# Ovulation during medicated FET



## KateMart (Jul 14, 2014)

Hi ladies,

I'm doing a medicated FET in Feb/March and I'm confused about ovulation. I know you have to track ovulation during a natural cycle, but will I need to do so with medicated? Do I need to ovulate before the embryo can be put back?

The reason I ask is I am concerned: I have had IVF for male factor issues but it's never been proven whether I ovulate or not. My cycles are irregular and initial two blood tests showed anovulation (both done on day 21 thouigh, one of a 39 day cycle!). However, this was never followed up when the male factor was found and my clinic wasn't concerned when doing IVF.

Thanks for your help x


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## ema1978 (Sep 19, 2013)

Kate - if it is medicated and you down regulate first and than you take estrogen and progesterone than you won't ovulate naturally. Your body is switched off. You get progesterone supplements because this is normally produced by corpus luteum which is formed by follicle rupture. As an ovulation does not happen this needs to be added to your medication to help the embrio grow after implantation.

I'm not sure what your medicated cycle is line, but I would suggest you address the same question to your doctor. My statement above is only when a down regulation step it is used. Medicated could also be a triggered ovulation during a natural cycle.


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## KateMart (Jul 14, 2014)

Thanks Ema1978! Mine is definitely medicated in every way, they said this would work better for me because they could totally control the cycle. I was worried ovulation would be part of this. Glad it isn't! x


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## mierran (Apr 24, 2009)

Hi
even where you don't down regulate first , you just take oestrogen from the start of your cycle cd 2 or 3 you usually don't ovulate as the.oestrogen supresses it in most women. Again artificial progesterone is used to simulate the.luteal phase after ovulation.

In triggered natural cycles hcg is used to trigger ovulation of a.naturally produced follicle. These are considered natural cycles rather than medicated.

Good luck and i hope you get your bfp.

X x


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## KateMart (Jul 14, 2014)

Thanks Mierran, that's good to know. Congrats on your BPF! Xx


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## mierran (Apr 24, 2009)

Ta.    Still can't believe it a lot of the time.


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## KateMart (Jul 14, 2014)

It's an amazing feeling.. I couldn't believe it when I got mine, but sadly it wasn't meant to be this time. fingers crossed for next year, and best of luck to you, not long now! X


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## mierran (Apr 24, 2009)

It is heartbreaking to loose one. I still grieve for the baby I lost, and each year at due date I think about the birthday they should've had. My bubba should be 6 now.  

on the plus side your body knows how to get pregnant, and you have icebabies waiting for you. It is cold comfort I know, but on this roller coaster you have to take what pluses you can as there are so many negatives you have no control over  

Yes, I'm officially 3rd trimester on monday so home stretch.  Hoping to find out what it is at next scan on wed so that will help a bit - I hate to think of as it so I think knowing if a boy or girl will help make them seem more real. Just hope more cooperative than at 20w scan as wasn't for sharing then.


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## KateMart (Jul 14, 2014)

Thanks Mierran. I'm so sorry for your loss   I know it was early on but I did feel my loss pretty hard. You are right though,  there are pluses to it and positivity is so important. Having had a mc before in a previous relationship, I am concerned I may have immune issues though. Getting level 1s at GP and thrombophillia at the clinic next year. If this FET fails we may fork out for NK cell tests. 

Nearly there now! It must feel amazing. Good luck for your scan next week,how exciting xx


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## mierran (Apr 24, 2009)

When were your losses? Nk cells normally cause m/c between 6 and 8 weeks. The test isn't that much just for nk so if that fits... I think only about 100 tho don't quote me on that. If your clinic will agree to do it. 

the other thing worth considering is the greek hidden c test. Hat can affect implantation as well as cause m/c

this last cycle I went for intralipids as it wouldn't do any harm and i wanted to cover all bases after 2 bfns. I got an endometrial scratch for the same reason. Not sure if either of them helped, but worth it anyway  

if your clinic are willing maybe something to consider? 

Our losses may have been early but they were still much wanted and loved babies. Ok, maybe not as bad as a stillbirth but still we lost our children. And when you have to go through so much to even get pregnant in the first place.  It's not as if we can just jump back in the sack and hey presto


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## KateMart (Jul 14, 2014)

My losses were at 5 weeks and 8, so I suppose the former sits out of NK cells and that is my IVF loss. The consultant thinks it was just bad luck but the confusing thing was that it was a 5AA embryo so it seems strange that thus happened. 

Thanks for the info! I have read about hidden c so will look into it further. I mentioned the scratch to my clinic and they asked why I needed it, as they said implantation didn't fail. But the consultant did agree that if there is more evidence that a scratch helps by January when I go back, he will consider it. I don't think they do intralipids but if they find a clotting issue they will do blood thinners. 

Thanks again for the advice. They have agreed to put two back next time if we choose to. But I just want them to find an issue they can treat or I'll just think this will happen again x


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## mierran (Apr 24, 2009)

It's also worth when you get bloods tested for hcg get progesterone and oestrogen checked too.

Don't think just because your embryo was a good grade there couldn't have been issues. Misty b had I think 5 top grade blasts screened and only one was normal - and it wasn't the best grade. It is now her 6month old daughter. All grade looks at is basically how pretty an embryo is. So there is no reason your best embryo from a chromosomal point of view isn't in the freezer waiting for you. 

ociwoman had 8 top grade embies. 2xdet both bfn . Her last and "worst" 3 transferred and she is pregnant. And this story is not unusual.

Glad you are getting to put 2 back next time. Are you ok with twins? They are good fun but hard work. About 25% of pregnancies from det are twin, 75% singleton. I would say if you aren't ok with the idea of twins stick to eset. If you're ok with it go for it. 
I had 2 embies transferred this time and have just the one on board. It still looks odd on scan as I was so used to seeing two 

Remember too shared risk programmes in the states it is 90% success over 3 cycles where one cycle is the fresh and all frozen embryos from that cycle transferred. So the odds are still v high that you will get your take home bubba. Often it is just a case of the right embryo.

Big hugs.

x x


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## KateMart (Jul 14, 2014)

Thanks Mierran   I'm guessing the clinic might have the other figures along with the HCG, I was going to ask in January when we are back.

It's so strange how the grading doesn't transfer to the embryos, I wish we had the facility to have them screened. DH and I joke that we think it'll be the last frozen one that sticks! It's great to hear the success rate of 90% and I would love to not go through full IVF again. The thing is though, as we are NHS we get two frozen and two fresh. I didn't fully compute at the time, but our consultant seemed to think after this FET (if it doesn't work), funding would be supplied for a fresh rather than using our two remaining frosties. I would rather use my frozen first and you'd think it would save the NHS in the long run if one of the FETs worked?!

In terms of twins, I think I'm ok with it! I do need to think it through and it's mainly the pregnancy risk factor that would haunt and worry me. Actually having twins, I reckon we could handle!

Thanks for all this information, it's so valuable to hear from someone who has been through it before! It's your scan this week isn't it? You must be really excited xx


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