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  1. #1
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    Default To cancel or not!!

    Hi all,

    Yesterday morning I had my first scan to see how my follicles were developing for my first IVF cycle. It turned out that there hadn't been as much action as I had hoped.

    The appt happened so quickly that I'm trying to remember details but what I do remember is that between both ovaries I had about 6 or 7 follicles. Of these there were 2 large ones and the others were a lot smaller. The FS has told me to keep going with injections and we will reassess at the next scan which is on Monday. He mentioned the possibility of cancelling the cycle if there wasn't much change on Monday. He didn't really tell me much else except sometimes this happens (again in and out appt).

    Of course I was devastated (but somehow not really suprised). I'm now anxious about Monday's scan as obviously it's likely I have a big decision to make. I am hoping that the decision is very easy eg: "my gosh they grown well and multiplied - all systems go!" or "Yep, we definately need to cancel"

    I am worried it will be a not so easy decision and the FS will sit on the fence and make me decide. At the end of the day it's a very expensive gamble and I do not want to go ahead if it will be, quite bluntly, a wate of money this cycle...my DH's advise has been if it looks less the 50/50 chance of a good cycle let it go; if it's 2/3 looking good go for it...as you can tell he likes numbers and doesn't really understand that fractions may not help with this decision

    I have googled a bit so now I have come to realise that in addition to size and amount of follicles there are other important signs such as blood test results and lining size etc. Google seraching has also suggested that quantity may not have anything to do with quality...

    They have had to squeeze me in on Monday so I know I will feel pressured to quickly make a decision and leave and the FS will not have a lot of time. Obviously this is too important to do this, so I want to go in armed.

    So I need some help around things I need to consider to help me come to a decision and questions I need to ask at this appt.

    What should I ask or consider if this decision becomes tricky?

    Thanks for your time!

  2. #2
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    I had only one enlarged follie and that became DD. they talked about canceling but the price difference wasn't substantial enough for me to cancel so we went for it and I'm glad we did! I guess it's a decision only you can make but here's what I was told

    -50% chance that there's actually an egg in the follie
    From there to
    -50% they'd get the egg out without damage
    from there to
    -50% chance the egg would
    From there to
    -50% chance I'd fall pregnant.

    HTH do you know what the price difference is going to be? For us it was a difference of $500 and taking the gamble for us paid off.

  3. The Following 2 Users Say Thank You to kribby For This Useful Post:

    MGC Bertie  (19-04-2013),Renvind  (03-03-2012)

  4. #3
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    Hi there,

    You mention this is your first IVF. Have they put you on a low dose of medication to begin with. Sometimes they do that as they do not want you to get OHSS and have no idea how you will respond to the drugs until you start using them. My first cycle was also almost cancelled because I wasn't responding to the drugs then they increase the dose and everything was ok after a couple of days. I would wait until Monday and you'll see where you are at. The first cycle is a bit of trial and error.
    Also it's not always about how many, I always get a good number of eggs but the quality is not there. My FS is now trying something different with me to get less eggs but hopefully increase quality. So more doesn't always = better.
    I really hope on Monday you get a clear cut answer.

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    Renvind  (03-03-2012)

  6. #4
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    Quote Originally Posted by kribby View Post
    I had only one enlarged follie and that became DD. they talked about canceling but the price difference wasn't substantial enough for me to cancel so we went for it and I'm glad we did! I guess it's a decision only you can make but here's what I was told

    -50% chance that there's actually an egg in the follie
    From there to
    -50% they'd get the egg out without damage
    from there to
    -50% chance the egg would
    From there to
    -50% chance I'd fall pregnant.

    HTH do you know what the price difference is going to be? For us it was a difference of $500 and taking the gamble for us paid off.
    congrats Kribby! Thats a fantastic and inspirational story! To answer your question - from what I have read on their fact sheets, if we cancel before EPU we don't lose our $7 760 already paid for the cycle and can keep it for the next attempt but I need to ask about that more. If we go ahead with EPU then thats a different matter.

    Quote Originally Posted by SummerShine View Post
    Hi there,

    You mention this is your first IVF. Have they put you on a low dose of medication to begin with. Sometimes they do that as they do not want you to get OHSS and have no idea how you will respond to the drugs until you start using them. My first cycle was also almost cancelled because I wasn't responding to the drugs then they increase the dose and everything was ok after a couple of days. I would wait until Monday and you'll see where you are at. The first cycle is a bit of trial and error.
    Also it's not always about how many, I always get a good number of eggs but the quality is not there. My FS is now trying something different with me to get less eggs but hopefully increase quality. So more doesn't always = better.
    I really hope on Monday you get a clear cut answer.

    Hi SummerShine - thanks for your response. I also hope I get a clear answer on Monday too. The FS put me on 150 puregon however after my first blood test increased it to 200. After 2 days of 200 I had my first scan which was the Friday one I spoke about. So I have 3 more days of the increased dose to see if that makes a difference. I guess what I'm a bit worried about, is the size difference between follicles. If there were about 7 good sized follicles then maybe (???arrghh) it would be worth while going ahead. It doesn't help when he said at the initial consult before we started, that they hope to see between 10 - 15 follicles in a cycle...it kind of set up my hopes and expectations, only to be stomped on.

    Is there other factors that should be considered before going ahead or not?

    Good luck with your next cycle! I hope you get some beautiful quality eggs!!!

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    Quote Originally Posted by Renvind View Post
    I'm just curious - I am on down regulated cycle (my first IVF cycle), sniffing Synarel since CD20 last cycle, and jabbing since Day 6 this cycle. I have my Day 12 blood test tomorrow, then a Scan on Day 15.

    I am hoping that all will be as planned to have my Egg retrieval early next week (although haven't really felt any side effects).

    For those who have done this, which day did you end up having the trigger shot?

    I know everyone reacts differently to the meds, but was curious to know when others had their egg retrieval..

    Just getting things straight in my head:
    First BT was 28 Feb,
    and now first scan is 3 Mar.

    In my experience, and the IVF literature/cycle guides I was given it was normal to have 2 scans before EPU. You're still right on track. Sometimes you might need to stim for a bit longer on a cycle, but it doesn't necessarily stuff anything up.
    More follies isn't necessarily better. Once you get over 15 then success starts dropping again (haven't got the original reference on me, but saw it reported in a 1 inch article New Scientist in Jan this year (read it while in the IVF clinic waiting for my first BT, lol)).

    You say you had 2 large follies and a lot smaller on the scan. How large is large? how small is a lot smaller?
    They might sacrifice the large ones to catch the main bunch.
    Measuring 6-7 follies across both ovaries sounds good to me. I collected 7-8 mature eggs each cycle with a start like that. What was your oestrogen (E2) from your first BT (on 28 Feb). For me, every 200 oestrogens at that first BT indicates we'll collect 1 mature egg later.
    (At the last BT before EPU, roughly 1000 oestrogens indicates 1 mature egg for me.)

    IVF is allowed to work. It doesn't have to go wrong all the time.

  8. The Following 2 Users Say Thank You to felicita For This Useful Post:

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  9. #6
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    Quote Originally Posted by felicita View Post
    Just getting things straight in my head:
    First BT was 28 Feb,
    and now first scan is 3 Mar.

    In my experience, and the IVF literature/cycle guides I was given it was normal to have 2 scans before EPU. You're still right on track. Sometimes you might need to stim for a bit longer on a cycle, but it doesn't necessarily stuff anything up.
    More follies isn't necessarily better. Once you get over 15 then success starts dropping again (haven't got the original reference on me, but saw it reported in a 1 inch article New Scientist in Jan this year (read it while in the IVF clinic waiting for my first BT, lol)).

    You say you had 2 large follies and a lot smaller on the scan. How large is large? how small is a lot smaller?
    They might sacrifice the large ones to catch the main bunch.
    Measuring 6-7 follies across both ovaries sounds good to me. I collected 7-8 mature eggs each cycle with a start like that. What was your oestrogen (E2) from your first BT (on 28 Feb). For me, every 200 oestrogens at that first BT indicates we'll collect 1 mature egg later.
    (At the last BT before EPU, roughly 1000 oestrogens indicates 1 mature egg for me.)

    IVF is allowed to work. It doesn't have to go wrong all the time.
    Omg Felicita!!! I wish you could come with me to my appts!!!!!!! You seem to have so much brilliant knowledge! I feel totally clueless!

    Sadly the FS didn't/hasn't given me much info at all about E2 levels, follicle size, lining size etc...which is why I know I need to be super armed with questions for Monday. Is there an oestrogen level I should be comfortable with when I ask for the second BT results on Monday? Or any other good questions I should ask on Monday.

    When I saw the follicles myself, the two large ones looked significantly larger than the others...

    First BT was 28/02, first scan 01/03 (and second BT - don't know results of that yet). Second scan will be 05/03/12.

    It will be a relief if it all goes ahead next week for EPU, but I need to feel as confident as I can as we are not in a financial position to keep trying with IVF past a few times. I'm not a gambling person so feel a lot of pressure around making the right decision on the spot on Monday..therefore I am making sure I am arming myself!!!!

    Thanks so much Felicita - you make me feel more in control and reassured.

    And I love what you said " IVF is allowed to work. It doesn't have to go wrong all the time"
    It makes me realise I have to stop being an Eyore...

  10. #7
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    Renvind,
    I don't know if this will be helpful but my Estrogen levels on my first cycle (that was almost cancelled) were as follows - Day - 10 370, Day 14 1700 Day 21 4800. I was jabbing for a loooooong time that cycle. We got 8 eggs out of that cycle.

    Second cycle (which I started on a higher dose) estrogen was 5300 day 10! Big difference.

    Felicita knows her stuff! - definitely ask the size of the follies.
    This is info I got from an IVF site which I found helpful. The follicles start to grow and once they reach about 12 to 14mm, they will grow fairly predictably at a rate of 2mm per day. The egg within a follicle is usually mature and ready for harvest when the follicle measures between 16 and 20 millimeters.

    Also ask if your lining is good. If it's not I'm sure he will advise you and I think he will give you more guidance after your scan on Monday as to what you should do. The biggest thing with IVF is not to have expectations. I felt bad after my first cycle as I only got 8 eggs and others who I was cycling with got 15 and 22. Having been on these forums for awhile now I can't tell you the number of BFPs I've seen from women where only 3-4 eggs were collected. There are no rules to this game!

    Thanks so much for your well wishes!

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    I've no idea about oestrogens at the other BT, just the first and last. They'll still have the numbers from your first test so you can ask for them. My 200 per egg (for the 1st BT) can serve you as a guide until you establish through experience what your personal numbers are. Having that extra bit of info can help you to place your expectations at the right level, but it's only ever a rough guide. There's still a lot more art than science involved.
    Hopefully you never have to acquire heaps of IVF experience because it's going to work for you first time.

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  14. #9
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    Disney Baby is offline <--- That's my baby at 8 cells old <3 Ahh the perks of IVF =D
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    I'm not sure if this is of any help to you, but from my one and only experience so far, I only got 5 eggs at EPU.

    I can't remember exactly what day of my cycle I had EPU, but I know my e2 was at 5700 when told to trigger. My biggest follie reached 30mm!
    I also remember that it all happened sooner then when I would usually ovulate, which is CD15.

    I'm also not sure if you would count me as a 'success' story as I ended up losing my baby, but even though I only got 5 eggs, 4 fertilized and the one they transfered gave me my BFP, just not a sticky one.

    I guess you can only wait and see what Monday shows, but I don't think it sounds like a doom and gloom situation just yet

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    Hi Renvind,

    I was in a very similar situation to you last cycle. All the ladies on here have already given you some great advice. I know how frustrating it is when it doesn't work the way its supposed to. Sometimes it can take a few cycles to get the meds right.

    With my 1st cycle, i was on a very low dose of gonal (112) because i have pcos, and i stimmed for 10 days before they cancelled me. At my clinic i had a bt and scan every 2nd day, so they kept a close eye on it. I had one big follie on each side, and lots of smaller ones, and the dr said that once the big ones get going, they can just take over and not let anymore of the other ones come up. The dr said we would only have gotten 2 or 3 eggs, so we decided to cancel. I took the trigger anyway, but my partner has very low count, so we knew there was no chance of it working.

    I'm pretty sure, if it's cancelled because of under stimulation, you won't pay anything. We payed $450 and it was refunded 3 days later from medicare, so didn't cost us anything.

    Do you have low AMH? How was your lining looking? I think its meant to be around 9 or 10mm.

    We were pretty devastated, especially as it was our first cycle, but my FS basically said to us she thought i could do a lot better with a higher dose, and she didn't want to put us through the EPU and also the cost, when we might only get a couple of eggs (especially since we have MFI). She said we would have gone ahead if i was late 30s or had AMH, but since i'm not, better to try a new cycle. So we cancelled and i took the trigger, got af 2 weeks later and started again. They upped the dose to 142 this time and i got 13 eggs and 9 fertilised, so even though it was hard, it was totally worth trying a new cycle.

    I think sometimes each cycle can be totally different, you can take the same drugs at the same doses and you respond differently. I reckon see what your scan and BT say on monday, and then sit down and talk with your FS to see what they think you should do. Lots of people go to EPU with one or two eggs, but if the dr thinks your ovaries can do better, might get a better result if you cancel or take the trigger shot, get AF and start again in two weeks?

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