# how many days between ovulation and FET (and thrush problem)



## BarbWill (Aug 18, 2005)

Hi everyone, after a failed medicated FET this summer I am now trying for the first time with a FET on a natural cycle. My clinic don't usually to FETs on a natural cycle so I haven't been able to get much info from the nurses. Can you help ?

I've been for a scan on day 9 of the cycle last Friday and things looked good: follicle of 11-12 mm and womb lining still too thin, as it should be. I had another scan today, day 12 of the cycle. The follicle is now abouy 20mm and the lining of the womb is good at 10 mm. Very glad that my body is behaving really well on this natural cycle, since I am not relyig on any drugs !!! So I am all happy about this but:
1. The nurses told me that today they would start to tell me when to start using the ovulation sticks to detect the LH surge but when I called back as requested in the afternoon in order to be informed of the doctor's decision, I was just told that they would defrost the (1-day old) embies on Friday morning and that ET would take place on Sat. When I asked about the sticks, the secretary spoke to a nurse who was passing by who said to do a stick today and one tomorrow and if they are positive that's ok, if they are negative I should call them back. The process felt a bit random to me.... also, if I ovulate today or tomorrow, isn't it a bit late if they put the embies in on Sat ? How many days after ovulation do they normally transfer 2-day old embies ? Shouldn't it be after 2 days ?? 
2. Last cycle I had what felt like thrush for about 3 weeks, I treated it twice with canesten (pessary+external cream) and it didn't go away. The symptoms subsided when my period arrived. I had two vaginal swabs done by my GP (one when I was still very irritated and the secon one on the first day of the period) but they were both negative. Now the symptoms have come back. It's super itchy but I have no discharge for now and my DH has redness and he's also itchy. I told the nurse this morning and she told me to use canesten again tonight and that only if it got really bad I woudn't get to ET. She was supposed to talk about this with the doctor and perhaps she did but when I called the secretary didn't say anything about this and now I don't know if they have actually considered this or not ! Do you think I should call back ?


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## ☼♥ Minxy ♥☼ © (Jan 13, 2005)

Hi

Regards the timing of when to put back embies.  If your embies were 2 days old then they would put them back 2 days after ovulation.  When you have full ivf cycle, EC would be classed as ovulation and then if you had day 2 transfer, your embies would have been replaced 2 days after EC.  So if they've booked you to have ET on Friday or Saturday then they're assuming you'll ovulate Wednesday or Thursday...so if you think you're about to ovulate now (Monday/Tuesday) then I would say its quite late for transfer - but then I'm no medical expert so please don't quote me on that !!!!

OPK's only detect the LH surge before ovulation - they don't detect actual ovulation so if you're still getting negative OPK's then it means you've not had the surge yet, in which case ovulation could be later in week.  You would usually ovulate about 36hours after getting a +ve OPK.  Does that make sense   In which case, if you do ovulate later, then having ET on Friday/Saturday would be correct.

I can't really help you re your infection but if your DH is also feeling uncomfortable then I would suggest you both use the cream and perhaps you could get one of the oral thrush tablets eg Diflocan as this is just one oral treatment and may clear up any thrush you have.

Our last FET was natural "unmedicated"...clinic don't use OPKs but do regular scans.  I had scan on cd2 (consultant likes 1st scan as close to cd1 as possible to ensure no cysts and thin womb lining)...then more scans on cd9, cd11 & cd14.  Cd14 I had dominant follie of 18mm & womb at 9.7mm.  I naturally ovulate on cd14/15 but consultant wanted to exactly time everything so despite it being a natural cycle, I had to do Ovitrelle trigger jab (like Pregnyl) the early hours (like 2am !!  ) of cd15...that was a Tuesday and I had ET on the Friday - embies were 2 days old.  During 2ww I was on 400mg cyclogest.

This FET I had scan on cd3...I've got another this Wed which is cd12 and will see how it goes from there...I'm expecting ET around Mon/Tues next week.  I again have to have the Ovitrelle trigger jab to exactly time ovulation (although, as I say, I ovulate naturally no problem)...I will then be having cyclogest and crinone 8% during 2ww as well as 2 extra ovitrelle jabs as I got a very faint but sadly short lived positive last fet so consultant is tweaking the drugs during 2ww for me.

All my treatments I'm also prescribed clexane, prednisolone and baby aspirin because of various problems...so when I say I'm having a natural, unmedicated cycle I do use the term lightly !!!!

Wishing you loads of luck
Natasha


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## BarbWill (Aug 18, 2005)

Dear Natasha, thank you for your long message and I wish you the best of luck for your scan tomorrow and for this FET ... we are doing it nearly at the same time and looking at your hystory I see that we've had exactly the same history this year. I too had IVF in March/April (OHSS so froze all 18 embryos). I had my first (medicated) FET in July/Aug, like you had yours. And this is my first natural attempt. 
It's good that you'll have the ovitrelle jab so that you don't need to wonder about when the ovulation happens ... I did LH sticks yesterday, negative, and the one this morning was positive. I heard from other people that from the moment the stick detects the LH surge, the ovulation does not take 36 hours (that's how long it takes after the ovitrelle injection) but much less, about 12. I am not sure of the reason why there would be this difference between a natural LH surge and an ovitrelle injection but looking at my old ovulation charts (good for an antique shop now!), they would seem to confirm that ovulation always occurs on the day or the day after the positive OPK. I will ask the doctors about this though as I am just comparing what different patients say. 
And this is what I learnt about the timing of a FET after ovulation. If one ovulates normally, on day 14, the window of implantation goes from day 19 to day 24, and the embryos have to be 5-6 days old during this window. So, based on the age at which the embryos were frozen and the day of ovulation, one can work out the best day for thawing. Based on my case, Saturday seems a pretty good choice for the transfer of 2 day old embryos to take place (mine were frozen when they were 1 day old) and I now can't wait !!! And let's hope that Ms Luck wants to assist us all this month ....


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## ☼♥ Minxy ♥☼ © (Jan 13, 2005)

Hi

Sorry, don't want to contradict you but you would usually ovulate 12-48 hours after the surge but the average is 36 hours after a positive OPK - some women may ovulate a little earlier, some may ovulate a little later but its pretty average that you ovulate 36 hours after a postive OPK as the OPK detects the LH surge. Ovulation doesn't _usually_ happen the same day as a positive OPK (unless you ovulated quickly in less than average time at around 12 hours after surge)
...with OPKs to be +ve the test line (your line) must be the same colour, if not darker, than the control line. OPKs should ideally be used around midday/early afternoon and not first morning pee as the surge could happen in the morning but won't be detected in pee for approx 4 hours.

In natural conception, implantation happens around 5-12dpo (so would be cd19-cd26 assuming ovulation on cd14).

Not until an embie has reached blastocyst stage, which is around 5 days old, will it be ready to implant.

"A blastocyst is an embryo that has developed to the stage where it has two different cell types and a central fluid-filled cavity. The surface cells, called the trophectoderm, will become the placenta, and the inner cells, called the inner cell mass, will become the fetus itself. Blastocyst formation in the human usually occurs on the 5th day after fertilization"

"A healthy blastocyst should hatch from its outer shell, called the zona pellucida by the end of the sixth day. Within about 24 hours after hatching, it should begin to implant into the lining of the mother's uterus"

Check out this website...

www.visembryo.com

If the embies are frozen at 2 days old then they would replace them back in the womb 2 days after ovulation (because in a full ivf cycle, EC is classed as ovulation)...only if your embies were frozen at blasto stage would they replace them in your womb at 5 dpo. In natural conception it takes several days from ovulation & fertilisation for the embie to travel down the tube into the womb...however, with assisted conception the tubes are bypassed and it all depends on how old the embies were when frozen...they thaw the embies on the day of transfer (although since yours were frozen at 1 day old they may leave them overnight to see how they progress) so you would be having a 2 day transfer which would be 2 days after you ovulate. An embryo that was frozen at 5 days old would be replaced 5dpo, a 3 day old embie replaced at 3dpo etc etc.

I ovulate naturally every month on cd14/15 - have done bbt's as well as had follicle tracking scans and plenty of progesterone blood tests - the Ovitrelle is not to ensure I actually ovulate but to exactly time it because of timing ET - the same as last FET which was also natural cycle. I will ovulate and then 2 days later embies are put back.

If your embies were frozen on day one then they need to see if they will continue to divide which is why you're not having yours replaced until day 2...which should be 2 days after you ovulate.

Day 1 Check eggs for fertilization (the presence of two pronuclei or PN's) 
Day 2 Embryos at the 4-cell or more stage of development 
Day 3 Embryos at the 8-cell or more stage of development 
Day 4 Embryos at the compacted morula (16-32 cell) stage 
Day 5 Embryos at the blastocyst stage of development

Hope that helps...
Take care
Natasha

_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_


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## BarbWill (Aug 18, 2005)

Natasha, we have the same information, ie what I know coincides with the information you are giving me here, with the only exception that another patient has told me that it's not after 36 hours from a +ve OPK but less that the ovulation occurs. On the OPK box is just says that the best days to try to conceive are the days when the OPK is positive and the day after, which according to your information would be before ovulation. I will check this information with the doctor. 
For the rest, we agree. In particular, I didn't say that the ovitrelle jab is to ensure that you ovulate but that it gives you more certainty about WHEN you ovulate, as you said, so no discrepancy there. 
Thank you for all the details, I am not trained in medical science but I find all these things really fascinating and I love to learn more about them ...


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## ☼♥ Minxy ♥☼ © (Jan 13, 2005)

BarbWill said:


> On the OPK box is just says that the best days to try to conceive are the days when the OPK is positive and the day after, which according to your information would be before ovulation.


What the information on the OPK is suggesting is correct. Its always best to have plenty of sex BEFORE ovulation to ensure a fresh supply of sperm is waiting for when the egg is released. Sperm can live for around 3-5 days (on average) but an egg only survives for 12-24 hours...so if you have sex before ovulation, from the time you get a positive OPK then this would ensure that there was a fresh supply of swimmers for when the egg is released. And having sex the day of and the day after ovulation will ensure the whole "fertile" timeframe is covered.

Here's some info on OPK's...

http://www.ovulation-calculator.com/ovulation-tests/opk-faq.htm

Unfortunately, some people may get an LH surge and no ovulation happen whilst others may ovulate but get negative OPK's...this is why OPKs are not the most reliable things !! (I have been told this by 2 fertility consultants - I only ever used OPKs for couple of months when first started ttc - they were correct for me as I showed a positive a day or so before ovulation happened - I get ovulation pains, cm and temp rise to indicate). I've not used them since...
If you're unsure about OPKs & how long after positive you would ovulate, then perhaps, as you mentioned, you should speak with your consultant.

Good luck

Take care
Natasha

_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_


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## BarbWill (Aug 18, 2005)

Thanks Natasha, my doctor confirms what you say about the time of ovulation after the LH surge. 
I had my transfer last saturday and things went well. Out of the 15 1-day embryos we had left in the freezer, they thawed 3 which, again, all survived. On the two, two of them had morphologically perfect cells whilst the third was fragmented and was not transferred. The only glitch is that the two that were transferred were still of 2 and 3 cells ... I am not sure of the time at which they thawed, but in principle they ahould have been 2 day old embryos, ideally of 4 cells therefore ... we'll see ...
The transfer was easy this time, the previous time they struggled and I had suffered ... funny because the previous time I had had acupuncture just before  and after ... it seems to work better without acupucture for me!
Out of the 18 that were froze, they've now thawed a total of 6, selected at random because they cannot be graded for qality when frozen so early (but the advantage is that they survive the thawing better). They all survived the thawing and the previous two had reached the 4 cell stage on day 2 but were more fragmented than this time ... so I guess that overall I can be happy with this batch of embryos ... let's just hope, if these two don't work, that there is at least one top notch embryo left in the freezer ...
one more thing. They decided to put me on progesterone for the 2ww eventhough this is a natural cycle because there is some evidence that it helps even in a natural cycle .... we'll see ....


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