I found that none of the clinics ever want bloods. About reprofit just bear in mind you cannot fly the night before as they only have limited flights into Brno (morning and afternoon) but if you're more flexible then that's no problem or I flew into Vienna last time, 2 hrs by bus.

Briss, you're hard core   and it paid off!! Sounds a bit like what I've done the last 3 times but it was stressful as never know if I needed to stay to day 3 or day 5 for et. It's so useful what you've posted. You are so well informed and I am certain no. 2 will be on its way soon! Are your fsh and lh OK after the pregnancy?

About picsi and imsi, did picsi last time and maybe it was coincidence but we had implantation! Our morph went up from 100% abnormal to 75% within a year. We thought! But on this last ivf it was 100% abnormal so what I think is that different clinics measure it differently. We have 97% small heads and 3% midpiece defects so maybe imsi is the way forward. Just not at reprofit but that's where the frozen sample is uaaahh. I guess if your count is very low (bearing in mind ours isn't normal either but with 18mil/m and low volume of 1.5ml l we got 5 straws), then you're better off to leave a fresh sample each time. Bit maybe something to consider if you also have to deal with child care otherwise...


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## Briss

katkat, they used to have an evening ryanair flight to Brno. is it not there any more? i agree with you that all this uncertainty and planning and booking in the last minute can be stressful. having done it a few times i sort of got used to it i suppose. I wonder how we are going to manage it all with a baby  I BF so my DD is going to have to go with us for EC/ET. when I go for EC as soon as the egg is out they ask my DH to produce the sample so by the time i am out he is already back. i wonder if he will have to do that while holding the baby now...tricky  oh, things we have to do ... 

I did my bloods and had a scan but things are not quite right at the moment. looks like i have some kind of cycle but  it's all over the place so not ready for natural IVf yet. I started using my CBFM but can't do temping cos of BF through the night so i do not usually sleep for more than a couple of hours. this means my morning temperatures are not reliable to track ovulation. 

PICSI is a good option actually, it's a shame we were not able to do it. our count can be around 1 mil/m so not much , they are also not fast swimmers so PICSI cannot be performed. IMSI can work for any sample. when you say implantation was it a chemical or a MC? both are very traumatic.


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## katkat2014

Hey briss, Ryanair only have an afternoon flight now. Hahaha you had me crack up, on really hope that's not what your dh has to do  
That's tricky about the bf and ovulation, i hope it sorts itself out soon so you can use opks. We weren't able to do picsi until last time, the motility improved from 21% to 66% miraculously over a year (maybe not so miraculously as dp has done a lot of changes and taken all the supplements i fed him!). Briss, have you ever spoken to dr bollmann (Munich) and if so what's he like? Do they do ec and et on a Saturday and Sunday?
My friend just got pregnant with twins there with injections, trigger and timed intercourse  (she's 'only' 37 and they don't really have any big issues so not that surprising)...
Sorry more questions, do you have to pay the full amount if they cannot find an egg at either Munich or reprofit?

I guess it was a chemical, initially my low hcg tripled 2 days later but then started spotting and miscarried at 5w2d so early on. The clotting and bleeding was awful and I don't know how you ladies do this when this happens weeks later. I wasn't too attached yet though, I was still at the stage where I was thinking, what, me, a bfp, on round 6?!


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## Orchid-1

Chocolate box - Gorgy is extortionately expensive. We contacted locus medicus in Greece for the same equivalent tests and it worked out at 1% of the cost of Gorgy. But off course you should do what you feel is best. This is just my opinion.

Briss - Great to have you on this board. You bring a wealth of experience and determination. Glad you found the diary useful.  All the best for your second little twinkle in your eye.  

Lily - just read about your GP and prescription issues. If Team Miracle writes the prescription, ASDA here should be able to fill it. They must fill EU and UK prescriptions according to EU law. This is just for the future.

All the best to all of you ladies.   

AFM Waiting for my clinic to open again. I tried contacting the Munich clinic but no-one held the phone. Did not get a reply back from Dr Noss. Not sure if it was the holidays. So weighing up my options.

It has been a tremendously stressful year. Meanwhile my AF went 'walkabout' for several months due to stress. I have always been irregular anyway. Plus my TSH went off the scale. Sent off most recent blood test yesterday. 
Getting back on the GF diet and trying to keep up positive thinking. I have been having acupuncture once a month which is meant to regulate my period. This time AF is proving reluctant.


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## Briss

katkat, I do not think I've seen dr bollmann, although there were some other doctors at EC once but I do not know the names. generally if you get Dr D Noss for EC/ET you are in good hands. unfortunately they have some kind of problem with EC/ET on weekends which is super annoying. this is the reason why I had to get two more clinics on board last time I was expecting to ovulate on weekend and they said they could,not do it. i really do not get it. in a natural cycle you can't control ovulation. i guess that's why they offer modified cycle but I do not like it. 

in both clinics the price differs depending on how far you get. you pay less if there is no ET. at retrofit we had no eggs collected and were only asked to pay 50 euro!! but I understand they changed this rule now. shame. in Munch last cycle they did not charge us for IMSI, still do not know why. 

I am sorry about your chemical, although it's not as traumatic as MC but it hurts nevertheless. it took me months and months to recover from chemical, somehow as soon as i saw the two lines i assumed that was it and already (within seconds) planned the whole new life that was taken away the very next day. with MC I did not have any such plans but more importantly I got pregnant very quickly after that so had less time to grieve. 

Orchid, I am sorry Munich is not responding. I had this issue when i first contacted them. i think it's after I started cycling and liaising directly with Dr Noss that things got a bit more efficient. even then Retrofit usually reverts back on the same day while Munich the next day. it's not great but they did get me pregnant so i am going to try and overlook this flaw.


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## lovekalkan

Hi ladies I was just wondering if anyone knows of any clinics in North west England that do natural ivf? I have had 3 unsuccessful cycles two with mild ivf at Serum and have always had 1 or 2 eggs fertilise but no bfp so I'm thinking perhaps completely natural next time if I only get a couple eggs anyway.

Many thanks xxxx


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## katkat2014

Lovekalkan, so sorry but I cannot help you as am cycling abroad but am sure one of the other lovely ladies will be able to help you.

Briss, instead of pestering you I've finally read your blog and it's so nicely written and answers all my questions. You went througj quite a bit but am so happy for you you got there in the end. Almost all questions answered, but here's another one if you're reading sorry   . I am 12dp2dt today and had af type cramps last night and back pain for a week, so possibly heading for a bfn. Am not allowed to test till 18dp2dt! Because of the hcg booster shots grrrrr. I am on quite a high  dose progesterone of 800mg pessaries and prolutex injections every other day so would assume my period will stay at bay unless I stop it all. If I wanted to do a natural icsi starting right right next month, why is it so bad to take progesterone so long? Isn't it sort of a clean sheet if you get af which is CD1 and which is when fsh starts to rise and your follicle starts to grow?


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## Orchid-1

Lovekalkan - sorry it did not work out for you at Serum. 
re natural IVF - only know of Create and Zita West's clinic in London who do natural. Not sure about Northwest of England. Can you ask the gynae? 

Hope you don't mind me asking but what was the mild IVF protocol at Serum?

All the best.


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## Briss

Lovekalkan, sorry I cannot help you as I am also cycling abroad. I cycled with Create and CRGH and both offer natural IVF but CRGH is charging quite a bit the same as stimms

katkat, re progesterone, ideally it should be as you say AF comes it's CD 1 and follicles starts growing with FSH, oestrogen etc. and in a natural cycle that's how it works. but what I noticed (and again it might be just me cos my body does not work well with medical interventions) is when my af is artificially delayed by taking progesterone for some reason it does not stop my follicles/fsh/estrogen growing, they seem to be growing regardless of when the actual af started but more from the point when it was supposed to start naturally without the progesterone.  what happens is that I end up ovulating early on day 8 from the actual AF (but which would be around day 11 if my AF was allowed to start normally which is my usual ovulation day), so while follicles are ready my lining obviously does not have time to grow and the cycle gets wasted. but this is not a common issue otherwise people would not be able to do long protocol. I had similar issue on full stimms cycle cos I had to take nothisterone so they could time the cycle and I guess it also effected follicle growth cos my body was trying to ovulate earlier and we had to cut the stimm stage short. 

waiting until 18dp2dt would not be possible for me. I usually test on 11 DPO and then 14 dpo. if there is nothing on 11 DPO I start reducing progesterone 

i never did hcg booster shots but they are still supposed to go down so if you test (bloods) and then repeat in a  day you will see if the levels go up (pregnancy) or down (booster).


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## Chocolatebox

Thanks ever so much ladies xx


I just feel it such a shame that the uk clinics charge so much for natural/modified cycles. Dr Gorgy is eye wateringly expensive, i have also cycled with him, unfortunately I felt that for that cycle my immunes were under control but the very high dosage of meds for my cycle fried my eggs and created poor quality embryos.


I am grateful for the invaluable advice by the ladies on this site xxxx


I will definately look into the logistics of travelling to reprofit as Gennet was very easy to get to given the distance from the airport.


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## lmmttc

Hi all
I am looking into possibly doing mild ivf in april 17. I am looking at reprofit or praga medica (also known as the gest clinic afaik). Has anybody had any experience with either of these? 
Also, I realise that it is probably different for everyone, but what is the average cycle like for this kind of ivf? It's all very confusing at the moment! Also if you go abroad, how long are you looking at being there for? I have a 7 year old dd and feel like taking hwr would be a bit too much to deal with as she is extremely lively lol but I don't really fancy being away from her for 2 whole weeks either! 
Thanks in advance for any replies!


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## SMFoxing

lovekalkan said:


> Hi ladies I was just wondering if anyone knows of any clinics in North west England that do natural ivf? I have had 3 unsuccessful cycles two with mild ivf at Serum and have always had 1 or 2 eggs fertilise but no bfp so I'm thinking perhaps completely natural next time if I only get a couple eggs anyway.
> 
> Many thanks xxxx


Lovekalkan im based in the NW and I've just done a cycle with Create in Birmingham. Bit of a journey there and back and some days were easier than others but it's an option xx


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## katkat2014

Immttc, I did a mild cycle that include 2.5mg letrozole and 150 gonal f and ec was cd15 and another one that was 5mg letrozole and 100 gonal f also with ec cd15. My eggs develop slowly so many other women get to ec earlier than me. I usually fly out the day before and then stay till day of transfer, so a total of about 3-4 nights depending on day 2 or day 3 transfer (or longer for blast transfer). I tend to book my flights only a day before so quite pricey but had to change flights so often that it wasn't worth it to prebook them.


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## dee_30

Hey ladies! Hope u don't mind me popping in!! I'm doing mild IVF with reprofit and currently on CD 7, I started gonal f 125units on CD2  So I had my day 7 scan this morning, my lining is 4mm. I have 6x <10mm on right side, 5x <10mm and 1x 10mm on left side. Any advice on how to increase these numbers??


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## Pritamin

Hi girls, I hope you don't mind me joining this thread. 
I've been in the ARGC limbo since January and we finally got to the point where we can start our first ever cycle which will be a natural cycle. Not what I wanted but at least we are finally about to start.
I don't know much about natural cycles and I can't help but feel that my chances are lower with this type of IVF than a full stim one (which probably isn't true, quality over quantity has been my mantra in the last couple of days) so I would appreciate any advice, tips, positive stories.
Has anybody done natural cycle at ARGC?

I would appreciate any mood booster please 
I will slowly catch up on this thread and I'm sure I'll find some useful info. Xxx


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## ladybug8410

Hi Pritamin, i am not a regular on this thread but have had a natural cycle before so thought I could share my experience.

Before my natural cycle, i had 3 full stimms cycle, ranging from high dose stims to normal dose (if there is such a thing). All of these cycles gave varying number of eggs 6-14 but importantly, i only had 6 mature eggs in total for those 3 cycles. I then did a natural modified cycle in Create where i had Gonal F 150 only. On scans, they were only expecting 2-3 eggs but I got 8 of which 6 were mature. The rest of the story is less positive as we have problems with zero fertilisation but in terms of stimulations, if I were to do it again, i would certainly choose a natural modified cycle with low dose stimms.

Hope that is of some reassurance to you x


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## katkat2014

Hey pritamin, have sent you a pm already as you know but sorry I don't know much about argc. How is the cycle going?

I have a question for those doing a totally natural cycle. Did you take anaesthesia or collect without? I would like to opt for no anaesthetics for this time as think wer are collecting just the one egg. How do you cope? Any tips?  Perhaps some bum pessaries for relaxation? Painkillers?


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## Briss

katkat, i did both with and without sedation. in my case it was painful and my left ovary somehow is more sensitive but it's very quick. I did it in brno and Munich and have to say their technique is different. so the pain sensation was also different. but it's totally bearable. some ladies even said they had no pain at all.


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## Pritamin

Thank you girls for the reassuring words, I've triggered just now so let's see what Monday brings but scans show one "very nice looking" follicle and my lining is also looking "very good".
Xxx


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## katkat2014

Thank you, Briss. I was hoping reprofit would give me some kind of bum pessaries for relaxation but have just packed some paracetamol. Thanks also for your pm! Nervous and excited now. Fingers crossed there's an egg and that my lining grows a bit more

Pritamin, that's great news! Let's hope that they collect a lovely egg on Monday for you and that both or our eggs are our golden one!


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## Briss

katkat, I had bum pessaries in Munich, did not make any difference though. Just remember it really is quick. In Reprofit the first time I did not have sedation but they gave it to me on my second time, I never asked why. keeping everything crossed for your eggie!!


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## Briss

Pritamin, how exciting!! best of luck.


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## grg

How Briss, 

Congratulations for your success! You are an amazing person, and you are giving hope to everybody here.

I read your story, and i have a question for you that you may be able to answer, based on your experience.Like most of us, I started IVF with conventional protocols, having problems of quality eggs, and as i am a low responder, its obvious that no matter what drugs i am getting every time, in all cycling, two blasts.

My last protocol was mini IVF, but end up a MC, like  conventional one,  and we are waiting out biopsy to see if it was chromosomal error. Last MC was a trisomy 20 and i am suspecting that this time will be another trisomy, because pregnancy arrests in 5-6 weeks every time, after slow growth. So I am suspecting that  there is a problem of maturation of my eggs, that are not divided well, something bother them, so, I would like to continue with natural IVF, and let my body to mature alone the eggs, as natural as possible, with the surge of LH, if its possible without an antagonist medication of cetrodite, and i am wondering if in your case, you were using the natural elevation of LH or you were using HcG like Pregnyl or Ovitrelle. I understood that for you cetrodite was not working, so how you manage to control your maturation, in order to collect on time?

Also i would like to ask you if you had a low dose of gonadotropins, or not at all. 

In my case, i have a stable cycle , i ovulate every month in 14 days, and my AFC is about 8-9, so since i ovulate normally, i found difficult to give up my dream, to have my biological child. My DH has has no issues..

Thank you very much, 
GRG


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## katkat2014

Hello again grg! So looks like we're in the same boat - I am.also 40 and cannot give up on my own eggs. I also think that my eggs dont seem to mature well and divide properly when they go through meiosis. Do you think cetrotide would impact this process though? It only stops you ovulating I was told, not the egg maturation process. I did one natural cycle where I had one blastocyst and did 2 days of cetrotide and pregnyl 10,000 as trigger. It was 10 cells on day 3, but then it was slow growing after day 3 and became an early blast on day 6 and was frozen. Independently to that I also had a mc at 5.5 weeks. Does this mean the egg hasn't gone through proper meiosis because of medications and trigger and the cetrotide? That's a new angle I hadn't considered yet....


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## grg

Katkat, yes, i entered at 40s, i try to conceive last 2 years.

Nobody knows for sure what are the factors that eggs fail to be euploid. Its a big debate out there. For sure, lately studies show correlation between high doses of gonadotropins and deterioration in egg quality. I saw it also in my case, I got best quality with less meds. In the meantime, I had some uterine problems that now have been solved. So now theoretically, if i don't stay pregnant, should be because is not appearing a competence egg.  In my case, biopsy of first MC was a trisomy, now I am waiting the second. 

Cetrotide, stops the LH surge, so postpone the maturation, till when we decide to do the Pregnyl shot, for provoke the process of egg maturation. Its not that impacts the process directly, but indirectly. Usually we decide to trigger the shot when we see a follicle 20-24mm and we don't let the body to decide when to mature the leading egg.  But since we don't know, what is behind maternal age and aneuploid eggs, and in order to try to simulate nature as much as possible, I was thinking what if I go with natural selections of egg (natural IVF), and let the body to decide also when wants to maturate the egg, with its own hormones. I am having a regular cycle of 28 days, and a LH surge always take place.. I mean i am not having hormonal disorders.. its an idea, that I think in the case of Briss worked. 

All of this issue i will have to discuss with my Dr. But i believe in my case i should stay as natural as possible, because i think no matter what i do in my age, meds cannot improve quality ..

Last protocol i did, was quite natural and low in meds, and i got 4AA blast fro first time.. I hope i could repeat this several times in order to increase possibilities of a euploid egg..


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## Briss

grr, I can see that you are getting strong fertilisation results on stim cycles. I think this is positive. in my case it was different I never had any embryos after stimulation: there were more eggs but never embryos i.e. zero fertilisation. so I opted for natural IVF because I did not want to go through that again. Natural IVF is a slower process with lower success rates but sometimes it just works better or like in my case this seems to be the only choice. i am not sure you are there yet. having said that nothing stops you from trying one completely natural cycle just to see whether this may work better for you. 

now, your miscarriages may not be connected to stimulation/egg maturation process but most likely it's age related. and unfortunately natural IVF may not make it better. I had a chemical pregnancy and a missed miscarriage after natural IVF. both likely to be due to chromosomal errors. there only thing that can help (as far as I know) is doing chromosomal testing on embryos before transfer. but for this you really need to have a choice of embryos so it has to be a stimulated cycle rather than natural. After my miscarriage i did ask my clinic for advice and that's what they said: stims + embryo testing but because I insisted on natural IVF they said it's just not practical to test one embryo. so basically the risk of chromosomal error and MC is just there whether you do stims or natural. 

having said all that, if you are set to try natural IVF you will find it very easy on your body but a bit stressful cos the timing is very random and it may take a few cycles before you catch that egg.

with regards to medication, I usually used a trigger shot i.e. HcG like Pregnyl or Ovitrelle but interestingly on the cycle that I got pregnant with my daughter we missed my LH surge so I had egg collected the next morning after my fertility monitor had PEAK, so without any trigger shots. I do not know whether that;s a coincidence that this was my successful cycle (completely drug free). but i defiantly know know that you can have a natural IVF cycle without the trigger shot provided you know your body well enough to be sure the egg will still be there and your clinic agrees (it took a while to persuade my clinic to take us for EC without the trigger shot).

with regards to cetrodite, yes it was not working for me and i did not use it on natural cycles. it's not possible to control your ovulation so there is always a risk of not getting there in time. i missed a few eggs, quite a few in fact at least half of my cycles did not even go to EC. just last week the same thing happened to me. my body triggered LH surge before anyone realised so it was too late. one thing I always do and did on my successful cycle, I always take indomethacin from trigger/LH surge up to EC and my experience shows that it does work in a way that I keeps the follicle from releasing the egg. 

on natural cycles I do not take gonadotropins. the only medication I take is trigger shot (optional); indomethacin (optional), progesterone (after EC). this is it. 

it also seems to me that your issue might be more to do with staying pregnant rather than getting pregnant. you have a good cycle, your eggs fertilise, your embryos implant but something happens afterwards. I'd look into chromosomal embryo testing and possibly other reasons for miscarriage (once your get your biopsy report). 

I see that you are with Serum, did Penny suggest anything? has she done your hysteroscopy?


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## grg

Hi Briss, 

thank you for your long answer.

Yes i have strong fertilization rates, they fertilised but always, no matter the doses of meds i have, i always get two blasts. In my last mini natural i had after day 6, 150 merional (FSH/LH) and they collected 6 mature, almost the same i had with high doses, but as a said ..i always getting two blast. The big difference that i saw with my last cycle was the difference in quality, because for first time i had also a perfect 4AA blast.

So i was thinking, why to spend money on loads of medicine and controls, if i always get 2 blasts, and quality compromised.. I am convinced that mini o natural is better if i want to repeat many times.. You are right about age and chromosomal problems.. But my first mc was a trisomy 20, we did biopsy, but this cycle done with very high doses of meds, and the last in serum was the opposite, with the most low ever, and half days of stimming, now i waiting the results of 2nd mc. lets see the report..

P. believes that high meds and especially testosterone (androgen) can bring chromosomal errors, and thus bad quality eggs, so she suggested, hysto and implantation cuts for regenerate endomitrioum and rise its quality, antibiotics before protocol starts, because we saw some infections with video camera, and after mini ifv to get best quality blast. I did all. And i had the best cycle results ever with such a low dose. She also believes that i have some small immunologic disorders, because of the infections that we saw in uterus (were red spots with blemishes all over) and she believe that if that was chronic, some how uterus is raising  the intrauterine defense  by rise of natural killer cells for control the infection, so i took some light preventive dose of steroids and clexan after implantation.. 

I am glad about implantation cuts, because after that, my menstruation blood color changed to very red, and before was most of the days brown and was lasting less days. I don t think that now i have implantation problems any more..

I am waiting the results of biopsy to make the first consult with her after mc to see what she suggests. But i think she will suggest same protocol.. If mc is due to chromosomal anomaly .. i think we cannot do many corrective moves.. She didn´t suggest me banking though.. said i ll have better success with fresh cycles, and she doesn't like invasive approach as PSG.. I think with low a mini or natural once she told me that we should repeat at least 4 cycles before give up.. the point is that i would like to avoid all story of mc if embryo has always small chromosomal errors and implants.. but  there is no way without PSG to know that ...

I saw that you got your baby with the natural surge LH and is very interesting!

We keep in touch, and thank you very much for your time!


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## Briss

grg, I am sorry i am not more helpful on this. miscarriages are so complicating i just do not think they can be explained by stim meds. if you are getting two blasts on mini natural protocol then I'd carry on with that. did you miscarry your last 4AA blast? i do not think stims are to blame here, and 150 is a really low dose, not really stims as such but just getting a couple of additional follicles on board and timing EC that's all it does. 

re Penny's regime, i have to be honest with you I do not believe in uterine infections that Serum keeps identifying in almost everyone. but I do think taking AB by both partners before cycling is a good idea. but do not over do it. doing it once should be enough.

why did Penny mention testosterone? it's not part of the protocol, is it? or your natural levels are too high? 

I am all up for blood thinners like clexan but not sure about steroids or other immune stuff. have you done all the immune tests? did Penny find you have high levels based on the tests (not just hysto)?

if your second biopsy comes back as chromosomal error, I'd definitely carry on with your mini natural protocol (it seems to give you good results) but I'd only transfer one embryo and do chromosomal embryo testing and bank all other healthy embryos. age is so important. I;d also go easy on medication post transfer. unless you have a proven immune condition, I'd just do progesterone and blood thinners. it's a shame Penny is not supportive of banking embryos or doing chromosomal testing. it's all down to lab actually. chromosomal testing can go wrong but lab plays crucial role here. I'd only do it if you trust their lab. 

I did come across talented miscarriage specialists who are set against embryo testing. basically studies show that they do not improve the outcome. (my personal view is that because women have other reasons for MC. not just chromosomal) but they still cannot explain why it would not be helpful in situation where a women keeps having chromosomally abnormal pregnancies. it seems logical to me that if you know you are transferring a healthy embryo (after testing) then either you get to full term or if you still miscarry that means chromosomal is not the only issue and there is something else that prevents pregnancy developing. in either case it looks like a natural next step to me. I will probably do it if we ever get more than one embryo.


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## grg

Thank you Briss, 

Yes, i mc also the 4AA, but ok, i know that maybe was not so perfect as was looking! 
I agree, that stims of mini-ivf are very low to blame for quality, and as you say, i had some more additional follicles on board.

I did the protocol of AB, we both take it DH and me, after I did hysto and implantation cuts, so indeed i think, i finished with this matter. I am sure that everything now are ok in there in terms of infections, if any, and I agree that we should not over do it with AB. 

P. implied that testosterone could be a reason for bad egg quality.. Well, as you know, no Dr. likes to criticize directly other dr´s treatment. But i know that P. don't like androgen, and testosterone is androgen. On the other, here in Spain is very popular for low AMH patients..

I have not done any immune test. And i did take steroid like prednisolone and a session of intralipids, as also clexan and baby aspirin.    

Yes, i agree with you, if second test comes back with chromosomal error, I should carry on with this regime, will give me two blasts. You suggest PSG and freeze.. and banking no? 

Yes Serum is not doing PSG, unless you have a genetic disease.. But, i will discuss it with my new Dr. and Clinic here. I am afraid the cost of PSG it s high and worth if you have many eggs to check..


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## Sunflowerck

Hi Ladies
I've been doing quite a bit of research on where to go for treatment, having researched Czech Republic and Greece (Czech Republic won't treat single women and I would need to take too much time off for Greece). Anyway, I've now landed on Create and their natural/mild methods. My last cycle failed, and although I had 13 mature eggs only one of those fertilised; I'm nearly 43 and I think maybe the best route is to try it with less meds and aim for higher quality. My AMH is 12.9 but I think at this stage the quality of my eggs isn't great.
So I guess I just wanted to get some views on Create and whether to opt for the 3 programme package - it's a lot as I'm doing this on my own but also realistic to think that it might not work again. Any thoughts very welcome.

Hope everyone else is doing well.
Many thanks
xx


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## moorthya

Hi Sunflowerck

I have had two IVF cycles with stimms and produced only 3 eggs the first time and 4 the the second time bothe sets fertilised but first round they arrested on D3 second round I did the transfer on D3 but got a BFN.

Interestingly I have just opted for a natural cycle and they think I have 2 mature eggs - am waiting to see if they have fertilised tomorrow so we shall see  

In terms of egg quality I was told to take Ubiquinol (CoQ10) its expensive but I taken it on the last two cycles and I think personally it helped. I tried DHEA but that also increases testosterone and on the cycle where I used it all the eggs were immature (they did fertilise but the immaturity was because DHEA dosage was too high :/)

For any supplements that you do take you will need to take them for 3 months and I do believe you can get better egg quality but doing this. Hope it's of some use and wishing you all the luck in the world !! xx


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## lechatgris

I am considering Copenhagen Fertility Center for low stim / mini IVF. Has anyone been there? I originally was considering North Cyprus, but now want to switch. However, I just got an email that they could schedule a phone consult in 3 weeks! I want to do IVF in January, during my month break from work, so that seems cutting it way too close, especially if I have to do meds/prep. Does anyone know any other clinics in Denmark that are good in low stim IVF? 

Cheers!


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## Opossum

hi, I am starting Mini at reprofit soon, anyone else?

Im going to be on 150mg clomid per day and 75miu of menopur


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## Cloudy

Bump


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## Colyflower

Hi all

I'm on a 3 cycle natural modified with Create. I've had my first 2 cycles and got 4 good quality embryos frozen. First cycle we had three make it to blastocyst out of four collected and 2nd cycle we had one fertilise out of two collected which also made it to blastocyst. 2nd cycle my follicles hardly reacted to the stims.

I'm now debating whether to give myself a break before the 3rd cycle. I'm thinking that maybe the 2nd cycle wasn't as good because I did one cycle straight after the other. I'm not sure what to do. I know every cycle is different but part of me still thinks that if I give my ovaries a break it might just help.

Anyone have any theories on this?


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## 3babies

Hi,


I'm doing mini ivf at Reprofit currently on day9 
My day7 scan revealed my lining at 5.2mm 
I too was taking 150mg Clomid & 75miu Menopur 
I'm also taking V gel/pessaries twice a day so hoping this helps to thicken my lining by ec


x


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## 3babies

Did any of you ladies either do PGS or PGD with very few embryos? 
My ec is in 2days & wondered what you ladies take on this option is?  

Thanks in advance!


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## Sisi172

Colyflower said:


> Hi all
> 
> I'm on a 3 cycle natural modified with Create. I've had my first 2 cycles and got 4 good quality embryos frozen. First cycle we had three make it to blastocyst out of four collected and 2nd cycle we had one fertilise out of two collected which also made it to blastocyst. 2nd cycle my follicles hardly reacted to the stims.
> 
> I'm now debating whether to give myself a break before the 3rd cycle. I'm thinking that maybe the 2nd cycle wasn't as good because I did one cycle straight after the other. I'm not sure what to do. I know every cycle is different but part of me still thinks that if I give my ovaries a break it might just help.
> 
> Anyone have any theories on this?


Hi, this thread is the best ever, I have learnt the most about low amh and natural protocols. It's a shame it got so quiet lately.
I'm also going to have natural modified cycle in Create at the end of March. I considering 3 cycle package but we can'treally afford it  
We have 18 months old daughter from first ivf, long protocol with max doses of drugs, 5 eggs, 3 fertilised, one put back (2days 4A), no frosties. My amh was 5.7 back then, now is 3.2 and I had another long protocol in Poland. Less drugs, 225-300 and two follicles with only one egg. Put back on day three 8A, ended in chemical. 
Even though in Poland is much cheaper I will do another try here because it was too much stress being away from my husband and having to ask family to take care of my daugter while I had appointments. They were all happy to do it b4 I arrived and then everone was busy. Anyway... this is our last chance. I have IV stage of endometriosis, never checked immunes but i know it often comes in hand with it. Wanted to have steroid, endo scratch, glue and everything but dr said I don't need it. I hope she is right. 
Colyflower I wanted to ask what drugs were you using and how did your treatment go? 
I hope somebody is still here


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## SuperMaria

Sisi172 said:


> Hi all
> 
> I'm on a 3 cycle natural modified with Create. I've had my first 2 cycles and got 4 good quality embryos frozen. First cycle we had three make it to blastocyst out of four collected and 2nd cycle we had one fertilise out of two collected which also made it to blastocyst. 2nd cycle my follicles hardly reacted to the stims.


How did it go with Create?


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