# Understanding my fertility treatment



## rtsaintly (Oct 19, 2007)

Hi all,

I put this on here earlier, then thought I had posted it in the wrong place, so took it off, posted something similar on a different board, but now think it was ok on here to begin with! So -

We are going for fertility treatment with egg donation, through Care in Nottingham. I think everything is going well, but to be honest the whole process is still a mystery to me, and it would be great if someone non clinical could briefly tell me what stage we are at now! Family and friends keep asking, and because I have tried not to get too obsessive about knowing what and when, I think I may have gone too far the other way and am now completely confused!

So far I have had 2 months of a hrt to make my body think it has a cycle. Our donor person was at the clinic yesterday (for a scan?), and we had to ring yesterday to find out whether I needed to start taking the next two lots of treatment (oestradiol valerate and then utrogestan on day of donor egg recovery). We were told to ring back today because there were some blood tests taken.

Also, what is down regulating?! I think this was the point of the donor's scan yesterday!

Any information on understanding what is happening would be greatly received!

Rachel x


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## Marielou (Oct 18, 2003)

Hi Rachel,

There is a good description of 'the rough guide to IVF' here: http://www.fertilityfriends.co.uk/content/view/106/3/ which should explain what your donor is going through.  It describes D/R as this:



> For both the short and long protocols you have to stop your natural cycle - putting you into temporary menopause sometimes this is done with the use of a nasal spray, Synarel which leaves an unpleasant taste at the back of your throat and some people inject burserlin. The effects of this drug can make you very hormonal, hot flushes; headaches etc but some people don't have any side affects to this drug at all. Some people call this part of the cycle the "down regulating��? stage. Before you commence the next stage you may down regulate for between one and it has been known up to eight weeks! You will continue with these drugs throughout your cycle up to the stage they collect your eggs.
> 
> Once you have started your period you may have to call you clinic (or you may already have been given a date for this when you start treatment) to arrange either a blood test or a vaginal scan (this doesn't hurt, in fact it's quite interesting because you can see what is going on, on the screen!) to confirm that your natural cycle has stopped. This blood test and/or scan will show that the lining of your womb has thinned out (from your last period) in order for your body to be clear ready for the cycle.
> 
> Once you have been given the go ahead to start, the next stage is stimulating your ovaries to produce lots of follicles (which will hopefully contain eggs!).


I hope thats helped you!

Marie xxx


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## Bewley (Oct 14, 2007)

Hi Racheal,

Heres a bit more info for you. I've had one failed cycle with donor and about to start a FET.

What you describe as HRT is the drug for downregulation. It in affect shuts your body down and stops you producing follicles. It will be timed so that you and your donor will downreg together to synchronise your cycle. You should have a Downreg scan like your donor once your period arrives to check lining is thin and no cysts or follicles.

Once both downregged your donor will start stimulation to produce follicles whilst you need the oestradial to thicken your lining ready for ET so it can recieve the embryo. If you are downregging with a nasal spray you will continue with this alongside the oestradial to stop your body producing follicles, if it was an injection the dose will have been given so it lasts to continue keeping you downregged whilst the lining thickens. You will have scans to check your lining is getting thick enough whilst your donor has scans and blood tests to check the number and size of her follicles. 

The day of EC will be determined by when your donor is ready and the urogestan you have to take that day is progesterone to prepare your body to recieve the embryo on day of ET. As your body has been tricked by the drugs artificial progesterone is needed to maintain the pregnancy. You will need to continue with the oestradial and progesterone up till test day, if its BFP then carry on till you're 12 weeks pg. You stop the downreg nasal spray the day before EC usually but obviously your clinic will tell you what you need to do for your case but this is the standard protocol

Good luck !
Bewley x


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## rtsaintly (Oct 19, 2007)

That makes perfect sense to me now! I dont need to 'down reg', because I had already gone thorugh the menopause at 27, so that explains that too!

Thank you so much for your time in explaining it to me  Its scan and blood tests for me on Friday, so will keep you posted on how we get on.

Rachel x


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## shellspain (Oct 29, 2007)

Hi Ladies,
hope you dont mind me 'jumping' on your thread!?
I too get a bit confused about the donor process. I have been through IVF using my own eggs but Im about to start my 1st donor cycle.
Bewley - I have 1 small question I hope you can help me with. Ive just had a 3mth medicated menopause using Decapeptyl. My AF is now about 2wks late (which im told is normal). The clinic have said to go in next week if it goesnt arrive and have a scan to check the endometrium.
My question is do you think that once they have checked the lining that they will be able to start stimming the donor (here in spain they use SP so the donor will not downreg) and giving me my meds or do I need to wait for AF?? 

Rachel - hope your blood tests and scan goes ok today and wish you all the luck  in the world with your treatment



Shelly
x


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## kimmycoo36 (Jan 2, 2008)

*Hiya this advice has also helped me so thank you rtsaintly for asking this question   I dont need to down reg either because I'm on the Menopause and HRT patches and have been since I was 33 (37 now).. I'm hoping my sister who is my egg donor will be on Short protocol.. The long one takes to long lol

GOOD LUCK with your treatment hun hope you get your BFP      

Lv Kim xxx*


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## Bewley (Oct 14, 2007)

Hi Shelly,

Not certain about that one to be honest. Usually as you know the criteria for dowreg scan is that had a period, the lining is thin and no follies or cysts. However they may be happy to start you on the meds to thicken your lining if you have two out of three i.e no period or they may give you medication to bring on your period if the lining is too thick. I'm not sure as it may differ the fact you've been on decapetyl for extended time. I only have downreg 11-12 days and I chose to have Suprefract rather than decapetyl. 

I don't think they will start your donors stimulation until you can start your Progynova or whatever you're taking to thicken your lining because otherwise the donor could be ready before you. Once she starts it will be her body's response that dictates when EC will be and therefore when your ET will be. You need long enough to get your lining ready. If after your first scan usually about week later its not thick enough they then have time to increase your dose. 

I hope AF arrives for you in the meantime but try not to worry too much it could be that period hasn't arrived as your lining is very thin already due to the decapetyl in which case I would think you'd be ready to begin. Not knowing is the worst so hang in there and you'll get the information very soon. As frustrating as it is don't forget that its best they don't start the donor till your ready as you need to be synchronised so you can have a fresh transfer.

Good luck hun
Bewley x


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## rtsaintly (Oct 19, 2007)

Hi,

I thought I was the only one that got confused, at least we are not alone 

I go for my second scan today, my lovely donor woman (whoever she is!), is ready. My partner is there tomorrow to give his swimmers, so I should imagine it wont be long now!

Good luck to all and I will let you knw how it goes  
Rachel x


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